Academic journal article Social Work

Puerto Rican Sons as Primary Caregivers of Elderly Patients

Academic journal article Social Work

Puerto Rican Sons as Primary Caregivers of Elderly Patients

Article excerpt

Elders' long-term care needs are the subject of considerable attention in the United States, with controlling government spending on this population at the forefront of the debate. Numerous studies attest to the importance of family in providing care for elders and to the need for formal organizations to support them in the caregiving role (Bass & Noelker, 1987; Horowitz, 1985; Horowitz & Shindelman, 1983; Weeks & Cuellar, 1981). Therefore, health care providers should never lose sight of the family in the caregiving process: "However comprehensive the network of services for the elderly, the family as the second target population will continue to have unique needs. Programs that provide individual and group counseling, skills training, and in-home and institutional respite will remain important" (Horowitz, 1985, p. 233).

Reliance on family as primary caregivers can prove troubling for elders (Winbush, 1993):

Families today are faced with numerous new challenges not evident in the past, which raise questions about the families' ability to overcome - and to overcome without assistance. For example, family caregiving today is taking place in a societal setting characterized by changes in family composition, technology and social advances, life-threatening health problems, and a devalued attitude towards family. (p. 131)

These societal changes require that social workers develop innovative ways to reach out to and support "new" caregivers.

Literature Review

The role of women, particularly daughters, as primary caregivers is well documented (Baum & Page, 1991; Chappell, 1989; Cicirelli, 1993; Noelker & Bass, 1994; Pratt, Jones, Shin & Walker, 1989; Tennstedt & McKinlay, 1989). Historically, women have been the primary and often only caregivers. As a result, most social services organizations have developed services, expertise, and comfort with female caregivers as the beneficiaries. The fields of social work and gerontology have not paid sufficient attention to the role of sons as primary caregivers. When addressed in the professional literature, sons have received minimal attention; often only their numerical presence in a caregiving system is mentioned.

Nevertheless, a few publications have examined sons' presence, roles, and unique issues in fulfilling caregiving roles (Coward & Dwyer, 1990; Dwyer & Coward, 1991; Dwyer & Seccombe, 1991; Stoller, 1990):

There is evidence that growing numbers of men are becoming elder caregivers, yet little is known about their unique needs, experiences, and contributions. As men are called on to assist, augment, or replace the caregiving efforts of women, it is crucial to understand the particular stresses and gratifications this task holds for them and to study their specific coping strategies. (Kaye & Applegate, 1990, p. 289)

The needs of elders of color and their caregivers are expected to grow in importance and priority as this group increases in population and continues to age at a rapid pace (Hayes-Bautista, 1992; Treas, 1995). During the past decade social services organizations have been paying close attention to Latino elders in the United States (Bastida & Leuders, 1994; Lockery, 1992; Sotomayor & Curiel, 1988). The professional literature on Latino elders has portrayed a group that is becoming more diverse and that has tremendous social services needs because of the effects of poverty and racism and high levels of functional disabilities (Castex, 1994; Espino, 1993). A reconceptualization is needed of who can provide informal care to this population: "The research findings highlight that both structural and dynamic forces are important in understanding the variation in family caregiving to the frail elderly. The strongest influence on behaviors and experiences of families is the caregiving context itself" (Horowitz, 1985, p. 225). Culture represents an important component of context, influencing caregiving expectations and behavior. …

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