Family Caregiving among Chinese American Caregivers of Older Dependent Relatives

Purpose: The purpose of this study was to increase the state of current knowledge about the caregiving experiences of family caregivers who are providing care to their older relatives. Existing caregiving research has primarily focused on non-Hispanic White caregivers. This study expands the limited amount of research findings available on Chinese American caregivers on a wide range of measures, including caregiver characteristics, stressors, cultural values, informal support, and caregiving outcomes. Two research questions were examined in this study: 1) Do cultural values predict caregiving outcomes (caregiver burden and positive aspects of caregiving)? 2) Does informal support predict caregiving outcomes?

Methods: Data were collected over a six-month period through face-to-face interviews with 113 Chinese American caregivers of elderly relatives in the San Francisco Bay Area. This cross-sectional study used a snowball sample method. The recruitment methods included referrals through newspaper outlet, memory disorder centers, adult daycare centers, caregiver support groups, senior centers, senior housing apartments, and local churches; and referrals by other caregivers.

Data were collected with the combination of a socio-demographic questionnaire and a number of valid and reliable standardized instruments. Predicting variables were measured by using The Revised Memory and Behavior Problem Checklist (RMBPC; Teri, Truax, Logsdon, Uomoto, Zarit, & Vitaliano, 1992), Physical Self-Maintenance Scale (PSM; Lawton & Brody, 1969), and Instrumental Activities of Daily Living (IADL; Lawton & Brody, 1969) scale. A 29-item measure of cultural values developed specifically for this study was used. The social support measure developed specifically for the REACH (Gallagher-Thompson et al., 2000) project was modified and used to measure informal support. Caregiving outcomes were measured by using the Cost of Care Index (CCI; Kosberg & Cairl, 1986) and Revised Positive Aspects of Caregiving (PAC; Schulz et al., 1997).

Correlation analyses and regression analyses were conducted to examine how caregiver background variables, stressors, cultural values, and informal support related to the caregiving outcomes.

Results: The results of correlation analyses showed that cultural values, informal support, elderly relative's maladaptive behaviors, elderly relative's functional limitations and caregiver's health were associated with caregiver burden. Cultural values, informal support, caregiver's health, and caregiver's age were associated with positive aspects of caregiving. The results of regression analyses indicated that caregiver's health, older relative's behavioral functioning, and informal support predicted caregiver burden. Cultural values, informal support, and caregiver's age predicted positive aspects of caregiving.

Implications: Chinese American caregivers with greater informal support and stronger cultural values were found to have lower levels of caregiver burden and greater positive feelings toward caregiving. This study is one of the first studies to examine the effects of cultural values on both negative and positive aspects of caregiving. The use of the construct of cultural values further represents an advance in the caregiving literature. These findings indicated a need for the development of interventions that empower caregivers to enhance their informal support system and uphold their cultural values that are associated with caregiving. Service providers and social work practitioners can develop and implement culturally competent service programs for caregiving families.