This article examines the experiences of African American women who are caring for a parent with heart failure. Seven adult daughter caregivers completed in-depth, qualitative interviews, and a phenomenological approach was used for data analysis. Results suggest the presence of caregiving stressors, including heart failure symptoms and comorbidity, caregiving duties, social–emotional stressors, and distrust of the health system. Relevant coping strategies included valuing the caregiving role, coordinating care with siblings, taking charge, and spirituality. Social workers can play a critical role in supporting and advocating for caregivers of persons with heart failure, helping them to cope with stressors associated with advanced illness, connecting families with culturally acceptable services, and facilitating communication between families and health care providers.
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References
1.
AdamsK., & ZannadF (1998). Clinical definition and epidemiology of advanced heart failure. The American Heart Journal, 135(6), S204-S215.
2.
AldredH., GottM., & GariballaS. (2005). Advanced heart failure: Impact on older patients and informal carers. Journal of Advanced Nursing, 49(2), 116–124.
BennettS. J., PerkinsS. M., LaneK. A., DeerM., BraterD. C., & MurrayM. D. (2001). Social support and health-related quality of life among heart failure patients. Quality of Life Research, 10, 671–682.
7.
BriarK. H., & KaplanC. (1990). NASW Commission on Family and Primary Associations, technical assistance report: The family caregiving crisis. Silver Spring, MD: National Association of Social Workers.
8.
BurtonL. (1996). Age norms, the timing of family role transitions, and intergenerational caregiving among aging African American women. Gerontologist, 36(2), 199–208.
9.
ChadihaL. A., AdamsP., BiegelD. E., AuslanderW., & GutierrezL. (2004). Empowering African American women informal caregivers: A literature synthesis and practice strategies. Social Work, 49(1), 97–108.
10.
Damron-RodriguezJ., WallaceS., & KingstonR. (1994). Service utilization and minority elderly: Appropriateness, accessibility and acceptability. Gerontology and Geriatrics Education, 15(1), 45–63.
11.
EdmondsM. (1999). Serving minority elders: Preventing chronic illness and disability in the African American elderly. In WykleM. L. & FordA. B. (Eds.), Serving minority elders in the 21st century (pp. 25–36). New York: Springer.
12.
EvangelistaL. S., DracupK., DoeringL., WestlakeC., FonorowG. C., & HamiltonM. (2002). Emotional well-being of heart failure patients and their caregivers. Journal of Cardiac Failure, 8(5), 300–305.
13.
FarranC. J., MillerB., KaufmanJ., & DavisL. (1997). Race, finding meaning, and caregiver distress. Journal of Aging and Health, 9(3), 316–333.
14.
FarleyR., DanzigerS., & HolzerH. J. (2000). Detroit divided. New York: Russell Sage Foundation.
15.
FarleyR., & HaagaJ (2005). The American people: Census 2000. New York: Russell Sage Foundation.
16.
FiscellaK., & WilliamsD. R. (2004). Health disparities based on socioeconomic inequities: Implications for urban health care. Academic Medicine, 79(12), 1139–1147.
17.
GambleV. N. (1997). Under the shadow of Tuskegee: African Americans and health care. American Journal of Public Health, 87(11), 1773–1778.
18.
GrogerL., MayberryP., & StrakerJ. (1999). What we didn't learn because of who would not talk to us. Qualitative Health Research, 9(6), 829–835.
19.
HinrichsenG. A., & RamirezM. (1992). Black and White dementia caregivers: A comparison of their adaptation, adjustment, and service utilization. Gerontologist, 32(3), 375-381.
20.
KnightB. G., SilversteinM., McCallumT. J., & FoxL. S. (2000). A sociocultural stress and coping model for mental health outcomes among African American caregivers in southern California. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 55, 142–150.
21.
KriegerN. N., RowleyD. L., HermanA., AveryB., & PhillipsM. (1993). Racism, sexism, and social class: Implications for studies of health, disease, and wellbeing. American Journal of Preventive Medicine, 9(Suppl. 6), 82–122.
22.
KuryloM., ElliottT. R., DeVivoL., & DreerL. E. (2004). Caregiver social problem solving abilities and family member adjustment following congestive heart failure. Journal of Clinical Psychology in Medical Settings, 11(3), 151–157.
23.
LeeD. S., AustinP. C., RouleauJ. L., LiuP. P., NaimarkD., & TuJ. V. (2003). Predicting mortality among patients hospitalized for heart failure: Derivation and validation of a clinical model. JAMA, 290, 2581–2587.
24.
LoehrL. R., RosamondW. D., ChangP. P., FolsomA. R., & ChamblessL. E. (2008). Heart failure incidence and survival (Atherosclerosis Risk in Communities Study). American Journal of Cardiology, 101, 1016–1022.
25.
MolloyG. J., JohnstonD. W., & WithamM. D. (2005). Family caregiving and congestive heart failure. Review and analysis. European Journal of Heart Failure, 7, 592–603.
26.
MorrisT., & EdwardsL (2006). Family caregivers. In LubkinI. M. & LarsenP. D. (Eds.), Chronic illness: Impact and interventions (pp. 255–284). Boston: Jones & Bartlett.
27.
MurrayS. A., KendallM., BoydK., & SheikhA. (2005). Illness trajectories and palliative care. British Medical Journal, 330, 1007–1011.
Navaie-WaliserM., FledmanP., GouldD., LevineC., KuerbisA., & DonelanK. (2001). The experiences and challenges of informal caregivers: Common themes and differences among Whites, Blacks, and Hispanics. Gerontologist, 41(6), 733–741.
30.
Navaie-WaliserM., SpriggsA., FeldmanP. H. (2002). Informal caregiving: Differential experiences by gender. Medical Care, 40(12), 1249–1259.
31.
PadgettD. K. (2008). Qualitative methods in social work research (2nd ed.). Thousand Oaks, CA: SAGE.
PinderhughesE. (1995). Empowering diverse populations: Family practice in the 21st century. Families in Society: The Journal of Contemporary Human Services, 76(3), 131–140.
34.
PinquartM., & SorensenS (2005). Ethnic differences in stressors, resources, and psychological outcomes of family caregiving: A meta-analysis. Gerontologist, 45(1), 90–106.
35.
PolednakA. P. (1997). Segregation, poverty, and mortality in urban African Americans. New York: Oxford University Press.
36.
Samuel-HodgeC. D., HeadenS. W., SkellyA. H., IngramA. F., KeyserlingT. C., JacksonE. J., … ElasyT. A. (2000). Influences on day-to-day self-management of type 2 diabetes among African American women: Spirituality, the multicaregiver role, and other social context factors. Diabetes Care, 23(7), 928–933.
37.
SaundersM. M. (2003). Family caregivers need support with heart failure patients. Holistic Nursing Practice, 17(3), 136–142.
38.
SchulzA. J., WilliamsD. R., IsraelB. A., & LempertL. B. (2002). Racial and spatial relations as fundamental determinants of health in Detroit. Milbank Quarterly, 80(4), 677–707.
39.
SmedleyB. D., StithA. Y., & NelsonA. R. (Eds.). (2003). Unequal treatment: Confronting racial and ethnic disparities in healthcare. Washington, DC: National Academies Press.
40.
SterrittP. F., & PokornyM. E. (1998). African American caregiving for a relative with Alzheimer's disease. Geriatric Nursing, 19(3), 127–134.
41.
StollerE. P. (1983). Parental caregiving by adult children. Journal of Marriage and Family, 45(4), 851–858.
42.
TurnerW. L., WallaceB. R., AndersonJ. R., & BirdC. (2004). The last mile of the way: Understanding caregiving in African American families at the end-oflife. Journal of Marital and Family Therapy, 30(4), 427–438.
43.
WaitesC. (2009). Building on strengths: Intergenerational practice with African American families. Social Work, 54(3), 278–287.
44.
WhiteT., TownsendA., & StephensM. A. (2000). Comparisons of African American and White women in the parent care role. Gerontologist, 40(6), 718–728.
