“Honoring their stories”: care providers’ understanding of psychosocial concerns among Bhutanese American older adults with refugee life experience

Abstract

Purpose This paper aims to explore the barriers and facilitators to psychosocial well-being among ethnic Nepali Bhutanese American older adults from the perspective of health care and service providers working with this population. Specifically, the authors aimed to understand health-care and service providers’ perceptions of the psychosocial well-being in this community and appropriate interventions. Design/methodology/approach Qualitative research methods were used to collect and analyze data in collaboration with a community-based organization. A total of ten participants were interviewed. Interviews were conducted in either English or Nepali, based on participant preference. An inductive thematic analysis approach was used to analyze the data. Findings Three major themes were generated from the analysis. The first two were in reference to perceived barriers to mental well-being among Bhutanese American older adults: isolation that older adults faced in the USA and shifting responsibilities and lifestyles that arose from the cultural and structural barriers in the USA. Throughout these themes, there was an understanding that acculturation threatened families’ connections to each other and impacted older adults’ connections with younger generations. The third theme, a perceived facilitator of well-being, was the power of storytelling to counteract feelings of isolation and disempowerment caused by shifting lifestyles felt by older adults, especially amid community events. Originality/value Bhutanese American older adults, many of whom have limited English proficiency, face numerous challenges, psychosocial stressors and factors contributing to well-being. Care for this population should prioritize dignity, empowerment and the incorporation of strengths within their narratives. Interventions and services tailored for older Bhutanese American adults need to be adapted to integrate multiple care systems.