Caregiving Abuelas: Mexican American Grandmothers’ Self-Management of T2DM while Caring for Grandchildren

Abstract

Purpose: The purpose of this study was to describe the perceptions of Mexican American grandmothers managing type 2 diabetes (T2DM) while caring for a grandchild. The author explored these women’s behaviors, barriers, facilitators, and perceived resources necessary when managing T2DM. With the T2DM crisis becoming increasingly prevalent in the Mexican American population, a clear understanding of experiences of caregiving grandmothers managing T2DM as traditional family nurturers is critically important. Background: Mexican Americans are more likely to be diagnosed with, suffer complications from, and die from T2DM than Non-Hispanic Whites. Older Mexican American women, often seen as the family nurturer, are likely to be managing this disease in the context of caring for a grandchild. Women in this role often report self-sacrificing behaviors, fatigue, and stress- but also fulfillment and a sense of purpose in the caregiving role. Methods: Eight Mexican American women managing T2DM for at least one year while regularly caring for grandchildren were interviewed in English and Spanish for this qualitative description study. Interviews were transcribed verbatim and analyzed using qualitative content analysis. Results: Three domains emerged under the overarching theme of T2DM Self-Management in the Context of Caring for Grandchildren: 1) T2DM Attitudes, Beliefs and Perceptions, 2) T2DM Self-Management Behaviors, and 3) T2DM Self-Management in the Family System. Grandmothers consistently reported feeling a personal responsibility for their T2DM self-management as well as for the health and wellbeing of their families, including their grandchildren. Conclusions: Mexican American grandmothers saw themselves as family caregivers while emphasizing personal ownership for their T2DM self-management. Fundamental motivators for T2DM self-management included grandchildren and other family members. This also extended into descriptions of behaviors reflecting a responsibility to prevent diabetes and promote health across generations. These grandmother’s descriptions of barriers, facilitators, perceived necessary resources, and the impact of grandchild caregiving on T2DM self-management fills a previous knowledge gap and the new valuable insights will guide tailoring T2DM self-management interventions for Mexican American grandfamilies.