Yaolin Pei, PhD

Dr. Yaolin Pei is Assistant Professor in the School of Nursing at UT Austin. She is a gerontologist who studies how social psychological factors affect end-of-life decision-making and end-of-life outcomes. For example, she studies how family relationships influence older adults’ end-of-life decision making. She develops culturally adapted educational tools and interventions that facilitate end-of-life decision making, especially for Chinese American dementia caregivers. Her goal is to improve the quality of end-of-life care quality in older adults, especially in Asian older adults. 

Project Title: A qualitative study to inform the cultural adaptation of an existing decision aid intervention for Chinese American dementia caregivers in feeding-related decision-making

Email: yaolin.pei@austin.utexas.edu  

Full Community Brief

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The Development of a Culturally Adapted Decision Aid Intervention for Decision-Making
on Feeding Options for Chinese American Dementia Caregivers

AUTHORS, AFFILIATIONS
Yaolin Pei
School of Nursing, The University of Texas at Austin

PURPOSE OF THE STUDY
The purpose of this study is to develop a culturally adapted decision aid to support Chinese
American families in making informed, values-based decisions about feeding options for loved
ones with dementia.

WHAT IS THE PROBLEM?
Many Chinese American families are unsure about their loved ones’ wishes about feeding
options at the end of life. They may not be familiar with tube feeding and its potential benefits or
risks. Feeding decisions are often made collectively within the family, which can make the
process more complex and emotionally challenging. Values such as filial piety and the cultural
significance of food play a central role in such decisions, shaping how families perceive care and
nourishment for their loved one near the end of life.

KEY FINDINGS

1. Chinese American families often have unique needs when making feeding decisions for a
   loved one with dementia. These needs may include navigating collective family decision-making, managing feelings of guilt associated with “giving up” feeding, and addressing
   limited knowledge about tube feeding, dementia progression, advance care planning, and
   end-of-life issues.
2. The cultural importance of food, expectations of filial piety, and the emotional burden
   experienced by caregivers all play important roles in shaping how end-of-life decisions are
   made.

KEY TAKEAWAYS

• This project advances scientific knowledge by applying a rigorous cultural adaptation
  framework to the development of a feeding decision aid for Chinese American dementia
  caregivers—an area with little existing research.
• By integrating cultural values (e.g., filial piety, collective family decision-making, beliefs
  about food and nourishment) with evidence-based decision science, this study addresses
  critical gaps in end-of-life care literature.
• Study findings expand our understanding of how culture shapes decision-making, improves
  the methodological standards for culturally adapting decision aids, and generates a model
  that can be applied to other immigrant and minority communities