Empowering African American Women Informal Caregivers: A Literature Synthesis and Practice Strategies‪.‬

Informal caregivers are people who provide unpaid care for elderly people in the home, involving much time and energy for long periods and requiring assistance with tasks that may be physically, emotionally, socially, or financially challenging (Biegel, Sales, & Schulz, 1991). Most informal caregivers are women--primarily family members (National Alliance for Caregiving & American Association of Retired Persons [AARP], 1997; Older Women's League, 2001). Elderly African Americans rely heavily on the informal system of care (Chadiha, Proctor, Morrow-Howell, Darkwa, & Dore, 1995; Stommel, Given, & Given, 1998). African American women caregivers, under demanding circumstances of social, economic, and health challenges, demonstrate strengths through strong coping abilities in providing care to elderly African Americans (see reviews by Dilworth-Anderson, Williams, & Gibson, 2002, and Janevic & Connell, 2001). Yet, being able to cope does not mean that these women are also able to transform stressful caregiving situations into positive change. Power is the ability to access and influence control over resources to improve deleterious environmental conditions (Lee, 2001). Caregiving can be gratifying (Kramer, 1997; Miller & Lawton, 1997). African American caregivers report high rewards and low burden in caring for elderly African Americans (Knight, Silverstein, McCallum, & Fox, 2000; Picot, 1995; Picot, Debanne, Namazi, & Wykle, 1997). These reports of high rewards and low burden are a testament to the personal strengths of African American women as a resource in caregiving. However, literature suggests the personal gains that caregivers receive may be insufficient to offset the economic, social, and psychological costs of caregiving (Arno, Levine, & Memmott, 1999). Informal caregiving, according to Arno and colleagues, may not only strain individual and family resources of the caregiver, but also may increase the caregiver's risk poor health, family destabilization, and impoverishment. Research indicates that caregiving is a known risk factor for women's hypertension, mortality, low immunity levels, and low levels of physical activity (Grason, Minkovitz, Misra, & Strobino, 2001). Unemployed caregivers run the risk of being uninsured and losing income and social insurance benefits (Arno et al., 1999). Strained resources, poverty, lack of health insurance, lost income, and poor health may also contribute to caregivers' feelings of low self-efficacy and potential powerlessness.