Preference Importance Ratings among African American and White Nursing Home Residents.

OBJECTIVES: The Preferences for Everyday Living Inventory (PELI-NH) assesses psychosocial preferences of nursing home (NH) residents. This study explored the association of race with importance ratings of self-dominion preferences (i.e., preferences for control). METHODS: PELI-NH interviews were conducted with 250 NH residents. Tests of mean differences compared African American (n = 57) and White (n = 193) residents on demographic (age, gender, education, length of stay) and clinical attributes (self-rated health, depressive symptoms, anxiety, functional limitations, hearing, vision, cognition). Stepwise multiple regression accounted first for associations of demographic and clinical attributes then for the unique association of race with total importance of self-dominion preferences to determine whether African American and White residents differ. For between group demographic/clinical differences, interaction effects were tested. RESULTS: African Americans were younger and more functionally impaired. After accounting for the effects of gender (female), age (younger), anxiety (greater), and functional impairment (less) with higher reports of importance of self-dominion preferences, race was significant. There were no significant moderating effects. CONCLUSIONS: African American residents reported greater importance of self-dominion preferences than Whites. CLINICAL IMPLICATIONS: Cultural sensitivity is critical; it may be more important to provide opportunities for autonomous decision-making for African American than for White residents.

What Matters Most? Intersectional Correlates of Caregiver Burdens.

Increasing numbers of older adults require caregiver support from unpaid caregivers. Yet, there is limited research on caregiver burden type and interactions across race, gender, and other sociodemographic characteristics. This quantitative study uses an intersectional framework to examine associations between caregiving burden and sociodemographic factors. Using survey data from the National Survey of Caregiving the sample included unpaid caregivers (N = 1304) of older adult (65+) Medicare beneficiaries. Binary logistic regression analysis revealed that over 40% of the respondents reported emotional difficulties. Correlates to emotional difficulties included race, gender, age, and income with an age by income interaction. For physical difficulties, gender, age, work, and education mattered most, with an age by education interaction. Age and income predicted financial difficulties without interactions. Findings suggest that policymakers target emotional and physical difficulties, attend to age and socioeconomic status, and address the unique challenges faced in midlife by caregivers.