Caregiving Practice Patterns of Asian, Hispanic, and Non-Hispanic White Family Caregivers of Older Adults Across Generations

Background & Purpose: A rapid increase of the number and diversity of elder populations and their family caregivers has raised several concerns.  Caregiving practice patterns by racial/ethnic groups have previously been examined; however, knowledge on changes in caregivers’ behaviors due to their assimilation to mainstream U.S. society is limited.  In order to effectively serve diverse family caregivers, it is imperative to develop not only racially/ethnically specific, but also generationally appropriate services and supports for caregivers.  This study examined caregiving practice patterns among three immigrant generations of Asian, Hispanic and non-Hispanic White American family caregivers of older adults.  Based on Gordon’s classical assimilation theory (1964), three research questions were to examine the association between 1) respite care use; 2) caregiving hours; and 3) caregiving duration and caregivers’ race/ethnicity and generation.  Hypotheses were tested that the later the caregivers’ generation, the more respite care used, the less caregiving hours, and the shorter caregiving duration. 

Methods: This study used the 2009 California Health Interview Survey, a biennial, multi-stage sample design population-based telephone health survey.  Only filial caregiving dyads were drawn from the dataset, and final samples consisted of Asian (n=591), Hispanic (n=989) and non-Hispanic White (n=6,537) caregivers.  Caregiving practice patterns (dependent variables), caregivers’ race/ethnicity and generation (independent variables), and caregivers’ socio-demographic characteristics and caregiving conditions (control variables) were examined.  Caregiving practice patterns were measured by respite care use, weekly caregiving hours and yearly caregiving duration.  Socio-demographic measures and conditions included caregivers’ age, gender, marital status, education, employment status, self-rated health, residential situation, and the availability of alternative caregivers.  Descriptive analyses using chi-square tests were run to compare caregivers’ characteristics and caregiving situations with care recipients.  Logistic regression and generalized linear models were performed to answer the three research questions.

Results: Caregiving patterns of all generations of non-Hispanic White caregivers supported the hypotheses that the later generation, the most frequent user of respite care, least caregiving hours and shortest caregiving duration fully endorsing assimilation theory.  However, compared to 1^st generation, later generations of Asian and Hispanic caregivers used less respite care but had longer caregiving hours.  The patterns of caregiving duration varied by racial/ethnic groups: the later the Hispanic generations, the longer caregiving duration, but 3^rd generation Asian caregivers spent the longest duration, followed by 1^st and 2^nd generations.  Care recipients’ health conditions and language proficiency could be contributing factors to these differences; however, traditional filial caregiving practice (Asian’s filial piety and Hispanic’s familism) seemed to persist across generations among caregivers of color.

Conclusions & Implications: This study provided data on generational similarities and differences in Asian, Hispanic and non-Hispanic White American caregivers’ practice patterns, and found that later generation Asian and Hispanic caregivers maintained their traditional caregiving practices across multiple generations.  Findings point to the importance of cultural competency training for social workers regarding caregivers’ cultures and traditions.  Because Asian and Hispanic American populations are heterogeneous, recognizing within ethnic group differences along with generational variations is of great value for the development of culturally competent and generationally appropriate caregiver policies and programs.