Asian-Americans and Senior Caregiving: Challenges and Solutions

In our local communities, Asian-Americans represent a growing portion of the population. This population is one that faces significant challenges when it comes to aging and caregiving.

Asian-American immigrant families tend to be smaller, with a less extensive support network of relatives. Language barriers are also frequently an issue, and adult children often assume the role of interpreters or translators for parents who are attempting to navigate the medical or social service systems.

Studies have shown that Asian-American caregivers tend to make less use of professional support services than other groups. This finding may be due, at least in part, to cultural expectations of inter-generational caregiving. It is considered an honored duty to care for one’s parents or grandparents in most Asian cultures, an expectation born out by the numbers; e.g., Asian-American caregivers are more likely to live in the same home as the person they care for (35%, as opposed to 19% of white caregivers).

Small support networks, language barriers, and strong cultural admonitions can combine to make caregiving particularly challenging for families of older Asian-Americans.

And the challenge is growing, as the number of older adults of Asian, Hawaiian, or Pacific Islanders origin in the U.S. increases. Less than one million Asian-Americans were aged 65 and above in 2000, according to the Administration on Aging. By 2020, that number is expected to grow to 2.5 million.

To improve the caregiving arena for special populations such as Asian-Americans, there basically two ways in which the healthcare or social services field can respond:

1. Mainstream providers can adapt services to address special populations; e.g., add bilingual workers, train workers in cultural sensitivity and awareness, utilize translators, provide written materials in native tongues, etc.

2. Parallel services can be developed for the target population, with all services specifically tailored toward this group and the target population primarily represented in staff and leadership.

Either method can work. The first method is less expensive, and the latter has the potential to be more effective.

One excellent example of the first method is Net of Care, a service of Beth Israel University Hospital in New York. It has issued a very thorough handbook for caregivers and care recipients that is targeted specifically toward Chinese Americans. Not only is the handbook written in both Chinese and English, but it addresses relevant cultural issues in seeking healthcare services. You can find a PDF of the handbook on the Net of Care website.

For a great example of the second approach to care, we need look no further than our own backyard. Self-Help for the Elderly is a multi-service organization that was begun in San Francisco’s Chinatown district in the 1960s. Almost 50 years later, it has expanded to serve over 35,000 seniors each year in not only San Francisco, but Alameda, San Mateo, and Santa Clara counties. The program has also expanded beyond the Chinese community to serve other groups such as Vietnamese, Koreans, and other Asian-Americans.

Self-Help for the Elderly operates a broad range of sites and services, from training and employment services to residential care facilities. While many of its services are typical components of the elder services continuum, others address the specific needs of the population it serves.

For example, a naturalization program offers citizenship and civics classes as well as individual assistance with citizenship applications. Its Fun and Wellness Program provides many culturally relevant activities, such as Luk Tung Kuen, Tai Chi, calligraphy, and Chinese opera classes. Self-Help for the Elderly also participates in a Broadband Technology Opportunity Program and teaches computer and internet skills to a group of seniors who are a great risk for social isolation.

For those of us who work with families in culturally diverse areas, it is always worthwhile to remind ourselves of the importance of being culturally accessible to those who need services. And for those very families, it should be encouraging to know that a growing number of programs throughout the country are targeting their unique needs as they provide services.