Informal and Formal Support among Community-Dwelling Japanese American Elders Living Alone in Chicagoland: An In-Depth Qualitative Study
A key public health approach to promote independent living and avoid nursing home placement is ensuring that elders can obtain adequate informal support from family and friends, as well as formal support from community services. This study aims to describe the use of informal and formal support among community-dwelling Nikkei elders living alone, and explore perceived barriers hindering their use of such support. We conducted English and Japanese semi-structured, open-ended interviews in Chicagoland with a convenience sample of 34 Nikkei elders age 60+ who were functionally independent and living alone; 9 family/friends; and 10 local service providers. According to participants, for informal support, Nikkei elders relied mainly on: family for homemaking and health management; partners for emotional and emergency support; friends for emotional and transportation support; and neighbors for emergency assistance. Perceived barriers to informal support included elders’ attitudinal impediments (feeling burdensome, reciprocating support, self-reliance), family-related interpersonal circumstances (poor communication, distance, intergenerational differences); and friendship/neighbor-related interpersonal situations (difficulty making friends, relocation, health decline/death). For formal support, Nikkei elders primarily used adult day care/cultural programs for socializing and learning and in-home care for personal/homemaking assistance and companionship. Barriers to formal support included attitudinal impediments (stoicism, privacy, frugality); perception of care (incompatibility with services, poor opinions of in-home care quality); and accessibility (geographical distance, lack of transportation). In summary, this study provides important preliminary insights for future community strategies that will target resources and training for support networks of Nikkei elders living alone to maximize their likelihood to age in place independently.
KeywordsSocial support Asian Americans Nikkei Older adults Community health
We are extremely grateful to the individuals who graciously agreed to participate in this study. We also thank the following individuals for their guidance: Frances Chikahisa, Asayo Horibe, Gayle Y. Iwamasa, Tak Mizuta, Helen Nakayama, Melba Ristow, and Kiyo Yoshimura. We express special gratitude to Jean M. Fujiu for her intellectual contribution and leadership in the conception and execution of this project. We further thank Kay Kawaguchi, Beth M. Funk, Maria Papachrysanthou, and Ashlyn Pyfer for their research assistance. We also thank the Japanese American Service Committee and its staff members for their collaboration throughout the study.
This project was conducted under a grant from the United Way of Metropolitan Chicago Venture Investment Fund Program and the United Way of Suburban Chicago Venture Investment Fund Program (Academic co-PI: Denys T. Lau, PhD; Community co-PI: Jean M. Fujiu). The funding organizations played no role in the design or conduct of the study; in the collection, analysis, or interpretation of the data; or in the preparation, review, or approval of the manuscript. The authors declare no conflict of interests (personal, commercial, political, academic, or financial) related to the subject matter of this manuscript.
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