Prevalence and Risk Factors of Elder Maltreatment in Chinese American Elders in a Southwest Metropolitan Area

Background and Purpose: Elder maltreatment (EM) incorporates “elder abuse” (i.e. physical, emotional, financial maltreatment) and “elder neglect” (e.g. lack of attention, not providing the minimum of care), negatively affecting the physical and psychological well-being of older adults across ethnic groups. It is estimated that one in ten older adults in the U.S. have experienced some sort of EM. Immigrant elders may be more vulnerable to EM due to the specific historical and cultural reasons such as their tolerance of abusive situations or lack of access to or trust of formal services. Cultural values may influence perceptions of and solutions to EM. However, cultural explanations tend to be oversimplified by the term “culture”, and rarely disentangled and examined thoroughly in previous studies. This study aimed to understand the EM perpetrated by family members and the influence of family cohesion among community-dwelling Chinese American older adults in the Phoenix metropolitan area.

Method: This study first used focus group discussions to help understand what comprises EM in this population. With the input from four focus groups of 24 older Chinese volunteers, survey questionnaires were refined and then delivered to 266 participants (Mean age = 75.08; SD = 6.81) in the Phoenix metropolitan area. Participants were asked whether a family member has committed a specific act or non-act that had led to physical, emotional, financial abuse, or neglect in the past year. Data collection spanned from December 2014 to April 2015.

Results:

The prevalence rates of general EM and elder abuse are 10.2% and 8.3% respectively in this sample. The most prevalent type of EM is elder neglect (5.3%), followed by emotional (4.1%), financial (2.3%) and physical maltreatment (0.4%). The prevalence rate of a single type of EM, (versus multiple types of EM) was 7.1%. The most prevalent EM indicator was “verbal attack” from family members, followed by “abandonment in public” and “no help while in need”. The least prevalent EM indicators were “physical attack” and “physical restraint.” Logistic regression analysis suggested that depressed Chinese older adults (OR= 1.14) and those reporting low levels of family cohesion (OR = .82) were more likely to experience EM.

 Conclusions and Implications:

Chinese American older adults are not familiar with concepts such as elder maltreatment, elder abuse, and elder neglect. Chinese American older adults tend to tolerate the conflicts within the families, such as “destroying your belongings”, “uncomfortable relationship” and “verbal attack without causing serious emotional outcomes”. However, Chinese American older adults may not tolerate “no help while in need” and “no contacts/indifference” of family members and label such behaviors as elder neglect, which may result from Confucian teaching that emphasizes providing health care, financial support and showing obedience to parents. The prevalence rate 10.2% identified in this study resonates with a most recent nationwide study on EM in the U.S. The finding that Chinese older adults’ family cohesion is negatively associated with EM calls for service professionals to understand the cultural needs of older Chinese Americans and the importance of family harmony in EM prevention.