Examining the Relationship Between Community-Based Support Services Use and Mental Health in Black Family Caregivers of Persons Living with Dementia

Abstract

Background: Without remuneration or training, spouses, family members, and friends provide 83% of dementia patients' basic personal care. Caring for a person living with dementia is stressful and can negatively impact the caregiver's health. Caregiver stress is a major issue for Black family caregivers. Black family caregivers' stress-related mental health issues can be addressed through community support services (CSS) such as support groups, help-seeking, respite, and dementia training. CSS can help the person living with dementia and their community-dwelling caregivers delay or avoid institutionalization and stay safe in their homes. This study examines how using CSS affects Black family caregivers' mental health. Framework: The study utilized Pearlin’s caregiver stress model to guide the analysis, highlighting the importance of support services in moderating the relationship between stress and mental health outcomes. Method: This mixed-method study used logistic regression, bivariate, and multivariate models to analyze the nationally representative 2015 NHATS Round 5 and NSOC Rd II datasets (n= 2,204) caregivers using Stata 17. The RaDAR method was used to analyze and develop themes from the focus group (n=6) participant interview. Results/Conclusion: One-quarter (25%) of the Black caregivers reported feeling anxious and over a fifth (23%) reported feeling depressed. Fewer than 5% of the dementia caregivers participated in support groups: only 7% received training. Regardless of dementia classification, neighborhood cohesion is lower for both White and Black caregivers. The results suggest that Black caregivers may be experiencing more anxiety and depression than their White counterparts. Further, there was no distinction between Black and White family caregiver stress or use of support services. The focus group (n = 6) participants validated the quantitative findings that Black caregivers are less likely to use CSS, particularly respite and support groups. The focus group participants reported that financial constraints and lack of free time were the main barriers to support group and respite use.