Well-being, appraisal, and coping in African-American and Caucasian dementia caregivers: findings from the REACH study

Abstract

Although there has been considerable interest in racial differences in family caregiving for persons with dementia, most research to date has either ignored racial diversity or based conclusions on small numbers of caregivers drawn primarily from single site studies. The current study utilized participants from four sites of the REACH (Resources for Enhancing Alzheimer's Caregiver Health) multi-site study to compare well-being, appraisal, and religious coping by race. African-American (n = 295) and Caucasian (n = 425) dementia caregivers from four cities (Birmingham, Memphis, Boston, and Philadelphia) were compared in their demographics, care recipient characteristics, mental and physical health, and psychosocial coping resources including appraisal and religious coping. African-American caregivers reported lower anxiety, better well-being, less use of psychotropic medications, more benign appraisals of stress and perceived benefits of caregiving, and greater religious coping and participation, than Caucasian caregivers. Self-rated health did not differ by race, but African-American caregivers reported more unhealthy behaviors than Caucasian caregivers. Some results were specific to site, possibly due to differences in recruitment strategies, inclusion/exclusion criteria, and regional differences. Adjustment for covariates, including caregiver relationship to the care recipient, gender, age, socioeconomic status, and care recipient behavioral problems, altered few of these differences. Results are discussed in terms of their relevance to psychosocial intervention programs for ethnically diverse caregivers.

Predictors of hospitalization and institutionalization in Medicaid patient populations with Alzheimer’s Disease

“…A potential reason for these racial/ethnic differences is caregiver coping style or amount of involvement in care giving [18]. Minorities have less access to long-term care facilities, have different family structures, and have different attitudes toward institutionalization [19]. Determining the underlying factors behind these reasons for placement of patients with AD in long-term care remains an important question for future research when examining total cost of care and health disparities.…”

Too Much of a Good Thing?: Positive Religious Coping Predicts Worse Diurnal Salivary Cortisol Patterns for Overwhelmed African American Female Dementia Family Caregivers

“…Recent studies highlight the popularity of RCOPE among ADRD caregivers, notably non-Whites (5, 15-21). For instance, recent evidence shows that more religious non-White caregivers have better mental health, subjective well-being, and more positive attitudes toward the caregiver role (16, 18, 20, 21).…”

“…More impaired memory and behavior problems are linked with worse recipient Mini-Mental State Examination (MMSE) scores (24) and nursing home admissions (25), more depression from caregiving (7, 23) and dysregulated daily cortisol responses (2). Notably, AA (vs. White) caregivers have fewer negative judgments of troublesome behavior by impaired care recipients (15). …”

The Experience of Quality of Life for Caregivers of People With Alzheimer’s Disease Living in Sardinia, Italy

“…Latina and African American AD caregivers have been found to be less stressed and anxious, to have better well-being, and to use fewer psychotropic medications than Caucasians Haley et al, 2004). Haley et al (1995) found that QOL was influenced more by ethnicity than by caregiving since White caregivers were more prone to have poorer QOL than were Black caregivers.…”