Their Way or No Way: Elderly Asian Immigrants' Health-Related Service Utilization in Senior Housing

“Their way or no way”: Elderly Asian immigrants’ health-related service utilization in senior housing

Background and Purpose: Despite the relatively advanced elderly support in the U.S., elderly Asian immigrants have been found to underutilize health-related services and face various barriers accessing such services. It has been well documented that low English proficiency and complex service system in the U.S have impeded community-dwelling elderly Asian immigrants service utilization. However, little is known about Asian immigrants in senior housing settings. The purpose of this study is to explore elderly Asian immigrants’ experiences of utilizing health-related services when living in senior housing to inform policymakers and service providers to better address this group’s unique needs.

Methods: We conducted a qualitative field research project for 10 months, informed by ethnographic principles and methods. The senior housing facility is government-subsidized and located in a low-income community in a Midwestern city. All elderly residents in the facility (42 Chinese, 17 Korean immigrants) and four staff members participated in in-depth interviews. Nvivo 11 facilitated the data analysis 11.

Results: Elderly residents preferred to use health-related services that comply with their cultural norms and customs. As  Asian immigrants, they shared low expectations services and reluctance to apply for extra welfare benefits, even when they were entitled. Elderly residents were motivated to utilize entitled health-related services when their paperwork was parepared by staff members, when their health conditions were declining, and when their privacy was protected. However, when elderly residents encountered difficulties navigating the service system and lacked language support, they would rather forgo utilizing relevant services. Also, staff members noticed cultural preferences involved in these older adults’ willingness to utilize services. For example, residents prefer family involvement, rather than legal processes, to arrange their advanced care planning.

Conclusions and Implications: Elderly immigrants with different cultural backgrounds have unique ways of interpreting and managing their health. The health-related services in senior hoursing should offer multi-ethnic programs rather than assimilating immigrants to a universal or “mainstream” standard. The findings of this study illuminate the necessity of providing tailered services to accommodate elderly immigrants’ needs. Moreover, specific education interventions for both residents and service providers are necessary to improve the knowledge and cultural competency required to navigate the U.S. health-related service system.