Shan Qu

For Asian American family caregivers, transitioning loved ones with dementia into a U.S. nursing home can be particularly challenging due to cultural expectations and the scarcity of linguistically and culturally appropriate care. This qualitative study, focusing on the largest Asian American community, examined the experiences of Chinese family caregivers navigating this transition, using thematic analysis of twelve semi-structured interviews conducted in Mandarin Chinese or English. Filial piety profoundly influenced caregiving decisions. Caregivers reported significant physical, emotional, and financial burdens, with challenges including limited access to culturally and linguistically appropriate nursing home care, concerns about care quality, and difficulties in family discussions about the transition. The findings underscore the need for greater awareness within the Chinese community about dementia care options and for nursing homes to improve culturally sensitive care. Addressing these gaps could ease the transition process and better support caregivers and their loved ones.

Background and Objectives: This study examined the association between COVID-19 concerns and depression among adults in later life. We also examined whether race/ethnic status moderated this relationship. Research Design and Methods: This study used data from the 2020 Health and Retirement Study. Using the 8-item CES-D scale, we defined probable depression as having three or more depressive symptoms. COVID-19 concerns included items such as concerns about respondents’ own health, the health of family members, respondents’ ability to get help from others, and concerns about the future. The associations between COVID-19 concerns and older adults’ depression were estimated with logistic regression models. Results: Compared to respondents with lower scores on the COVID-19 concern measures, those with higher scores were more likely to be depressed. The moderation model showed the relationship between concerns about what will happen in the future and depression was not as strong among non-Hispanic Black older adults compared to non-Hispanic White older adults. Concerns about own health, family members’ health, the older adult’s financial situation, and the ability to get help did not show moderation effects. Discussion and Implications: The results suggested that healthcare providers should focus on older persons to reduce disparities in the risk of depression during public health emergencies.

Introduction Asian American caregivers supporting loved ones with dementia experience greater burden and more stress than other racial/ethnic groups, warranting the need for more culturally and linguistically appropriate formal support, such as in nursing homes. Transitioning loved ones into nursing homes with dementia care units is a complex process that can be impacted by a multitude of factors. Employing several established frameworks, including the socioecological model, this qualitative study will focus on the largest Asian American subgroup (people of Chinese descent) and explore the experience of family caregivers as they support the transition of their loved ones with dementia into nursing homes in the USA. Our focus will be on the nuanced influences of the Chinese language and culture and COVID-19-related social isolation and racial discrimination. Methods and analysis Recruitment will take place starting in January 2024. Current or former Chinese caregivers for Chinese loved ones with dementia, able to communicate in Mandarin Chinese or English, and currently residing in the USA will be eligible. Key informants with intimate understanding and experience with this population will also be included. Data will be collected through 2024 using semistructured, in-depth interviews with each participant. Depending on participants’ preferences, interviews will be conducted in either Mandarin Chinese or English and either in person, via Zoom or by phone. Interviews will be transcribed verbatim. Iterative thematic analysis will be employed. A coding structure will be developed based on interview questions and themes and patterns that are revealed through data immersion. Transcripts, prepared in their original language, will be dual-coded by bilingual researchers using NVivo 14. Consensus summaries of themes will be prepared. Relevant direct quotes for each thematic area will be identified (those in Chinese will be translated into English) and cited in reports and manuscripts. Ethics and dissemination The study is approved by the UMass Chan Medical School Institutional Review Board (ID: STUDY00001376). Findings will be published in peer-review journals following the consolidated criteria for reporting qualitative research.

Background: The overall impact of social connectedness on health outcomes in older adults living in nursing homes and assisted living settings is unknown. Given the unclear health impact of social connectedness for older adults in congregate long‐term care settings worldwide, a comprehensive systematic review is required to evaluate the overall relationship between social connectedness and health outcomes for them.Objectives: The purpose of this article was to synthesize the literature regarding the health impact of social connectedness among older adults living in nursing homes or assisted living settings.Methods: Using PRISMA guidelines, we identified eligible studies from Scopus, MEDLINE, PsycINFO, CINAHL and Cochrane databases (1990–2021). Bias and quality reporting assessment was performed using standardized criteria for cohort, cross sectional and qualitative studies. At each stage, ≥ 2 researchers conducted independent evaluations.Results: Of the 7350 articles identified, 25 cohort (follow‐up range: 1 month–11 years; with two also contributing to cross sectional), 86 cross sectional, eight qualitative and two mixed methods were eligible. Despite different instruments used, many residents living in nursing homes and assisted living settings had reduced social engagement. Quantitative evidence supports a link between higher social engagement and health outcomes most studied (e.g. depression, quality of life). Few studies evaluated important health outcomes (e.g. cognitive and functional decline). Most cohort studies showed that lack of social connectedness accelerated time to death.Conclusions: Social connectedness may be an important modifiable risk factor for adverse health outcomes for older adults living in nursing homes and assisted living facilities. Most studies were cross sectional and focused on quality of life and mental health outcomes. Longitudinal studies suggest that higher social engagement delays time to death. Evidence regarding other health outcomes important to older adults was scant and requires further longitudinal studies.