Hi there, and welcome to Aging Together! May is bringing us a month full of topics. This week, I’m focusing on Asian, Pacific Islander, & Desi American Heritage Month, also known as APIDA Heritage Month! In this article, I’m taking a dive into aging in APIDA communities within the USA.

Introduction to APIDA Communities

To begin, let me provide you a general definition of APIDA. The acronym “A-P-I-D-A” or “APIDA” stands for Asian, Pacific Islander, and Desi American. The term is often used in the United States to refer to individuals and communities with origins in various parts of Asia, the Pacific Islands, and South Asia (which is the “Desi” part of the acronym).

• “Asia” is a large and diverse region that includes many countries and ethnicities. Some of the countries commonly included in the category of Asian Americans include China, India, Japan, Korea, the Philippines, Vietnam, Cambodia, Laos, and Thailand, among others.
• Similarly, “Pacific Islander” is a broad term that encompasses many distinct island nations and territories, including but not limited to Fiji, Samoa, Tonga, Hawaii, and Guam.
• “Desi” is a term often used in South Asian communities to refer to people from India, Pakistan, Bangladesh, Nepal, Sri Lanka, and other neighboring countries.

It’s worth noting that the term “APIDA” is not used universally or consistently across all contexts, and some individuals and communities may identify differently. For the purpose of this article, I will be using this term as a useful shorthand for referring to the diverse range of cultures and identities within these broad categories.

The APIDA population is rapidly growing and aging in the United States. According to the US Census Bureau, the APIDA population in the US is projected to more than double from 23.1 million in 2020 to 51.9 million by 2060, making it the fastest growing racial/ethnic group in the country.

Disparities in Aging in APIDA Communities

However, the aging experiences of APIDA individuals are not uniform, and there are disparities in health outcomes and access to care. For example:

• Asian American elders are more likely to have limited English proficiency and lower income compared to non-Hispanic white elders, which can limit their access to health care and other resources (National Asian Pacific Center on Aging, n.d.).
• Pacific Islanders have higher rates of chronic diseases such as diabetes and cardiovascular disease compared to other racial/ethnic groups (Office of Minority Health, n.d.).
• Southeast Asian Americans, including refugees and immigrants, may have experienced trauma and stress related to resettlement and acculturation, which can impact their mental and physical health (Asian & Pacific Islander American Health Forum, 2019).

There are also disparities within the APIDA population. For example:

• Older Korean Americans have higher rates of depression and suicide compared to other Asian American groups (Nakanishi & Kim, 2014).
• South Asian Americans may be at higher risk for cardiovascular disease and diabetes due to factors such as diet and sedentary lifestyle (Hays & Singh, 2012).

The growing APIDA aging population in the US faces unique challenges related to health care access, language barriers, and cultural differences in care preferences. Addressing these disparities requires culturally appropriate care and increased awareness of the diversity within the APIDA population.

APIDA Values

Collectivist vs Individualistic Communities

To start, APIDA communities share many common values when it comes to aging, including a strong emphasis on family and respect for elders. APIDA cultures traditionally prioritize intergenerational care and view aging as a natural part of life that should be respected and honored. Many APIDA families also prioritize collective decision-making, with input from multiple family members when it comes to caring for aging relatives.

Compared to APIDA cultures, Western or American communities tend to have a more individualistic approach to aging. While family is still valued, the emphasis on independence and self-sufficiency in Western cultures can sometimes conflict with traditional family-based care. Western cultures often prioritize professional care over family-based care, and aging adults may opt to live independently or in assisted living facilities rather than with family members.

Respect & Honor

Additionally, APIDA cultures tend to view aging as a natural part of life that should be respected and honored, whereas in Western cultures, aging is sometimes viewed as a negative experience associated with physical and cognitive decline. APIDA cultures often have cultural practices and rituals that honor and celebrate aging, whereas Western cultures may place less emphasis on such traditions.

There are also differences in the role of decision-making in caring for aging relatives. In APIDA cultures, collective decision-making with input from multiple family members is often prioritized, while in Western cultures, decision-making may be more individualistic and based on the preferences of the aging adult.

Assimilation vs Acculturation

In terms of how these traditions have been retained or adapted in modern times, it varies by community and individual family. Some APIDA families have retained traditional practices such as multigenerational living arrangements, while others have adapted to modern living situations by providing care remotely or hiring professional caregivers. This has shed light to other challenges when it comes to generational living in the United States.

APIDA Children & Cultural Challenges

First- and second-generation APIDA children may face several cultural challenges when deciding on caregiver roles and responsibilities for their aging parents in the United States, particularly when their parents’ expectations conflict with Western cultural norms. Some of these challenges include:

1. Conflicting Cultural Values: APIDA cultures often prioritize collective decision-making and family obligation, which may clash with Western cultural values of individualism and autonomy. This can create tension when adult children are expected to take on caregiving responsibilities for their aging parents, which may interfere with their own goals and aspirations.
2. Language Barriers: Communication is key in any caregiving relationship, but language barriers can make it difficult to express needs, preferences, and expectations. This can be particularly challenging when working with healthcare providers or navigating complex legal and financial systems.
3. Generational Differences: APIDA seniors may have different expectations for their caregiving than their adult children, particularly around issues of respect and autonomy. This can create tension and misunderstandings when adult children attempt to balance their parents’ needs with their own.
4. Financial Constraints: Caregiving can be expensive, and APIDA families may face additional financial constraints due to cultural expectations around financial responsibility and family obligation. This can make it difficult for adult children to provide the level of care they would like to provide for their aging parents.

These cultural challenges can make caregiving for APIDA seniors a complex and emotionally charged issue.

Resources for Aging in APIDA Communities

There are resources available to help families navigate these challenges and make informed decisions about caregiving roles and responsibilities. Examples of these resources include the National Asian Pacific Center on Aging (NAPCA), the Asian American Health Initiative (AAHI), the AARP Public Policy Institute, and Stanford Health Care’s Asian Health Program.

In some cases, APIDA communities have also faced unique challenges when it comes to aging, such as limited access to healthcare services. Some organizations have worked to address these issues and promote culturally appropriate care for APIDA elders. For example, the NAPCA offers resources and support for APIDA seniors and their families. Examples of their resources and support include health and wellness programs, caregiver training and support, housing assistance, legal assistance, and community outreach. 

In addition to specific programs and services, NAPCA also provides general information and resources about aging-related issues, including health care, financial planning, and social services. They also offer translation and interpretation services to help seniors who may have limited English proficiency. Overall, NAPCA aims to support and empower APIDA seniors and their families to live healthy, independent, and dignified lives as they age.

Culturally-Informed Healthcare for Aging in APIDA Communities

It is important for aging APIDA communities and their families to seek culturally-informed healthcare services for several reasons:

1. Improved communication: APIDA communities have unique cultural values and beliefs around health care that can affect their attitudes and behaviors towards healthcare providers. Culturally-informed healthcare providers can understand and respect these values, and communicate with APIDA patients and their families in a way that is culturally appropriate and effective.
2. Addressing barriers to healthcare: APIDA seniors and their families may face unique barriers to healthcare access, including language barriers, transportation issues, and cultural stigmas around seeking healthcare. Culturally-informed healthcare providers can work to address these barriers and provide solutions that are sensitive to the needs of APIDA communities.
3. Better health outcomes: When healthcare providers understand and respect the cultural values and beliefs of APIDA patients and their families, they can provide more effective care. This can lead to better health outcomes for APIDA seniors and their families.
4. Increased trust: By seeking culturally-informed healthcare services, APIDA seniors and their families can build trust with their healthcare providers. This can lead to a stronger relationship between patients and providers, and ultimately lead to better health outcomes.

In summary, seeking culturally-informed healthcare services is important for aging APIDA communities and their families because it can lead to improved communication, better healthcare outcomes, and increased trust between patients and providers.

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At Caregiver Consulting & Healthy Solutions, we are dedicated to helping you navigate aging together. This blog page is for everyone: whether you are an older adult looking to age in place, a caregiver seeking support and guidance, a young or middle-aged adult planning for the future, or simply someone interested in learning more about the aging process. I hope you’ll join me on this journey. Let’s navigate aging together.

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Resources

• National Asian Pacific Center on Aging. (n.d.). About Us. Retrieved from https://www.napca.org/about-us/
  • The National Asian Pacific Center on Aging provides a range of resources and support for APIDA caregivers. This webpage offers information on caregiver training and support programs, respite care options, and legal and financial resources for caregivers.
• Yeo, G. (2018). The Asian and Pacific Islander population in the US: Diversity and change. Migration Policy Institute. Retrieved from https://www.migrationpolicy.org/article/asian-and-pacific-islander-population-us-diversity-and-change
• Sue, S., & Sue, D. W. (2013). Counseling the culturally diverse: Theory and practice. John Wiley & Sons.
• Hays, D. G., & Singh, A. A. (2012). South Asian American elders: An overview of selected cultural factors and implications for counseling. Journal of Counseling & Development, 90(3), 320-328. doi: 10.1111/j.1556-6676.2012.00024.x
• Nakanishi, M., & Kim, J. Y. (2014). Diverse experiences of Asian American elders: Implications for practice and research. Journal of Gerontological Social Work, 57(6-7), 624-639. doi: 10.1080/01634372.2014.907773
• Shaw, S., & Krause, N. (2001). Exploring Hispanic and Anglo attitudes toward aging using focus group methodology. Journal of Cross-Cultural Gerontology, 16(3), 269-284. doi: 10.1023/A:1012232015933
• Slabaugh, S. L., & Friesen, B. J. (2017). Elders in the US and Japan: Perceptions of intergenerational communication and support. Journal of Intergenerational Relationships, 15(4), 357-373. doi: 10.1080/15350770.2017.1356145
• Asian & Pacific Islander American Health Forum. (2019). Southeast Asian Americans and mental health. Retrieved from https://www.apiahf.org/resource/southeast-asian-americans-and-mental-health/
• Office of Minority Health. (n.d.). Asian American, Native Hawaiian, and Pacific Islander communities. Retrieved from https://www.minorityhealth.hhs.gov/omh/browse.aspx?lvl=3&lvlid=63
• AARP Public Policy Institute. (2019). Cultural Competence in Caregiving: AARP Study of Asian Americans and Pacific Islanders. https://www.aarp.org/content/dam/aarp/ppi/2019/06/cultural-competence-caregiving-asian-americans-pacific-islanders.doi.10.26419-2Fppi.00056.001.pdf
  • This report from the AARP Public Policy Institute summarizes findings from a study of Asian American and Pacific Islander caregivers in the United States. It highlights some of the cultural values and expectations that can create challenges for APIDA caregivers, including the importance of filial piety, respect for elders, and the cultural stigma associated with institutionalized care.
• Zhou, M., & Logan, J. R. (2014). Asian Americans and aging: Population trends and challenges. The Gerontologist, 54(1), 1-12. https://doi.org/10.1093/geront/gnt087
  • This article provides an overview of demographic trends among Asian American seniors and highlights some of the unique cultural challenges that may impact caregiving in these communities. It discusses the importance of filial piety and family obligation in APIDA cultures, as well as the potential for intergenerational conflict as cultural norms clash with Western expectations.
• National Asian Pacific Center on Aging (NAPCA). (n.d.). Caregiving. https://www.napca.org/caregiving/
  • The NAPCA provides a wide range of resources and support for APIDA caregivers, including training programs, respite care options, legal and financial resources, and support groups. They also offer bilingual counseling services to help caregivers navigate the challenges of caregiving.
• Asian American Health Initiative (AAHI). (n.d.). Caregiver Resources. https://www.montgomerycountymd.gov/hhs/programindex/health/asian.html
  • The AAHI provides a variety of resources and support for Asian American and Pacific Islander caregivers in Montgomery County, Maryland. They offer caregiver support groups, counseling services, respite care options, and educational programs to help caregivers navigate the challenges of caring for aging family members.
• AARP Public Policy Institute. (2019). Cultural Competence in Caregiving: AARP Study of Asian Americans and Pacific Islanders. https://www.aarp.org/content/dam/aarp/ppi/2019/06/cultural-competence-caregiving-asian-americans-pacific-islanders.doi.10.26419-2Fppi.00056.001.pdf
  • This report from the AARP Public Policy Institute summarizes findings from a study of Asian American and Pacific Islander caregivers in the United States. It provides recommendations for healthcare providers and policymakers to improve cultural competence in caregiving and highlights some of the unique cultural challenges that APIDA caregivers may face.
• Stanford Health Care. (n.d.). Asian Health Program. https://stanfordhealthcare.org/medical-clinics/asian-health-program.html
  • Stanford Health Care’s Asian Health Program offers a range of resources and support for Asian American and Pacific Islander patients and their families, including caregiver support groups and educational programs. They also provide language interpretation services to help families navigate complex healthcare systems.