Native Hawaiian and other Pacific Islander families tend to keep their elderly relatives in the home with them. This can create caregiver stress as family members cope with Hawaii’s high cost of living, work responsibilities and the needs of other family members. Interestingly, in Hawaii, 37% of caregivers are aged 60 years and older and Native Hawaiians represent 18% of all caregivers (Braun & Browne, 1998). In addition, Native Hawaiian grandparents are twice as likely as non-Native Hawaiian grandparents to be the main caregivers for their grandchildren (Anderson et al., 2006). Therefore, the elderly Native Hawaiian and Pacific Islander patient may actually be the ones experiencing “caregiver stress”.