In many multigenerational South Asian families in the United States, adult children find themselves squeezed between demanding careers, raising their own children, and caring for the complex needs of aging parents.
The first wave of South Asian immigrants who arrived in the mid-1960s is now entering their 80s and 90s, reaching a critical age where care is an immediate necessity. The U.S. healthcare and elder care systems were fundamentally not designed for immigrant communities. From language barriers to dietary restrictions, there is a profound gap between available services and the cultural reality of desi households.
In a recent Chai & Chat live talk, India Currents talked with Salina Shah, the founder of Desi Daughters, a community platform dedicated to supporting South Asian families with eldercare resources and culturally relevant support systems, the discussion focused on the roadmap, resources, and support needed to bridge the divide between formal systems and the unique needs of South Asian seniors. Based on her lived experiences caring for aging family members, Shah recognized that many South Asian families in the U.S. are struggling to find culturally compatible support for seniors in their families, so she launched Desi Daughters as a trusted peer network to help South Asian families navigate elder care.
Key Takeaways
The Power of Culturally Compatible Care
Generic senior care often fails South Asian elders because it ignores the whole person. Good care isn’t just about medical monitoring — it also means understanding someone’s language, spiritual life, and familiar foods. Without these, many seniors can become isolated.
Specialized senior day centers are becoming an important solution. They do more than provide services—they help address a growing mental health crisis, serving as a primary defense in reducing the loneliness many immigrant seniors face.
When seniors are understood in their own language and traditions, they feel valued, and it helps to build trust. This connection results in improved medication adherence and greater willingness to participate in physical therapy, leading to better health outcomes
The healthcare system, the elder care system in the U.S. is not designed for the immigrant communities, including ours.
Salina Shah, Founder, Desi Daughters
Bridging the Information Gap with Crowdsourcing
What started as a small Facebook group has exploded into Desi Daughters, a community of over 13,000 members. It was created to ensure that South Asian families don’t have to “reinvent the wheel.”
The platform offers virtual support groups for specialized conditions like Parkinson’s and dementia. Local chapters point to hyper-local resources, like finding a Desi caregiver in a specific metro area rather than searching a national database.
By crowdsourcing knowledge on everything from the best walker to purchase to navigating recovery from a knee replacement, the community saves families months of trial and error finding information and resources, and helps alleviate the psychological weight of caregiving.
Navigating Cultural Expectations
In the South Asian diaspora, caregiving is deeply tied to family duty, an expectation that falls disproportionately on women. About 90% of the Desi Daughters community are daughters and daughters-in-law.
While a senior advisor may present a wide range of professional care options, families frequently narrow that list down immediately based on perceived community judgment or traditional expectations. To ensure the best fit for the family dynamic, caregivers are encouraged to objectively review all professional options—such as assisted living or professional home care. Considering every choice leads to better, more sustainable outcomes for both the parent and the caregiver.
Financial Realities and the Medicare Misconception
A common misconception in South Asian families is that Medicare covers long-term care. In reality, Medicare mainly pays for short-term medical needs. Families need to plan for key milestones like these:
- Home Care: National average of 30–35 per hour (higher in coastal metros).
- Assisted Living/Memory Care: Monthly costs between $6,000 and $10,000+.
Women face a “double whammy” in this financial landscape: they often retire early or switch to part-time work to provide care, which jeopardizes their own retirement security. As women tend to outlive men, they are more likely to run out of savings. Because of this, some families are looking at care options in India, where reliable care is more affordable.
The Art of the “Hard Conversation” and Early Planning
Starting conversations about downsizing or end-of-life wishes is often difficult. However, these conversations are more effective when a senior initiates them. When parents lead the discussion, it reduces the awkwardness and guilt that adult children feel when suggesting their parents need help.
To avoid emergency-based decision-making, Desi families should utilize resources like The Conversation Project or Five Wishes, which provide information on planning for culturally specific end-of-life needs, such as funeral planning, guides for Indian rituals, and logistics for returning ashes to India.
It’s always too early until it’s too late.
Salina Shah
“Prioritizing the Caregiver: The 8-Year Warning
Caregiving is a physical and mental marathon that can reduce a caregiver’s lifespan by up to eight years.
Caregivers must adopt micro-strategies for self-care to maintain well-being, such as a five-minute decompress in the car before entering the house or maintaining an identity through hobbies and social circles, or even getting external help. Devising ways to ‘ease the burden of care is important in preserving the emotional bond that often gets buried under the weight of chores and medical management.
Aging with Dignity and Independence
One of the best things an adult child can do is support their parent’s independence. Doing everything for them can lead to increased dependency and o a loss of confidence.
Don’t do for your parents what they can still do for themselves
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This text was edited with the assistance of an AI tool and has been reviewed and edited for accuracy and clarity by India Currents.