"I lay awake at night": Latino Family Caregivers' Experiences Covering Out-of-Pocket Costs when Caring for Someone Living with Dementia.

BACKGROUND AND OBJECTIVES: The financial burden of caregiving has received less research attention than physical and emotional costs. This is especially true for underserved ethnic minorities. Financial strain affects mental and physical health and is unequally distributed across caregivers of different races and ethnicities. While caregivers overall spend, on average, one-quarter of their income on caregiving, Latino caregivers, the focus of this study, spend nearly half.

RESEARCH DESIGN AND METHODS: To better understand this disparity, we conducted eleven qualitative interviews with fourteen Latino caregivers of persons living with dementia located in either California or Texas. Interview transcripts were thematically coded, guided by a material-psychosocial-behavioral conceptual model of financial strain.

RESULTS: We identified three themes: daily needs and costs, psychological distress caused by financial issues, and stressful barriers accessing family and societal support. Further, interviews revealed how Latino culture may influence spending patterns and management of costs. Findings suggest that preference by Latino families to care for a family member in the home may be met with financial disadvantage due to the high out-of-pocket costs of care.

DISCUSSION AND IMPLICATIONS: A better understanding of the factors contributing to high costs for Latino caregivers and how these costs affect caregivers will inform approaches at both the individual- and policy-levels and develop culturally relevant interventions to help Latino families to lower caregiving costs. This is especially important as the number of Latinos living with dementia is expected to increase over the next four decades and effective interventions are lacking.