Who Cares for the Elderly? Comparison of Recent Trends and Reports On Informal Caregiving Between the U.S. and South Korea

Background and Purpose: Considering the population aging, the demand for informal care will increase exponentially in the next few decades both in the U.S. and Korea. Though there are some differences regarding how elder parents are cared between countries, there are also similarities. In Korea, traditionally, families are responsible for caring for the elderly. While in the U.S., although home- and community-based care and institutional eldercare play a substantial role in caring older people, informal caregivers are still taking a responsibility of caregiving. The purpose of this study is to identify the characteristics of informal caregivers and to compare them between the U.S. and Korea. Through comparative studies from a cross-national perspective, we can not only learn from each other but also promote a broader view of aging and caregiving.

Methods: Content analysis was used to identify the characteristics and differences of informal caregivers in the U.S. and Korea. We reviewed the recent survey results from “Caregiving in the U.S.” (National Alliance for Caregiving, 2009) and “National Survey of the Life and Welfare Needs of Older People” (Korea Institute for Health and Social Affairs, 2005). The US data were collected based on telephone interviews with 1,397 caregivers aged 18+. The Korea data were surveyed by visiting nationally representative sample of 3,278 elderly aged 65+.

Results: An estimated 18.9% of the US adult population provided care for those aged 50+, whereas 25% of adults aged 65+ in Korea received care from their informal caregivers. Commonly, the primary caregivers for elderly parents were female in the US (67%) and Korea (80%). While most of informal caregiving was provided by adult child in both countries (61%), spousal caregivers were 6% in the US and 29.7% in Korea, respectively. While among 61% of child caregivers, adult children consisted of 50% and children-in-law took 11% in the U.S., in Korea the eldest son and daughter-in-law took most of caregiving responsibility (31.8%), daughter and son-in-law (15.3%), and other son and daughter-in-law (13.8%). Given that 55% of the primary caregivers were daughters-in-law in Korea, whereas only 8.6% in the US, caregiving by son in Korea was actually done by their wife. In terms of living arrangement, about 28% and 26.5% of older adults lived with spouse in US and Korea, respectively. While 13% of older adults lived with child in the US, 51.9% lived with child in Korea. Conversely, elderly living alone were 47% in the US and 19% in Korean.

Conclusions and Implication: Comparisons of Korea and the United States underscore the importance of the cultural difference in elderly caregiving. In Korea, parental care is provided from their child by living together, whereas American elderly live alone but they are still cared by their child. Also, cultural expectations with regard to parental caregiving tend to fall on the female, especially daughters in US and daughters-in-law in Korea. Findings imply underdevelopment of formal caregiving system in Korea because of cultural values on family responsibility and informal care as a substitute for formal care system in the U.S.