Minority and immigrant elderly in the United States use long-term care (LTC) services less often than their white counterparts. Aside from other factors, preference may play a role in use of LTC, suggests a study of older Korean Americans. Traditional values, especially those of children's devotion and obligation to care for elderly parents, appear to underlie their preference for informal over formal LTC arrangements, concludes Jong Won Min, Ph.D., of San Diego State University, in a study funded by the Agency for Healthcare Research and Quality (HS10785).
Using two disability scenarios—hip fracture and stroke—Dr. Min surveyed 153 community-dwelling Korean Americans aged 60 years or older, who had lived in the United States for an average of 17 years about their LTC preferences. When faced with a scenario of hip fracture, about half of those surveyed preferred to have a mixed formal (paid care) and informal (care by a relative) arrangement in their own or their children's home. About one-third (35 percent) said they would turn to informal caregivers at their own or their children's home, and only 16 percent would rely on paid helpers at formal care facilities.
In the stroke scenario, which requires more care, 51 percent preferred a formal care arrangement in terms of both caregiver and care location. About 28 percent preferred an informal care arrangement, and 21 percent preferred a mixed care arrangement. Taking into account all factors, those with stronger adherence to traditional values and better self-rated health status were significantly less likely to choose a mixed arrangement over an informal care arrangement for hip fracture and stroke.
See "Preference for long-term care arrangement and its correlates for older Korean Americans," by Dr. Min, in the June 2005 Journal of Aging and Health 17(3), pp. 363-395.