The Experience of Alzheimer's Disease Family Caregivers in a Hispanic Community: Cultural congruence and disparities in utilization of support services

项目摘要 拟议的研究项目的目的是：1）描述西班牙裔的表达偏好 南佛罗里达的护理人员提供服务，帮助他们更好地照顾老年痴呆症患者 疾病和相关痴呆（ADRD）; 2）检查可用支持的文化一致性， 西班牙裔ADRD照顾者的期望，通过比较从采访中出现的主题， 提供者和照顾者。老年拉美裔是美国增长最快的人口群体之一， 到2050年，估计将占65岁及以上人口的20%。西班牙裔似乎有更高的比率， 与白色美国人和非洲裔美国人相比， 老年群体。佛罗里达迈阿密-戴德县近70%的老年人是西班牙裔， 人口在增长，特别是80岁以上的年龄组。因为这些老年西班牙裔人口 阿尔茨海默氏病和相关痴呆症（ADRD）的增长，所以将他们的生存需求。寿命更长， 身体更健康的阿尔茨海默氏症将增加对家庭护理人员以及家庭和社区的需求- 基于支持他们的服务。有害的影响已与毒品有关，包括 情绪负担，经济和社会影响，抑郁症风险增加，精神药物使用， 高血压、心血管疾病、保健服务利用率的增加和死亡率。我们知道在 一般来说，西班牙裔提供更密集的培训，更多的时间，更多的援助与活动， 日常生活。然而，它们似乎也与不同的压力有关，而且利用不足 服务，如支持团体。地区老龄化机构提供的当地利用率数据显示， 目前提供的培训和支持服务。尽管当地劳动力种族一致， 可能仍然是西班牙裔护理人员持有的价值观，与服务提供者的价值观不同。这种差异 可能影响服务的交付和接收方式，并导致服务受到严重限制 目前可用。如果我们预计西班牙裔老年人得到家庭照顾的人数会增加， 需要更密切地关注当前服务的潜在局限性，以便提供 将适当地支持西班牙裔护理人员。拟议的研究旨在通过以下方式改变目前的做法： 深入了解西班牙裔ADRD护理人员对 需求和服务提供者通过人种学研究和叙述了解这些需求 分析通过深入访谈和参与者观察收集的数据。这项研究将在 与当地老龄问题机构合作，为直接服务提供信息， 照顾者最终目标是设计和评估文化上适当的西班牙裔照顾者支持 服务在未来。

Project Summary The purpose of the proposed research project is to: 1) Describe the expressed preferences of Hispanic caregivers in South Florida for services that would help them better care for older adults with Alzheimer’s Disease and related dementias (ADRD); and 2) Examine the cultural congruence of available supports with the expectations of Hispanic ADRD caregivers through the comparison of themes emerging from interviews with providers and caregivers. Older Hispanics are one of the fastest growing demographic groups in the country, representing an estimated 20% of all persons 65 and over by 2050. Hispanics appear to have higher rates of Alzheimer’s and other dementias when compared to White Americans and African Americans, particularly in older age groups. Nearly 70% of the older adult population in Miami-Dade County, Florida is Hispanic, and this population is growing, especially among the 80+ age group. As this population of older Hispanics with Alzheimer’s disease and related dementias (ADRD) grows, so will their caregiving needs. Living longer and physically healthier with Alzheimer’s will increase the need for family caregivers and the home and community- based services that support them. Deleterious effects have been associated with caregiving, including emotional burden, economic and social impact, higher risk for depression, psychotropic medication use, hypertension, cardiovascular diseases, increases of health care services utilization, and mortality. We know in general that Hispanics provide more intensive caregiving, more hours, and more assistance with Activities of Daily Living. However, they also appear to relate to the stresses of caregiving differently, and underutilize services, such as support groups. Local utilization data from the area agency on aging show an underutilization of training and support services as currently provided. Despite an ethnically congruent local workforce, there may still be values held by Hispanic caregivers that differ from those of the service providers. This difference could impact the way services are delivered and received and result in critical limitations to the services currently available. If we are expecting an increase of Hispanic older adults being cared for by family, then closer attention needs to be paid to the potential limitations of current services in order provide services that will appropriately support Hispanic caregivers. The proposed research seeks to shift current practice by providing in-depth understanding of the potential differences between Hispanic ADRD caregivers perception of need and service providers understanding of these needs through ethnographic research and narrative analysis of data collected through in-depth interviews and participant observation. This research will be carried out in collaboration with the local area agency on aging with the goal of informing direct services to caregivers. The ultimate goal is to design and evaluate culturally appropriate Hispanic caregiver support services in the future.