Caregiver Burnout and Supporting the Elderly in the Asian Community

When parents become elders, crossing the line from family member to caregiver is often gradual.

It can start off as monitoring healthcare appointments for our parents and translating during doctors’ visits… to then full-time managing all of their domestic chores, social calendars, and hospital treatments.

Yet, it’s not like we can simply not care for our family and parents. After all, they sacrificed so much for us (whether or not we asked for it)... isn’t it simply expected that we’ll just care for them when they need us?

Plus, according to the Pew Research Center, 27% of AAPIs live in households with family members from other generations. It’s therefore not surprising that caregiving is something that we currently do or will need to consider in the future.

How do we take care of ourselves when we are trying to take care of others? What about our own feelings of resentment, fatigue, and pride? This article will take a culturally-informed perspective in addressing these nuanced topics.

What is Caregiving? 

According to the Center for Disease Control, a caregiver is someone who provides regular care or assistance to a friend or family member with a health problem or disability. 

Caregiving can be lengthy, with half of caregivers in the US offering their time and energy for at least two years; it can also be intense, as 30% of caregivers provide at least 20 hours per week. They help with tasks ranging from managing household chores

Oftentimes, these roles are underpaid and undervalued. The national partnership for women and families estimates that unpaid caregiving is worth 1 trillion US dollars annually. 1 in 3 caregivers are currently providing unpaid care, meaning they are not being financially compensated for their labor.

This field is growing as the aging population increases. In the Asian community specifically, there are currently 6.7M adults over the age of 50 and this number is expected to double by 2060. Therefore, it is important to examine the intersection between caregiving and culture.

How does culture, gender and race impact caregiving in the Asian community?

Anecdotally, it can feel like you or someone you know is already caregiving. In fact, it’s likely the case. 48% AAPIs aged 45+ have experience providing unpaid care to a loved one 

These statistics become especially staggering when you layer on the dimension of gender in addition to race. Research from AARP shows that 84% of Asian American and Pacific Islander adults say caring for a loved one is extremely important or very important to them. Furthermore, most AAPI caregivers are female (59%), married (71%), with at least one chronic condition themselves (66%) (Miyawaki, et al. 2022).

Caregiving for elderly family members is a deeply rooted tradition in many Asian cultures, often seen as a duty and honor. While this practice reflects strong familial bonds, it can also lead to caregiver burnout if not managed effectively. Understanding the unique challenges faced by caregivers in the Asian community and implementing supportive strategies can ensure both the well-being of the caregiver and the elderly.

How Does Caregiving Lead to Burnout?

Caregivers face a range of challenges, including but not limited to:

• Heightened strain with family members (often the recipients of the caregiving), who used to be sources of support but have now become sources of stress

• Increase in the range of emotions experienced simultaneously, such as anger, avoidance, social withdrawal, and self-blame

• Less time and energy to invest in habitual self-care

• Feeling unseen, unappreciated, or undervalued for their hard work and contributions

Caregiver burnout occurs when individuals experience physical, emotional, and mental exhaustion from the responsibilities of caregiving. Common symptoms include:

• Fatigue

• Anxiety or depression

• Irritability

• Withdrawal from social interactions

• Decline in personal health

Burnout not only impacts the caregiver’s quality of life but can also hinder their ability to provide adequate care. As a result, 40-70% of AAPI caregivers experience anxiety and depression. 34% of AAPI caregivers reported feeling depressed in the past week. However, only 14% received therapy from a professional in the past 5 years 

Unique Challenges in the Asian Community - How Cultural Values Influence Caregiving

Many culturally-embedded values will influence the type of care that is deemed socially acceptable. These values include:

• Collectivist cultures: prioritizing the needs of the family or group over individual needs. This means that caregivers’ emotions may be suppressed; they may be expected not to complain. Taking time for themselves may be seen as selfish or indulgent

• Filial piety: the important virtues of respect, obedience, and care for one’s parents and family. This may lead to stigma against institutional care and therefore chastizing adults who send their parents to a nursing home or assisted living facility

• Gender roles: women are expected to uphold traditional responsibilities and mental health needs are secondary to these domestic tasks. It may lead to internalized feelings of low self-worth if women are not allowed to pursue their passions, hobbies, or empowering professions because they are busy caregiving

Other cultural challenges include the stigma around mental health in general. Plus, language barriers may make it difficult to find providers, thus pushing individuals to take caregiving roles themselves. Finally, living in multigenerational households likely increases stress due to not having space to be alone and recharge.

Strategies to Prevent Caregiver Burnout

1. Acknowledge the Stress

Recognizing the signs of burnout is the first step. Caregivers should feel empowered to speak about their experiences without fear of judgment.

2. Seek Community Support

Many Asian communities have cultural organizations and support groups that provide resources and a platform to share experiences. Faith-based groups can also offer emotional and spiritual support.

3. Leverage Professional Resources

• Respite Care: Temporary relief services allow caregivers to take breaks while ensuring the elderly receive proper care.

• Counseling Services: Mental health professionals familiar with Asian cultural nuances can offer tailored guidance.

4. Encourage Open Communication

Family discussions about caregiving responsibilities can distribute tasks more evenly and reduce the burden on one individual.

5. Practice Self-Care

Caregivers should prioritize their health through activities like:

• Regular exercise

• Mindfulness or meditation

• Engaging in hobbies

Supporting the Elderly

Asian Americans might feel like there isn’t any time to take care of ourselves when we’re supporting our elderly loved ones. That couldn’t be farther from the truth. While maintaining high-quality care for the elderly is important, one of the best ways to take care of them is to take care of yourself too.

But how do you do this if it feels overwhelming? First, consider choosing culturally-relevant activities that both you and the person you are caring for can go to together. This can be mah-jong night at the local community center, a tea-drinking event, or even a small show at nearby performance hall. 

Secondly, find ways to increase social interaction so you don’t feel like you’re doing this all on your own. For example, public places like libraries and parks often host community events which don’t require you to plan things in order to participate.

Thirdly, see if there are any tech-enabled gadgets that can help with video calls or immediate response tools, so you don’t have to be physically present all the time. Understandably, this might not be possible in all cases, so evaluate this on a case-by-case basis. 

Finally, book time with a culturally-informed therapist so you can vent to someone who gets it (before you find other ways to release steam that might be less healthy).

Breaking the Cycle of Burnout

Addressing caregiver burnout in the Asian community requires a balance of honoring cultural values and adapting to modern support systems. By fostering open communication, utilizing available resources, and prioritizing both caregiver and elder well-being, families can navigate the challenges of caregiving while preserving their cultural heritage.

If you’re a caregiver experiencing burnout or looking for resources in your community, consider applying to Anise Health here to receive support from providers familiar with the unique needs of the Asian community. Remember, just because you are providing support, doesn’t mean that you shouldn’t invest in supporting yourself too.