The health experiences of Black family caregivers of persons with dementia: An integrative review.

Background

Family caregivers of persons with dementia experience caregiving-related stress within distinct social, cultural, and health contexts; however, limited attention has been given to the specific health needs of Black family caregivers.

Methods

An integrative review guided by the Whittemore and Knafl methodology was conducted to synthesize existing literature on Black family caregiver health and identify touchpoints for intervention and future research. A team of six reviewers identified 97 peer-reviewed, English-language studies through searches of PubMed, CINAHL, PsycInfo, AgeLine, Sociological Abstracts, and Scopus. The Roy Adaptation Model was used to organize and interpret findings.

Results

The literature primarily emphasized psychosocial outcomes, including depression, stress, burden, and coping. Black caregivers generally reported low to moderate depressive symptoms, high levels of positive reappraisal, and strong social support. Physical health outcomes were less frequently examined and were primarily self-reported; however, available evidence suggested elevated cardiovascular risk, including hypertension, and impaired physiological stress recovery as measured by cortisol. Measures of role strain and burden were common, while constructs central to adaptation, such as role mastery and role expectations, were infrequently assessed.

Discussion

Findings suggest a discrepancy between caregivers' self-reported health and more objective indicators of physical health risk. Greater conceptual clarity and increased use of objective physical health measures are needed to inform inclusive interventions aimed at improving the health of Black family caregivers.