Gender Disparities in Caregiver Stress for Providing Help to Older Mexican-Americans: A Descriptive Study of the HEPESE

RESEARCH QUESTION: How does the stress of providing care to older Mexican Americans differ by caregiver gender?

RATIONALE: Prevalence of disability and need for personal assistance increase with age. With a large population of Americans reaching retirement age, understanding how this need for assistance affects the health and well-being of their caregivers is vital. Thus, we investigated gender differences among caregivers of older Mexican Americans to inform us of this population’s needs.

DESIGN: A secondary analysis of the Hispanic Established Population for the Epidemiologic Study of the Elderly (HEPESE) survey conducted in five Southwestern U.S. states: Texas, Colorado, Arizona, New Mexico, and California.

PARTICIPANTS: The study sample consisted of 925 caregivers of older Mexican Americans.

DATA MEASUREMENTS: This study was a secondary data analysis of in-home assessments of sociodemographic and self-reported medical characteristics of caregivers of older Mexican Americans.

ANALYSIS: Normally distributed continuous variables were analyzed with t tests, and skewed variables were analyzed with Mann–Whitney U statistics. Categorical variables were compared using χ² statistics. Significance level was set a priori at p < .05.

RESULTS: Though most caregivers were female (73.8%), they did not differ significantly from male caregivers in age (mean = 55.6 yr, standard deviation = 12.7) or marital status, because most were married (57.25%). Most caregivers (men = 97.5%; women = 89.0% ) were relatives of the care recipients. A daily total of 2–10 hr of care per day was provided by most caregivers (44.5%). Female caregivers were significantly more likely to perform bathing, grooming, and cooking tasks (all ps = .04). Time of providing care differed significantly by gender. Most female caregivers (35.8%) began providing care 3–5 yr ago, and most male caregivers (30.8%) began 1–2 yr ago. Finally, female caregivers were significantly more likely to report having arthritis (p = .01) and experiencing depressive symptoms (p = .04).

DISCUSSION: Women report greater burden associated with caregiving than do men. Typically, women are expected to care for their ill family members, more so than men. Lifting tasks such as transferring family members on and off of toilets and working in wet conditions when bathing family members can be taxing on joints. Therefore, female caregivers more commonly report having arthritis. Because they are restricted to their homes, female caregivers lose their social status and support systems as well as income sources available to women who work outside the home. Because female caregivers have been providing care for longer periods of time, these caregivers may start to feel less empowered and therefore experience depressive symptoms.

Occupational therapists (OTs) working in the home to treat ailing family members are perfectly positioned to provide caregiver education in joint protection techniques, body mechanics, and use of assistive devices and energy conservation programs for caregivers with painful joints. OTs can also educate caregivers to ask for respite care to live more balanced lives and rebuild their social supports to seek psychosocial relief.

IMPACT STATEMENT: OTs can play an active role in providing joint protection and energy conservation techniques, as well as assistive devices, to support caregivers who have arthritis because they complete daily tasks for older Mexican-Americans. Similarly, they can encourage female caregivers to seek out respite care and psychosocial support to deal with their depressive symptoms, as well as teach mindfulness and assertiveness techniques.