Caregiving Across Cultures: Priority Areas for Research, Policy, and Practice to Support Family Caregivers of Older Asian Immigrants

Background: About 4.6 million older adults (aged 60 years and older) in the United States are foreign born, and Asian Americans are projected to become the largest immigrant group in the United States by 2055. Older Asian immigrants have to navigate new sociocultural contexts, including relationships with health care providers, dietary recommendations and adjustments, and care-seeking norms. They may also experience structural challenges, such as discrimination in the health care system because of race, ancestry, and language. These adults often require assistance from unpaid family caregivers (e.g., adult children)-with whom they are also likely to reside-to navigate these sociocultural complexities and barriers in the health care system. Yet, our understanding of the experiences and challenges of family caregivers of older Asian immigrants remains limited despite their unique circumstances as children of immigrants who are simultaneously balancing and navigating multiple cultural identities of their own while often being viewed as perpetual foreigners or outsiders to US culture. Immigration history and experiences likely also influence the use of formal services. Minority family caregivers are less likely than White caregivers to use formal support services (e.g., mental health treatment), suggesting that they may face additional burdens and barriers in the process of supporting their older relative in the health care system. Identifying ways to better support family caregivers as they care for their immigrant older relatives is critical for promoting inclusion in the health care system. This requires concerted research on Asian American caregivers and their experiences and challenges in their role supporting older relatives with household, daily functioning, and health care activities as well as navigating sociocultural aspects of care. It also requires recognition and consideration of the diversity of experiences and challenges faced by Asian American families, including heterogenous Asian ethnic subgroups with distinct cultures, languages, needs, and preferences.