Independent Living and Social Support among Chronically-Ill Puerto Rican Elderly

Purpose: Geriatric patients face self-care and chronic illness management challenges. For Latinos responsive to values of familismo, close relatives are expected to be primary caregivers of the elderly. This study examines social support of Puerto Rican older adults with chronic illness. Method: A concurrent, mixed-methods approach (qualitative and quantitative) was employed with a consecutive sample of geriatric Puerto Rican patients with chronic illness attending an inner-city primary care clinic. Of 49 participants who completed the Instrumental Activities of Daily Living (IADL) assessment, the 40 who needed help with any IADL were probed with open-ended questioning to identify how they addressed IADL needs. Standardized questionnaires captured demographics, socio-economic status, and quality of life. Results: Mean age was 76 (±5.3) years; 72% had annual household income of ≤ $15,000 and all had health care insurance (primarily Medicaid, Medicare). Eighty-percent communicated in English "some, but not well" or "not at all"; 61% managed their chronic illness(es) "well" or "very well" although 45% stated that health problems limited their quality of life "fairly" or "a lot." Primary caregivers were spouses (29%) and children (47%). Qualitative findings corroborated and elaborated on quantitative IADL findings, providing context that IADL needs are being met. Conclusions and Implications: In this sample of poor, chronically-ill, Puerto Rican elderly, quantitative and qualitative findings indicated family members most often helped in meeting IADL needs. Frail Latino elders and their family caregivers would benefit from culturally-grounded and linguistically-accessible care coordination to access and navigate available in-home and community-based support services.