Is Our Duty to Care for Our AAPI Elders at Odds with the Pressure of Modern Life?

By Dr. Raj Sundar, MD

I grew up in Thamarankotai, a small Indian village of thatched huts, coconut trees, cows, and chickens. I grew up living the value of family and filial piety—a belief that we respect and care for our elders. At the age of 8, I left India and came to the US. Years later, I returned to India and witnessed the hardships faced by our elders. It seemed apparent to me; we needed a senior living community. I proposed this idea to my family, who were immediately shocked and confused. “You mean, abandon our own family? We take care of our own,” they replied and ended the conversation.

But I wasn't talking about abandoning the people we love; it was about our elders receiving the care and connection they need. The reality was that many people were moving away from their roots, leaving a void in the lives of our beloved elders.

As an Indian-American, I understand the importance of honoring and respecting our parents and elders. Many of us still live it. Studies show that nearly 27% of Asian Americans live in multigenerational households. However, the younger generation is increasingly facing the challenge of caring for children, extended family members, and elders, alongside the pressure of closing the wage gap and finding financial stability. It's becoming harder and harder to live up to our duty of caring for our family. But we don't need to do it alone, as senior living communities can be a bridge to ensure our elders' well-being while supporting the younger generation in their pursuits.

Can senior living communities support aging AAPI loved ones' autonomy?

As a physician, I have had countless conversations with AAPI patients and families about the decision to help elders into a senior living community. These conversations are delicate and multifaceted because families want to care for their parents—who often struggle with memory loss and chronic illness—but cannot meet their complex needs. They want a solution that protects and cares for their aging loved ones.

On the other hand, my elderly patients fiercely fight to retain their autonomy and dignity, feeling that a move to a senior living community would threaten their independence. They want to be able to live life on their terms. As AAPI immigrants, they have suffered through systematic marginalization, xenophobia, and discrimination. How can they trust a foreign institution to care for them at this stage of their life?

I've sat with them, patiently listening over many visits and then explaining how senior living communities can provide ways to reclaim their identity, share their wisdom, and find purpose and meaning. Senior living communities can also help with technology, which many elderly patients struggle to use because of limited digital literacy, language barriers, and cultural communication norms.

Is lack of technology education holding back AAPI seniors? How can we provide the necessary resources for them to thrive?

In many ways, technology can feel intimidating for seniors in the AAPI community. Our elders hesitate to use technology not because they don't want to but because it is daunting. While my son navigates smartphones quickly and gracefully, many seniors face language barriers and foreign terminology attempting to use any technology. We say open the "browser" and go to the link to get on "Zoom." Be careful about "cookies" that track your data, and don't download anything that could lead to "malware" and "identity theft." Would you trust technology if this was what was taught to you?

To make technology trustworthy for our seniors, we need to provide technology education through small groups and one-on-one sessions, use visual aids for people with limited English proficiency, and encourage peer support to build confidence. This kind of education requires resources many families do not have, but senior living communities could fill this gap.

Can technology help reconnect AAPI generations, celebrate ancestral wisdom, and retain "familyhood"?

Technology is more than accessing email and keeping up with the news; it can facilitate connection and create a sense of familyhood. My son has had a new favorite request from me in the last few months. "Call தாத்தா (grandfather in Tamil) and பாட்டி (grandmother in Tamil) so they can read me a book." It's a demanding but precious request because he wants to connect with my parents in our native language, Tamil, over FaceTime.

In the US, aging is often viewed as a decline, but in many AAPI cultures, aging is associated with wisdom and tradition. We revere our elders for their generational knowledge and ancestral wisdom, and we seek not just to care for and protect them but to celebrate and learn from them.

But for many in the AAPI community, physical distance has increasingly become a reality due to professional obligations, which has made it harder to connect in the ways that we want. Despite this distance, I have witnessed how technology can bridge the gap between generations to honor and learn from the wisdom of the past.

What role can technology play in celebrating diversity within the AAPI community?

Technology can connect more than family; it can connect entire communities. The complexity of the AAPI identity has been a topic of discussion recently, and a recent survey showed that only 16% of people in this group identify as Asian Americans. Most prefer to identify with their ethnicity. For me, I never say I'm Asian-American; I say I'm Indian-American. Many of my Pacific Islander patients also feel their identity lost in the AAPI term, as many celebrations during May focus solely on Asian heritage and culture.

Technology can help reclaim people's sense of identity within the AAPI community by connecting them to their people. I just attended an event for Native Hawaiian and Pacific Islanders where people from multiple states listened to a traditional Tongan song called "Me'akai ki he Loto" played with lali (a wooden slit drum) and fangufangu (a bamboo percussion instrument). The event ended with a reflection from a senior participant, a Native Hawaiian, "What beautiful blessing to have my whole identity acknowledged and celebrated."

From advocacy to social justice, AAPI seniors use technology to make an impact.

Technology can also help seniors find purpose and meaning during this phase of their life. Many AAPI seniors have used technology to engage in advocacy and social justice issues that affect their communities. For example, the National Asian Pacific Center on Aging, a national coalition of AAPI senior organizations, uses online platforms and social media to advocate for policies that support AAPI seniors, such as healthcare access, housing, and elder abuse prevention.

As we celebrate the wisdom and knowledge of our elders; we can also support them and provide them with opportunities to create a more compassionate and equitable world through technology.

It's always a challenging conversation in the AAPI community when it comes to senior living communities. Still, it's a conversation worth having to ensure we find ways to care for our elders the way they deserve to be cared for.

About the Author

Dr. Raj Sundar, MD, is a full-spectrum family physician and community organizer dedicated to improving healthcare for culturally diverse communities. As the host of Healthcare for Humans, a podcast aimed at educating clinicians on cultural safety in healthcare, Dr. Sundar has shared his expertise with community engagement to a wide audience. Based in Washington State, Dr. Sundar provides full spectrum care to patients from all walks of life, while also working with healthcare systems to prioritize the dignity of each individual.