Caregiving Support Service Utilization Among Korean, Vietnamese, and Non-Hispanic White Family Caregivers for Persons with Dementia

Background and Purpose: Family caregivers of persons with dementia (PWD) experience significant burden and stress due to their ongoing responsibilities. As dementia remains a leading cause of death among older adults, accessible support services are crucial for sustaining caregiver well-being and care quality. Caregiving services—including in-home services, adult day centers, and support groups—can mitigate caregiver stress, yet little is known about how different racial and ethnic groups access and utilize these resources. This study aims to assesses awareness and use of dementia care resources among Korean American (KA), Vietnamese American (VA), and non-Hispanic White (NHW) family caregivers in California, to compares caregiver characteristics and resource utilization patterns across these groups, and to examines the association between race/ethnicity and the use of caregiving support services.

Methods: A cross-sectional analysis was conducted using data from the Dementia Family Caregiver Study, conducted in Southern California. Participants were recruited through community outreach by bilingual health workers, with surveys administered in Korean, Vietnamese, or English. Descriptive analyses assessed awareness and engagement with dementia support services by race/ethnicity, while binomial logistic regression examined the association between race/ethnicity and the use of services, adjusting for caregiver sociodemographics (age, gender, marital status, education, income, employment), caregiving characteristics (duration, ADL/IADL assistance, receiving help, caregiver relationship to PWD), and PWD health insurance status.

Results: A total of 192 caregivers participated: 65 KA, 75 VA, and 52 NHW. Caregiver mean ages were 68 (KA), 65 (VA), and 69 (NHW). Most caregivers were female (64%-74%). Educational attainment (college or higher) was highest among KA (80%) and NHW (79%) and lower among VA (57%) (p < .003). Medicaid coverage was most prevalent for VA (68%), versus KA (35%) and NHW (15.4%). Language barriers were notable: 89% of KA and 96% of VA caregivers were monolingual. KA caregivers had resided in the U.S. for a mean of 40 years, VA for 32 years. Utilization of state-funded in-home support services was lowest among KA (10%), highest among VA (43%), and intermediate among NHW (25%). Adult day care usage was similar across groups (17%-22%). Awareness of support groups was lower for KA (46%) and VA (47%) than NHW (87%); actual attendance was 12% (KA), 43% (VA), and 44% (NHW). Awareness of Alzheimer’s-serving agencies was also lower among KA (33%) and VA (29%) versus NHW (85%). Regression analyses showed KA and VA caregivers were significantly less likely than NHW to utilize in-home support and adult day services. KA caregivers were less likely, and VA caregivers more likely, to attend support groups compared to NHW.

Conclusions and Implications: Significant disparities exist in both awareness and use of dementia caregiver support services among KA and VA caregivers compared to NHW counterparts. Cultural and linguistic barriers contribute to these gaps, indicating the urgent need for culturally and linguistically tailored outreach and education. Workforce development, culturally competent service delivery, and targeted policy efforts are essential to advance equitable access to supportive services for diverse family caregivers of older adults with dementia.