Examining Utilization of Formal Supports and Related Impacts on Overall Well-Being Among East Asian American Family Caregivers of Persons With Dementia: A Mixed-Methods Study

Overview

Journal Gerontologist

Publisher Oxford University Press

Specialty Geriatrics

Date 2023 Jul 3

PMID 37394998

Authors

Kathy Lee

Jessica Cassidy

Jihui Lee

Chang Hyun Seo

Alan Kunz Lomelin

Hye-Won Shin

Joshua D Grill

Affiliations

Soon will be listed here.

Abstract

Background And Objectives: Although East Asian American family caregivers are known to underutilize formal support services, there is a lack of evidence regarding the associations of formal service utilization with caregivers' well-being. This study examined the prevalence of different types of home-and community-based formal service utilization among Korean and Chinese American family caregivers of persons with dementia and how utilization of such services was associated with their well-being. We also explored their overall experience in accessing and utilizing formal dementia support services and programs.

Research Design And Methods: We employed a convergent mixed-methods study design. In a convenience sampling method, we recruited 62 family caregivers. Logistic regression and thematic analysis were utilized to analyze data.

Results: The results showed in-home services were mostly utilized among family caregivers of these ethnic groups. Out of 9 different support services, those who utilized nutrition programs and case management were more likely to report higher overall well-being. Four themes were developed: (1) awareness of formal support services but uncertainty on how to access them, (2) language barriers imposing additional challenges in accessing formal support services, (3) traveling to access culturally appropriate services, and (4) desire for culturally tailored medical and long-term care services.

Discussion And Implications: Findings from this study suggest the importance of case management services to overcome barriers to accessing and utilizing a wide range of formal support services and provision of culturally appropriate food in formal support services to increase East Asian American family caregivers' utilization of long-term care services.

References

Liu J, Lou Y, Wu B, Mui A . "I've been always strong to conquer any suffering:" challenges and resilience of Chinese American dementia caregivers in a life course perspective. Aging Ment Health. 2020; 25(9):1716-1724. PMC: 7855650. DOI: 10.1080/13607863.2020.1793900. View

Liu C, Badana A, Burgdorf J, Fabius C, Roth D, Haley W . Systematic Review and Meta-Analysis of Racial and Ethnic Differences in Dementia Caregivers' Well-Being. Gerontologist. 2020; 61(5):e228-e243. PMC: 8276619. DOI: 10.1093/geront/gnaa028. View

Han H, Choi Y, Kim M, Lee J, Kim K . Experiences and challenges of informal caregiving for Korean immigrants. J Adv Nurs. 2008; 63(5):517-26. PMC: 2861280. DOI: 10.1111/j.1365-2648.2008.04746.x. View

Jang Y, Kim G, Chiriboga D . Knowledge of Alzheimer's disease, feelings of shame, and awareness of services among Korean American elders. J Aging Health. 2010; 22(4):419-33. PMC: 2882867. DOI: 10.1177/0898264309360672. View

Cheng S, Lam L, Chan L, Law A, Fung A, Chan W . The effects of exposure to scenarios about dementia on stigma and attitudes toward dementia care in a Chinese community. Int Psychogeriatr. 2011; 23(9):1433-41. DOI: 10.1017/S1041610211000834. View

Kim H, Kehoe P, Gibbs L, Lee J . Caregiving Experience of Dementia among Korean American Family Caregivers. Issues Ment Health Nurs. 2019; 40(2):158-165. PMC: 6445682. DOI: 10.1080/01612840.2018.1534909. View

Wolf Z . Exploring the audit trail for qualitative investigations. Nurse Educ. 2003; 28(4):175-8. DOI: 10.1097/00006223-200307000-00008. View

Andersen R . Revisiting the behavioral model and access to medical care: does it matter?. J Health Soc Behav. 1995; 36(1):1-10. View

Lee S, Hong M, Casado B . Examining public stigma of Alzheimer's disease and its correlates among Korean Americans. Dementia (London). 2020; 20(3):952-966. DOI: 10.1177/1471301220918328. View

10.

June K, Lee J, Yoon J . [Effects of case management using Resident Assessment Instrument-Home Care (RAI-HC) in home health services for older people]. J Korean Acad Nurs. 2009; 39(3):366-75. DOI: 10.4040/jkan.2009.39.3.366. View

11.

Liu J, Lou Y, Cheung E, Wu B . Use of tangible, educational and psychological support services among Chinese American dementia caregivers. Dementia (London). 2022; 21(6):1914-1932. PMC: 10123869. DOI: 10.1177/14713012221099781. View

12.

Richardson V, Fields N, Won S, Bradley E, Gibson A, Rivera G . At the intersection of culture: Ethnically diverse dementia caregivers' service use. Dementia (London). 2017; 18(5):1790-1809. DOI: 10.1177/1471301217721304. View

13.

Robinson K, Buckwalter K, Reed D . Differences between dementia caregivers who are users and nonusers of community services. Public Health Nurs. 2014; 30(6):501-10. DOI: 10.1111/phn.12041. View

14.

Dilworth-Anderson P, Moon H, Aranda M . Dementia Caregiving Research: Expanding and Reframing the Lens of Diversity, Inclusivity, and Intersectionality. Gerontologist. 2020; 60(5):797-805. PMC: 7362616. DOI: 10.1093/geront/gnaa050. View

15.

Ta Park V, Grill J, Zhu J, Nguyen K, Nam B, Tsoh J . Asian Americans and Pacific Islanders' perspectives on participating in the CARE recruitment research registry for Alzheimer's disease and related dementias, aging, and caregiving research. Alzheimers Dement (N Y). 2021; 7(1):e12195. PMC: 8288079. DOI: 10.1002/trc2.12195. View

16.

Tang M . Can cultural values help explain the positive aspects of caregiving among Chinese American caregivers?. J Gerontol Soc Work. 2011; 54(6):551-69. DOI: 10.1080/01634372.2011.567323. View

17.

Pinquart M, Sorensen S . Ethnic differences in stressors, resources, and psychological outcomes of family caregiving: a meta-analysis. Gerontologist. 2005; 45(1):90-106. DOI: 10.1093/geront/45.1.90. View

18.

Sun A, Bui Q, Tsoh J, Gildengorin G, Chan J, Cheng J . Efficacy of a Church-Based, Culturally Tailored Program to Promote Completion of Advance Directives Among Asian Americans. J Immigr Minor Health. 2016; 19(2):381-391. PMC: 5074907. DOI: 10.1007/s10903-016-0365-7. View