Elderly Immigrants Research Articles

Health care and social service use among Chinese Immigrant elders

We explored patterns and reasons for health and social service use among Chinese immigrant elders. Interviews were conducted with 27 Chinese immigrant elders, 11 adult care giving children, and 12 health and social service providers. Content analysis of these data indicated that participants across groups agreed that Chinese elders under-utilize services because of problems related to language, transportation, cost, long waits for appointments, and because of cultural norms/values related to need for care, preference for self-over professional care, fear, and distrust of western biomedicine, and the obligation to refrain from using formal services. These problems are complicated by geographical dispersion and dialect differences in the local Chinese immigrant community.

Improving mental health services for Latino and Asian immigrant elders.

Given the changing demographics of the aging population in the United States, it is likely that professional psychologists will encounter elderly clients from diverse backgrounds in their practice. Asians and Latinos represent the 2 fastest growing groups of elderly immigrants. This article offers information and practical suggestions to assist clinicians working with elderly Asian and Latino immigrant clients. Specific recommendations for enhancing assessment and treatment efficacy with these populations are also provided.

Chronic Illnesses and Depression Among Chinese Immigrant Elders

Objectives: The purpose of the study is to explore the unique effects of various chronic illnesses on depression in a sample of Chinese immigrant elders. Methods: The data were collected in the Greater Boston area at various social service agencies, social, and religious institutions. A self-administered sample of 177 Chinese-speaking immigrant elders was included in the study. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to measure depressive symptoms in the study. Regression analysis was performed for three measures of depression: 7-selected CES-D scale, its subscale somatic symptoms, and depressive symptoms. Results: Chronic illnesses have various effects on the selected CES-D score, and its subscales under the total sample and the samples of male and female respondents. Conclusions: The findings suggest that medical, psychological, and social work treatments or interventions for depression should take the impact of chronic illnesses into consideration.

Use of Home Care Services by Elderly Chinese Immigrants

ABSTRACT Using the Anderson Service model, this study examined the level and predictors of using selected home care services by elderly Chinese immigrants in Canada. Data from 1,537 randomly selected Chinese immigrants aged 65 years and older were used. Only 5.2% of participants reported using home care services. Being older, living alone, having a post-secondary education, immigrating from Hong Kong or Southeast Asia, having a higher level of agreement with Chinese health beliefs, higher social support, and poorer physical and mental health were predictors for home care service use among elderly Chinese. The probability of using homecare services lessens with increased self-rated financial adequacy. These findings point to the need for service providers to address the gap in use of home care between elderly Chinese immigrants and overall elderly Canadians through promoting appropriate use of home care among elderly Chinese immigrants.

Expatriation experiences of Chinese immigrants in New Zealand: factors contributing to adjustment of older immigrants

This seminal research investigates the adaptation experiences of elderly dependent Chinese immigrants who have come to New Zealand under the Family Reunion Category between 1994 and 1998. The study involved a group‐administered questionnaire to measure the various aspects of the adaptation experiences of 105 elderly dependent Chinese from China aged 50 years and over. The data set was subjected to ANOVA, Kruskal‐Wallis and Factor Analysis to analyse and establish relationships between variables. The results confirmed that there were five main factors that influence the living conditions of the elderly dependent Chinese immigrants in New Zealand. These were, in order of severity, communication in the English language, medical care, transportation, cost of living and interestingly relationships with other family members. The study also confirmed that age, length of time in New Zealand, and the need to stay in New Zealand permanently influenced the adaptability of the elderly Chinese immigrants in New Zealand.

Chapter 3 The Impact of the 9/11 Attacks on the Elderly in NYC Chinatown

This article discusses the findings of a study on the impact of the 9/11 attacks on the elderly Chinese immigrants in Chinatown, a community in close proximity to the World Trade Center. The findings reveal the stories of a vulnerable population who suffered extensive traumatization from 9/11, and describes their struggles with their issues of loss from a history of poverty, war and immigration. Implications of service recommendations are made in the context of the participants' help-seeking behavior and their cultural beliefs and norms.

Reliability of the Geriatric Depression Scale for use among elderly Asian immigrants in the USA.

The increasing numbers of Asian and other immigrants in the United States have resulted in greater demands for research methodology sensitive to cross-cultural issues. A regional probability sample (n = 407) of Asian elderly immigrants of different nationalities (Chinese, Korean, Indian, Filipino, Vietnamese, or Japanese) residing in New York City was used to examine the reliability of the Geriatric Depression Scale (GDS). Using the 30-item GDS, about 40% of this representative sample of Asian elderly immigrants was considered to be depressed, indicating higher depression rates than in the previous studies of other Asian elderly samples in the US and in Asia. Results also showed that the 30-item GDS and 15-item GDS Short Forms were reliable measures to assess depression in community-dwelling Asian immigrant elders. Data strongly suggest that Asian elderly immigrants in the US are at risk of depression, indicating a need for the design of culturally sensitive mental health programs.

Language deterioration in four Japanese–Portuguese bilingual patients with Alzheimer's disease: a trans‐cultural study of Japanese elderly immigrants in Brazil

AbstractBackground: Bilingualism is an area of linguistics that has been investigated in aphasic patients. However, bilingualism and Alzheimer's disease (AD) have not been fully investigated despite the fact that language impairment is a frequent symptom of AD. Brazil has the greatest number of Japanese immigrants and, consequently, there are many bilingual people who are fluent in both Japanese and Portuguese in Brazil.Methods: Using the results from a previous epidemiological survey, we found four AD patients who were fluent in both Japanese and Portuguese before developing AD, and performed the following evaluations in both languages: confrontation naming, oral reading ability, vocabulary comprehension (matching words and drawings), written lexical decision and the Western Aphasia Battery (WAB).Results: All patients demonstrated impaired naming ability in both languages. Oral reading ability was most impaired in the case of Kanji, followed by irregular words in Portuguese. The patients could recognize and pronounce Kana perfectly, and regular Portuguese words almost perfectly. In the severest case, the patient showed disturbed lexical comprehension and lexical decision, especially when faced with Kanji. The WAB classified three patients as having anomic aphasia in both languages, whereas in the severest case the patient was classified as having anomic aphasia in Portuguese and Wernicke aphasia in Japanese.Conclusion: These results may reflect different patterns in language deterioration as AD progresses, with Kanji being more readily affected by the disease than Kana and Portuguese. This is the first study to focus on Japanese–Portuguese bilingualism in AD patients.

Elderly Care for Ethnic Minorities--Wishes and Expectations among Elderly Finns in Sweden

Objectives. Although elderly people from immigrant and minority groups utilise elderly care facilities to a lesser extent than elderly people from majority groups, there is a lack of research on how elderly people with different ethnic backgrounds wish and expect to be cared for when they are in need of institutional elderly care. This study aims to illuminate the role that culturally appropriate care plays in elderly Finnish immigrants' wishes and expectations of institutional elderly care in Sweden. Design. Thirty-nine elderly Finnish immigrants in Sweden, aged 75 years or more, were interviewed in their homes. The data were analysed with latent qualitative content analysis. Results. The elderly Finnish immigrants in Sweden wished to be able to continue living in their current homes for as long as possible. Later on, when entering institutional elderly care, they wanted to feel continuity, familiarity, security and companionship with others. As immigrants, they had to choose to be cared for either in well-known physical environments close to their current homes, or in a culturally appropriate care setting with familiar socio-cultural conditions. Conclusions. To be able to provide institutional elderly care for minority groups it is important to ease the access to elderly care amenities by providing care that results in maintaining as much continuity and familiarity as possible in the lives of the elderly people. This includes the care providers and other residents who share the familiar aspects of their lives. This involves providing culturally appropriate elderly care close to the elderly people's current homes.

Vision Problems Of Elderly Immigrants In Israel: A Prospective Study

Eye disorders restrict sight and limit ability of elderly people to function. A model community-based outreach program, Negev Project Vision, was organized to address the eye care needs of the elderly -specifically, immigrants from the former Soviet Union and Ethiopia now living in Israel. Findings show that about 80% of the elderly screened were in need of eye care (e.g., medical or optometry-related services). Among those needing medical treatment, 67% had cataract; 14% trachoma; 9% glaucoma; 9% age-related macular degeneration, and 2% diabetic retinopathy. Half (50%) were found to have vision disorders that could be corrected by prescription eyeglasses. A post intervention interview showed that those provided eyeglasses tend to report a better health status, ability to function, address daily living conditions, as well as interact and a higher level of more with interaction with family and friends. This article discusses community outreach services and policy recommendations related to eye care of the elderly. Since the late 1980's, Israel has absorbed many immigrants who constitute about 20 percent of the present population. While the vast majority of these people are from the former Soviet Union, others came from Ethiopia. Among the population of immigrants, it is estimated that 16% are over 65 years of age (Brodsky et al., 2000). For many elderly immigrants, life before moving to Israel was a considerable challenge. For example, Ethiopian elderly left behind some of the most destitute living conditions in the world, characterized by average life expectancy of 47 years, lack of food and safe drinking water, and inadequate sanitation and sparse health services (UNICEF, 1995; Isralowitz, 2000). While not at the same level found in Ethiopia, living conditions with restrictions on food and adequate heath care in the former Soviet Union made life difficult there. Poor living conditions have been found to affect the nature and rate of deterioration that occurs among people over the age of 50 in terms of their vision and social, psychological, and physical ability to function (Brenner, et al., 1993). Studies show limited sight linked to the mental health of elderly people, their behaviors and social involvement (Horowitz, 1995; Wahl, et al., 1999a, 1999b). Visually impaired elderly people experience a range of emotions, including grief, anger, depression, anxieties and other negative feelings leading to decreased self-confidence and self-perception, lower morale, loss of control and feelings of vulnerability (Gillman, et al., 1986; Orr, 1991). Loss of vision is associated with adjustment difficulties that in turn lead to social isolation, detachment and feelings of loneliness (Heinemann, et al., 1988;Orr, 1991). Additional research shows vision disorders to be a major factor restricting indoor and outdoor daily living activities such as moving in and out of bed or a chair, walking or crossing roads, or traveling (LaPlante, 1988). Moreover, without the ability to read bus numbers, see traffic lights and notice close cars, travel becomes dangerous and stressful causing many elderly to become homebound. Vision disorders have a negative impact on instrumental activities of daily living (IADL) that include homemaking chores and on basic activities of daily living (ADL) such as dressing, washing, and eating (Branch, et al., 1989;Cherry, et al., 1991; Gillman, et al., 1986). NEGEV PROJECT VISION In Israel, eye care services are available to older persons needing medical treatment. Routine examinations and optometric care including the provision of eyeglasses are services that must be paid for by the individual. Such services are prohibitively expensive for many elderly persons, especially immigrants with a minimum fixed Vision Problems Of Elderly Immigrants In Israel: A Prospective Study

Devolution and the Social Welfare of Elderly Immigrants: Who Will Bear the Burden?

Growing ethnic diversity translates into rising numbers of individuals facing socioeconomic disadvantage, creating a context in which detailed examinations of public policy are critical for understanding the health care needs of immigrant populations in the United States. Although many scholars document the link between social disadvantage and increased morbidity and mortality, additional analyses are needed to identify specific public policies associated with decreased access to social goods and public services. The implications of the latest welfare bill, the Personal Responsibility and Work Reconciliation Act of 1996, on the health and social welfare of the aging Hispanic population provides a unique opportunity for such inquiry. On the basis of demographic trends and recent analyses of data from the Hispanic Established Populations for Epidemiologic Study of the Elderly, the results suggest that older, Mexican–origin immigrants are likely to become an even greater administrative responsibility of state and local governments.

The Role of Community Context in Immigrant Elderly Living Arrangements

Previous studies of the determinants of living arrangements for immigrant elderly have focused on cultural tradition or individual characteristics, without addressing community-level structural factors. This study examined the living arrangements of Korean American elderly. The authors hypothesized that the probability of Korean American elderly living independently is associated with community characteristics, specifically the availability of subsidized housing near Korean ethnic communities. Using the U.S. Census Bureau 1990 Public Use Microdata Sample, the authors compared the living arrangements of Korean Americans aged 60 and over in Los Angeles, Chicago, and New York City. After adjusting for demographic, socioeconomic, cultural, and health factors, Korean American elderly in New York City are less likely to live independently compared to those in Los Angeles or Chicago. Using Korean business directories and public housing lists, the authors found that the availability of subsidized housing and the concentration of Korean businesses are jointly associated with residential autonomy.

Subcontracting Filial Piety

Based on in-depth interviews with middle-class Taiwanese and Hong Kong immigrant families in California, the author examines how the cultural meaning and social practice of filial care for aging parents have been transformed in the U.S. context. The author analyzes the commodification of elder care from three dimensions—where care takes places, who gives care, and who pays for care—and examines its impacts on Chinese family relations. Although three-generational cohabitation may have declined on foreign soil, the family remains the nexus of care networks and economic ties among Chinese immigrants. Through recruiting home care workers as fictive kin, immigrant adult children are able to maintain the cultural ideal of filial care. The receipt of public care among immigrant elders does not necessarily indicate the diminishment of family bonds, but it reinforces kin connections as channels for circulating economic resources.

Constructing Deservingness

On August 22, 1996, President Clinton signed the welfare reform law that ended eligibility for all immigrants to federal means tested entitlements. Poor elderly immigrants on Supplemental Security Income were specifically targeted. This article documents how the print media responded to these policy changes. The following are the major research questions: (1) How were older immigrants on Supplemental Security Income portrayed in the print media before and after federal welfare reform? (2) Who was involved in the print media coverage of older immigrants on Supplemental Security Income before and after federal welfare reform? (3) What types of statements were made by those involved in the print media coverage of older immigrants on Supplemental Security Income, before and after federal welfare reform? The approach used was an in-depth content analysis of newspaper articles from major U.S. newspapers. The findings demonstrate that older immigrants were constructed as “undeserving” in news articles prior to the passage of the federal welfare reform bill. However, after the passage of the federal welfare reform bill the coverage of older immigrants on Supplemental Security Income started to change, and older immigrants were portrayed as “deserving.” In advancing aging policy for poor, vulnerable elderly, such as elderly immigrants, advocates, health and social service providers can play an influential role in bringing their voices to the print media.

Social and Health Factors Associated with Support among Elderly Immigrants in Canada

This article assesses determinants of social support among the foreign-born elderly in Canada. We draw cross-sectional data from the second cycle of the National Population Health Survey, conducted by Statistics Canada in 1996-1997, and use ordinary least squares models for our empirical analysis. We focus on three measures of social support: perceived social support, social involvement, and social contact. Generally, we find that poorphysical and/ormental health is negatively associated with ourmeasures of support. Emotional problems, one of the most consistent predictors, erode social support. Also, social involvement declines with mobility problems but increases with self-reported health status, whereas social contact also increases with cognitive function. As with otherstudies, and consistent with relationships witnessed among the native-born population, our results indicate that the married/cohabiting are more likely than the separated/divorced or widowed to perceive social support. Further, we find that those with children experience greater perceived support.

The Effects of the U.S. Public Welfare System Upon Elderly Korean Immigrants' Independent Living Arrangements

ABSTRACT Elderly Korean persons who immigrated to the United States often live in a situation coined ‘multiple jeopardy’ (being old, poor, and minority; having low educational attainment, language problems, and cultural differences). Contrary to the assumption that Asian elders often live with their adult children, these elderly tend to live separately, thus ignoring their traditional custom of intergenerational co-residence. Consequently, the lives of these elderly are dramatically different from their peers in Korea where the tradition of filial piety is still prevalent. This divergence of customs for elderly Korean Americans living in the United States has given rise to our research. Based on a review of the findings of three studies about elderly Korean immigrants, we discuss major factors influencing their decisions to live separately from their adult children. The results of this review show that public welfare programs are a major factor associated with their preference for more independent lifestyles.

Caregiving between two cultures: an integrative experience.

In 1995, more than half of elderly immigrants to the United States were born in Asia or the Pacific region. The purpose of this study was to describe the process of caring for elderly parents by Asian American women. Forty-one women (22 Chinese American and 19 Filipino American) caring for elderly parents were interviewed in a study based on Strauss and Corbin's grounded theory methodology (1990). Although the women were moderately acculturated, indications of being in transition were evident. Analysis of interview data led to development of a substantive theory of caregiving between two cultures, reflecting the paradox of living and caregiving by two sets of standards and worldviews. The primary strategies used to manage the caregiving challenges were connecting and calibrating. Through personal growth and finding meaning, the caregivers integrated the caregiver role into their lives and became more connected with their families and within themselves.

Screening for Depression in Immigrant Chinese-American Elders

Background: Depression is a common mental health problem among Chinese elderly, but it often goes undiagnosed and untreated. Despite an increase in the population of elderly Chinese immigrants in the US, there have been few published studies on this topic. Objective: Our purpose was to determine the extent of depression in the participant population, using an updated Chinese translation of the original 30-item Geriatric Depression Scale (GDS; Yesavage et al., 1983). Study Design: A convenience sample of 102 Mandarin speaking Chinese elderly participants in two senior centers in Santa Clara County, CA was recruited. Results: A total of 29.4% of participants showed symptoms of depression, higher than the range found in the older adult American population (13-20%). Those most likely to be depressed ranged in age from 60 to 69 years (32%), lived with their children (37%), rated their financial and health status as below average, had less than a high school education, and lived in the US for less than 5 years. Conclusion: This updated Chinese translation of the GDS is a promising screening measure to detect depressive symptoms in elderly Chinese.

Migratory Grief and Depression Among Elderly Chinese American Immigrants

This article examines factors that affect psychological distress (depression) among elderly Chinese immigrants. The factors included in the study were their grief experience associated with immigration along with acculturation, length of residence in the U.S. and other demographic factors, such as age, gender, marital status, living arrangement, contact with relatives, relatives in home country, home country visits, and home country identity. A total of 150 Chinese immigrants from a major city in the U.S. aged between 55 and 86 participated in the study. The results of the regression analysis indicated that those respondents who had a higher degree of migratory grief experience and a lower English proficiency score, who visited their home country, and were younger, were more likely to feel depressed. Among these four variables, migratory grief alone contributed to 41.5% of the variance while the remaining three variables contributed to 12.4% of the variation. Implications for social work practice were discussed.

Accessibility of health and social services to immigrant elders: the Islington Study.

Numbers of immigrant elders are increasing and it is unclear whether they can access services. To examine service utilisation of older immigrants compared with their UK-born counterparts and relate it to health difficulties. Method Cross-sectional study in inner London measuring service use, mental health and disability. A total of 1085 people aged > or = 65 years were interviewed. Independent predictors of contact with a general practitioner included being born in Cyprus. Cypriots were the only immigrant population to report significantly more somatic symptoms than those born in the UK (P=0.005). Africans and Caribbeans used day care and other social services most frequently. Immigrants could access services. Africans and Caribbeans appear to have poorer physical health and thus have greater contact with services. Cypriots who experience depression may present with prominent somatic symptoms. This is likely to be due to a different idiom of distress.