Seniors and staff enjoying the sun at Boston's South Cove Manor. Image credit: Southcovemanor.com

The largest

generation in U.S. history is cruising into their golden years. Over the next twenty years, the number of

folks in the U.S. aged 65 and older will double in size and climb to 20% of the population. These

staggering numbers loom over national debates regarding the budget and healthcare as we tackle the issues raised by the aging of

our parents and grandparents.

Many public figures have joined the discussion,

including Lisa Ling and Martha Stewart -- Stewart, for instance, has channeled her

energies and star power into setting up the Center

for Living at Mount Sinai Hospital, a geriatric primary care facility, and publishing

the book Living

the Good Long Life: A Practical Guide to Caring for Yourself and Others.

In this richly designed guide, Stewart offers up “Golden Rules” for seniors to

abide by for a long and satisfying life, including tips on travel, exercise,

skin care, and safety-proofing one’s sunlit home.

Of course,

for the millions of AAPI seniors who live in the U.S., Stewart’s guidelines for

aging gracefully may seem wistfully out of reach – if they’re able to

read them in English at all. Although today’s AAPI elderly are a heterogeneous

group, the majority of them arrived after the 1965 Immigration Reform Act and

the Vietnam War. But while AAPI seniors over age

65 – expected to grow to 2.5 million by 2020 and 7.6

million by 2050, from fewer than one million in 2000 – are one of the most

rapidly growing elderly sub-groups in the U.S., “they remain largely invisible”

in national discourse and public policy, as the National Asian Pacific Center

on Aging states. And they are facing many troubling challenges as they grow older.

Everyday challenges

“Because we are different and do not speak

English, Americans

seem to ignore us. Another day, my husband got on a bus and then he paid the fare. While

he waited to receive

his change, the driver threw it on the bus floor. He cried and could not stop

crying. It is hard to live in this foreign land with our language problem.”[1]

By far the most critical issue for a

majority of AAPI seniors is their limited English proficiency. "For AAPI seniors who immigrated to the U.S. in middle age or later,

cultural and language isolation can be a major factor," says Sam del

Rosario, LCSW, a social worker who works with older adults. Language

barriers can certainly turn dangerous, as we saw in January when 84-year-old

Kang Chun Wong was beaten and bloodied by NYPD after jaywalking and purportedly

resisting arrest because he couldn’t understand English. But the problems

exacerbated by language barriers needn’t be so violently realized in order to

impact a senior’s life in fundamental ways. For many seniors who choose not to “burden” their children by living

with them, not understanding English means not being able to navigate the

healthcare system, be civically engaged, apply for subsidized senior

housing, or access community social services on their own. It means a million daily indignities, like

the one experienced by the Korean American couple above, who can’t shake off a

sense of their own “foreignness” even on their daily bus rides.

Former restaurant owner Kang Chun Wong, 84, of Manhattan, who was beaten and bloodied by NYPD police in January for jaywalking. Image credit: Jesse Ward/New York Daily News

Barriers to community

For many, it also means

living in nursing homes and other long-term senior care environments that

aren’t always attuned to AAPI seniors’ linguistic and culturally specific

needs. As Tanzina Vega writes in The New York Times, “Finding a home health aide or nursing home

supervisor who speaks Spanish is usually easier than finding one who speaks,

say, Khmer.” Diet is also a concern; it’s hard to find food at senior homes

that are tailored not only to the tastes but also the dietary needs of Asian

American elderly, who often have specific nutritional concerns such as calcium

and vitamin A and C deficiencies.[2]

The lack of welcoming communal areas in their places of residence has driven

many seniors out into the open to seek out makeshift watering holes to

socialize together in their own languages. This can lead to even more difficulties, however: In one high-profile incident in January 2014, elderly Koreans were

escorted by police from a McDonald’s in Queens after managers complained that the

seniors were overstaying their 20-minute dining limit. While the incident ended more or less amicably

after protests led by Asian American community leaders, it drew

national attention to the need for more inviting social spaces for AAPI

seniors.

Invisible problems

Other, often unacknowledged problems plague the

elderly in our communities, including mental health challenges. Compared to the

general senior population, older war refugees from Southeast Asia exhibit

“unusually high rates of psychological disturbance, particularly posttraumatic

stress disorder.”[3]

Stressors seem to hit elderly Asian American women especially hard: suicide rates among AAPI women over age 75 are almost double the rate of other women in the same age

group.

The financial situation is also precarious for too many Asian American seniors. A 2012 survey found that 12.3% of Asian Americans

over 65 lived in poverty, compared to 9.1% of the general population

over 65. (The dismal figures are compounded for those within the LGBT community.) Many AAPI seniors are uninsured, while nearly 40% – including my own parents – rely on

Medicare and Medicaid as their only sources of health insurance.

Like so many other Asian immigrants, my

parents were small business owners with limited English. Living on the margins

of the mainstream economy, they never learned how to navigate the

bewildering world of Social Security and retirement planning. Their story is

sadly typical: recent Census numbers

from Chicago, where we live, indicate that two-thirds of elderly Koreans like

my parents are living under the poverty line, and nearly all of them are

immigrants who have resided in the U.S. for more than ten years.[4] The tragic irony is that an increasing number of these seniors are choosing to “reverse emigrate” back to Korea because they foresee a

future where they die alone in a country that no longer feels like home.

How can we help?

These statistics

are simply unacceptable. So what can be

done to help our folks and other elderly in our communities?

Fortunately, some national and local trends indicate cause for hope. Growing awareness about the

diversity of the aging population in the U.S. has prompted organizations such as AARP to reach out to Asian American communities. The National Institute on Aging has sought to educate health care providers about their patients’ culturally

specific needs, and also recommends increasing seniors' access to professional

interpreters, who are mandated by federal policies to be made available by

healthcare providers who receive federal funds such as Medicare. And despite incidents like the McDonald’s

controversy, much progress has in fact been made, especially in major cities,

to provide spaces for AAPI elderly to socialize, learn

English, vote, enjoy free lunches, obtain information about housing and social

services, and even become politically active in their

communities.

As family members and caregivers, we can help and advocate for our elders by educating ourselves first. As the only child of older parents, I’ve long felt frustration and despair over

the lack of information and support networks for Asian American seniors and

their children/caregivers. All too often, it’s incumbent on us to seek out

resources on our own. Some of the most helpful mainstream resources I’ve found

are the National Council on Aging’s website, and books such as Virginia Morris’s How to Care for Aging Parents and Joy Loverde’s The Complete Eldercare Planner.

As for AAPI resources, we’re fortunate to have the National

Asian Pacific Center on Aging, the nation’s leading organization for AAPI elders. In 2012, the

Diverse Elders Coalition, to which the NAPCA belongs, published a

comprehensive report on minority and LGBT elderly that you can read here. (For those

in the Chicago area, the Coalition of Limited English Speaking Elderly provides

a list of all the

various community organizations that serve immigrant elderly in the region.)

If the seniors in your life are able-bodied and healthy, check

in on them regularly and encourage their independence as long as possible.

According to Jisun Sohn, Deputy Executive Director of Chicago’s Hanul

Family Alliance, it’s

important to include seniors in everyday social activities and encourage them to volunteer

and be active in the community. “They

might actually not be physically capable, but we should always remember to ask,

invite, and keep them in various circles of social life, because it is so easy

for them to develop depression when they feel they are alone and no longer

productive members of society,” Sohn advises.

As your

loved ones grow older, talk with them about their preferred living

arrangements. Do they want to live alone, with family, or friends? In a

retirement community – perhaps one that is specific or sensitive to their cultural needs, whether a single floor or an entire facility? Do they need to be in a nursing home, or do they require hospice care? (The U.S. Department of Housing has information about senior living options here, and A Place for Mom works directly with you for free to help find the best senior residence for your loved one.) Wherever

they live, be vigilant and check for signs

of elder abuse. In the meantime, keep a copy of their medical, financial,

and other important records close at hand, and open up a conversation about the

difficult topics of end-of-life wishes and arrangements.

And don’t

forget political advocacy. As Ai-jen Poo, Director of the National Domestic

Workers Alliance, encouraged in her Colorlines bucket list earlier this year, “Call each and

every candidate running for office in your community this year, and let them

know that caring for our aging loved ones and the [predominantly women of

color] workforce that supports them is a priority for you.”

As our family

and loved ones get older, it’s important for us to think seriously

about how we can ensure their health, dignity, and well-being well into their

golden years.

The author's parents. Image credit: Author's own

[1] Young-Me Lee, “The Immigration Experience among Elderly

Korean Immigrants,” Journal of

Psychiatric and Mental Health Nursing 14.4 (2007): 403-410, pp. 407-408.

[2]

Katherine K. Kim, Elena S. Yu, William T. Liu, Jaekyung Kim, and Mary Bess

Kohrs, “Nutritional Status of Chinese-, Korean-, and Japanese-American

Elderly,” Journal of the American

Dietetic Association 93.12 (1993): 1416-1422.

[3]Amy Weisman, Greg Feldman, Cynthia Gruman, Roberta

Rosenberg, Rebeca Chamorro, and Irene Belozersky, “Improving Mental Health

Services for Latino and Asian Immigrant Elders,” Professional Psychology: Research and Practice 36.6 (2005):

642-648, p. 642.

[4]

Kiljoong Kim, “The Korean Presence in Chicago,” in The New Chicago: A Social and Cultural Analysis, ed. John Patrick

Koval (Philadelphia: Temple University Press, 2006), p. 166.