Yaron G. Rabinowitz

Ethnicity and time to institutionalization of dementia patients: A comparison of latina and caucasian female family caregivers

Objectives: To compare rates of institutionalization of dementia patients cared for by Latina and Caucasian female caregivers and to explore which caregiver and care‐recipient characteristics predicted institutionalization.

The Relationship Between Self-Efficacy and Cumulative Health Risk Associated With Health Behavior Patterns in Female Caregivers of Elderly Relatives With Alzheimer's Dementia

Objective: To promote caregiver well-being and to help caregivers persevere in their invaluable roles, personal resources that predict increased self-care and reduced health risk behaviors need to be identified. Method: This study examined relationships between self-efficacy beliefs in three distinct domains of caregiving and cumulative health risk associated with health behavior patterns. Results: Higher levels of self-efficacy for Obtaining Respite and self-efficacy for Controlling Upsetting Thoughts were found to be related to reduced health risk. Discussion: These findings suggest that caregivers who believe that they can remove themselves from the stresses of caregiving and who can manage the distorted cognitions often associated with caregiving may experience tangible benefits in health behaviors and, ultimately, improved physical health.

Caregiver Self-Efficacy, Ethnicity, and Kinship Differences in Dementia Caregivers

OBJECTIVE The authors sought to determine the effect of kinship status (daughters versus wives) and ethnicity (Hispanic/Latino versus Caucasian) on self-efficacy to perform tasks relevant to caregiving in a sample of family caregivers for people with memory problems. METHODS Baseline data were collected from 238 female caregivers who participated in an intervention program. Ethnic and kin relationship groups were compared on measures of caregiver self-efficacy, acculturation within the Hispanic/Latino sample, and the relationship of self-efficacy to key outcome variables. RESULTS Hispanics/Latinos reported higher self-efficacy on two of three self-efficacy subscales (Responding to Disruptive Behaviors and Controlling Negative Thoughts About Caregiving). Daughters reported higher self-efficacy on all three self-efficacy scales. Among Hispanics/Latinos, acculturation did not relate strongly to self-efficacy. Caucasian and spousal caregivers appeared to make more generalized appraisals about caregiving. CONCLUSION Higher self-efficacy among Hispanic/Latino caregivers may relate to cultural values about caregiving and/or ethnic differences in appraisal. Wives may be more at risk for low self-efficacy, which may relate to greater role frustration and distress. This study highlights the heterogeneity among caregivers in their experience of caregiving.

Self-efficacy as a moderator of the relationship between care recipient memory and behavioral problems and caregiver depression in female dementia caregivers.

PurposeThe purpose of the current study was to explore the moderating effect of 3 domains of caregiver self-efficacy on the relationship between exogenous caregiving stressors (care recipient memory and behavioral problems) and depression. Design and MethodsModerator analyses were used to analyze data for 256 caregivers of elder relatives with dementia recruited at the Palo-Alto site of the National REACH (Resources for Enhancing Alzheimers Caregiver Health) Project. Significant interactions between the stressor and self-efficacy indicated a potential moderating effect. Post hoc analyses were then conducted to determine the nature of the interaction(s). ResultsSelf-efficacy for managing disruptive behaviors and self-efficacy for controlling upsetting thoughts had a direct effect on depression. Self-efficacy for responding to disruptive behaviors moderated the relationship between care recipient memory and behavioral problems and symptoms of depression. ImplicationsSelf-efficacy may be an important clinical tool for identifying the caregivers who are most vulnerable to depression. Self-efficacy for responding to disruptive behaviors may be especially helpful in identifying caregivers at the greatest risk for depression when care recipient memory and behavior problems are high.

Is Religious Coping Associated with Cumulative Health Risk? An Examination of Religious Coping Styles and Health Behavior Patterns in Alzheimer’s Dementia Caregivers

The current study explored the relationship between religious coping and cumulative health risk associated with health behavior patterns in a sample of 256 Latina and Caucasian female caregivers of elderly relatives with dementia. Primary analyses examined the relationship between religious coping (both positive and negative) and an overall index of cumulative health risk. Secondary analyses were conducted on the individual health behaviors subsumed in the broader index. Findings revealed that negative religious coping was significantly associated with increased cumulative health risk. Positive religious coping was predictive of decreased cumulative health risk among Latina caregivers but not among Caucasians. Negative religious coping was significantly associated with both an increased likelihood for weight gain and increased dietary restriction. Positive religious coping was associated with decreased likelihood for weight gain in Latinas. Implications for both caregivers and clinicians are discussed.

The relationship between religiosity and health behaviors in female caregivers of older adults with dementia.

The current study explored the relationship between three dimensions of religiosity: (a) organizational religiosity (e.g. attendance at religious events), (b) non-organizational religiosity (e.g. prayer), and (c) subjective religiosity (e.g. importance of religion) and caregiver health behavior patterns in a sample of Latina and Caucasian female caregivers of older adult relatives with dementia. It was hypothesized that religiosity would have a significant association with reduced cumulative health risk as determined by an index of health behaviors. It was also hypothesized that, when examining the individual health behaviors subsumed in the overarching index, religiosity would be positively associated with adaptive health behaviors like exercise and negatively associated with health risk behaviors like smoking. Amongst Caucasians, increased subjective religiosity was related to increased cumulative health risk. Conversely, in Latinas, non-organizational religiosity was positively correlated with improved dietary practices (reduced dietary restriction). Increased levels of subjective religiosity were significantly associated with decreased maintenance of a routine exercise regimen across ethnic groups. Recommendations for clinicians and religious leaders, and avenues of future research are discussed.

Understanding Caregiver Health Behaviors: Depressive Symptoms Mediate Caregiver Self-Efficacy and Health Behavior Patterns

Previous research on female caregivers of elderly relatives with dementia has demonstrated that caregiving self-efficacy (SE) is associated with reduced cumulative health risk. The overarching aim of the current study was to expand on that research by exploring whether depressive symptoms mediate the relationship between 3 domains of caregiving SE and cumulative health risk associated with health behavior patterns. Data from 256 female family caregivers of patients with dementia are presented. Path analysis revealed a significant mediated effect for depressive symptoms as both SE for obtaining respite and SE for controlling upsetting Thoughts had a significant, indirect effect on cumulative health risk. There were no direct effects between caregiver SE and cumulative health risk. The current study sheds light on the complex pathway between caregiver SE and health and speaks to the importance of skills-based interventions designed to enhance efficacy beliefs and minimize depression in dementia caregivers.

Health and health behaviors among female caregivers of elderly relatives with dementia : The role of ethnicity and kinship status

Abstract This study examined ethnic and kinship status differences in health behavior patterns, self-rated health, and health conditions in an ethnically diverse sample of 256 female family dementia caregivers. The findings revealed that Latina caregivers rated their health as significantly worse than their Caucasian counterparts. Moreover, Latina caregivers were observed to be significantly more likely to eat fewer than two meals per day or to have gained more than 10 lbs. in 6 months, and to have had difficulty with bouts of dizziness. Caucasian caregivers were significantly more likely to smoke, have a heart condition, and experience gastrointestinal difficulties. With respect to kinship status, daughter caregivers were more likely to have experienced recent weight gain, to have high blood pressure, or a chronic lung condition than spousal caregivers. The findings suggest that specific interventions, designed to address the unique patterns of health behaviors and conditions observed across ethnicity and kinship status, may be needed to improve the health behavior patterns of specific populations of caregivers.