Asian American Elder Caregiving Experiences: Realities of Immigrant and Refugee Populations

Overview: Despite older adults’ population growth, studies on Asian American (AA) elder caregivers remain underrepresented. This study explored the elder caregiving realities in AA communities, examined the prevalence, health, and caregiving characteristics of AA caregivers, and compared the experiences of AA caregivers to non-caregivers and caregivers in other racial/ethnic groups.Proposal text:

Background: Asian Americans (AAs) including AA older adults (65+ years) are the fastest-growing racial group in the U.S. (Jones, 2021). Many AAs (59%) and older AAs (66%) are foreign-born immigrants and refugees from 50+ countries speaking 100 different languages (Budiman, 2019). Despite these growths, studies on AAs remain scarce (AARP, 2014). Though heterogeneous, AAs share common cultures such as collectivism, intergenerational relationships, and elder caregiving. Thus, multigeneration households are common in Asian countries (Miyawaki, 2015). However, due to the new living environment in the U.S., it is important to explore the elder caregiving realities in AA communities so that they can provide appropriate care to their families. As baseline knowledge, we assessed the prevalence, health, and caregiving characteristics of AA caregivers and compared the experiences of AA caregivers, non-caregivers, and caregivers in other racial/ethnic groups.

Methods: Data from the 2015-2019 Behavioral Risk Factor Surveillance System Caregiver Module from 44 states, the DC, and Puerto Rico were used (Nf252,602). We classified elder caregivers as those who had provided assistance to a parent/parent-in-law or grandparent with a long-term illness/disability during the past 30 days and excluded caregivers for children and friends. We examined sociodemographic, caregiving-, and health-related variables and used Chi-square tests to compare among AAs, American Indian/Alaska Native (AIAN), Black, Hispanic, and white caregivers.

Results: Of the 4,564 AAs, 4.1% were elder caregivers (n=321) and non-caregivers (n=4,243). Most caregivers were younger ( < 45 years)(68%), single (56%), employed (65%), and male (60%) with a college education (84%). Over 86% reported excellent/very good/good health but 38% had one+ chronic condition. Compared to AA non-caregivers, caregivers were more often unmarried and had more chronic conditions. AA caregivers most frequently assisted a parent/parent-in-law (73%). They had provided care for < 2 years (55%) and < 20 hours/week (77%) assisting with personal care (53%) and household tasks (78%). The prevalence of elder caregiving was higher among adults in other racial/ethnic groups than among AAs (ranging from Hispanic (8.3%) to AIAN (14.8%), p < 0.001). Nonetheless, the characteristics of the caregiving experiences were generally similar across all racial/ethnic groups.

Conclusions: We found that AA caregivers served less frequently than caregivers in other racial/ethnic groups. Due to AA’s elder caregiving culture, this finding was surprising. It could be that because elder caregiving is expected, AAs did not identify themselves as caregivers (Miyawaki, 2017, 2020). The data collection was conducted in English or Spanish but 59% of AAs are immigrants with limited English proficiency (44%)(Radford, 2019). Foreign-born AA immigrants and refugees may not have participated in the survey, and thus this sample may not reflect the full picture of AA caregivers. The strengths of this study included the use of AA elder caregivers, a rarely-studied sample, and the comparison with non-caregivers and other racial/ethnic groups of caregivers across the nation. However, in order to be inclusive and hear the voices of AA immigrants and refugees, we need to disaggregate data for each AA ethnic group and administer surveys in other languages tailoring to the needs of all AA populations.