Gender Differences in Caregiving: A Case in Chinese Canadian Caregivers

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Gender Differences in Caregiving: A Case in ChineseCanadian CaregiversDaniel W. L. Lai PhD and RSW a , Phyllis K. F. Luk MSW and RSW a & Cynthia Lee AndruskePhD aa Faculty of Social Work , The University of Calgary , 2500 University Drive NW, Calgary,Alberta, Canada , T2N 1N4Published online: 17 Oct 2008.

To cite this article: Daniel W. L. Lai PhD and RSW , Phyllis K. F. Luk MSW and RSW & Cynthia Lee Andruske PhD (2007) GenderDifferences in Caregiving: A Case in Chinese Canadian Caregivers, Journal of Women & Aging, 19:3-4, 161-178, DOI: 10.1300/J074v19n03_11

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Gender Differences in Caregiving:A Case in Chinese Canadian Caregivers

Daniel W. L. Lai, PhD, RSWPhyllis K. F. Luk, MSW, RSW

Cynthia Lee Andruske, PhD

ABSTRACT.This study examines the gender differences in Chinese-Canadian family caregivers providing care to elderly Chinese care receiv-ers. A random sample of 339 Chinese-Canadian caregivers for elderly carereceivers completed a telephone survey. Most of the Chinese family care-givers were females. No major gender differences were reported in theamount and types of caregiving tasks. The level of caregiving burden andpredictors were generally similar for both gender groups. Contrary to com-mon belief that sons and daughters-in-law are the key family caregivers inthe Chinese culture, the daughters played a more important role in familycaregiving. In addition to providing support and services to Chinesefemale caregivers, strategies to enhance Chinese males’ involvement infamily caregiving are needed and discussed in the paper. doi:10.1300/J074v19n03_11 [Article copies available for a fee from The Haworth DocumentDelivery Service: 1-800-HAWORTH. E-mail address: <[email protected]> Website: <http://www.HaworthPress.com> © 2007 by The Haworth Press,Inc. All rights reserved.]

Daniel W. L. Lai, PhD, is Professor and Alberta Heritage Health Scholar; PhyllisK. F. Luk, MSW, is Research Coordinator; and Cynthia Lee Andruske, PhD, is a post-doctoral fellow; all with the Faculty of Social Work, The University of Calgary, 2500University Drive NW, Calgary, Alberta, Canada T2N 1N4.

Funding for this research was received from the Alberta Heritage Foundation forMedical Research. The completion of this manuscript was supported by the HiddenCosts and Invisible Contributions project funded through the Major CollborativeResearch Initiative Program of the Social Sciences and Humanities Research Council.The authors would also like to thank Grace Leung for her assistance in preparing thismanuscript.

Journal of Women & Aging, Vol. 19(3/4) 2007Available online at http://jwa.haworthpress.com

© 2007 by The Haworth Press, Inc. All rights reserved.doi:10.1300/J074v19n03_11 161

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KEYWORDS. Chinese, family caregivers, caregiving, immigrants, genderrole, women

INTRODUCTION

Family caregiving for elderly relatives is a growing phenomenon inan aging society. Research has indicated that family caregiving is a gen-dered role, with women shouldering an overwhelmingly large share ofthe responsibilities. With the growth of culturally diverse and immi-grant populations in North America, understanding how this genderedrole manifests itself in these populations is important for service pro-viders to develop appropriate services and support. This study examinesgender differences in Chinese family caregivers in Canada, in an ethnicminority group with a strong cultural value of familial obligation.

GENDER AND FAMILY CAREGIVING

In the United States, approximately 5.8 to 7 million adults are provid-ing care to an elderly family member or relative (Family CaregivingAlliance, 2005). In Canada, 12% of the population provides unpaid as-sistance to seniors (Statistics Canada, 2002). Understanding family care-giving cannot be done without exploring gender roles as they are oftenculturally prescribed and socially defined. In Canada, 77% of family care-givers are female (Health Canada, 2002). Gender differences emergedin caregiving tasks; and more female caregivers than male caregiversreported that caregiving affected their social activities, holiday plans,health, and extra expenses (Statistics Canada, 2002).

Men have stepped into the caregiver role because of the increasingnumber of nuclear families and working-women (Maniwa & Iida, 1997).Nevertheless, wives are more likely to be the spousal caregivers amongelderly couples. When the spouse is not available, daughters are the pre-dominant care providers (Stone, Cafferata, & Sangl, 1987). Womencaregivers tend to spend more time with their care receiver than mencaregivers do (Chiou, Chen, & Wang, 2005), but female caregivers re-ceive less assistance with caregiving tasks (Lutzky & Knight, 1994).Women spend more time providing personal care and domestic chores,whereas men spend more time running errands and shopping (Zhan &Montgomery, 2003).

Female caregivers also reported a higher level in relational deprivation,loneliness, and depression than male caregivers (Bookwala & Schulz,

162 JOURNAL OF WOMEN & AGING

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2000). Yet, men viewed caregiving with less negative and more self-efficacious attitudes than women (Adams, Aranda, Kemp, & Takagi,2002). Poor health and lower levels of emotional involvement were pre-dictors of burden for husbands. However, wives’ burden was linked topoorer health, less emotional involvement, greater spouse impairment,and provision of more assistance to the spouse (Gitlin et al., 2003).

CHINESE CULTURE, GENDER,AND CAREGIVING

In recent decades, culturally diverse groups have grown dramaticallyin Canada. While the overall Canadian population increased by 4% be-tween 1996 and 2001; the number of visible minorities grew by 25%(Statistics Canada, 2003), with an approximate population of 4 million.Growth of ethnic minorities in Western societies has brought morefocus and attention to the role of cultural values, norms, and practicesrelated to caregiving in ethnocultural minority populations (Dilworth-Anderson & Gibson, 2002).

Filial piety, respect for the elderly, and caring for parents are some cen-tral concepts shared by many Asian cultures (Ishisaka & Takagi, 1982).In the Chinese culture, children are seen as a means of security in old age.In particular, male offspring are highly valued because they pass on thefamily name and provide economic security and care to parents (Ikels,1989). Sons are expected to be the ultimate financial providers for theirparents. Traditionally, married daughters have been integrated into theirhusbands’ families, and are expected to share caregiving responsibili-ties with their husbands and become a caregiver to the parents-in-law(Zhan, & Montgomery, 2003). Researchers also noticed a major differ-ence in gendered care between Chinese and Western cultures. In Chineseculture, daughters-in-law have been the key care provider in the tra-ditional society (Ikels, 1990). In the West, daughters are more likely toperform the caregiver role (Abel, 1986; Stroller, 1994).

However, traditional caregiving patterns have undergone changes, asfamily caregiving is no longer the exclusive domain of sons and daughters-in-law. Some adult children may be able to hire paid caregivers for theirelderly parents (Zhan, 2004). Owing to improved and stable financesand career paths, urban Chinese daughters are increasingly assumingeven more responsibility for the economic, physical, and social careof their aging parents (Zhan, 2004; Zhan & Montgomery, 2003). LikeChina, Hong Kong, and Taiwanese societies are founded on reciprocal

Lai, Luk, and Andruske 163

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harmonious parent-child relationships of nurturing, with a parent car-ing for a child, and the child caring for the parent in old age (Holroyd,2001). In recent years, families have decreased in size, and both hus-bands and wives continue to seek well-paying careers outside of thehome (Chiou, Chen, & Wang, 2005). As more women enter the laborforce, pressures are put on gender roles, particularly in caring for the el-derly. Balancing obligations in the workplace and the needs, duties, andaffection to the elderly has become more complicated, while genderedidentities in society are shifting (Chao & Roth, 2000). Women in HongKong and Taiwan reported tensions on their health in trying to meetall these obligations, duties, and gendered roles (Chao & Roth, 2000;Chiou, Chen, & Wang, 2005). However, particularly in Taiwan, womenoften choose to sacrifice themselves if need be, to maintain filial piety(Chao & Roth, 2000).

In the context of evolving cultural norms and practices within Chinesetraditions, it is important to understand how gender differences are mani-fested for Chinese family caregivers residing in a Western society. TheChinese Canadians belong to the largest visible minority group in Can-ada. With a population of about one million, they account for over 25%of all visible minorities. The aging ratio among the Chinese in Canada isapproximately 10%, much higher than the 7.2% reported in all visibleminority populations. The perception that Chinese culture places astrong emphasis on caring for the elderly people continues to prevail.Strong expectations exist that adult children will provide support andcare to their elderly parents or grandparents. Understanding how this cul-tural trait may manifest in a Western society would facilitate researchersin developing a more accurate picture of Chinese Canadian care-givers. Exploring gender roles also helps identify female Chinese fam-ily caregivers’ specific needs. The key research questions included:(1) What are the differences between the male and female Chinese fam-ily caregivers in caregiving responsibilities and caregiving burden?(2) What are the gender differences in predicting caregiving burden ofthe Chinese family caregivers?

METHOD

The data for this study were obtained through a cross-sectionaltelephone survey conducted between February 2003 and April 2003 inCalgary, Alberta. In the survey, 339 randomly selected Chinese care-givers who provided care to an elderly Chinese care receiver were inter-


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viewed. The sample was obtained through the following process. First,Chinese surnames and the listed telephone numbers were identifiedfrom the local Calgary telephone directory to form the sampling frame.From the surnames and telephone numbers identified, a random sampleof telephone numbers was selected. Then, telephone contact was made toall the randomly selected telephone numbers to identify eligible partici-pants who identified themselves as Chinese, 18 years of age or older,and were providing care to an older Chinese at least 65 years of age orolder. Care could range from assistance with simple tasks to intensivepersonal care. The elderly person that one cared for could be living ornot living with the caregiver.

Using telephone directories and Chinese surnames for sample se-lection excluded caregivers who do not own a telephone, Chinesecaregivers with non-Chinese surnames, and caregivers with unlistedtelephone numbers. However, strong support exists for using ethnicsurnames for locating Chinese and other Asian research participants(Lauderdale & Kestenbaum, 2000; Quan et al., 2006; Tjam, 2001).From the local telephone directory, 22,891 telephone numbers listedunder a total of 725 different Chinese surnames were identified. Fromthese numbers, 3,545, or close to 15% of the identified telephone num-bers were randomly selected. Of these 3,545 telephone numbers con-tacted, 1,481 Chinese households were identified. The remaining2,064 telephone numbers were either non-Chinese households (n =935) or unable to be contacted (n = 546) for the reasons such as no oneanswered, the answering machine was activated, it was a nonresiden-tial number, the number was disconnected, or the respondents hung upor refused to talk. Among the 1,481 Chinese households, 396 individ-uals were eligible for the telephone interview. Among them, 339 com-pleted the survey, representing a response rate of 85.6%. A lack ofinterest in the survey and being too busy were the key reasons for thosewho refused to participate. A structured questionnaire was used indata collection. It consisted of demographic questions about care-givers and care receivers, health status of the care receivers, and ques-tions related to caregiving tasks and responsibilities of the familycaregivers. The questionnaire was administered by trained interview-ers and conducted in language or dialect preferences of the partici-pants: Cantonese, Mandarin, Toishanese, or English.

The health status of care receivers and their dependence on basic andinstrumental activities of daily living are significant in predicting familycaregivers’ well-being and burden level (Neundorfer et al., 2001). There-fore, this study integrated variables measuring the number of illnesses of


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the care receivers and ADL (Activities of Daily Living) and IADL (In-strumental Activities of Daily Living) tasks provided to the care receiversby the caregivers. Number of illnesses of the care receivers was measuredby asking the caregivers to report either Yes (1) or No (0) to a list of 14health problems. The participants were also allowed to add additionalhealth problems to the “others category.” A higher score representedmore health problems experienced by the care receivers. The level of as-sistance the caregivers provided to the care receivers in a range of Activi-ties of Daily Living (ADL) and Instrumental Activities of Daily Living(IADL) were also measured. Examples of the ADL and IADL includeddressing, grooming, toileting, bathing, ambulation (e.g., walking, climb-ing stairs), transfer (e.g., chair to bed, chair to toilet), eating, medicationadministration, meals preparation, housework, use of telephone, shop-ping (e.g., grocery shopping), money management (e.g., banking and fi-nancial management), use of transportation (e.g., to and from physician’soffice), and interpretation and translation. Participants were asked to indi-cate the level of assistance provided to their elderly relative on each of theactivities. Responses range from “none” (0) to “a lot” (3). The responseswere summed to form the ADL and IADL scores. The final scores wereaveraged by the total items measured and resulted in a score that rangedbetween 0 and 3, with a higher score representing a higher level of assis-tance provided to the care receivers by the caregivers in these two majortypes of daily living activities.

Caregiving burden was measured by a Chinese version of the ZaritBurden Interview (ZBI) (Chan, 2002). The Chinese version is a trans-lated version of the 22-item Zarit Burden Interview (Zarit, Reever, &Bach-Peterson, 1980). The instrument, the same as the English version,covers areas including caregiver’s health, psychological well-being, so-cial life, finances, and relationship between the caregiver and care re-ceiver. The caregiver was asked to indicate the impact of the carereceiver’s condition on his/her life by specifying how often he/she hasfelt the way described by each item. The validity and reliability of thisChinese version of the ZBI were demonstrated in previous research(Chan, 2002). The same as the English version, each of the items is an-swered on a 5-point scale with 0 for Never, 1 for Rarely, 2 for Sometimes,3 for Quite frequently, and 4 for Always. The total score of all the itemsranges from 0 to 88 with higher scores implying greater perceived care-giver burden.

Caregiving burden was also related to role conflicts due to other care-giving responsibilities for children and families (Gupta & Pillai, 2002).Variables measuring the multiple roles of the family caregivers were


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examined in this study. These were employment status, whether thecaregiver is a primary caregiver, and whether the caregiver providescare for other children and other elderly family members. Employmentstatus was grouped into not working, represented by a score of zero,working part-time, represented by a score of 1, and working full-time,represented by a score of 3. A higher score represented a greater levelof employment involvement. A question was also used to measurewhether caregivers considered themselves as the primary caregiver, de-fined as the key person providing the major caregiving; whether theyhad to take care of other elderly person(s); and whether they hadchildren 17 years or younger under their care.

The financial factor is crucial to family caregivers (Morgan & Eckert,2001). Self-rated financial adequacy of the caregivers was measured bya question asking participants to rate how well one’s current financialstatus satisfied one’s needs from a 4-point scale ranging from “veryinadequate” (1) to “very well” (4). Immigrant caregivers from culturalminority communities are not exempt from the burden of family care-giving (Tan, Fleming & Ledwidge, 2001). For many immigrants, lan-guage barriers are often the key challenges for them to access servicesand support. Therefore, the self-rated English competence level of thefamily caregivers was included. It was measured by asking the care-givers to rate their own English language capacity along a 5-point scaleranging from Poor (1) to Very good (5). Other demographic variablesexamined were the caregivers’ age, marital status, and education level.Age of the caregivers was grouped into seven categories ranging from18 to 24 years to 75 years and older. Marital status was grouped as singleor married. Education was divided into four groups ranging from no for-mal education to post-secondary education and above.

RESULTS

Seen in Table 1 are the study details of the selected demographicbackground of the caregivers and care receivers, with gender comparisonincluded. In this study, all caregivers identified themselves as ethnic Chi-nese. Interviews with the caregivers were mainly conducted in Cantonese(77%), followed by Mandarin (8.8%), English (8.8%), Toishanese andChiu Chow (5.3%). Most (92.9%) of the Chinese caregivers in thisstudy were first generation immigrants in Canada. The mean length ofresidency in Canada for the immigrants was 18.39 years (SD = 10.07,


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BLE

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range: 3 to 53). Cantonese was the most common dialect spoken by thecaregivers at home (72%) followed by English (8.6%), Mandarin andToishanese (both 7.7%), and other dialects or languages such as ChiuChow, Fujianese, Shanghaiese, and Vietnamese (4.2%).

Most (65.5%) caregivers were females (n = 222). Over half (54.7%)of the caregivers were between 35 years and 54 years of age, about onein five (19.2%) were between 18 and 34 years old. Over a quarter (26.1%)were 55 years and over. Daughters accounted for more than one-third(35.4%) of the caregivers, sons accounted for 22.4%, daughter-in-lawsfor 11.8%, wives for 13.3%, husbands for 5.3%, and son-in-laws for4.1%. Over three-quarters (76.7%) of the caregivers interviewed weremarried. Nearly half of the caregivers reported a post-secondary educa-tion and above. Those with a secondary level education accounted for38.8%. Among the participants, 67.8% identified themselves as a pri-mary caregiver. The remaining individuals considered themselves as non-primary caregivers, meaning another person was performing the majorcare responsibilities, and the participant was playing a supplementaryrole. The average age of the person receiving care was 74.6 years old(SD = 6.95).

When comparisons were made between male and female family care-givers, there were more female caregivers than male caregivers amongthe age range of 55 and 64 years. More female caregivers reported beingmarried than the male caregivers. Female caregivers reported a lowerlevel of self-rated English competence than the male caregivers. Mostof the female caregivers are daughters and daughters-in-law, whilethe male caregivers are sons and sons-in-law. No significant differencesexisted between male and female caregivers in self-rated financialadequacy, caregiving role as primary caregiver, other caregiving re-sponsibilities, and caregiving burden. Illnesses of the care receivers andthe amount of ADL and IADL assistance provided to them were alsosimilar among male and female caregivers.

The types of caregiving tasks performed by family caregivers are pre-sented in Table 2. Among the ADL caregiving tasks for all care receivers,ambulation, bathing, dressing, and grooming were the most commonprovided by both female and male caregivers. No significant gender dif-ferences were reported in the ADL caregiving tasks. In terms of IADtasks, interpretation, transportation, and shopping were the three majorIADL tasks performed by both female and male caregivers. Again, nosignificant gender differences existed in IADL caregiving tasks.

Among the caregivers providing care to male care receivers, no signif-icant gender differences were reported in the types of ADL and IADL


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caregiving tasks. For caregivers performing care for female care receiv-ers, few gender differences existed except more female caregivers assis-ted with money management and transportation than male caregivers.

No significant differences were reported in caregiving burden be-tween male and female caregivers. However, owing to the gender dif-ferences, we expected that the predicting factors of caregiving burdenmight be dissimilar for these two groups. Multiple regression analysiswas conducted separately to examine the predicting factors of burdenfor male and female caregivers. The predicting variables entered intothe regression models included caregivers’ demographic variables andthe health variables of care receivers as illustrated in Table 3.

For the male family caregivers, when adjusted for other confoundingfactors, having a lower level of self-rated financial adequacy, workingfull-time, being a primary caregiver, caring for a care receiver with moreillnesses and more caregiving tasks in ADL were significant in predict-ing the level of caregiving burden they reported. For the female familycaregivers, similar predictors were identified. When adjusted for otherconfounding factors, having a lower level of self-rated financial ade-quacy, working part-time, caring for a care receiver with more illnesses,and more caregiving tasks in IADL were significant in predicting thelevel of caregiving burden.

DISCUSSION

The limitations of this study should be noted. The sample size of thisresearch was small and obtained from one city. The findings cannot begeneralized to all Chinese family caregivers in other Canadian loca-tions. Telephone surveys only included those individuals with access toa telephone. Also, Chinese family caregivers using non-Chinese sur-names were not interviewed. The sample did not fully represent the ex-periences of those caring for individuals with major diseases such asAlzheimer’s, Parkinson’s, Osteoporosis, and heart or kidney failure.Therefore, further research is needed to explore gender differences incaregiving for elderly people in these disease groups. Finally, familycaregivers too stressed and overwhelmed owing to their caregiving re-sponsibilities may have chosen not to participate. Views of those whoare in extreme distress and have many needs should be further examinedin future research.

The gender differences in caregiving probably are reflective of the pa-triarchal values in Chinese culture where women as wives are expected


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to perform caregiving duties for their husbands as sons of aging parentsand relatives. This argument can be substantiated by comparing the pro-portion of men caregivers in this study with those in the general popu-lation. According to the 2001 Census, men accounted for 41.3% of thepopulation in Calgary providing unpaid care or assistance to an elderly


TABLE 3. Multiple Regression Analysis of Predictors for Caregivers’ Burden(N = 339)

Demographic variables of caregivers Male (n = 117) Female (n = 222)

StandardizedCoefficients

Beta

p value StandardizedCoefficients

Beta

p value

Agea

25-34 0.10 0.58 0.05 0.6535-44 0.09 0.68 �0.06 0.6445-54 �0.02 0.91 �0.10 0.4655-64 �0.02 0.91 0.07 0.5465-74 �0.23 0.23 0.10 0.3875 & above �0.29 0.09 �0.06 0.36

Being Marriedb 0.01 0.96 0.07 0.21Educationc

Elementary 0.06 0.78 0.04 0.66Secondary 0.26 0.43 0.20 0.11Post sec. & above 0.32 0.38 0.13 0.36

Self-rated financial adequacy(range: 1-4)

�0.21 0.02* �0.25 0.00*

English competency of caregivers(range: 1-5)

�0.24 0.06 0.04 0.54

Employment statusd

Working full time �0.27 0.03* 0.10 0.11Working part time �0.11 0.23 0.15 0.01*

Primary caregiverse 0.18 0.04* 0.06 0.27Having child(ren) younger than 13f 0.00 0.99 �0.09 0.13Having child(ren) between 13 and 17g 0.07 0.44 0.07 0.21Caring other elderly person(s)h 0.09 0.27 �0.02 0.74Health variables of care receivers

Number of illnesses (range: 0-14) 0.23 0.02* 0.32 0.00*ADL (range: 0-3) 0.40 0.00* 0.06 0.33IADL (range: 0-3) 0.07 0.47 0.36 0.00*

R2 0.50 0.52Adjusted R2 0.39 0.47

*p value is significant at 0.05 level.Reference groups: a18-24; bsingle; cno formal education; dnot working; enot primary caregivers; fnothaving child(ren) younger than 13; gnot having child(ren) between 13 and 17; hnot caring other elderlyperson(s).

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person. For this research, men represented only 34.6% of the Chinesefamily caregivers, further supporting the differences in gender-relatedcaregiving roles between Chinese and Canadian Western culture.

Despite Chinese men’s low participation as caregivers, for those whodo become involved, their level of engagement in family caregiving tasksand responsibilities is similar to the women’s. This finding challengesthe traditional division of labour in caregiving tasks between men andwomen caregivers (Cooney & Di, 1999; Levande, Herrick, & Sung,2000). No major differences existed in the amount and types of ADLand IADL caregiving tasks performed by men and women. A possi-ble reason could be that immigrant men are accepting changing rolesand have become more willing to assume traditionally gendered roles ofwomen, such as personal care and household chores, as demonstrated inresearch on immigrant men (Shimoni, Este, & Clark, 2003). This is alsodemonstrated as the population ages and more men become responsiblefor elderly parents. This emerging trend is supported by the number ofmen in Calgary providing unpaid care work to elderly people. It has in-creased from 37,070 in 1996 to 40,416 in 2001 (Statistics Canada, 1996,2001). For this same period, women family caregivers grew from53,660 in 1996 to 65,910 in 2001. Although the actual number ofwomen caregivers is still greater than men in both 1996 and 2001, therate of growth of male caregivers actually increased slightly higher thanwomen caregivers.

Previous research on family caregiving tends to emphasize the cul-turally unique role of daughters-in-law in shouldering most of the care-giving responsibilities for the elderly in Chinese culture (Zhan &Montgomery, 2003). However in this study, although women remain asthe major family caregivers, the daughters and wives of the care receivers,rather than the daughters-in-law, play the most important caregivingroles. Among all the family caregivers, daughters are the largest group.When differentiating family caregivers into men and women, daugh-ters and wives are the two largest groups among the women caregiversfollowed by daughters-in-law. This ranking among women caregivers isalso parallel with the ranking in men caregivers. Sons and husbands arethe two largest groups while the sons-in-law come in third.

Contrary to other studies in which sons and daughters-in-law arethe key family caregivers for elderly individuals in Chinese culture(Levande, Herrick, & Sung, 2000; Zhan, 2004, 2006; Zhan & Mont-gomery, 2003), over a third (35.4%) of the Chinese family caregiverswere Chinese daughters. Sons and daughters-in-law combined onlyaccounted for a slightly smaller proportion (34.2%) of caregivers. The


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“daughter-in-law phenomenon” is not obvious in this study. Changesexperienced by immigrant women in cultural values, beliefs, and re-lated socialization in Western society may be a reason that daughters-in-law no longer embrace the traditional gendered caregiving role(Levande, Hetrick, & Sung; 2000; Zhan, 2006). Also, the aging popula-tion increases, women are often in demand for their caregiving role.When Chinese women must make a choice between providing care totheir own parents and parents-in-law, daughters are now more likely tochoose to care for their parents; consequently, they become the keycaregivers. On the other hand, their husbands’ parents tend to be caredfor by other female members of the husbands’ family, for example, thedaughters on the husbands’ side.

Since women provide most of the family caregiving, strategies areneeded to relieve their burden, particularly for many Chinese daughterswho are the key caregivers for elderly care receivers and mothers them-selves. One approach would be to strengthen support and services forfemale family caregivers. In addition to respite services to allow familycaregivers relief from long hours of burdensome caregiving tasks, ade-quate child-care programs are essential to female family caregivers havingthe dual roles of caregiving. Family caregiving can be financially costly.Female family caregivers, particularly ethnic minority women, are oftenchallenged, due to their less stable financial status when compared withmale caregivers. Financial assistance for female family caregivers shouldbe enhanced to alleviate the hidden economic costs that drain women’sfinancial resources, particularly those on fixed or low incomes.

Strategies to remove the gendered stigma of caregiving are needed.Levande, Herrick, and Sung (2000) have called for socializing boysto caregiving duties, as a way to introduce caregiving for the elderly asearly as possible, particularly to boys and young men. This can help todevelop long-term attitudinal changes towards a balanced gender role.Ultimately, this would also reduce the caregiving burden of women inthe long run.

This is an encouraging sign that some male caregivers herald changestowards more involved in caregiving. To increase the number of men asfamily caregivers would legitimate and emphasize the importance ofdaily family caregiving commitments, in addition to the economic sup-port they provide. By providing gender specific services for male care-givers, they can be more supported to take up the caregiver role.

Family caregivers from culturally diverse groups are not exempt fromburdens and stresses associated with personal care to their elderly fam-ily members and loved ones. However, owing to the cultural values that


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emphasize filial obligation, it may be challenging to persuade familycaregivers to accept use of formal services. Therefore, supportive pro-grams and services should come with planned community educationand promotion to enhance the acceptance of appropriate service use withthe Chinese community.

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RECEIVED: 10/09/06REVISED: 11/17/06

ACCEPTED: 12/17/06

doi:10.1300/J074v19n03_11


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Gender Differences in Caregiving: A Case in Chinese Canadian Caregivers

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