Challenges for Immigrant and First-Generation Caregivers of Patients With Cancer
To improve the well-being of these caregivers and their patients with cancer, oncology nurses and APPs should prioritize cultural competence, language support, and accessible resources.
Challenges for Immigrant and First-Generation Caregivers of Patients With Cancer
Immigrant and first-generation caregivers face significant challenges in handling the demanding role of caring for a loved one with cancer. These caregivers may confront barriers including language and cultural differences, lack of knowledge of United States healthcare systems, and increased stress. Attention should be paid to providing adequate support and improving communication techniques and cultural competence in healthcare.
Language Barriers, Communication Challenges, and Cultural Differences in Caregiving
Language difficulties are one of the obstacles that immigrant and first-generation caregivers may face. Communication with medical providers plays a crucial role in caregiving, yet language barriers can make comprehension of medical terms and navigation of healthcare systems extremely challenging. Lack of understanding or failure to grasp the information provided by treatment providers can result in confusion and stress, and possibly influence future treatment.1 Language differences can greatly affect the quality of care and the extent to which the caregiver is able to address the condition of the patient.2 The absence of professional medical interpreters, or having family members including children provide interpretation, also presents ethical and practical dilemmas. Interpretation by family members may lend itself to inaccurate communication, while children interpreting for adults may develop stress and other negative psychological effects.1 Such challenges underscore the importance of quality professional interpreter services to facilitate good interaction between caregivers and providers.
Cultural differences can also make the caregiving situation more challenging for immigrant and first-generation caregivers. Individuals from diverse cultural backgrounds may have an understanding of health and disease systems that is different than conventional Western medicine. As a result, they may have different views about the role of the caregiver and the treatments that are appropriate to offer the patient. For example, some might prefer cultural practices that use herbs to treat illnesses or may have a different perception of the role of pain management and medical aid in dying. These cultural differences may trigger conflicts and misunderstanding when patients or caregivers attempt to combine folk healing practices with contemporary approaches to medicine. Cultural competence in healthcare plays an important role in determining the satisfaction level of patients and caregivers and the outcomes of the patients.2 Providers should be sensitive to these cultural disparities and should engage caregivers as partners in caring for and communicating with the patient.
Navigating Healthcare Systems and Practical Challenges
Healthcare needs, accessibility, insurance issues, and financial concerns add more complexity to the lives of immigrant and first-generation caregivers. Unfamiliarity with health care systems, insurance, and financing can be overwhelming when one is new to another country. The use of health-related policies, forms, and other supportive services can be a challenge for immigrant caregivers.3 They can lead to a delay in care when one is unfamiliar with what to do. Moreover, the role of caregivers may require obtaining support and assistance through formal healthcare systems, where outside help or intervention may be needed to gain access to important resources. Excessive paperwork and administrative processes may lead to confusion, and where an individual has a poor understanding of English, the processes become daunting.3 This may result in failure to meet deadlines, wrong forms being completed, insurance claims being rejected, and more, all adding pressure and expense.
Emotional Toll, Support Networks, Resilience, and Resourcefulness
The stress and burden of language and cultural differences can lead to loneliness and emotional and physical exhaustion. Immigrant and first-generation caregivers may need access to a support system, which is crucial for morale and actual support.4 Such emotional challenges are aggravated by the stress of caregiving and difficulty articulating feelings in a language that is not their own. Caregivers may suffer from physical and mental symptoms, often leading to adverse results for them and the patient.5 Culturally appropriate support groups and mental health services in multiple languages will be instrumental in relieving the suffering of these caregivers. These support networks can serve as a means through which caregivers can talk to other caregivers, get information on how to handle their tasks, and find solace.5 Furthermore, employing culturally sensitive professional mental health services in the language spoken by the caregiver contributes to enhanced caregiver and patient satisfaction.
Immigrant and first-generation caregivers can overcome many of these obstacles, proving themselves resourceful and strong. They demonstrate this through their strong commitment to their families, and they may search for community or support services.4 These outlets offer much-needed support and a feeling of community. Another potential area of focus is related to promoting education and awareness in the healthcare domains to reduce communication barriers and increase the acceptance of diversity in caregiving practices. Educating healthcare personnel on multicultural issues and offering material support to caregivers will go a long way in enhancing caregiving.
Conclusion
Though cancer caregiving is a challenging task for anybody, having to navigate the healthcare system and deal with language barriers as a first-generation caregiver complicates the process. By addressing these challenges with proper intervention, appropriate communication techniques, and cultural competency, caregiving services can be improved, and the caregivers themselves can be better supported in these roles. Addressing the unique concerns of first-generation physicians and other caregivers in healthcare settings will not only assist patients but will also contribute to the caregivers’ well-being.
References
- Gerber K, Maharaj E, Brijnath B, Antoniades J. End-of-life care for older first-generation migrants: a scoping review. BMJ Support Palliat Care. Published online December 9, 2020. doi:10.1136/bmjspcare-2020-002617
- Miyawaki CE. Caregiving attitudes and needs of later-generation Chinese-American family caregivers of older adults. Journal of Family Issues. Published online June 17, 2020. doi:10.1177/0192513X20930366
- Wang J, Leong IT, Johnson MK, et al. What Matters to Chinese and Korean American Dementia Caregivers: Navigating Cultural Influences in Dementia Care from Caregivers' Perspectives. J Alzheimers Dis. 2024;98(2):519-538. doi:10.3233/JAD-231140
- Khor HW.Stress and coping strategies among immigrant caregivers in elderly care: A qualitative study from Western Norway. The University of Bergen. Published online May 18, 2021. Retrieved July 23, 2024. https://hdl.handle.net/11250/2759836
- Broxson J, Feliciano L. Understanding the Impacts of Caregiver Stress. Prof Case Manag. 2020;25(4):213-219. doi:10.1097/NCM.0000000000000414
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