Nativity Status and Sources of Care Assistance Among Elderly Mexican-Origin Adults

Abstract

Much like other racial/ethnic groups, Latinos are facing challenges to provide needed care to aging adults. Older Latinos underutilize nursing homes and home health care services and primarily rely on their families for assistance. While this general trend has been established, little attention has been paid to nativity differentials in patterns of caregiving for this segment of the aging population. The analyses are based on the latest wave (Wave 7) of the Hispanic Established Population for Epidemiologic Studies of the Elderly or H-EPESE (2010/2011) a sample of older Mexican-origin adults and their family caregivers living in the southwestern U.S. We examine 629 child caregiver/parent care recipient dyads using bivariate statistics and multinomial logistic regression analyses. The results reveal that while grown children of Mexican-origin elders play a critical role in providing instrumental and financial supports to their aging parents, the burden that the children of foreign-born parents bear is greater. Despite higher rates of disability, Mexican-born elders are more dependent on a child for help and far less likely to call upon other family members, relatives and community based-providers for help than the U.S. born. Given the recent and future growth in this segment of the aging population, intervention strategies will need to focus on nativity status and acculturative processes in the context of caregiving and caregiver burden.

Caregiver Well-Being and Burden: Variations by Race/Ethnicity and Care Recipient Nativity Status

“…We found that caregivers of foreign-born older adults report more care burden than caregivers of U.S.-born older adults. Previous studies on caregiving in immigrant families show that foreign-born care recipients tend to be more dependent on one focal child for help and less likely to rely on other relatives for late-life health support ( Angel et al, 2014 ; Rote & Moon, 2018 ). Our results supported these findings in that caregivers of foreign-born older adults provided more help with ADLs and IADLs, medical care and medical insurance, and appointments than care recipients of U.S.-born older adults.…”

“…The current study only included the primary caregivers (who spent more time than other available caregivers) from the data and a large portion of care recipients are dependent on a daughter or son who may face multiple social roles (e.g., employment and child/other family care). Possibly, caregivers may experience or perceive more demands from their foreign-born care recipients compared to caregivers of U.S.-born older adults ( Angel et al, 2014 ; Rote & Moon, 2018 ). However, when the interactions between care recipient nativity status and caregiver’s race/ethnicity and all covariates were considered, care recipient nativity status was no longer significant.…”

“…However, there are many reasons Hispanic caregivers of foreign-born care recipients are at a disadvantage for these factors. First, Hispanic foreign-born care recipients tend to have smaller caregiving networks and be dependent on one caregiver for support in late life ( Angel et al, 2014 ; Rote & Moon, 2018 ). Therefore, they may face secondary stressors, especially limitations of caregiving on activities due to less sharing of care work.…”

“…Where health disadvantages exist, explanations include the effects of migration and acculturation stress, occupational differences and hazard exposure, diminished social support, lack of access to health care and insurance, and lower rates of help-seeking behavior and health care utilization among the foreign-born ( Choi, 2015 ; Cunningham et al, 2008 ; Min et al, 2005 ). Reasons for lower rates of health care utilization include systemic inequalities and cultural barriers including socioeconomic constraints (e.g., low education and physically demanding occupations), lack of resources (e.g., insurance), lack of information regarding available services, limited English proficiency, “factors related to stigma and marginalization” ( Derose et al, 2007 , p. 1262), availability of culturally appropriate services, and expectations regarding family care ( Angel et al, 2014 ; Choi, 2015 ; Choi et al, 2015 ; Cunningham et al, 2008 ; DeNavas, 2011 ; Derose et al, 2007 ; Derr, 2016 ; Graham et al, 2009 ).…”

“…Due to a higher prevalence of functional disabilities in foreign-born older adults, for some, health advantages in mortality occur simultaneously with longer periods of disability and greater need for care in older age ( Garcia et al, 2015 ; Markides & Rote, 2014 –2015; Mehta et al, 2014 ). Foreign-born older adults needing care are more likely to live with and receive care informally through family and social networks compared to older adults born in the United States ( Angel et al, 2014 ; Lahaie et al, 2013 ; Torres-Gil et al, 2005 ; Treas & Mazumdar, 2002 ). Previous research suggests that due to racial/ethnic disparities in morbidity and disability among older care recipients, racial and ethnic minority caregivers such as Hispanic and non-Hispanic black caregivers transition into the caregiving role earlier in the life course and remain in the caregiving role for a longer time compared to non-Hispanic white caregivers ( Aranda & Knight, 1997 ; Coon et al, 2004 ; Moon et al, 2019 ).…”