Cultural differences in caring for people with dementia: a pilot study of concern about losing face and loneliness in Chinese American and European American caregivers

ABSTRACT

Objectives

Heavy demands upon dementia caregivers can lead to a number of poor health outcomes including declines in physical, mental, and brain health. Although dementia affects people from all backgrounds, research in the US has largely focused on European American caregivers. This has made providing culturally-competent care more difficult. This study begins to address this issue by empirically examining how culturally-shaped beliefs can influence loneliness in family caregivers of people with dementia.

Methods

We conducted a preliminary questionnaire study with Chinese American and European American family caregivers of people with dementia (N = 72).

Results

Chinese American caregivers were more concerned than European American caregivers about losing face, which in turn, was associated with greater loneliness. This pattern remained when accounting for caregiver gender, age, and relationship to the person with dementia.

Conclusions

These preliminary findings highlight the role that cultural beliefs can play in adverse caregiver outcomes, and suggest that addressing concerns about losing face may be an important way for healthcare providers to help reduce loneliness among Chinese American caregivers.

Clinical Implications

Understanding how cultural beliefs influence caregiver outcomes is critical as healthcare professionals work to provide culturally-competent care and design culturally-sensitive interventions.

KEYWORDS:

• Chinese culture
• Chinese Americans
• dementia
• caregiving
• loneliness
• losing face
• aging

Acknowledgments

We thank all our caregivers for their participation, and Kuan-Hua Chen, Fiona Cheong, Lily Seah, Marian Tse, Catherine Wong, Benjamin Woo, and Yuerui Wu for their assistance with recruitment and data collection.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author, SL, upon reasonable request

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/07317115.2022.2137448

Notes

1. We note that the association between concern about losing face and greater loneliness was not moderated by culture, interaction B = 0.50 (SE = 3.32), CI₉₅ = [−6.15, 7.14], p = .882. Post-hoc power analysis indicated that this sample size was well-powered for this analysis (f² = .11, 87% power). This finding indicates that concern about losing face was associated with greater loneliness to comparable degrees in both Chinese American and European American caregivers.

2. Because 19 (of the 72) of the caregivers completed questionnaires in Chinese, we also examined the results with questionnaire language included as a dummy variable (0 = English, 1 = Chinese). All results remained consistent.

Additional information

Funding

Preparation of this manuscript was supported by National Institute on Aging grants awarded to Robert W. Levenson [R01 AG041762, P01 AG019724].