Eliciting the Patient’s Perspective: Level of Acculturation

The initial approach with respect to assessment of the Japanese-Americans should include an understanding of the degree to which the elder and his or her family still maintain traditional Japanese values, views and beliefs, i.e., their degree of acculturation.

There is a marked variability in the level of acculturation in the Japanese-American community. Depending on the number of generations removed from the original immigrants and the degree to which the traditional values have been maintained in the family, the elder and his or her family may be more “Americanized”, having adopted the Western culture and outlook on life. Values such as individualism, autonomy, and frankness in expression of thoughts may then become the norm, whereas these values would have not been readily observed in traditional families where group or family honor precedes individualism and autonomy. As in many immigrant families, many individuals of the third generation do not speak the native language of their grandparents and are culturally quite westernized.

Among Asian Americans, the proportion of United States born Japanese American elders is highest among Japanese Americans. Of note, however, is that there may also be different levels of acculturation within the same generation of a family. For example, an adult child may marry a native Japanese person who holds onto traditional values and customs, an acculturated Japanese American, or someone outside the ethnic group.