The Impact of Gender and Cultural Factors on the Patterns of Elder Care Service Utilization among Family Caregivers of Japanese Ancestry in the State of Hawai‘i

Abstract

Various types of elder care services have been developed to accommodate the needs of older adults and caregivers; however, what factors affect service use decisions are mostly unknown, especially among racial/ethnic minority groups. The purpose of this study was to examine how gender and cultural factors affect elder care service utilization among caregivers of Japanese ancestry in the State of Hawaiʻi. A 2-stage mixed method design, including quantitative and qualitative approaches, was utilized. For the quantitative stage, a secondary data analysis was conducted based on a sample of 151 (115 females and 36 males) Japanese caregivers in Hawaiʻi to examine the impact of caregiver gender on service use patterns. Independent t-test results indicated female caregivers used a greater amount and a wider range of services than their male counterparts. Multiple regression results indicated caregiver gender still remained as a statistically significant predictor of service utilization after controlling for other predictors (e.g., education level and living arrangement). For the qualitative stage, one-time semi-structured interviews were conducted with 23 Japanese caregivers in Hawaiʻi to examine the impact of culture on service use patterns. Seven themes emerged in the process of content analysis by using grounded theory. The major qualitative finding was that both cultural and non-cultural factors influenced the service use decision-making, but non-cultural factors (e.g., caregiver’s work) were essential determinants of service use. In practice, social workers need to pay attention to the dyadic relationship between caregivers and care recipients when it comes to service use decision-making. Each culture shapes certain ways to perceive caregiving; therefore, understanding cultural values/beliefs of caregivers and care recipients helps social workers to suggest appropriate service options. As for future elder care systems, educating male caregivers on elder care services, providing language support for foreign-born caregivers and care recipients, and improving current transportation services are suggested.