Korean Senior Care Experiences and Lessons

As Korean society has transformed, various traditions have been contested or ignored into obsolescence, but the tradition of family Korean senior care doesn’t appear to be one of them. 

The strong-held belief that adult children bear the responsibility for elder care has been directly influenced by Confucianism. Confucianism compels children to personally see to the care of their parents. The titles “효자” (romanization: hyoja) and “효녀” (romanization: hyonyeo), both refer to a child – male and female respectively who prioritizes the care of their parents. Or simply, who makes their parent(s) happy.

Societal pressure plays a large part in some individual’s choice to care for aging parents and in-laws, and this is not just a characteristic of the South Korean community, but also mirrored among Korean Americans (Han et al. 2008). Filial piety is a desired value among the average member of Korean society and that leaves many individuals going the extra mile to secure what they believe is the best care service for their parent(s).

Many Korean caregivers are quick to disclose that they don’t mind caring for aging family members. Although a good number agree that it is physically, emotionally, and socially draining work, many refuse to seek outside eldercare options until they decide that their senior’s health has deteriorated beyond their caregiving capacities.

Korean society fuels the subjective compulsive to satisfy one’s parents, affecting a lot of Korean youth life choices, including marriage prospects.

Marriage, Family, and Korean Senior Care

The concept of marriage in Korean society is distinct from the prevalent Western practices. Although westernization has influenced some changes in Korean traditional marriage culture, a lot of seemingly outdated practices still hold true. Confucian ideals engender the placing of family needs above those of individuals and the general continuity of family customs.

Marriage Customs and Responsibilities

When considering marriage, family input weighs in heavily. Marriage is not considered just a union between two people, but a unification of two families. Family members – parents specifically – are usually involved in selecting a partner.

Parents might be directly involved in the initial stages of finding suitable prospects from their own social network. They may set up a series of blind dates or gatherings to make introductions. Other times, they come in later to help with wedding preparations and with securing customary gifts for the in-laws.

Parents’ direct involvement in their child’s marriage process enables them to ensure that family traditions are passed down. Getting married and having kids is a filial responsibility to one’s parents and as an extension, one’s ancestors.

Even when their child’s prospect is first chosen by their child, that partner is heavily scrutinized. Meetings with parents may feel like a job interview.  There are many qualifications to consider, such as academic and family background, as well as employment and financial status. 

How the Women Provide Korean Senior Care

A Korean male, especially the first-born male, is bestowed the greatest responsibility of finding and marrying a wife who is obligated to fill the position of nurturer and caretaker of both her immediate family and her in-laws.

The ramifications of this obligation can be far-reaching, and the wife could be assigned the role of primary caregiver for a seriously ailing in-law.

At the same time, the eldest is guaranteed the greatest financial support and inheritance from his parents.

Modern Patterns of Caregiving

Things aren’t so black and white these days. Today, Korean children may share fiscal responsibility and care of aging parents.

One study showed that 55.1% of persons 65 years and older who live with their grown children. Admittedly, it wasn’t clear whether any of the grown children needed or wanted this arrangement due to financial hardship.  

In the U.S., when the economy is doing poorly, you’ll see a growth in the number of adults coming back to live with their parents. The question of who is helping who gets complicated.

Another older national study found that among 55.3% of impaired or disabled seniors receiving primary care from their adult children in South Korea, 35.1% of the caregivers were daughters-in-law, 13.5% were daughters, while only 6.7% were sons (Lee et al., 2007).

In recent times, younger Korean families are living in Seoul, away from the suburbs where aging parents may choose to remain. This makes it all the more challenging to provide appropriate senior care, raising expectations and demands on women across South Korea. It’s no surprise that feminist voices have been raised against unrealistic expectations and unfair treatment of women in Korean marriages and the larger society.

The Use of Nursing Homes Among Korean Families

Many Korean seniors who have chosen to remain in the rural regions have lived all their lives farming and fishing and tend towards self-sufficiency.  Their children, both sons and daughters, may have moved to Seoul in search of a better life. They grow older in the company of their senior friends with whom they’ve built close relationships. They may benefit from frequent senior activities.

There are cases of live-in grandparents, or children giving up their busy lives for a simpler one that allows them take care of their parents personally.

Enforcement of the Long-Term Care Insurance Service (LTCIS) which was first provided by the government in 2008, opened the door to wider acceptance of nursing homes in South Korea. The number of nursing home residents in South Korea between 2001 and 2012 saw a 1,222% increase, with barely 7,864 senior residents in 2001 and a record 103,973 senior residents in 2012.

As LTCIS has been made available to everyone regardless of social strata, senior care is now less perceived solely as a filial responsibility of the family, but the option of nursing home care via long-term care service is viewed as a right the family should take advantage of.

Koreans in the United States

More than 95% of the Korean American population today is made up of Korean immigrants and their children that moved after the year 1965. Some of the factors that contributed to the move in the earlier years of this period included the low standard of living in Korea at the time, political insecurity, and tensions between the North and South territories that threatened war.

Many children from this period affirm that they arrived at the U.S.A with next to nothing. They were letter readers and designated translators for their parents at restaurants and with complicated documents they were too young to fully understand.

The unfamiliar task of getting used to American life was a journey that parent and child took hand-in-hand. It’d be understandable, if not expected, that these children share a closer bond with the parents who shared life’s greatest obstacles compared to their counterparts who have lived all their lives back in South Korea.

In more recent years, Koreans have migrated to America on the premise of education, employment, and for what some consider a more lenient society – a pattern that may lead to different bonds between parents and children, along with different approaches to elder care.

If you reside in the U.S., check out our new book, Multicultural Guide to Caregiving. Our goal is to help families with roots in countries outside of the U.S. to better tackle caring for aging parents, even from a distance. We connect you to critical benefits and social services in the U.S., as well as strategies for managing the financial demands of elder care across the seas.

The Use of Nursing Homes Among Korean American Families

Korean American immigrants are relatively younger than other Asian Americans, as most arrived in the United States following the 1965 Immigration Reform Act. About 6% of the entire Korean American population are over the age of 65, although the number is predicted to be on the rise. A survey indicated that 45% of Korean American seniors were willing to use a nursing home, and more so when they perceived they were not so healthy (Jang et al., 2008).

Like most other seniors, Korean American seniors prefer to stay in their individual homes for as long as they can. However, there are other factors driving their hesitation to take up residence in assisted living facilities or nursing homes.

The nursing home model doesn’t do much to cater for the specific needs of ethnically diverse and non-English-speaking elder communities. Minority seniors find it difficult to blend into a system that is culturally unfamiliar, with insurmountable communication barriers to deal with.

Why Korean Americans May Avoid Nursing Homes

A lot of modern studies have argued that Korean American families don’t shy away from the use of nursing homes and other forms of assisted living majorly because of filial piety, but because of incompatibility issues.

Communication barriers naturally make it more difficult for non-English-speaking seniors to get familiar with their environments or express their thoughts and wishes more easily.

Imagine if you had to request help with getting to the bathroom, or wanting something as simple as a glass of water? Or what if you’re in pain and aren’t being understood? Even Korean seniors who may have learned English, may soon forget it – even common in bilingual seniors. The need for Korean-speaking formal eldercare systems becomes evident (Han et al. 2008).

There are other factors too, including culturally specific needs like familiar food, TV shows, and Korean ethnic churches. As one study highlighted, Korean families have a strong desire to maintain their individual culture, making Korean customs an important part of daily life (Lee, 2010).

Plus, the immense financial costs of formal eldercare, whether provided at home or in a facility, is still an out-of-reach luxury for some families.

Common Issues Faced by Families Engaged in Korean Senior Care

A lot of the issues reported to be faced by South Korean family caregivers run parallel with those faced by their Korean American counterparts. 

Double Role Conflict

As the primary role of women in the household has shifted from full-time housekeeping and family care to more significant roles in the labor force, keeping up with elder caregiving becomes an extra burden difficult to keep up with.

This is a major challenge for daughters-in-law and married daughters. Among Korean American caregivers, difficulty balancing the challenges of staying on top of harsh immigrant factors like having to work extended hours to maintain a life in the USA with parental care is frequently experienced.

Lack of Information

As is characteristic of family caregiving, caregivers have little to no formal training on the proper care for their senior’s special needs and health conditions. A lot of Korean American informal caregivers have identified uncertainty in caring for their impaired seniors as a major challenge. Conflicting advice from other non-professionals only contributes further to their confusion.

Family Dynamics

Daughters-in-law may struggle with the interpersonal dynamics that come with caring for their husband’s parent. Blame shifting or a perceived lack of appreciation for their efforts is a major point of concern among Korean American family caregivers.

Sharing the financial cost of providing care also tends to contribute to conflicts among siblings regarding eldercare.

Steep Learning Curve

In cases of some medical conditions among disabled seniors, specialized care must be provided by their informal caregiver who has little previous experience.

They would have to invest extra time and effort into learning how to do things like administer injections and offer emergency care aid where required. This steep learning curve can make Korean senior care feel even more difficult.

Inadequate Socialization for Seniors

As much as family caregiving offers familiarity, sometimes it does not quite meet the social needs of seniors. Not all children share platonic relationships with their parents, and sometimes in the case of in-laws, senior care can get awkward.

In Korean American homes where everyone but the senior has to be out for most of the day, the elder is often left alone unattended.

What Can Korean Children Do?

While the role of supporting one’s parents can seem overwhelming at times, there is some good news for Korean caregivers too, regardless of whether they life in Korea, the United States, or somewhere else.

The first is the growing recognition of the needs of both seniors and their caregivers. Governments and local businesses are getting better at finding ways to support seniors. The Long-Term Care Insurance Service in South Korea is one example of this pattern. The amount of support provided should continue to increase as time goes on and governments develop more programs.

There are other sources of information and support too.

The online environment has been a lifesaver for many caregivers, helping them to tap into a wealth of knowledge and experience. This information can make crises much easier to solve, while also helping caregivers to feel like they have a support network.

References:

• Pyong Gap Min, Pyong. Korean’s Immigration to the United States: History and Contemporary Trends. Research Report No 3. January 27, 2011
• K.A. Shin. Defamilization of elderly care and the experiences of the aged. Korean Journal of Sociology, 45 (4) (2011), pp. 64-96
• U.S. Census Bureau. Population census. Washington, DC: U.S. Department of Commerce; 2000
• Han HR, Choi YJ, Kim MT, Lee JE, Kim KB. Experiences and challenges of informal caregiving for Korean immigrants. J Adv Nurs. 2008;63(5):517-526. doi:10.1111/j.1365-2648.2008.04746.x
• Jang Y, Kim G, Chiriboga DA, Cho S. Willingness to Use a Nursing Home: A Study of Korean American Elders. J Appl Gerontol. 2008;27(1):110-117. doi:10.1177/0733464807307313
• Lee, Minhong, et al. “Factors Affecting Burden of South Koreans Providing Care to Disabled Older Family Members.” The International Journal of Aging and Human Development, vol. 64, no. 3, 2007, pp. 245–262., doi:10.2190/c4u5-078n-r83l-p1mn
• Lee, Eun-Hee, and Benyamin Schwarz. “Providing Culturally Appropriate Environments in Nursing Homes for Frail Ethnic Minority Elders in the U.S.: Three Case Studies of Korean-American Nursing Homes.” 2010.
• Wikipedia, Wikimedia Foundation. Korean Confucianism (2021). Retrieved from https://en.m.wikipedia.org/wiki/Korean_Confucianism
• Ministry of Health and Welfare, 2012 statistics on the elderly care facilities (2012).
• 2021 World Population Review, South Korea Population 2021 (Demographics, Maps, Graphs) (2021) Retrieved from https://worldpopulationreview.com/countries/south-korea-population