A Systematic Review of Mexican American Elders With Type-2 Diabetes Under Family Care of Medication Administration in Borderland - A Systematic Review of Mexican American Elders With Type-2 Diabetes Under Family Care of Medication Administration in Borderland - Open Access Pub

The prevalence of type-2 diabetes (T2DM) among Mexican-American older adults along the U.S.-Mexico border region is at epidemic proportions. Healthcare reform is trending toward long-term home-based management of chronic conditions. Under the Mexican cultural norm of familism, daily care for elders is also often provided by family caregivers whose competence levels may vary. Adherence to the prescribed medication regimen is critical to attainment of optimal glucose control. However, there is a startling lack of literature that addresses the link between family medication administration and care recipients’ health outcome. This paper explores the role of culture in medication administration by family caregivers of elders with T2DM from the perspective of caregiver capabilities and caregiving demands. A critical review of the literature offers suggestions to guide future studies. DOI10.14302/issn.2474-7785.jarh-16-1350 Mexican Americans are twice as likely to develop type-2 Diabetes (T2DM) as non-Hispanic Whites.1 In Texas, 34.8% of Hispanics 65 or older suffer from T2DM versus 17.0% of their non-Hispanic White counterpart.2 T2DM is exceedingly prevalent along the U.S.-Mexico border, where 1.2 million people bear the burden of T2DM and its related co-morbidities,3 ranking it the fifth leading cause of death in El Paso County.4 Despite technologic and pharmacologic advances, individuals with T2DM at age 50 years still have a life expectancy 8.5 years shorter than their counterparts without diabetes.5 Diet, physical activity, and medication have long been recognized as the three major strategies for diabetes management.1 While there is a great deal of literature on diet and physical activity assisted by families, there is virtually no research linking family care of medication administration to effects on glucose control outcomes in individuals with T2DM. Thus, the purpose of this review is to propose key variables in family medication administration for Mexican American older adults with T2DM through the lens of the Family Adjustment and Adaptation Response Model (FAAR)6 and propose future studies taking cultural home-based chronic care into consideration. Culture and Family Caregiving Mexican Americans highly value the family care for older adults. Caregiving is likely to take place within the cultural context of familism, in which family members may be trusted as caretakers. Among Mexican Americans this translates into a likelihood of the caregiver being a younger female family member, usually a daughter or daughter-in-law. 7, 8 The older adult may