Abstract
In recent years, a vast literature has accumulated on the negative effects on family caregivers of providing care to elders, while relatively little research has explored caregiving as a positive experience. Only a handful of studies have examined any aspect of informal caregiving among American Indians. This mixed methods study explores the negative and positive aspects of providing elder care among 19 northern plains American Indian family members. These caregivers described low levels of burden and high levels of reward, attributable to cultural attitudes toward elders and caregiving, collective care provision, strong reciprocal relationships with elders, enjoyment of elders, and relatively low levels of care provision. Caregiving manifested as part of a complex exchange of assistance rather than a unidirectional provision of assistance from the family member to the elder. That caregiving emerged as such an overwhelmingly positive experience in a community faced with poverty, alcohol disorders, trauma, and cultural traumatization is testimony to the important roles that elders often continue to play in these communities.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Aranda, M. P., & Knight, B. G. (1997). The influence of ethnicity and culture on the caregiver stress and coping process: a sociocultural review and analysis. The Gerontologist, 37(3), 342–354.
Beals, J., Manson, S. M., Whitesell, N. R., Spicer, P., Novins, D. K., Mitchell, C. M., et al. (2005). Prevalence of DSM-IV disorders and attendant help-seeking in two American Indian reservation populations. Archives of General Psychiatry, 62, 99–108.
Bedard, M., Molloy, D. W., Squire, L., Dubois, S., Lever, J. A., & O'Donnell, M. (2001). The Zarit Burden interview: a new short version and screening version. The Gerontologist, 41(5), 652–657.
Butler, S. S., Turner, W., Kaye, L. W., Ruffin, L., & Downey, R. (2005). Depression and caregiver burden among rural elderly caregivers. Journal of Gerontological Social Work, 46(1), 47–63.
Cohen, C. A., Colantonio, A., & Vernich, L. (2002). Positive aspects of caregiving: rounding out the caregiver experience. International Journal of Geriatric Psychiatry, 17(2), 184–188.
Dilworth-Anderson, P., & Anderson, N. B. (1994). Dementia caregiving in Blacks: A contextual approach to research. In E. Light, G. Niederehe, & B. D. Lebowitz (Eds.), Stress effects on family caregivers of Alzheimer's patients: Research and interventions (pp. 385–409). New York: Springer.
Dilworth-Anderson, P., Williams, I. C., & Gibson, B. E. (2002). Issues of race, ethnicity, and culture in caregiving research: a 20-year review (1980–2000). The Gerontologist, 42(2), 237–272.
DuBois, J. W., Scheutze-Coburn, S., Cumming, S., & Paolino, D. (1993). Outline of discourse transcription. In J. A. Edwards & M. D. Lambert (Eds.), Talking data: Transcription and coding in discourse research (pp. 45–90). Hillsdale: Lawrence Erlbaum Associates.
Faison, K. J., Faria, S. H., & Frank, D. (1999). Caregivers of chronically ill elderly: perceived burden. Journal of Community Health Nursing, 16(4), 243–253.
Farran, C. J., Miller, B. H., Kaufman, J. E., & Davis, L. (1997). Race, finding meaning, and caregiver distress. Journal of Aging and Health, 9(3), 316–333.
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). "Mini-mental state": a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.
Gaugler, J. E., Kane, R. A., & Langlois, J. (2000). Assessment of family caregivers. In R. L. Kane & R. A. Kane (Eds.), Assessing older persons: Measures, meaning, and practical applications (pp. 320–359). New York: Oxford University Press.
Glaser, B., & Strauss, A. (1967). The discovery of grounded theory. Chicago: Aldine.
Hennessy, C. H., & John, R. (1995). The interpretation of burden among Pueblo Indian caregivers. Journal of Aging Studies, 9(3), 215–229.
Hennessy, C. H., & John, R. (1996). American Indian family caregivers' perceptions of burden and needed support services. Journal of Applied Gerontology, 15(3), 275–293.
Jervis, L. L. (2006). The missing family: staff perspectives on and responses to familial noninvolvement in two diverse nursing homes. Journal of Aging Studies, 20, 55–66.
Jervis, L. L., & the AI-SUPERPFP team. (2009). Disillusionment, faith, and cultural traumatization on a northern plains reservation. Traumatology, 15(1), 11–22.
Jervis, L. L., Spicer, P., Manson, S. M., & the AI-SUPERPFP team, (2003). Boredom, "trouble," and postcolonial reservation life. Ethos, 31(1), 38–58.
Jervis, L. L., Beals, J., Fickenscher, A., & Arciniegas, D. B. (2007a). Performance on the mini-mental state examination and Mattis Dementia rating scale among older American Indians. Journal of Neuropsychiatry and Clinical Neuroscience, 19(2), 173–178.
Jervis, L. L., Shore, J., Hutt, E., & Manson, S. (2007b). Suboptimal pharmacotherapy in a tribal nursing home. Journal of the American Medical Directors Association, 8, 1–7.
Jervis, L. L., Fickenscher, A., Beals, J., Cullum, C. M., Novins, D., Manson, S. M., et al. (2010). Predictors of performance on the MMSE and DRS-2 among American Indian elders. Journal of Neuropsychiatry and Clinical Neuroscience, 22(4), 417–425.
John, R. (1988). The Native American family. In C. H. Mindel, R. W. Habenstein, & R. J. Wright (Eds.), Ethnic families in America: Patterns and variations (pp. 325–363). New York: Elsevier.
John, R. (1996). Demography of American Indian elders: social, economic, and health status. In G. D. Sandefur, R. R. Rindfuss, & B. Cohen (Eds.), Changing numbers, changing needs: American Indian demography and public health (pp. 218–231). Washington, D. C.: National Academy Press.
John, R., Hennessy, C. H., Roy, L. C., & Salvini, M. L. (1996). Caring for cognitively impaired American Indian elders: Difficult situations, few options. In G. Yeo & D. Gallagher-Thompson (Eds.), Ethnicity and the dementias (pp. 187–203). Washington, D.C.: Taylor & Francis.
John, R., Hennessy, C. H., Dyeson, T. B., & Garrett, M. D. (2001). Toward the conceptualization and measurement of caregiver burden among Pueblo Indian family caregivers. The Gerontologist, 41(2), 210–219.
Jurica, P. J., Leittan, C. L., & Mattis, S. (2001). DRS-2 Dementia Rating Scale-2 professional manual. Lutz: Psychological Assessment Resources, Inc.
Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A., & Jaffe, M. W. (1963). Studies of illness in the aged: the index of ADL: a standardized measure of biological and psychosocial function. JAMA, 185, 914–919.
Kaye, L. W., & Applegate, J. S. (1990). Men as caregivers to the elderly. Lexington: Lexington Books.
Knight, B. G., Robinson, G. S., Longmire, C. V. F., Chun, M., Nakao, K., & Kim, J. H. (2002). Cross cultural issues in caregiving for persons with dementia: do familism values reduce burden and distress? Ageing International, 27(3), 70–94.
Lawton, M. P., & Brody, E. M. (1969). Assessment of older people: self-maintaining and instrumental activities of living. The Gerontologist, 9, 179–186.
Lecovich, E. (2008). Caregiving burden, community services, and quality of life of primary caregivers of frail elderly persons. Journal of Applied Gerontology, 27(3), 309–330.
Manson, S. M. (1989). Long-term care in American Indian communities: issues for planning and research. The Gerontologist, 29(1), 38–44.
Manson, S. M. (1992). Long-term care of older American Indians: Challenges in the development of institutional services. In C. Barresi & D. E. Stull (Eds.), Ethnicity and long-term care (pp. 130–143). New York: Springer.
Manson, S. M., Beals, J., Klein, S., Croy, C. D., & the AI-SUPERPFP team, (2005). The social epidemiology of trauma in two American Indian reservation populations. American Journal of Public Health, 95(5), 851–859.
Mattis, S. (1976). Mental status examination for organic mental syndrome in the elderly patient. In R. Bellack & B. Karasu (Eds.), Geriatric psychiatry (pp. 77–121). New York: Grune & Stratton.
Navaie-Waliser, M., Feldman, P. H., Gould, D. A., Levine, C., Kuerbis, A. N., & Donelan, K. (2001). The experiences and challenges of informal caregivers: common themes and differences among Whites, Blacks, and Hispanics. The Gerontologist, 41(6), 733–741.
Nolan, M., Grant, G., & Keady, J. (1996). Understanding family care. A multidimensional model of caring and coping. Buckingham: Open University Press.
Noonan, A., & Tennstedt, S. (1997). Meaning in caregiving and its contribution to caregiver well-being. The Gerontologist, 37(6), 785–794.
Pearlin, L., Mullan, J., Semple, S., & Skaff, M. (1990). Caregiving and the stress process: an overview of concepts and their measures. The Gerontologist, 30(5), 583–594.
Pinquart, M., & Sorensen, S. (2005). Ethnic differences in stressors, resources, and psychological outcomes of family caregiving: a meta-analysis. The Gerontologist, 45(1), 90–106.
Qualitative Solutions & Research. (2006). NUDIST Vivo 7 (NVivo 7) (Version 7). Melbourne: QSR International Pty Ltd.
Red Horse, J. G. (1980). Family structure and value orientation in American Indians. Social Casework: The Journal of Contemporary Social Work.
Red Horse, J. (1983). Indian family values and experiences. In G. J. Powell (Ed.), The psychosocial development of minority group children (pp. 258–271). New York: Brunner/Mazel.
Rozario, P. A., & DeRienzis, D. (2008). Familism beliefs and psychological distress among African American women caregivers. The Gerontologist, 48(6), 772–780.
Sales, E. (2003). Family burden and quality of life. Quality of Life Research, 12, 33–41.
Schulz, R., & Beach, S. R. (1999). Caregiving as a risk factor for mortality: the caregiver health effects study. JAMA, 282(23), 2215–2219.
Schulz, R., O'Brien, A. T., Bookwala, J., & Fleissner, K. (1995). Psychiatric and physical morbidity effects of dementia caregiving: prevalence, correlates, and causes. The Gerontologist, 36(6), 771–791.
Schulz, R., Burgio, L. D., Burns, R., Eisdorfer, C., Gallagher-Thompson, D., Gitlin, L. N., et al. (2003). Resources for enhancing Alzheimer's Caregiver Health (REACH): overview, site-specific outcomes, and future directions. The Gerontologist, 43(4), 514–520.
Schweitzer, M. M. (1999). Otoe-Missouria grandmothers: Linking past, present, and future. In M. M. Schweitzer (Ed.), American Indian grandmothers: Traditions and transitions (1st ed., pp. 159–180). Albuquerque: University of New Mexico Press.
Sherwood, P. R., Given, C. W., Given, B. A., & von Eye, A. (2005). Caregiver burden and depressive symptoms: analysis of common outcomes in caregivers of ederly patients. Journal of Aging and Health, 17(2), 125–147.
Spicer, P., Beals, J., Croy, C. D., Mitchell, C. M., Novins, D. K., Moore, L., et al. (2003). The prevalence of DSM-III-R alcohol dependence in two American Indian populations. Alcoholism, Clinical and Experimental Research, 27(11), 1785–1797.
Strauss, A., & Corbin, J. (1990). Basics of qualitative research: Grounded theory procedures and techniques. Newbury Park: Sage.
Tarlow, B. J., Wisniewski, S. R., Belle, S. H., Rubert, M., Ory, M. G., & Gallagher-Thompson, D. (2004). Positive aspects of caregiving: contributions of the REACH Project to the development of new measures for Alzheimer's caregiving. Research on Aging, 26(4), 429–453.
U.S. Census Bureau (2002). The American Indian and Alaska Native population: 2000, Census 2000 Brief.
U.S. Department of Health and Human Services, I. H. S. (1997). Indian health focus: Elders.
White, T. M., Townsend, A. L., & Stephens, M. A. P. (2000). Comparisons of African American and White women in the parent care role. The Gerontologist, 40(6), 718–728.
Zarit, S. H., Reever, K. E., & Bach-Peterson, J. (1980). Relatives of the impaired elderly: Correlates of feelings of burden. The Gerontologist, 20(6), 649–655.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Jervis, L.L., Boland, M.E. & Fickenscher, A. American Indian Family Caregivers’ Experiences with Helping Elders. J Cross Cult Gerontol 25, 355–369 (2010). https://doi.org/10.1007/s10823-010-9131-9
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10823-010-9131-9