Health of Older Vietnamese Refugees and Their Family Caregiver's Psychological Status: Result from the Vietnamese Aging and Care Survey (VACS)

Background. As a result of the Vietnam War, since 1975, several waves of Vietnamese refugees have migrated to the U.S. comprising 1.3 million individuals. Vietnamese are the largest Southeast Asian ethnic group and one of the fastest growing immigrant populations. However, health research on this population is limited. Even less is known about elder caregiving in Vietnamese communities. The initial wave of refugees arrived 45 years ago and are now at an age where they may require assistance. Those who arrived as young children may be the primary caregivers of their aging parents. To fill this gap, we developed the Vietnamese Aging and Care Survey (VACS). The purpose of this study was to report the caregiver-care recipient dyads’ sociodemographic characteristics, and associations between care recipient’s health conditions and caregiver’s psychological status.

Methods. Data were collected on 58 caregiver-care recipient dyads via a network of Vietnamese social service agencies in Houston, Texas as a pilot study. The VACS surveys consist of older adults of Vietnamese origin and their adult-child and spousal caregivers. The survey included caregiver and care recipient’s socio-demographics, care recipient’s Activities of Daily Living (ADL) needs, cognitive functioning, depressive symptoms, and caregiver burden. Descriptive statistics and multivariable regression were used to run the analyses.

Results. Caregivers were on average 53.3 years old, mostly married (78%), Vietnam-born (97%), and female (76%). Adult-child caregivers were mean age 43.1, in good/excellent health (92%) while spousal caregivers (mean age 70.1) were in fair/good health (86%). Care recipients were on average, 74.9 years old, married (64%), Vietnam-born (100%), and male (53%). Adult children tended to care for their mothers (64%) versus spousal caregivers who cared for their husbands (82%)(p< 0.01). Caring for older family members was associated with more caregiver burden (b=0.35, p=0.03), and length of time caregiving was positively associated with caregivers’ depressive symptoms (b=-0.11, p=0.03). But caring for those with better cognitive function was associated with less caregiver burden (b=-0.41, p=0.02) and fewer depressive symptoms (b=-0.13, p=0.05). Caring for family members with more education (≥12 years) was associated with more caregiver burden (b=0.46, p=0.01) and depressive symptoms (b=0.16, p<0.01), especially for more educated caregivers (b=5.89, p<0.01).

Conclusions and Implications. This study reported Vietnamese refugees’ and their family caregivers’ socio-demographics and examined the associations between care recipient’s health and caregiver’s psychological status. Patterns such as the associations between care recipients’ age, cognitive function and length of caregiving, and caregiver burden and depressive symptoms have previously been supported. However, the associations between education and caregiver burden and depressive symptoms differed from those of non-Hispanic white counterparts because education was a protective factor for them. The difference could be that more educated caregivers and care recipients may be more acculturated and thus, more willing to express their psychological distress. Additionally, caregivers who are more educated may have more stressful occupations that further exacerbate the burden and caregiving stress. Future research should further focus on the effect of education and how education affect caregiver’s psychological status in order to develop interventions specifically for this understudied population.