No abstract

The purpose of the present study was to gain a better understanding of the role of culture in the use of respite services. Culture was defined in three different ways: (1) ethnicity (African-American, Hispanic/Latino, or White); (2) relationship of the caregiver to the care receiver (spouse, adult-child, or other); and (3) geographic location (urban or rural). All three of these classifications were significantly related to the use of respite services, even after controlling for elders' income. Two sets of potential intervening variables that might explain the effects of culture on respite use were investigated: caregivers' attitudes and beliefs, and clients' evaluation of aspects of service delivery. When these variables were controlled, the main effects for relationship of the caregiver to the care receiver and geographic location on respite use were no longer significant. The effect of ethnicity on respite use persisted in the presence of these controls, but was greatly diminished. The results suggest specific avenues by which respite providers can increase appropriate service use among caregivers of dementia patients.

Various explanations have been advanced to explain why older members of ethnic minority groups in the United States tend to use proportionally fewer assistive social and medical services than nonminorities. One possibility is that culturally based differences in attitudes toward need for particular services affect the likelihood of use. Data were analyzed from 2,947 Black, Hispanic, and White caregiving dyads participating in the Demonstration Grants to States program. Hierarchical logistic regression models were estimated separately for three discretionary services (adult day care, in-home respite, and meal services) and one nondiscretionary service (home health care). Hypothesized outcomes were observed in all of the service models tested

Caregiving is a process of transformed identities and reconstructed relations. The disruption of Alzheimer's disease affects both the individual with dementia and the person providing care. One becomes enselfed in dementia, the other transformed into a caregiver. Using data from twenty qualitative interviews with family caregivers, this article traces the transformative process by which the previous relational selves of both participants become casualties of the disease. Findings suggest that the ill person in this dyad is silenced through dementia, leaving the caregiver narratives to become the morality tales of transformation from disorder to order, from havoc to meaningful interaction. By becoming caregivers, family members construct value in their struggles to negotiate the disorder of illness and recreate meaningful and affirming selves and relationships.

Diabetes is the sixth leading cause of death from disease, shortens the average life span by up to 15 years, and is the main cause of new blindness, kidney failure, and amputations in the United States. Interviews with 2 practitioners and 8 individuals with diabetes illustrate how individuals embody their illness. Interviewed persons with diabetes tended to be most closely associated with the disciplined body type and pursued high levels of bodily control, in contrast to an idealized type, the communicative body, which can be considered an ethical ideal. This framework provides heuristic value by providing insight into the behaviors, needs, and struggles of persons with diabetes, as well as providing a means to more effective treatment and better practitioner-patient relationships.