A GRIEF SUPPORT GROUP FOR OLDER LATINAS:

A GRANT PROPOSAL

Nancy Gonzalez-ProutyCalifornia State University, Long Beach

May 2013

INTRODUCTION• A prevalence of mental health disorders among Mexican Americans was estimated

to affect 34 percent of the Latino community (Aguilar-Gaxiola, et al., 2002).

• The presence of mental health disorders is largely due to many older Latino/as’ non-willingness to display outward emotional expression of grief with those outside the immediate community (Zebracki & Stancin, 2007).

• Older Latinas were also found to rarely have access to culturally appropriate mental health and bereavement support services (Schoulte, 2011).

• Barriers to accessible mental health services, such as bereavement support, were due to a lack of culturally-relevant support throughout the mental health system as well as a lack of Spanish-speaking service providers (Jolicoeur & Madden, 2002).

• Bereavement support for older Latinas, conducted in a culturally-relevant support group, can help foster resilience, growth and serve as a valuable and alternative way to help individuals process their grief (Boyraz, Horne, & Sayger, 2012).

• Presenting culturally-relevant grief support programming, with a psycho-educational framework, that promotes individual resilience and growth, could prove to be a valuable asset for positive coping in older Latinas (Hardy-Bougere, 2008; Miranda, et al, 2003).

SOCIAL WORK RELEVANCE

• Bereavement support for older Latinas, conducted in a culturally-relevant support group, can help foster resilience, growth and serve as a valuable and alternative way to help individuals process their grief (Boyraz, Horne, & Sayger, 2012).

• A psycho-educational model and the inter-connectedness with peers in a support group setting can help facilitate the grief of loss and promote personal growth (Boyraz et. al, 2012; Ussher, Perz, Hawkins & Brack, 2009; Blevins, 2008; Davis, Nolen-Hoeksama & Larson, 1998).

• Promoting resilience also provides a cognitive restructuring of the loss to help survivors experience positive outcomes, such as a greater spiritual awareness and positive life reappraisal (Sondergren & Hyland, 2000).

CROSS-CULTURAL RELEVANCE

• The way individuals understand and cope with the death of a loved one is dependent on their cultural and ethnic values and beliefs (Clements, et. al, 2003).

• This project has the ability to promote culturally competent service programs and address the cultural nuances of older Latinas related to death and loss, in order to facilitate their grief in a culturally-relevant way.

• By addressing grief and also recognizing cultural beliefs and practices, social work practitioners can aid clients from culturally diverse backgrounds to promote personal strengths and positive coping strategies (Bonnano, 2004).

METHODSTARGET POPULATION:

• Latino/Hispanic individuals constitute 16.7 percent of the total U.S. population & it continues to climb (United States Census Bureau, 2010).

• However, a prevalence of mental health disorders among Mexican Americans was estimated to affect 34 percent of the entire community (Aguilar-Gaxiola, et al., 2002).

FUNDING SOURCE:

• The California Wellness Foundation (TCWF) was selected for funding because the criteria, field of interest, and mission were compatible with the goals of the older Latina grief group.

• TCWF is a private, independent foundation located in Woodland Hills, California. TCWF provides funding to support non-profit community agencies with a goal of improving the health of overall well-being of underserved communities. Since 1992, the foundation has awarded more than 5,900 grants totaling more than $800 million to programs that support TCWF’s mission and goals.

SOURCES USED FOR THE NEEDS ASSESSMENT:

• The proposal for an older Latina support group is based on the target needs of the growing Latino community of Los Angeles, CA.  The needs for the proposed program were assessed through information put forth by national and state hospice organization websites, such as the National Hospice and Palliative Care Organization (nhpco.org) and the California Hospice and Palliative Care Association (chapa.org).

PROJECTED BUDGET:

• The proposed program will cost $21,426.80 for 4 support groups This includes a one year budget for personnal, supplies, transportation.

• In-Kind services such as a facility and meeting space allow for a $16,800.00 savings per year.

METHODS CONTINUED…

The overarching goal of this proposed project is to develop a culturally-relevant support group for grieving Latinas to promote positive coping skills, awareness, and utilization of mental health services. The purpose of this project was to write a grant and seek potential funding for a grief support program that can support older Latinas by encouraging resilience and growth.

POPULATION SERVED:

• Culturally-relevant support groups will be facilitated for older Latina women, age 65 and older who have have lost a loved one 6 months

• Providing a supportive setting for older Latinas to grieve, develop relationships with peers, and promote positive coping, can help nurture resilience, and increase community mental health linkages to a group known for disparities in mental health and utilization.

GRANT PROPOSAL

GRANT PROPOSAL CONTINUED...• PROGRAM OBJECTIVES:

• Objective One: Upon successful completion of the 8-week, older Latina grief group 80% of the group members will be able to identify at least three positive coping skills they gained in group. In addition, 80% of the group members will express a sense of future orientation and hope with resilience as reflected in their responses at the last group assessment.

• Objective Two: This proposed program will provide a supportive environment throughout the group experience. In doing so, it is estimated that 90% of the older Latina women attending this group will be able to articulate their feelings about their loss and share their feelings in the context of the safe group environment. Further it is estimated that 100% of the attendees will receive the names and contact information of other group participants for emotional support after the group concludes.

• Objective Three: After 8-weeks, 80 % of group members will be able to identify three mental health resources in their community.

• EVALUATION: Group participants have the option to complete a short journal entry each group session. A pre and post evaluation will also be conducted at the time of the first group meeting and the last group session. One month after the group concluded, the group facilitator will contact each participant via telephone, to assess how the individual is coping since the the group ended. The follow up call will help the facilitator assess and identify new support systems and the life application of information gained during group.

LESSONS LEARNED:

• A lack of research on bereavement support specifically for older Latinas suggests that little is still known within the mental health community about the experiences and outcomes of older Latina women and their style for coping (Arriaza, Martin, & Csikai, 2011). Due to limited access and availability of community-based grief support programming, more evidence-based research is necessary to address the growing need for culturally-relevant support in the Latino community.

• The ability to identify and assess individual resilience is subjective and lacks measurement. more research is needed for assessing resilience and post-traumatic growth with older adults of color.

• Utilizing an agency or organization within the community, that has an existing relationship with the older Latino/as, is crucial so that mental health professionals may building connections and trust with individuals who are grieving.

SOCIAL WORK IMPLICATIONS:

• Program models, such as the one proposed by the grant writer, can promote better access to older Latinos and their families to help them grow and find hope after a traumatic loss.

• Implementing bereavement support models that reflect the needs of older Latinas, mental health professionals can demystify cultural myths about grief and promote hope and strength to a community that lacks support and knowledge of grief.

DISCUSSION

• Aguilar-Gaxiola, S.A., M.D., Ph.D., Zelezny, L., Ph.D., Garcia, B., Ph.D., Edmondson, C., Ph.D., Alejo-Garcia, C., B.A., Vega, W.A., Ph.D., (2002). Translating Research Into Action: Reducing Disparities in Mental Health Care for Mexican American, Psychiatric Services, 53(12), 1563-1568.

• Arriaza, P., Martin, S.S., & Csikai, E.L., (2011). An Assessment of Hospice Bereavement Programs for Hispanics, Journal of Social Work in End-Of-Life & Palliative Care, 7, 121-138.

• Blevins, S. (2008). A Personal Journey through the Grief and Healing Process with Virginia Satir, Dr. E. Kubler-Ross, and J. William Worden. Satir Journal, 2(2), 89-105.

• Bonanno, G.A., (2004). Loss, Trauma, and Human Resilience. Have we Underestimated the Human Capacity to Thrive After Extremely Aversive Events?, American Psychologist, 59(1), 20-28

• Boyraz, G., Horne, S., & Sayger, T., (2012). Finding Meaning in Loss: The Mediating Role of Social Support Between Personality and two Construals of Meaning, Death Studies, 36, 519-540.

• Clements, P.T., Vigil, G.J., Manno, M.S., Henry, G.C., Wilks, J., Das, S., Kellywood, R., & Foster, W., (2003). Cultural Perspectives of Death, Grief, and Bereavement, Journal of Psychosocial Nursing, 41(7), 18-26.

• Davis, C. G., Nolen-Hoeksema, S., & Larson, J. (1998). Making sense of loss and benefiting from the experience. Journal of Personality and Social Psychology, 75, 561-574.

• Hardy-Bougere, M., MSN, RN (2008). Cultural Manifestations of Grief and Bereavement: A Clinical Perspective, Journal of Cultural Diversity, 15(2), 66-69.

• Jolicoeur, P.M., Madden, T., (2002). The good daughters: Acculturation and caregiving among Mexican-American women, Journal of Aging Studies, 16, 107-120.

• Miranda, J., Duan, N., Sherbourne research literature. Health Psychology Review, 3(1), 85-107.

REFERENCES

• Schoenbaum, M., Lagomasino, I., Jackson-Triche, M., & Wells, K. B. (2003). Improving Care for Minorities: Can Quality Improvement Interventions Improve Care and Outcomes For Depressed Minorities? Results of a Randomized, Controlled Trial. Health Services Research, 38(2), 613-630.

• Schoulte, J.C., (2011). Bereavement Among African Americans and Latino/a Americans, Journal of Mental Health Counseling, 33(1), 11-20.

• Sodergren, Hyland, Crawford, & Partridge, (2004). Positivity in illness: self-delusion or existential growth?. British Journal Of Health Psychology, 9(Pt 2), 163-174.

• United States Census Bureau. (2010). State and County QuickFacts.

• Ussher, J., Perez, J., Hawkins, Y., & Brack, M. (2009). Evaluating the efficacy of psycho-social interventions for informal carers of cancer patients: a systematic review of the research literature. Health Psychology Review, 3(1), 85-107.

• Zebracki, K., & Stancin, T. (2007). Cultural Considerations in Facilitating Coping to a Father's Illness and Bereavement in a Latino Child. Clinical Case Studies, 6(1), 3-16. C.,

REFERENCES CONTINUED...