Cultural differences in burden experienced among caregivers of the urban homebound elderly adults

Limited research has explored whether the level of burden associated with caring for a homebound elderly patient tends to vary across racial groups or by relationship status. Drawing from a larger prospective study of homebound elderly patients, we surveyed 46 informal caregivers to examine the level of burden experienced among caregivers across racial groups and relationship status. Burden was measured using the Zarit Caregiver Burden Scale. Caregivers had an average age of 57 (SD=14), 76% were female, 37 % Black, 35% Hispanic, 28% white, 46% completed high school or an equivalent degree, and 11% pursued higher degrees. 81% of Hispanic caregivers identified as the children of patients in comparison to 71% of blacks and 62% of whites. Overall, informal caregivers of homebound patients experience high levels of burden [28.1 (SD=14.8)] associated with providing this care, with 19.2% experiencing moderate to severe caregiver burden. White caregivers had significantly higher average caregiver burden [37(SD=12)] than Black and Latino caregivers [25(SD=14), 23 (SD=14), respectively; (p=0.02). Burden was higher amongst caregivers who reported being spouses or partners of the patient [43(SD=10)], in comparison to those who identified as children [25(SD=14)] or other family or friends [26(SD=7); p =0.004]. Identifying as a spouse/partner, but not race,remained a significant predictor of increased burden after adjusting for caregiver race, age, relationship to patient, patient age, and patient limitations [B(SE) 15.9 (7.1), p=0.03]. Studies designed to further understand and support the needs of spouse-caregivers as well as cultural attitudes to providing care to homebound seniors are warranted.