Original ArticleFactors Influencing Appraisal of Upset in Black Caregivers of Persons With Alzheimer Disease and Related DementiasToth-Cohen, Susan PhD, OTR/LAuthor Information From the Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, PA. Received for publication November 11, 2003; accepted July 12, 2004. Supported by funds from the Geriatric Leadership Award, principal Investigator, Dr. Laura Gitlin, funded by the National Institute on Aging Grant #5 K07 AG00998. Reprints: Susan Toth-Cohen, PhD, OTR/L, Department of Occupational Therapy, Thomas Jefferson University, 130 South Ninth Street, Edison Suite 810, Philadelphia, PA 19107 (e-mail: email@example.com). Alzheimer Disease & Associated Disorders: October-November-December 2004 - Volume 18 - Issue 4 - p 247-255 Buy Abstract Black caregivers of persons with Alzheimer disease and related dementias (ADRD) have demonstrated significantly lower levels of stress and burden than white caregivers, as measured by instruments that assess caregiving burden and stressfulness of specific problem behaviors. However, the reasons for reported differences are unclear and cannot be attributed solely to race. This descriptive study used content analysis to compare black caregivers' descriptions and interpretations of responses to memory and behavioral issues of relatives with ADRD to 11 explanations for lower levels of upset proposed in the caregiving literature. Findings confirmed only two explanations from the literature, social support and religious orientation, as factors that influenced appraisal of upset. Two new themes emerged, categorized as Making Sense and Using Strategies, as explanatory frameworks. Findings extend current knowledge of black caregivers' emotional responses to caregiving and support the need for future study of the ways in which particular ethnic and racial groups experience caregiving. Understanding the meaning of appraisals may enable service providers and program developers to tailor services and interventions to support the efforts of black and other minority caregivers. © 2004 Lippincott Williams & Wilkins, Inc.