Service Barriers Faced by Chinese American Families With a Dementia Relative: Perspectives from Family Caregivers and Service Professionals

The exponential increase in the Chinese American elder population will result in a dramatic increase in Chinese family caregivers. In spite of the projected increase, Chinese American older patients with Alzheimer's disease and related disorders and their family caregivers have received insufficient attention in research. This study explored service barriers perceived by family caregivers and by service professionals in a U.S. Southwest metropolitan area where there are no organized Chinese communities. Focus groups were used to obtain perceptions regarding service barriers and strategies to overcome these barriers. Content analysis was used to identify themes that were transcribed from the focus group information session. Similar to previous research, this study identified shortages of culturally-competent services, stigma, caregivers' limited knowledge of the health care system, and lack of initiative to seek professional help as service barriers. In contrast to prior work, lack of communication concordance was identified as a major barrier in client-professional interactions, including professionals' insufficient understanding of the Chinese language and culture, patient and family tendencies to minimize issues in the treatment of Alzheimer's disease and related disorders, and incongruent expectations that health professionals and Chinese patients have for one another. Educating Chinese family members, the young generation in particular, and developing community resources for Chinese American families coping with Alzheimer's disease and related disorders are recommended as methods to remove service barriers. Findings were further discussed within a practice-oriented framework to provide implications for gerontological practice.