The Caregiving Trajectory for Community-Dwelling Mexican-American Elders

社区居住的墨西哥裔美国老年人的护理轨迹

• 批准号: 7885010
• 负责人: Bronwynne Cadwalader Evans
• 金额: $ 5.09万
• 依托单位: ARIZONA STATE UNIVERSITY-TEMPE CAMPUS
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-08-01 至 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7885010
• 关键词: Accounting; Acculturation; Activities of Daily Living; Address; Admission activity; Adult; Advisory Committees; Age; Americas; Area; Behavior; Caregiver Burden; Caregivers; Caring; Case Study; Censuses; Characteristics; Classification; Cognitive; Communities; Country; Deterioration; Elderly; Emotional; Enrollment; Ensure; Ethnic Origin; Ethnic group; Event; Eye; Family; Family member; Gender; German population; Gerontology; Goals; Health; Healthcare; Hispanics; Home Nursing Care; Home environment; Household; Individual; Institutionalization; Intervention; Interview; Knowledge; Lead; Life; Life Cycle Stages; Life Expectancy; Light; Literature; Measurement; Measures; Methods; Mexican Americans; Minority; Nature; Nursing Homes; Occupations; Participant; Pattern; Perception; Phase; Population; Population Heterogeneity; Populations at Risk; Price; Protocols documentation; Questionnaires; Reporting; Research; Research Design; Risk; Role; Sampling; Science; Sleeplessness; Societies; Socioeconomic Status; Time; TimeLine; United States National Academy of Sciences; Variant; aged; base; care giving burden; caregiving; cognitive function; cohort; cost; demographics; depression; design; disability; ethnic minority population; experience; functional decline; functional status; geriatric depression; health disparity; indexing; instrumental activity of daily living; minority health; neglect; patient home care; patient oriented; prevent; social; therapy design; vigilance

DESCRIPTION (provided by applicant): Caregiving burden among Hispanic caregivers is a little understood and growing problem. As a result, research to address caregiver burden and prevent institutionalization in these populations is critical. It is estimated that there are over 42 million Hispanics in the U.S. and the cohort over age 65 is expected to grow faster than any other racial or ethnic group, tripling in number by 2050. Thirteen percent of Hispanic households currently provide care to an adult aged 50 or older whose life expectancy will increase to 87 years by 2050, surpassing all other ethnic groups. Given this dramatic shift in demographics, a burgeoning number of Hispanic families will be placed in a caregiving role. The purpose of this proposed study is to investigate the burden of caregiving in this at-risk population by describing the level, circumstances, and consequences of caregiver burden/strain, and determining the impact of cultural and contextual variables on caregiving and caregiver gain, along with factors that lead to nursing home admission. This proposed project is a longitudinal mixed methods descriptive study designed to intensively explore the natural course of caregiving, caregiving burden and strain, caregiver gain, and admission to nursing homes among Mexican-American families. One hundred ten caregiver-care recipient cases will be enrolled and followed for 15 months. Interviews and standardized questionnaires will be completed at baseline and every 10 weeks, with an additional measurement point if nursing home admission occurs. We will compare and contrast transitions and turning points in the caregiving trajectory (taking into account acculturation, the nature of the caregiver-care recipient relationship, gender, functional and cognitive status, and depression); identify factors that support caregiving; and determine what factors are most important in delaying institutionalization. The core component will be a case-oriented approach, that is, an intensive, qualitatively-driven, study of cases with an eye toward configurations of similarities and differences. A simultaneous, complementary, quantitatively-driven variable-oriented component will look for broad patterns across cases and enable the drawing of inferences based on these broad patterns. These approaches will be integrated throughout the analytic and interpretive phases of the study. This in-depth, systematic research into the caregiving trajectory should prove useful in designing interventions that are timed to occur simultaneously with known crisis points and help keep elders at home or to help families acknowledge when formal nursing home care should be sought. PROJECT NARRATIVE Using life course perspective, this longitudinal, descriptive, mixed methods study is designed to explore the natural course of caregiving, caregiving burden and strain, caregiver gain, and admission to nursing homes among 110 Mexican-American families. The core component will be a case-oriented approach, that is, an intensive, qualitatively-driven, study of cases with an eye toward configurations of similarities and differences. A simultaneous, complementary, quantitatively-driven variable-oriented component will look for broad patterns across cases and enable the drawing of inferences based on these broad patterns. We will compare and contrast transitions and turning points in the caregiving trajectory (taking into account acculturation, the nature of the caregiver-care recipient relationship, gender, functional and cognitive status, and depression); identify factors that support caregiving; and determine what factors are most important in delaying nursing home admission.

描述(由申请者提供)：西班牙裔照顾者的照看负担是一个鲜为人知的日益严重的问题。因此，解决照料者负担和防止这些人口中的制度化的研究至关重要。据估计，美国有超过4200万拉美裔美国人，65岁以上的群体预计将以比其他任何种族或民族更快的速度增长，到2050年人数将增加两倍。目前，13%的拉美裔家庭为50岁或50岁以上的成年人提供护理，到2050年，他们的预期寿命将增加到87岁，超过所有其他种族。鉴于人口结构的这种戏剧性变化，越来越多的拉美裔家庭将被安排担任照顾者的角色。这项拟议的研究的目的是通过描述照顾者负担/压力的水平、情况和后果，并确定文化和背景变量对照顾者和照顾者获得的影响，以及导致养老院入院的因素，来调查这一高危人群的照看负担。这项拟议的项目是一项纵向混合方法描述性研究，旨在深入探索墨西哥裔美国家庭中照顾、照顾负担和压力、照顾者获得和入住养老院的自然过程。110个照顾者-护理接受者病例将被登记并跟踪15个月。访谈和标准化问卷将在基线和每10周完成一次，如果进入养老院，还会有一个额外的测量点。我们将比较和对比照看轨迹中的转变和转折点(考虑到文化适应、照顾者-照顾者关系的性质、性别、功能和认知状况以及抑郁症)；确定支持照看的因素；并确定哪些因素是延迟制度化的最重要因素。核心部分将是以案例为导向的方法，即对案例进行密集的、定性驱动的研究，着眼于相似和不同的配置。一个同步的、互补的、数量驱动的、面向变量的组件将跨案例寻找广泛的模式，并能够根据这些广泛的模式进行推论。这些方法将贯穿研究的分析和解释阶段。这种对照料轨迹的深入、系统的研究应该被证明有助于设计干预措施，这些干预措施的时机与已知的危机点同时发生，有助于让老年人留在家里，或者帮助家庭认识到何时应该寻求正式的养老院护理。项目叙事使用生命历程的视角，这项纵向的、描述性的、混合的方法研究旨在探索110个墨西哥裔美国家庭中照顾、照顾负担和压力、照顾者获得和入住养老院的自然过程。核心部分将是以案例为导向的方法，即对案例进行密集的、定性驱动的研究，着眼于相似和不同的配置。一个同步的、互补的、数量驱动的、面向变量的组件将跨案例寻找广泛的模式，并能够根据这些广泛的模式进行推论。我们将比较和对比照看轨迹中的转变和转折点(考虑到文化适应、照顾者-照顾者关系的性质、性别、功能和认知状况以及抑郁症)；确定支持照看的因素；并确定哪些因素是推迟养老院入院的最重要因素。