Advertisement

Journal of Cross-Cultural Gerontology

, Volume 14, Issue 4, pp 335–356 | Cite as

The role of religion and ethnicity in the help seeking of family caregivers of elders with Alzheimer's disease and related disorders

  • Sue Levkoff
  • Becca Levy
  • Patricia Flynn Weitzman
Article

Abstract

Stages of help seeking during illness have been identified as follows: disease experience, symptom attribution, decision to seek care, and contact with care providers. These stages have not been evaluated amongst family caregivers of elders affected with Alzheimer's disease and related disorders (ADRD). Since minority families typically care for ADRD elders at home, it seems important to understand the help seeking of minority family caregivers in particular, and the role of religious/ethnic factors. Thematic analyses were conducted on in-depth interviews from 10 caregivers from 4 groups (total n = 40): African-American, Chinese-American, Puerto Rican, and Irish-American. Aside from the disease experience stage, where religious/ethnic themes were negligible, between-group differences existed in these themes at other stages. For example, themes of extended family support emerged around decision making, with much between-group variation. At the contact with providers stage themes of contacting religious or ethnic service organizations were present, again with between-group variation. Chinese-American and Puerto Rican narratives contained themes of language barriers to care, and a lack of culturally-competent services. Both Irish-American and African-American narratives showed themes of alienation from religious groups on the one hand, and using prayer to cope on the other. Narratives from all groups contained themes of religious and/or ethnic imperatives for providing care. Overall, findings reveal that religious/ethnic factors may both aid and impede the help seeking of caregivers.

ADRD Care providers Dementia Ethnicity Religion 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Advisory Panel on Alzheimer' Disease (1992). Fourth report of the advisory panel on Alzheimers disease. Washington, DC: National Institutes of Health.Google Scholar
  2. Baker, F. M. (1992). Ethnic minority elders: A mental health research agenda, Hospital and Community Psychiatry 43: 337–342.Google Scholar
  3. Barresi, C. M. (1990). Diversity in black family caregiving: Implications for geriatric education. In Minority aging: Essential curricula content for selected health and allied health professions. Washington, DC: U.S. Department of Health & Human Services.Google Scholar
  4. Blazer, D. & Houpt, J. (1979). Perception of poor health in the healthy older adult, Journal of the American Geriatrics Society 27: 330.Google Scholar
  5. Elliott, K. S., Di Minno, M., Lam, D. & Tu, A. M. (1996). Working with Chinese families in the context of dementia. In G. Yeo & D. Gallagher-Thompson (eds.), Ethnicity and the dementias (pp. 89–108). Washington, DC: Taylor & Francis.Google Scholar
  6. Fox, K., Hinton, L. & Levkoff, S. (1999). Take up the caregiver' burden: Narratives of caregiving for urban African American elders with dementia, Culture, Medicine, and Psychiatry (forthcoming).Google Scholar
  7. Gubrium, J. F. & Sankar, A. Qualitative methods in aging research. Thousand Oaks, CA: Sage.Google Scholar
  8. Hanser, S., Howe, D. & Kelly, K. (1996). Implications for future policy and research. In G. Yeo and D. Gallagher-Thompson (eds.), Ethnicity and the dementias (pp. 245–254). Washingtn, DC: Tayler & Francis.Google Scholar
  9. Harel, Z. & Dunkle, R. E. (1995). Matching people with services in long-term care. New York: Springer.Google Scholar
  10. Henderson, J. N. (1996). Cultural dynamics of dementia in a Cuban and Puerto Rican population in the United States. In G. Yeo and D. Gallagher-Thompson (eds.), Ethnicity and the dementias (pp. 153–166). Washington, DC: Taylor & Francis.Google Scholar
  11. Hicks, M. & Lam, M. (1999). Decision-making within the social course of dementia: Accounts by Chinese-American caregivers, Culture, Medicine, and Psychiatry (special issue, quest editors L.W. Hintom and S. Levkoff) (forthcoming).Google Scholar
  12. Koenig, H. G., George, L. K., Blazer, D. G., Pritchett, J. T. & Meador, K. G. (1993). The relationship between religion and anxiety in a sample of community-dwelling older adults, Journal of Geriatric Psychiatry 26: 65–95.Google Scholar
  13. Krause, N. & Tran, T. V. (1989). Stress and religious involvement among older Black Americans, Journal of Gerontology: Social Sciences 44: S4–S13.Google Scholar
  14. Kvale, S. (1996). InterViews: An introduction to qualitative research interviewing. Thousand Oaks, CA: Sage.Google Scholar
  15. Levkoff, S., Cleary, P. & Wetle, T. (1987). Differences in the appraisal of health between the aged and the middle aged, Journal of Geronotology 42: 114.Google Scholar
  16. Levkoff, S., Cleary, P., Wetle, T. & Besdine, R. W. (1988). Illness behavior in the aged: Implications for clinicians, Journal of the American Geriatrics Society 36: 622–629.Google Scholar
  17. Levkoff, S., Hinton, W. L., Simmons, J., Lam, M., Hicks, M., Guo, Z., Hillygus, J., Dunigan, R., Lui, B., Reynoso, H., Levy, R., Fung, S. & Kleinman, A. (1997). A qualitative analysis of dementia explanatory models across four ethnic groups. In K. Iqbal, B. Winblad, T. Nishimura, M. Takeda, & H. M. Wisniewski (eds.), Alzheimer' disease: Biology, diagnosis and therapeutics. New York: Wiley.Google Scholar
  18. Liu, K., McBride, T. & Coughlin, T. (1994). Risk of entering nursing homes for long versus short stays, Medical Care 32: 315–327.Google Scholar
  19. Luborsky, M. R. (1994). The identification and analysis of themes and patterns. In J. Gubrium & Sankar (eds), Qualitative methods in aging research (pp. 189–210). Thousand Oaks, CA: Sage.Google Scholar
  20. Markides, K. S. (1983). Aging, religiosity, and adjustment: A longitudinal analysis, Journal of Gerontology 38: 621–626.Google Scholar
  21. Mechanic, D. (1978). The experience and expression of distress: The study of illness behavior and medical utilizaton. In D. Mechanic (ed.), Handbook of health care and the health professions (p. 591). Newark, NJ: Free Press.Google Scholar
  22. Pang, K. Y. C. (1996). Self-care strategy of elderly Korean immigrants in the Washington DC metropolitan area, Journal of Cross-Cultural Gerontology 11: 229–254.Google Scholar
  23. Picot, S. F., Stuckey, J. C., Humphrey, S.W., Smyth, K. A. & Whitehouse, P. J. (1996). Cultural assessments and the recruitment and retention of African Americans into Alzheimer' disease research, Journal of Aging and Ethnicity 1: 5–18.Google Scholar
  24. Roughan, P. A. (1993). Mental health and psychiatric disorders in older women, Clinics in Geriatric Medicine 9: 173–190.Google Scholar
  25. Vargas, L. A. (1992). Diversity of aging experience in Latin America and the Caribbean. In T. L. Brink (ed.), Hispanic aged mental health (pp. 5–20). New York: Haworth.Google Scholar
  26. Vitaliano, P. P., Maluro, R. D., Ochs, H. & Russo, J. (1989). A model of burden in caregivers of DAT patients. In E. Light and B. Lebowitz (eds.), Alzheimer' Disease Treatment and Family Stress: Future Directions for Research (pp. 267–291). Washington DC: Government Printing Office.Google Scholar
  27. Walls, C. T. & Zarit, S. (1991). Informal support from black churches and the well-being of elderly blacks, The Gerontologist 31: 490–495.Google Scholar
  28. Wood, J. & Parnham, I. (1990). Coping with perceived burden: Ethnic and cultural issues in Alzheimer' family caregiving, Journal of Applied Gerontology 9: 325–339. ??Google Scholar

Copyright information

© Kluwer Academic Publishers 1999

Authors and Affiliations

  • Sue Levkoff
    • 1
  • Becca Levy
    • 2
  • Patricia Flynn Weitzman
    • 1
  1. 1.Harvard Medical SchoolUSA
  2. 2.Yale University School of Public HealthUSA

Personalised recommendations