Understanding how social context shapes decisions to seek institutional care: a qualitative study of experiences of progressive cognitive decline among latinx families.

IF 3.2 2区 医学 Q1 GERONTOLOGY
Ignacia Arteaga, Alma Hernandez de Jesus, Brandi Ginn, Corey M Abramson, Daniel Dohan
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引用次数: 0

Abstract

Background and objectives: Latinx individuals in the United States experience elevated risk of cognitive impairment, less access to institutional care, and more caregiver strain. Cultural orientations have been emphasized as a factor in caregiving decisions in Latinx families but rarely in the context of community structural position and institutional circumstances. This ethnographic case study illustrates how cultural, institutional, and structural factors shape Latinx families' deliberations and decisions about institutional care for members experiencing cognitive decline.

Research design and methods: We use comparative ethnography to examine experiences of older adults with cognitive decline and their care partners. Analysis focuses on ten care partners and nine older adults in urban and rural Northern California. Drawing on analytical memos that integrate data from semi-structured interviews and participant observation in community settings, we explore how older adults and care partners make decisions to pursue institutional care.

Results: Among our Latinx respondents, decisions to relocate from private to institutional care is complex and context-dependent. These decisions reflect cultural orientations including values of familism and individuality as well as access to resources that reflect structural circumstances and support networks that assist in navigating local institutions. Familism is enacted in diverse ways, with family involvement playing a role before, during, and beyond institutionalization.

Discussion and implications: This study illustrates how social factors contextualize culturally-mediated decisions regarding older adult caregiving in Latinx families. Its results imply that navigational assistance could support decision-making in Latinx communities. it highlights the utility of fine-grained data for accurately capturing this dynamic process.

了解社会环境如何影响寻求机构护理的决定:拉丁裔家庭认知能力逐渐下降的定性研究。
背景和目的:美国的拉丁裔个体认知障碍的风险较高,获得机构护理的机会较少,护理人员压力更大。在拉丁裔家庭中,文化取向被强调为照料决定的一个因素,但很少在社区结构地位和体制情况下加以强调。这个人种学案例研究说明了文化、制度和结构因素如何影响拉丁裔家庭对经历认知衰退的成员的机构护理的考虑和决定。研究设计和方法:我们使用比较人种学来研究认知能力下降的老年人及其护理伙伴的经历。分析集中在北加州城市和农村的10名护理伙伴和9名老年人。利用分析备忘录,整合了来自半结构化访谈和社区环境参与性观察的数据,我们探讨了老年人和护理伙伴如何做出寻求机构护理的决定。结果:在我们的拉丁裔受访者中,从私人到机构护理的搬迁决定是复杂的,并且取决于具体情况。这些决定反映了文化取向,包括家庭主义和个性的价值观,以及反映结构环境的资源获取和帮助在当地机构中导航的支持网络。家庭主义以多种方式发生,家庭参与在制度化之前、期间和之后都发挥着作用。讨论和启示:本研究说明了社会因素如何使拉丁裔家庭中有关老年人护理的文化介导决策成为背景。其结果表明,导航辅助可以支持拉丁裔社区的决策。它强调了细粒度数据用于准确捕获此动态过程的实用性。
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来源期刊
Gerontologist
Gerontologist GERONTOLOGY-
CiteScore
11.00
自引率
8.80%
发文量
171
期刊介绍: The Gerontologist, published since 1961, is a bimonthly journal of The Gerontological Society of America that provides a multidisciplinary perspective on human aging by publishing research and analysis on applied social issues. It informs the broad community of disciplines and professions involved in understanding the aging process and providing care to older people. Articles should include a conceptual framework and testable hypotheses. Implications for policy or practice should be highlighted. The Gerontologist publishes quantitative and qualitative research and encourages manuscript submissions of various types including: research articles, intervention research, review articles, measurement articles, forums, and brief reports. Book and media reviews, International Spotlights, and award-winning lectures are commissioned by the editors.
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