Housing Choices of Asian American Older Adults

Zoe Yang
 

I am a third generation Asian American high school student interested in the aging process and experience of aging Asian Americans. I completed a project this summer as part of a mentorship program. My focus was housing choices and care options for Asian American older adults. My grandparents have varied beliefs about their housing choices as they have aged, and I am interested in understanding why they hold different beliefs.

There is a continuum of housing alternatives available for aging adults in need of support. Supportive services can be provided in one's own home, enabling the older adult to age in place. Home care providers can help run errands, and assist with household needs. Home health and personal care aides support personal care and help with activities of daily living. Care can also be provided in a variety of congregate housing settings ranging from independent living through skilled nursing. Assisted living communities provide support for residents who need assistance with activities of daily living. Lastly, skilled nursing homes provide care for aging adults with medical care needs. The image of nursing homes iswhat most people think of retirement homes, despite the various levels of care. There are also some homes that offer special care for people living with dementia. Continuing care retirement communities (CCRC) offer various levels of care, providing access to increasing levels of care if their needs increase.

As both American and Asian societies are dealing with the reality of more aging adults, they approach this matter differently. Care ofaging parents is an important component of Asian culture. The term filial piety, an attitude of obedience, devotion, and care towards one's elders,embodies generational traditions in families (Spielman, 2012). This tradition stems from the belief that parents dedicate their lives to their children, and in return, the children should repay them through taking care of their parents. In Asian culture, affection is shown through material care, and providing for one’s parents displays filial piety. Children show their love and appreciation through physically taking care, or making sure there is someone to take care of their parents. Often, the Chinese view their culture as “harmonious” through filial piety practices, looking down at Western “individualism” (Teon, 2016). Unlike Chinese culture, in Western societies, aging is often associated negatively, with fear and as something to beavoided. There is a stigma against aging in the U.S., and long term care is often provided in congregate communities based on the predominant medical model of care. Many aging adults don’t want to live in long term care communities because of its stigma, but they don’t want to be a burden to their children. On the other hand, even hiring live-in domestic workers in Chinese households was associated with negative self esteem for the child (Chan, 2020). Recently, ‘integrated care’ has become popular in Asian societies, especially in Singapore. The concept of integrated care is to provide people with necessary medical and social support while enabling them to remain in their community (Chan, 2020).

In this study, I explored the views of aging Asian Americans about filial piety and housing choices in their own lives. Five subjects wereinterviewed, four of whom immigrated from Taiwan and one from Cambodia. Each of the subjects discussed how they have interpreted filial piety in their own lives and that is the primary focus of this paper.

Methods

I interviewed five people including my maternal and paternal grandparents, and my maternal uncle’s wife’s father. Four of the interviews were conducted by Zoom or telephone call, but my first interview came as a discussion in the car with my maternal grandfather. I had the opportunity to talk with him in person during a visit while my mother and uncle took him and my maternal grandmother to visit retirement communities. I recorded this in-person discussion while I waited with him in the car because he did not want to go inside. This discussion was not structured like the rest of the interviews, and focused more on his opinion and hesitancy about moving. After this discussion, I met with Dr. Shenk to craft open-ended questions for the remaining interviews. I first interviewed my paternal grandmother over Zoom, which I recorded and later transcribed. I followed this same process with my paternal grandfather a couple of days later. I later interviewed my aunt’s father through Zoom. Lastly, I called my maternal grandmother to interview her, which I recorded on an app on my phone and later transcribed. All interviews, except with my maternal grandfather, followed the same series of questions. After the interviews were conducted and the transcriptions were finished, Dr. Shenk and I reviewed and talked about anecdotes and statements that stood out to us. We identified key themes and I coded the data to prepare for analysis. Because these subjects are my paternal and maternal grandparents and fictive grandfather, I hold personal knowledge of each of them. As I had previous relationships prior to this study, it was comfortable to talk and ask follow-up questions to fill in gaps, while following the sequence of interview questions. On the other hand, our previous relationships may have impacted the interview conversations, as well as creating bias or affecting my perceptions while writing this paper.

Findings

These are my findings related to their background and current living situation for each participant.

Paternal Grandmother

My paternal grandma came to the US from Taiwan in 1964. Her parents encouraged her and her siblings to move to the US to further their education. After meeting her husband and starting her career, she and her husband started their family in Pennsylvania. My paternal grandma had along and successful career as a State Farm agent for 25 years. She is in excellent health, often found swimming or going for a stroll outside.

My paternal grandma currently resides in the Capriana Retirement community. She and her husband have found they love and appreciatetheir life at Capriana even more than their old home in Whittier, California. Although they had to downsize, her interests continue and thrive at Capriana. She takes advantage of the many resources offered in her retirement community, like the swimming pool. She enjoys the convenience of living at Capriana- not having to cook or clean, free time, and many activities. She participates in weekly bingo nights and excursions with her friends. During the day, you can find her taking care of her garden or welcoming newcomers to the community over dinner.

She has a modern perspective on filial piety. Living in the US for over 60 years, my paternal grandma is familiar with Western culture’s views towards aging. After her husband's stroke, she took the initiative to move into a CCRC, knowing it would be best to move into an independent living community with more support. As she and her husband have saved for retirement throughout their careers, they were able toafford living in a luxury retirement community. Her routine and relationship with exercise was so “we can be healthy, so we don’t become a burden on our kids''. She has immense trust that her family will provide for them if needed, but she and her husband do their best to stay independent.

Paternal Grandfather

My paternal grandpa was born in Xi’an, China. He and his family later fled to Taiwan in 1949 as a result of the communists taking control of China, leaving the nationalist government to flee to Taiwan. Despite his parents having little formal education, he and his siblings worked their way through high school and came to the US for college. After meeting his wife, they started a family in Pennsylvania. During the interview, he vividly remembered the jobs he had throughout his career, describing them in much detail.

In 2019, my paternal grandpa had a stroke, which affected his entire right side of his body. Despite this setback, he went to physicaltherapy to help him walk and continues to exercise. He currently uses a wheelchair and a cane to support him while walking. After the stroke, he and his wife decided a retirement community would be a better fit to support them. He notes that their new home is especially convenient, as the house does not have any steps, the community has many social activities, and he has a garden he can take care of. When asked about his new home, he said “We feel like this is a much better living environment. Not only for my stroke, but also for the normal people. I think it’s social and there are so many activities”.

My paternal grandfather discussed filial piety in terms of his own life. He understands his responsibility to take care of his parents, noting that if they had come to the US, “...my parents [could not have] survived in this country without us to support them”. Because of the language barrier and financial situations, it's harder for older immigrant generations in a new country. His perception of filial piety in terms of his children issimilar to his wife’s. He notes “...we feel like we can be independent. We have no reason to add a burden to your dad or mom”. His adaptation to American culture is shown in the ways he raised his sons. He would borrow books in the library to learn the rules for various games, and coach his sons in tennis, basketball, and baseball. He knew that sports played a major role in American culture, and wanted to provide opportunities for his children. While my paternal grandparents speak Mandarin to each other, they are able tospeak English well to communicate to their family and others around them.

Fictive grandfather

My maternal uncle’s wife’s father is a fictive grandfather to me. He immigrated from Cambodia in 1978 with his wife and three children, who were 13, 9, and 5 at the time. He and his family came to the US out of desperation during the Vietnamese war, and survived with little food and shelter. These hardships proved to be challenging, and he and his family made sacrifices to help each other. His family's fierce love for oneanother kept them together, and their love is still prevalent in their family's relationships today.

My fictive grandfather recently moved to Kansas City with his wife, approximately 20 minutes from his daughter and son in law. Beforethe move, he resided in a suburb in Seattle, running his donut shop, Happy Donuts. After his daughter suggested moving to Kansas City, he retired and sold the business. He feels grateful that his daughter suggested moving to Kansas City, where they are “surrounded by open fields, lots of greens, and open roads”. He’s built a comfortable routine in his new home, often going to the Lifetime gym whenever he has the chance to in order to maintain his good health.

When asked about his thoughts on moving into a retirement community, he quickly responded with “Oh totally. Yeah, with no second thoughts. We would do it. When the time comes, it would be the time to do it”. He expressed that he feels the next generation should not hold that burden: “Because they will eventually have their own families, and if they carry the burden of taking care of older adults, how can they do both?”

Maternal Grandfather

My maternal grandfather grew up in Tainan, Taiwan, and immigrated in 1964 to obtain a Master's degree at the University of Missouri.After receiving a PhD at the University of Texas, Austin, he settled in Ohio with his wife where he raised a son and daughter. He and his wife currently live in their home in Kansas City near his son. He suffered a stroke in 2021 and walks with a cane and uses a wheelchair. He also exhibits cognitive memory issues, although he has not been diagnosed with dementia.

His ability to walk is deteriorating as a result of his stroke, and he had an elevator installed in his home last year to help access his upstairs bedroom. My maternal grandpa is a man who now lives with a strict routine. He wakes up at 8am, followed by breakfast at 10am. Around1:30 he takes lunch, and likes his nap at 4. Seven is dinner time, and by 10pm he is in bed. At 86 years old, he has health concerns. Because of his health conditions, his two children are encouraging him and his wife to move into a retirement community, but he refuses to move. He often relies on his son to help with tasks around the house.

My maternal grandpa has a more traditional Asian mindset towards filial piety. In a conversation with him, he expressed uncertainty and doubt with a new life in a retirement community. He worried about laundry, mail service, medical staff, religious practices, and more. My maternal grandpa seemed to be most worried about disrupting his schedule. He describes how “selling the house is a pain in the neck and having people come to my house to pack is a pain in the neck”. He argued that moving into a new home causes an inconvenience to him and his wife despite his children’s offer to help. When asked why he was hesitant to move, he answered “You know, it's not the perfect place, you know. But we’ve been living there for 20 years, and all of a sudden I want change, it's hard”.

Maternal Grandmother

My maternal grandma was born in Taiwan, and then came to the US in 1964 to study at the University of Mississippi for a master’s degree in pharmacology. She later worked as an engineer for an aerospace company before moving to Kansas to be closer to her son when she retired. She currently lives with her husband in Kansas City, 10 minutes away from her son and daughter in law.

She takes care of her husband- cooking, cleaning and driving- but does not seem to mind, as she seems happy to be able to stay in theirhome. She expressed that “Grandpa does not want to move there”, also referencing his daily schedule, which she believes would be difficult to accommodate. She notes that “if we move in, it interrupts his schedule…I think that's the main reason. Because that's how he is”. She expressed concern with moving into the small room, saying “So if you want me to move into thatroom, I don’t want to. Unless I have no choice.” when reflecting on the sample apartment she visited at a retirement community.

Her perception of filial piety is similar to her husband, as she seems to bow to his preferences. She does not have much interest in downsizing into a “small room”, as she comes from a wealthy family. She also describes that part of the problem is that her husband doesn’t wantto move out of the house. She expressed that her ability to drive and take care of her husband would keep her in her own home, unless “[she] has no choice”. My maternal grandparents speak Taiwanese at home to each other, and can speak in broken English to communicate with family and others.

As her son lives 10 minutes away, they depend on him to help with miscellaneous chores, often asking him to fix light bulbs or the fire alarm around the house. Although the son is willing to help, he is frustrated by the constant calls from his parents. He encourages his parents to move into a retirement community, but they consistently turn his offer down. They express concern about their finances and ability to pay for whatthey perceive as expensive residential care, but their son and daughter are prepared and offer to assist with financial support.

Discussion

After the five subjects came to the US, they learned to adapt and thrive in their new homes. My aunt's father and his family concealed their heritage by speaking broken English in public and their native language in the privacy of their home. My paternal and maternal grandparentsadapted to their new American culture while studying at various universities across the country. As the subjects grew older, their relationships withtheir homeland culture and American culture varied. Factors such as children, careers, and backgrounds shifted their perspectives of filial piety and new expectations.

Even though the subjects have had similar experiences, they handled those experiences differently. For example, my paternal grandpa and maternal grandpa both have had strokes. For my paternal grandparents, this triggered them to move into independent living. For my maternalgrandparents, this led them to be more dependent on their children and they are struggling to remain in their own home.

One of the first factors to take into consideration is the backgrounds of the subjects. All of the subjects immigrated to the US, but theirreasons and experiences vary, and as a result, impact their expectations for aging and opinions of their housing choices. My Aunt’s father, who immigrated with his family, holds a tight and trusting relationship with his children. He takes pride in his children, and took his daughter’s advice tomove to Kansas City. He understands the American perspective on housing alternatives, and feels comfortable moving when the time is right.Possibly it's the trust between him and his children, or the familiarity with American culture that brings him to this mindset. Similarly, both my paternal grandparents have beliefs that align with American culture. Having both immigrated from Taiwan to pursue further education, they are acculturated and haven’t retained a strong belief in filial piety. They both worked hard for their degrees, and eventually moved to Pennsylvania to raise a family. They balanced their careers while maintaining a strong relationship with their children, like coaching their sports teams.

Due to the 60 plus years they’ve lived in the US, my paternal grandparents value American ways to help them and their children succeed. Ultimately, it comes down to adaptability and acceptance of a new culture. For someone like my maternal grandpa, who is against moving into aretirement community, it's difficult for him to accept the norm in America. This may come from his set mindset, as he doesn’t like to disrupt his rigid schedule. He is also the oldest of all the subjects, and this is possibly a factor in him not wanting to move again.

Across the five subjects, there are various personality traits, which contribute to their attitudes towards their housing choices. While there are common traits among all subjects, including that they are all hard working and want the best for their children, there are many differences too. The subjects who are more open to living in a retirement community include my paternal grandparents and fictive grandfather. They are open minded and easy going. My paternal grandparents, who have been living in a retirement community for 3 years now, say “we want to be independent, financially wise, and we try to keep ourselves very healthy”. When asked about moving into a retirement community, my fictive grandfather answered “Yeah, with no second thoughts. We would do it”. This mindset to not burden their children reflects a tight knit relationship with their children, as these subjects show trust, and also independence. The other two subjects are not as open minded about moving into a retirement community. This position seems to be driven by the husband, who is quite sure about his decision. My maternal grandpa, who came to the US to further his education, is also a hardworking and determined man. Hisset personality appears to be a key factor in his beliefs against moving into a retirement community. Additionally, his fixed schedule may be a way to deal with his failing health. His wife expresses similar beliefs, and doesn’t want the hassle of moving into a new home. She also seems used to following her husband's choices. Both subjects' mindsets align with traditional approaches based on filial piety.

The subjects’ varied perspectives toward filial piety affect their relationships with their children. My maternal grandparents live close to their son, and often depend on him to help. Though they don’t expect their children to directly take care of them everyday, they expect their son toprovide assistance for them frequently. Their children are encouraging their parents to move into a retirement community as they want to provide them good care but are frustrated by their parents' dependence on their son. Despite their children’s wishes, my maternal grandparents have astrong desire not to move. My Aunt’s father also lives close to his daughter, and he and his wife feel open to moving into a retirement community “when the time comes”. My paternal grandparents, with an Americanized perspective on filial piety, took the initiative to move into independent living.

Each subject had various reasons for their decisions regarding moving into retirement communities. For my maternal grandpa, he is concerned about maintaining his daily routine. He fears that a new home environment won’t accommodate his complex schedule, and doesn’t want to go through the hassle of moving everything. My maternal grandma feels similarly, as she doesn’t like the idea of moving into a “small room”. On the other hand, my paternal grandparents felt encouraged to move into a retirement community after he had a stroke. They felt like the convenience and support was necessary in order to take care of themselves. Other factors, like social life and other opportunities attracted them to their new living environment. Both my paternal grandparents note how they enjoy talking with their friends and welcoming the newcomers over dinner. Factors like this may not appeal to my maternal grandparents, who seem satisfied with their current living situation. The couple don’t seeminterested in the appeal of social activities and excursions, or meeting new people. My fictive grandpa, who is open to housing alternatives, seemsto embrace new opportunities. When speaking about his recent move to Kansas City, he spoke of his mindset: “if we want to do something new, this is the time”.

Throughout this project, I’ve had time to reflect on my personal history and have learned more about my grandparents' backgrounds. I initially interviewed my grandparents to hear about their beliefs and perspectives on filial piety and housing choices, but I also had theopportunity to learn more about my culture and family stories. I believe that everybody has a story worth listening to, and I want to find ways tohighlight voices that are typically disregarded.

References

Chan, Angelique. "Asian Countries Do Aged Care Differently. Here's What We Can Learn from Them." SBS News.
Last modified October 23, 2020. Accessed August 14, 2022. https://www.sbs.com.au/news/dateline/article/asian-countries-do-aged-care-differently-heres-what-we-can-l earn-from-them/osmb6iuio.

Spielman, B. "Elderly, Social Attitudes toward." ScienceDirect. Last modified 2012. Accessed August 14, 2022. https://www.sciencedirect.com/topics/psychology/filial-piety#:~:text=Xiao%2C%20or%20filial%20piety%2C%20is,through%20service%20to%20one%27s%20parents.

Teon, Aris. "Filial Piety in Chinese Culture." The Greater China Journal. Last modified March 14, 2016. Accessed August 14, 2022. https://china-journal.org/2016/03/14/filial-piety-in-chinese-culture/.

About the Author

Hi! I am Zoe Yang, and I am a current high school student. Over the summer I had the opportunity to undertake a study under the mentorship of Dr. Shenk, a professor emerita of anthropology at UNC Charlotte. I was interested in understanding the differences between my maternal and paternal grandparents' approaches towards aging. Through this research, I discovered how personality, age, and health status affects Asian American’s experiences with retirement communities and perspectives of filial piety.