Caregiver strain among black and white daughter caregivers: a role theory perspective.

The emotional strain associated with caregiving as experienced by both black (n = 117) and white (n = 464) daughter caregivers was examined from a role theory perspective. Black daughters reported less role strain overall. Conflict between caregiving duties and the caregivers' personal and social life was a predictor for both groups. For black women the unique predictors were: poor perceived health, unavailability of respite support, and lower caregiving role demand. For white women poor quality of parent-daughter relationship and work conflict were the unique predictors.

Caring for frail elderly parents: a comparison of adult sons and daughters.

This research examines the impact of various factors on perceived emotional strain of adult son and daughter caregivers of frail elderly parents. Daughters experienced higher levels of emotional strain than did sons. Perceived interference between caregiving and the caregiver's personal and social life predicted emotional strain for both sons and daughters. For daughters the most important predictors of emotional strain were interference with work and quality of relationship with the parent. For sons the most important predictors were behavioral problems of the parent and few informal helpers.

Long-term care service use by frail elders: is ethnicity a factor?

Using data from the 1982-84 National Long-Term Care Channeling Demonstration, this study examines factors associated with long-term care service use by African American, Hispanic, and white frail elders living in the community. Findings indicate that in addition to predisposing, enabling, and need factors, race/ethnicity is a significant predictor of each type of service use.

Perceived health and functional status among spouse caregivers of frail older persons.

This national interview study examined the health impact of caring for frail elders in a sample of 437 spouse caregivers. The principal findings were that (a) caregiver emotional strain was the strongest common predictor of both poor perceived health and functional limitations, (b) wife caregivers' poor health was associated with care recipients' perceived unmet needs and increased depression, (c) husband caregivers' poor health status was predicted by longer caregiving duration, and (d) non-White wife caregivers reported poorer perceived health than did their White counterparts.

The Program of All-Inclusive Care for the Elderly (PACE): an innovative long-term care model in the United States.

This article examines the long-term care service system in the United States, its problems, and an improved long-term care model. Problematic quality of care in institutional settings and fragmentation of service coordination in community-based settings are two major issues in the traditional long-term care system. The Program of All-Inclusive Care for the Elderly (PACE) has been emerging since the 1970s to address these issues, particularly because most frail elders prefer community-based to institutional care. The Balanced Budget Act of 1997 made PACE a permanent provider type under Medicare and granted states the option of paying a capitation rate for PACE services under Medicaid. The PACE model is a managed long-term care system that provides frail elders alternatives to nursing home life. The PACE program's primary goals are to maximize each frail elderly participant's autonomy and continued community residence, and to provide quality care at a lower cost than Medicare, Medicaid, and private-pay participants, who pay in the traditional fee-for-service system. In exchange for Medicare and Medicaid fixed monthly payments for each participating frail elder, PACE service systems provide a continuum of long-term care services, including hospital and nursing home care, and bear full financial risk. Integration of acute and long-term care services in the PACE model allows care of frail elders with multiple problems by a single service organization that can provide a full range of services. PACE's range of services and organizational features are discussed.

Correlates of psychological distress among Mexican, Cuban, and Puerto Rican elders living in the USA.

Little is known about the impact of coping resources and health-related and family stresses on the well-being of Hispanic elders, or the extent to which these factors operate differentially for various Hispanic nationality groups. The present study examined the correlates of psychological distress of three groups of Hispanic elders. The researcher analyzed the Mexican American (n = 773) Cuban American (n = 714), and Puerto Rican (n = 368) elderly individuals drawn from the 1988 National Survey of Hispanic Elderly People in the USA. Multivariate analyses results indicated that activities of daily living impairments, poor perceived health, and unmet needs in formal social service were common predictors of psychological distress for all three groups. Older Mexican American women and Puerto Rican women reported higher levels of psychological distress than their male counterparts, other things being equal. For Cuban American elders, fear of depending too much on others, conflicts in the family, and living alone were unique predictors of their psychological distress. jg]Key words gw]Stress gw]Coping gw]Psychological well-being gw]Mexican Americans gw]Cuban Americans gw]Puerto Rican Americans gw]USA.

Geriatric Depression Scale as a community screening instrument for elderly Chinese immigrants.

Depression is the most prevalent mental health problem among the elderly, including Chinese-American elderly. A Chinese-language version of the popular Geriatric Depression Scale Long Form (GDS-LF) and Short Form (GDS-SF) was developed. Based on the responses of 50 elderly Chinese immigrants to the U.S. (25 women and 25 men), the GDS-LF evidenced high internal consistency but the GDS-SF did not. Factor analysis was then used to develop a new version of the GDS-SF, which was internally consistent. The revised GDS-SF is an important and easy-to-administer tool for community screening of depression among elderly Chinese immigrants.

Depression among elderly Chinese immigrants: an exploratory study.

Despite an increase in the population of elderly Chinese immigrants, little is known about their mental health problems. The most prevalent mental health problem of elderly people-depression-often goes unrecognized and untreated. In an interview format, the author administered the Geriatric Depression Scale and measures of health status, living situation, stressful life events, and informal support to a community sample of 50 elderly Chinese immigrants recruited at senior centers and meal sites. Respondents who rated their health as good, who lived with others, and who were satisfied with help received from family members were least likely to be depressed. The impact of these factors on the mental health of elderly Chinese immigrants can be understood in light of their unique cultural values.

Physician utilization by Hispanic elderly persons: national perspective.

BACKGROUND: The number of elderly Hispanic Americans is projected to more than double by 2010 and account for 16% of all elders by 2050. The complex health needs and diversity of that growing population poses challenges for planning and delivery of health services. OBJECTIVES: The behavioral model of health services utilization was used to examine predisposing, enabling, and need factors associated with physician use by Hispanic elders and to assess whether Mexican American, Cuban American, and Puerto Rican elders differ in their likelihood of use. RESEARCH DESIGN: Data are from the 1988 National Survey of Hispanic Elderly People, which is a nationally representative sample of Hispanic elders living within telephone exchanges with at least 30% concentration of Hispanics. SUBJECTS: There were 2,299 completed interviews. Analyses are based on a subsample of 773 Mexican Americans, 714 Cuban Americans, and 368 Puerto Ricans. MEASURES: The dependent variable, physician utilization, was self-reported number of visits in the previous year. It was dichotomized because of skewness. Independent variables include predisposing, enabling, and need factors. RESULTS: Using hierarchical logistic regression, all three sets of factors contributed to the likelihood of a visit. Enabling factors, especially insurance coverage and adult children, had the greatest impact. Cuban Americans and Puerto Ricans were 2.3 and 2.6 times more likely, respectively, to have seen a physician than were Mexican Americans. CONCLUSIONS: In seeking to improve access and use of physician services, health care providers and policy makers should consider the role of social and economic factors and national origin group.

A community needs assessment among Asian American elders.

Despite a significant increase in the size of the Asian American elderly population, little is known about their social service needs and the level of service being provided them. This study used a survey methodology to examine all Asian American senior programs (N=20) in a major American metropolitan region. The response rate was 90% with respondent agencies serving as the unit of analysis. Findings suggest that Asian elderly clients were primarily women and 'old-old', and that many of them were on SSI. Services provided were primarily tangible and facilitative, rather than clinical. Services needed but not provided were emergency psychiatric care, home attendants, home-delivered meals, legal services, medical services, and protective services. Findings of this study provide useful information for further research and program planning for Asian American elders in urban settings.