Date of Award

12-2024

Document Type

Campus Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Gerontology

First Advisor

Jan Mutchler

Second Advisor

Qian Song

Third Advisor

Peter Kiang

Abstract

Understanding how older immigrants expect to meet long-term care (LTC) needs is important for policymakers, service providers and families to ensure that the future LTC supply meets the needs of a growing older population from diverse cultural backgrounds. This dissertation employed a convergent parallel research design, in which quantitative and qualitative studies were conducted concurrently, to examine the roles of the following cultural aspects in older immigrants’ long-term care expectations: caregiving experience, acculturation, and transnational ties. Caregiving experience and transnational ties reflect orientations toward one’s origin-culture, while acculturation reflects orientation towards one’s host-culture. Results from both studies revealed that older immigrants were not expecting their adult children to be future LTC providers. Older immigrants’ caregiving experience did not show evidence of influencing LTC expectations, pointing to how structural conditions surrounding LTC have changed since care was provided to parents. Acculturation was found to operate on multiple pathways in relation to LTC expectations, in that older immigrants can simultaneously express low acculturation on proxy aspects and high acculturation on direct aspects. Older immigrants who migrated later in life and have little to no English proficiency can still orient toward American values and behaviors that emphasize independence, if structural conditions support such values and behaviors. Maintaining transnational ties with family members in the origin-country did not lead older immigrants to expect to return to their origin-country for LTC needs. While one’s origin-culture may prioritize familial-based caregiving for LTC needs, older immigrants in this study did not expect such transnational ties would adequately support LTC needs if they returned to their country of origin. Therefore, participants expected to stay in the U.S. for LTC needs, in an environment where they can draw on existing formal structures for LTC support even if familial support is not available. As older immigrants are not expecting to primarily depend on children to meet future LTC needs, formal LTC structures should prepare for a growing demand for LTC services among an increasingly diverse older population. This research emphasizes that origin- and host- cultural aspects are intertwined with social structures in older immigrants’ LTC expectations. LTC providers, policymakers, and researchers are encouraged to carefully consider what is deemed a cultural influence in long-term care among older immigrants and acknowledge how culture fluidly interacts with existing structures.

Comments

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