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  • Angela Yip

Why Asian Americans and Pacific Islanders should focus on elder care

I talk about my grandma a lot. How could I not?

Everyone loves my grandma. Long before Facebook ever existed, her network of friends numbered in the thousands, I'm convinced. Her heart-warming smile and convivial nature easily attract people and make them stick around for decades. I've seen her work the sidewalks of Chinatown like a regular celebrity, stopping at least once every block to talk to an old friend she's run into by chance. Once, my grandma matter-of-factly described herself to me over a plate of cut oranges, "Angela, I'm a 'go out and have fun' kind of person."

Unlike a lot of Chinese grandmas I've met, my grandma was born in the States. A native San Franciscan, she grew up during a time when it was not safe for Chinese and Chinese Americans to leave Chinatown. Her parents had immigrated to San Francisco from the Guangdong province of southern China to leave behind poverty and joblessness.

With the help of a next-door neighbor in her tenement home, she went to the one Catholic school in Chinatown, graduated high school, eventually married and worked as a bank teller for more than 20 years. With my grandpa, she raised two boys who both became successful journalists and traveled across Asia, Europe, and North America.

Growing up, my grandma and I would take the packed 30 Stockton to Chinatown to shop for fresh produce or catch up with her old friends from the bank. She joyfully introduced me to friends and shop owners and offered me the best cha siu baos San Francisco had to offer. My grandma always spoke to me in English, and I never learned Chinese. She relished in the time to gossip with her friends in Cantonese, me oblivious to what tea they were spilling.

During college, my grandma was one of the people I always called when I was feeling stressed or alone. Hearing her voice nurtured me and helped me slow down and step away from my anxieties. "Take it easy, Angela," she would always remind me before asking when I was coming home next. "Not until winter break, Yin Yin," I would say.

Recently, my grandma was diagnosed with Alzheimer's, a disease of the brain that destroys memory and other important mental functions. Though she would never choose it this way, she relies on others to get through the mundane motions of each day--making lunch, paying bills, taking pills, etc. My parents and uncle have done the brunt of the caregiving, juggling full-time jobs, maintaining other responsibilities, and caring for multiple sets of grandparents--a full-time job in itself--all at once.

I try to help wherever I can and spend time with my grandma whenever I'm home in the Bay Area, so she doesn't feel so alone. It's important to me that I take care of her because she took such good care of me for most of my life. The time, energy, and finances my family uses to take care of her are definitely well spent, but it would be dishonest to tell you that I haven't seen it impact my family's mental health and finances. My parents work to take care of my grandma and everything else in their life sometimes to the point of experiencing near exhaustion.

And my family is not alone. Forty-two percent of Asian Americans ages 45-55 are caregivers to an elderly person, compared to 22 percent of the general population, making Asian Americans more likely than any other racial group to take on caregiving roles. Asian Americans and Pacific Islanders (AAPIs) are more liable to live in multigenerational households than other Americans, which put them in living situations where becoming a caregiver for a senior family member seems inevitable. Nearly three-quarters of AAPIs ages 45-55 report familial expectations to keep elder care within the family by taking care of their parents.

It's no surprise that AAPIs are the more likely than any other racial group to report that they want their kids to plan to take care of them when they are older. Cultural expectations brought from countries of origin may play a significant role, as a vast majority of AAPIs over age 50 are immigrants. All this caregiving represents perhaps an innumerable amount of hours of unpaid labor by family members and takes a toll on the caregivers' mental and physical well-being.

Last week, I stayed with my grandma for two straight days. During this time, she couldn't remember who I was and insisted on calling me by the wrong name. "You're not my granddaughter, you're my niece," she told me over and over.

"Getting old isn't easy, dear," my grandma tells me. As the AAPI population grows bigger and older, more and more Asian Americans and Pacific Islanders will take on caregiving for their family members. As caregiving shifts to multiple generations, the age of caregivers will go down, impacting many years of our lives.

Elder care is no longer an issue that can wait until you're older. Our communities need affordable long-term insurance, in-language and culturally relevant health services, accessible information about giving care, and disaggregated health data to meet the needs of our elders like my grandma and the families who care for them.

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