Evolving Understandings of Dementia Caregiving Among Chinese Families in Cross-Cultural Migration: An Exploratory Qualitative Study.

AIM: This study examines how Chinese family carers reconstruct their understandings of dementia and caregiving responsibilities after migrating to Australia and identifies key factors influencing the evolution of these understandings within a cross-cultural context.

DESIGN

An interpretive-oriented exploratory qualitative design.

METHODS

The study was conducted in Chinese community settings in Brisbane, Queensland. Purposeful maximum variation sampling recruited Chinese adults with direct caregiving experience for a family member living with dementia. Eighteen in-depth semi-structured interviews were included based on data saturation. Data were analysed using reflexive thematic analysis supported by inductive coding, cross-case comparison and independent analytical review. A Sankey diagram was used to visualise thematic relationships across pre-migration understandings, transitional influences and post-migration reinterpretations.

RESULTS

Three interpretive patterns were identified regarding how understandings of dementia and caregiving were reconstructed across pre-migration, transitional and post-migration contexts. First, cumulative caregiving fatigue, including sustained burden and nocturnal vigilance, shaped carers' reassessment of responsibility boundaries and filial expectations, particularly within transnational caregiving contexts. Second, exposure to new care norms contributed to the reinterpretation of caregiving values, with carers increasingly integrating relational dignity, autonomy and emotional support into their understandings of family responsibility. Third, pre-migration misunderstandings of dementia symptoms were associated with diverse caregiving responses after migration, ranging from adaptive emotional communication to persistent intra-family conflict. These evolving understandings were shaped by fragmented information systems, culturally misaligned educational materials and support from Chinese-speaking community organisations.

CONCLUSION

Chinese family carers continually reconstruct their understandings of dementia within cross-cultural contexts. Changes in caregiving expectations are shaped by lived experiences within cross-cultural migration contexts and influenced by structural, educational and community factors.

IMPACT: Filial expectations among migrant families may be renegotiated through cumulative caregiving experiences and changing migration contexts. Culturally responsive information systems, community support and culturally adapted dementia education are needed to support sustainable cross-cultural caregiving.

PATIENT OR PUBLIC CONTRIBUTION: Not applicable.