Crisis and the Filial Caregiving Situation of African American Adult Offspring

Abstract

Although there is emerging knowledge about caregiver strain and health, little is known about this linkage from the perspective of African Americans who care for a demented parent. A two-group comparison design was used to examine the caregiving situation and experience of crisis in a preliminary sample of 38 African American adult offspring. Findings showed that subjects spent an average of 4 hours a day on parent care in the previous 6 months, and reported significant caregiver strain. The 17 subjects with crisis experience reported greater caregiver strain in the form of exhaustion and emotional arousal when compared with those who reported no crisis experience (n = 21). They were more likely to associate feelings of uncertainty and a low sense of mastery with the crisis experience and to associate feelings of frustration and confinement with lower ratings of perceived health. In addition, these subjects associated their distress in the caregiving situation with their health, childhood experiences, family strains, and death. The findings are evidence that distressed African American adult offspring with high caregiver burden and low health ratings can be at risk for failing to thrive in their situation and may need critical supportive care.

Reviewing the definition of crisis in dementia care

“…• caregiver illness possibly leading to death [7,12,13,17,19,26,29,31,38] institutionalization, [7,17,26]…”

“…Multiple articles espoused the benefits of a nurse in the home aimed at preventing crises by identifying potential problems and helping caregivers to develop new coping strategies [7,12,13,17,28,30,32,39,41]. England et al [12,13,17] provide examples where a nurse can be helpful, such as: …”

“…Trained nurses may provide interventions promoting a sense of relatedness with other (informal) carers thereby providing confidence, will and strength for caregivers to continue caregiving [17]. England [12] also looked at crisis support for minorities and recommended expansion of the caregiver’s personal and social support network by telephone and visits, prevention and treatment of caregiver burden with help of professionals, clergy, family and friends.…”

Racial differences in abused older African American males, caucasian males, and their abusers

“…More African American men than Caucasian men experienced physical neglect. This may be attributed to a number of key factors such as caregiver burden and the level of frailty of the victims (England, 1995;Fredman et al, 1995). A substantial number of older Caucasian men, compared to older African American men, experienced physical (46.7%) and emotional (46.7%) abuse (Table 3).…”

“…Since African American families are the primary source of care for their aging relatives, it is likely the case that these caregivers would also experience significant caregiver burden, especially as they are likely to be caring for individuals with significant disease burden (Fredman et al, 1995). Another study showed that African Americans who provided care to their demented older relatives reported more exhaustion and emotional arousal than those who did not (England, 1995). It has also been shown that African American families are more likely to care for relatives with greater functional and cognitive impairments than Caucasian families.…”