Multigenerational caregiving at home for a relative with dementia amidst COVID-19: A qualitative multiple case study of the new immigrant South Asian experience

South Asian multigenerational households have been reported to have increased potential for contracting and spreading the COVID-19 virus to vulnerable older family members. Public health measures (e.g., lockdowns) intended to protect older adults have had unintended consequences for those caring for a relative with dementia (RwD). Creating additional vulnerability is a hesitancy to reach out to community supports due to language barriers, cultural and religious beliefs, and stigma surrounding dementia. Our goals are to 1) gain an in-depth understanding of new immigrant, multigenerational, South Asian family caregiving (for a relative with dementia) amidst COVID-19, and 2) to inform future family-centred, healthcare interventions aimed at supporting equity-deserving families during times of crisis. To achieve these goals we will employ a qualitative multiple case study to 1) understand how and why caregiving experiences within multigenerational South Asian families originating from Pakistan, Bangladesh, India, and Sri Lanka were impacted by COVID-19; 2) understand how and why the intersections of ethnicity, gender (identities, roles, relations, institutionalized), age, religion, and culture influence the experience of caring for an RwD; 3) understand how structural, personal, and relational processes changed during COVID-19 and 4) how and why these changes influenced multigenerational family caregiving for an RwD. We will employ purposeful, criterion, and maximum variation sampling to generate data from semi-structured interviews and focus groups with South Asian family caregivers. We will examine secondary data sources including genograms and ecomaps to understand the family structure, roles, caregiving responsibilities, and available formal and informal resources to support their caregiving activities. We will gather and analyze key documents including provincial, regional, and local policies to understand the COVID-19 context in Ontario and the GTA.