Caregiving burden among Hispanic caregivers is a little understood and growing problem. As a result, research to address caregiver burden and prevent institutionalization in these populations is critical. It is estimated that there are over 42 million Hispanics in the U.S. and the cohort over age 65 is expected to grow faster than any other racial or ethnic group, tripling in number by 2050. Thirteen percent of Hispanic households currently provide care to an adult aged 50 or older whose life expectancy will increase to 87 years by 2050, surpassing all other ethnic groups. Given this dramatic shift in demographics, a burgeoning number of Hispanic families will be placed in a caregiving role. The purpose of this proposed study is to investigate the burden of caregiving in this at-risk population by describing the level, circumstances, and consequences of caregiver burden/strain, and determining the impact of cultural and contextual variables on caregiving and caregiver gain, along with factors that lead to nursing home admission. This proposed project is a longitudinal mixed methods descriptive study designed to intensively explore the natural course of caregiving, caregiving burden and strain, caregiver gain, and admission to nursing homes among Mexican-American families. One hundred ten caregiver-care recipient cases will be enrolled and followed for 15 months. Interviews and standardized questionnaires will be completed at baseline and every 10 weeks, with an additional measurement point if nursing home admission occurs. We will compare and contrast transitions and turning points in the caregiving trajectory (taking into account acculturation, the nature of the caregiver-care recipient relationship, gender, functional and cognitive status, and depression);identify factors that support caregiving;and determine what factors are most important in delaying institutionalization. The core component will be a case-oriented approach, that is, an intensive, qualitatively-driven, study of cases with an eye toward configurations of similarities and differences. A simultaneous, complementary, quantitatively-driven variable-oriented component will look for broad patterns across cases and enable the drawing of inferences based on these broad patterns. These approaches will be integrated throughout the analytic and interpretive phases of the study. This in-depth, systematic research into the caregiving trajectory should prove useful in designing interventions that are timed to occur simultaneously with known crisis points and help keep elders at home or to help families acknowledge when formal nursing home care should be sought. PROJECT NARRATIVE Using life course perspective, this longitudinal, descriptive, mixed methods study is designed to explore the natural course of caregiving, caregiving burden and strain, caregiver gain, and admission to nursing homes among 110 Mexican-American families. The core component will be a case-oriented approach, that is, an intensive, qualitatively-driven, study of cases with an eye toward configurations of similarities and differences. A simultaneous, complementary, quantitatively-driven variable-oriented component will look for broad patterns across cases and enable the drawing of inferences based on these broad patterns. We will compare and contrast transitions and turning points in the caregiving trajectory (taking into account acculturation, the nature of the caregiver-care recipient relationship, gender, functional and cognitive status, and depression);identify factors that support caregiving;and determine what factors are most important in delaying nursing home admission.
