Caregivers' Culture of Care

Chinese Americans are the fastest growing minority group in the United States. Their cultural belief of filial obligation–the sense of responsibility to respect and care for aging parents–is the most predominant cultural value relating to their caregiving experience. In a recent study published in the Journal of the American Geriatrics Society, we examined the influence of having a strong sense of filial obligation on Chinese-American caregivers’ caregiving burdens and how adapting to Western culture affects their experience.

Based on survey data from 393 Chinese adult immigrants in Chicago who were primary caregivers of parents aged 60 years or older, we found that adhering to the traditional family norm of filial obligation had a protective effect on Chinese immigrants’ developmental, emotional, social, and physical caregiving burdens. For these caregivers who are confronted with different family norms, the sense of filial obligation may represent the ethnic identity and traditional values that many of them strive to maintain. Embracing this traditional norm may thus provide these immigrants with a clear expectation and sense of acceptance about their caregiving responsibilities. It may also sustain them with psychological endurance that is needed in daily tasks of caregiving.

Community programs for immigrant caregivers could focus on celebrating their cultural heritage, which may help improve the well-being of these immigrant caregivers.

In addition, we found that such a protective effect seems to be particularly salient among immigrants who have lower levels of acculturation, indicated by low English proficiency or lack of social engagement in the host society. However, among immigrant caregivers with higher levels of acculturation, holding a strong sense of filial piety was actually associated with more objective burdens relating to time and physical burden.

We speculated that more acculturated caregivers may be more likely to perform tasks out of necessity or demand instead of personal belief compared to less acculturated caregivers. There might be a greater sense of reluctance or lack of control among acculturated caregivers when they provided care. Thus, the more obligated they feel, the more burden these caregivers may have relating to physical health and time constraint.

Overall, we found that, although filial obligation has a protective effect on the caregiving experience of Chinese-American immigrants, endorsing this traditional norm may have a negative effect on caregiving experience of highly acculturated immigrants. For health care providers working with older immigrants, it is important to understand the variance of their acculturation background and thus caregiving experience. Community programs for immigrant caregivers could focus on celebrating their cultural heritage, which may help improve the well-being of these immigrant caregivers. Intervention programs should also be designed to help immigrant caregivers find the most optimal way to balance traditional and new social norms, which in turn will enhance successful care to the rapidly increasing aging immigrant populations.

Photo by LS d’Avalonia on Unsplash