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Ethnicity and Time to Institutionalization of Dementia Patients: A Comparison of Latina and Caucasian Female Family Caregivers

Authors

  • Brent T. Mausbach PhD,

    1. From the *Older Adult and Family Center, Stanford University School of Medicine and Veterans Affairs Palo Alto Health Care System, Palo Alto, CaliforniaMental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CaliforniaDepartment of Psychiatry, Stanford University School of Medicine, Palo Alto, California§Institute on Aging, San Francisco, CaliforniaPacific Graduate School of Psychology, Palo Alto, CaliforniaDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California.
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  • David W. Coon PhD,

    1. From the *Older Adult and Family Center, Stanford University School of Medicine and Veterans Affairs Palo Alto Health Care System, Palo Alto, CaliforniaMental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CaliforniaDepartment of Psychiatry, Stanford University School of Medicine, Palo Alto, California§Institute on Aging, San Francisco, CaliforniaPacific Graduate School of Psychology, Palo Alto, CaliforniaDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California.
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  • Colin Depp PhD,

    1. From the *Older Adult and Family Center, Stanford University School of Medicine and Veterans Affairs Palo Alto Health Care System, Palo Alto, CaliforniaMental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CaliforniaDepartment of Psychiatry, Stanford University School of Medicine, Palo Alto, California§Institute on Aging, San Francisco, CaliforniaPacific Graduate School of Psychology, Palo Alto, CaliforniaDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California.
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  • Yaron G. Rabinowitz MA,

    1. From the *Older Adult and Family Center, Stanford University School of Medicine and Veterans Affairs Palo Alto Health Care System, Palo Alto, CaliforniaMental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CaliforniaDepartment of Psychiatry, Stanford University School of Medicine, Palo Alto, California§Institute on Aging, San Francisco, CaliforniaPacific Graduate School of Psychology, Palo Alto, CaliforniaDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California.
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  • Esther Wilson-Arias BA,

    1. From the *Older Adult and Family Center, Stanford University School of Medicine and Veterans Affairs Palo Alto Health Care System, Palo Alto, CaliforniaMental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CaliforniaDepartment of Psychiatry, Stanford University School of Medicine, Palo Alto, California§Institute on Aging, San Francisco, CaliforniaPacific Graduate School of Psychology, Palo Alto, CaliforniaDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California.
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  • Helena C. Kraemer PD,

    1. From the *Older Adult and Family Center, Stanford University School of Medicine and Veterans Affairs Palo Alto Health Care System, Palo Alto, CaliforniaMental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CaliforniaDepartment of Psychiatry, Stanford University School of Medicine, Palo Alto, California§Institute on Aging, San Francisco, CaliforniaPacific Graduate School of Psychology, Palo Alto, CaliforniaDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California.
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  • Larry W. Thompson PhD,

    1. From the *Older Adult and Family Center, Stanford University School of Medicine and Veterans Affairs Palo Alto Health Care System, Palo Alto, CaliforniaMental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CaliforniaDepartment of Psychiatry, Stanford University School of Medicine, Palo Alto, California§Institute on Aging, San Francisco, CaliforniaPacific Graduate School of Psychology, Palo Alto, CaliforniaDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California.
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  • Geoffrey Lane MS,

    1. From the *Older Adult and Family Center, Stanford University School of Medicine and Veterans Affairs Palo Alto Health Care System, Palo Alto, CaliforniaMental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CaliforniaDepartment of Psychiatry, Stanford University School of Medicine, Palo Alto, California§Institute on Aging, San Francisco, CaliforniaPacific Graduate School of Psychology, Palo Alto, CaliforniaDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California.
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  • Dolores Gallagher-Thompson PhD

    1. From the *Older Adult and Family Center, Stanford University School of Medicine and Veterans Affairs Palo Alto Health Care System, Palo Alto, CaliforniaMental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CaliforniaDepartment of Psychiatry, Stanford University School of Medicine, Palo Alto, California§Institute on Aging, San Francisco, CaliforniaPacific Graduate School of Psychology, Palo Alto, CaliforniaDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California.
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  • This research was supported by funding associated with the Resources for Enhancing Alzheimer's Caregiver Health project, which is sponsored by the National Institute on Aging (Grant U01-AG13289), and Grant AG 18784 from the National Institute on Aging, within the program project grant headed by David Spiegel, MD, entitled, “Stress, the HPA, and Aging.”

Address correspondence to Brent Mausbach, PhD, Older Adult and Family Center, Stanford University School of Medicine and VA Palo Alto Health Care System, Mail Code 182C/MP, 795 Willow Road, Menlo Park, CA 94025. E-mail: mausbach@stanford.edu

Abstract

Objectives: To compare rates of institutionalization of dementia patients cared for by Latina and Caucasian female caregivers and to explore which caregiver and care-recipient characteristics predicted institutionalization.

Design: Longitudinal.

Setting: San Francisco Bay area, California.

Participants: Two hundred sixty-four female caregivers of dementia patients (154 Caucasian women, 110 Latinas) who participated in an intervention project designed to reduce caregiver stress and may represent a sample that is more stressed and motivated than a general sample of caregivers.

Measurements: Number of days between baseline interview and institutionalization was recorded over an 18-month period. Kaplan-Meier survival analysis with the log rank statistic was used to test for ethnic differences in time to institutionalization. Cox regression analyses were conducted to determine whether care-recipient or caregiver characteristics (e.g., care-recipient age and memory and behavior problems; caregiver depression, years of education, income, and views of the caregiving role) significantly interacted with ethnicity to explain time to institutionalization.

Results: Latinas delayed institutionalization significantly longer than their Caucasian counterparts; care-recipient characteristics or caregiver demographics did not explain these results, although Latinas who identified greater benefits or more-positive aspects of the caregiving process at baseline were less likely to institutionalize their loved one than those who reported fewer benefits of caregiving. Less-acculturated Latinas were significantly more likely to identify positive aspects of caregiving than more-acculturated Latinas.

Conclusion: Latina dementia caregivers delay institutionalization significantly longer than female Caucasian caregivers. In addition, Latino cultural values and positive views of the caregiving role are important factors that may significantly influence their decision to institutionalize loved ones with dementia.

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