Immigrant Seniors Research Articles

Rethinking Intergenerational Living as the Ideal Form of Senior Care: Life Course Research with Immigrant Families in Toronto

Canada’s care systems are ill-equipped to support its aging population, and this crisis intertwines with an acute shortage of affordable housing. Immigrants to Canada have a higher propensity to cohabitate multi-generationally, an arrangement that is sometimes romanticized as an ideal form of senior care. This article contributes to scholarship exploring intergenerational cohabitation as a practice of care, using life course research to consider how class and migration timing shape experiences of intergenerational living and senior care. Based on 19 in-depth interviews with immigrant seniors from Latin America and the Caribbean (n=10) and family caregivers (n=9) living in the Greater Toronto Area, this study uncovers two central findings. First, intergenerational living should not be viewed as an ideal form of senior care since (1a) some seniors resist intergenerational living, preferring independence and downtown residence nearer to culturally relevant communities and (1b) cohabitation does not always provide sufficient or better care. Second, access to smooth multigenerational cohabitation is inequitable, as housing arrangements are structured by class and migration timing, with middle-class families who have been in Canada longer facing fewer barriers to positive experiences of intergenerational living, compared to more recent migrants with lower incomes. This article challenges culturally essentializing assumptions about immigrant intergenerational cohabitation and argues that access to affordable housing is a senior care issue.

Scoping review protocol: what is the state of evidence for the use of communication apps with immigrant seniors in long-term care and community settings?

First language care is critical for older immigrant adults with limited English proficiency, especially in long-term care settings where most residents require staff assistance and experience complex chronic conditions, resulting in multiple communication interactions where language poses a barrier. Although there are a myriad of cultural-language translation apps and devices available, there is a gap in both research and practice on the acceptability and feasibility of these digital resources within the context of long-term care and community settings for older immigrant adults, from a cultural relevance and digital health equity perspective. Our paper outlines a scoping review protocol to examine the state of the literature on the extent to which cultural-language translation apps are used in long-term care settings and community-based elder care. We will also examine the extent to which such apps bridge or further gaps in equitable, accessible and acceptable care for older immigrant adults with limited English language proficiency. This scoping review protocol will employ an adapted five-stage framework outlined by Arksey and O'Malley guided by enhancements recommended by Levac et al and Colquhoun et al. Using the Joanna Briggs Institute's population, concept and context framework, we defined the scope of the scoping review by identifying the target population, concepts for investigation and the context within which the research is situated. We will conduct a search of the literature from 2005 to 2024 using five bibliographic databases from health sciences (Healthstar OVID, MEDLINE OVID and Cumulative Index to Nursing and Allied Health Literature (CINAHL) EBSCO), engineering (Engineering Village Elsevier) and a cross-disciplinary database (Web of Science Clarivate). The research team will adopt a critical, equity-focused approach for the scoping review by integrating Richardson et al's framework for Digital Health Equity into our analysis of the findings. This will ensure that health and social equity perspectives are integrated within our methodology and analytical lens. Our analysis will specifically examine selected studies for their engagement with health equity and their ability to address issues such as ageism, ableism and the digital divide within geriatric care. Ethics approval is not required for this scoping review as it involves secondary analysis of published works and no primary data collection involving human subjects. Findings of the review will be shared with community partners and disseminated through publications, conferences and peer-reviewed publications.

"I Love to Write My Story": Storytelling and its role in seniors' language

This article examines the role of storytelling as an arts-based educational approach in an older-adult immigrant language-learning program. As a special group within the adult language-learner population, immigrant seniors benefit from educational strategies that emphasize recognition of life experience over knowledge accumulation, which is a common goal of more traditional educational approaches. We present a small study of a storytelling class held within the English Conversation Program at the University of British Columbia Learning Exchange. Based on compelling results, we argue that storytelling is a powerful strategy that not only facilitates language learning, but creates a safe, inclusive learning community.

Exploring the intersections of immigrant seniors’ digital literacies and social connectedness: a Canadian study

Seniors’ adoption of emerging technologies is crucial to their social connectedness, well-being, and digital participation in society. This article presents a Canadian study on how immigrant seniors established and sustained social connections through their engagement with digital technologies during the COVID-19 pandemic. Specifically, we aim to (1) deepen understandings of how immigrant seniors’ learning through and about technologies can shed light on our conceptualization of seniors’ digital literacies and (2) suggest programs and pedagogies that could foster lifelong learning for seniors. Data were collected through interviews, observations, and digital artifacts from a sample of immigrant seniors (N:16). Through narrative, we stitch together the personal and sociocultural perspectives from four seniors’ stories for holistic insights into their learning and engagement with technologies. Their stories also emphasize possibilities for dynamic and interconnected digital engagement and the inseparable link between community support and developing seniors’ digital literacy. Social interaction plays a pivotal role in facilitating, fostering, promoting, and enhancing seniors’ digital literacies. Our findings challenge preconceived notions about how seniors navigate digital technologies and offer strategies for supporting community service agencies in designing and implementing senior-friendly digital literacy programs.

Spreadable Action: Mapping Connections between the Arts and Action Research through an Arts-Based Research Exhibition

Many Canadian immigrant seniors living independently in Canada face unique challenges such as language barriers, adjusting to a new culture, and isolation from friends and family. Within the context of the COVID-19 pandemic these issues have become more complicated. This article explores a form of arts-based research (ABR) as an inquiry into ways that COVID-19 has impacted immigrant seniors in Vancouver, Canada. We situate our inquiry within action research (AR) and explore new methodological possibilities stimulated by merging artistic engagement within the inquiry. Our research is mobilized through two gallery exhibitions of Letters to COVID: an invitation to visually reflect on seniors’ experiences. We consider what we might do to facilitate support for these citizens, inviting the public to rethink perceptions and strategies of social inclusion and support for immigrant seniors living independently in Canada.

The aging of international migrants and strategic transnational practice in later life: Exploring Portuguese seniors in Toronto, Canada

The Portuguese community in Toronto is the largest in North America; however, its immigrant population is now aging. This paper addresses senior immigrants who had a transnational “later life” and discusses this practice in the transatlantic context, using a lifecycle model of transnational migration. Later life is a life stage that is highly feasible for transnational migration, as seniors are mostly disentangled from various obligations, such as work, child rearing, and caregiving for parents. Transnational senior migrants in Europe and North America can be categorized into four groups: Intra‐Europe Rich, Intra‐Europe Immigrant, North American Snowbird, and Trans‐Atlantic Immigrant. Trans‐Atlantic Immigrant seniors, the target group of this paper, differ from the other groups on several points, including seasonal preference for transnational migration, motivations, and legal regulations. The paper considers the questions of why senior Portuguese immigrants choose to stay in Portugal for an extended period each year, while mainly living in Canada, and how their later life is structured between the two countries. Transnational later life is a strategic practice of senior Portuguese immigrants in Canada in the last stage of their lifecycle, allowing them to maximize government pension payments while simultaneously enjoying the highest quality of life possible in both countries.

Dental utilization among aging immigrants in Canada

Objective: To compare the dental-care utilization of elderly immigrants to that of non-immigrants in Canada. Materials and Methods: This is a secondary data analysis of publicly available data from the 2008/09 Canadian Community Health Survey: Healthy Aging (CCHS-HA) component. The target population consisted of 30,865 people aged 45 years and above. A modified Andersen’s health-service utilization model was used as the framework for analysis, grouping predisposing (age, sex, marital status, immigrant status, time since immigration, smoking, alcohol use), enabling (Education, household income, dental insurance, social support), need (Self-reported health and self-reported oral health) and behavioural factors (Brushing and physician visit), to compare the dental care utilization between elderly immigrants and non-immigrants. Descriptive statistics and binary and multivariable logistic regressions were performed. Results: Results for the entire population indicate age, sex, marital status, level of education and income, dental insurance, physician visit, smoking and self-reported oral health as significant predictors of dental visits. Predictors for utilization among immigrant seniors were: age, sex, marital status, social interaction, and level of education. Predictors for non-immigrant seniors included: age, level of education, household income, dental insurance, smoking, and self-reported oral health. Conclusion: By comparing elderly immigrants and non-immigrants, this study draws attention to what influences dental care utilization in each group. Implications for oral health policy include integrating oral health insurance into Canada’s universal healthcare system, changes in legislation that improve the availability and access to dental insurance, and better utilization of existing dental public-health resources by including targeted services to elderly immigrants.

Social Isolation and Aging Out of Place Among Immigrants and Refugee Seniors in Canada

Immigrant and refugee seniors experience cultural barriers, discrimination, and limited networks which increase the risk of social isolation and thus hinder their active participation in the society. This paper explores social isolation among immigrant and refugee seniors in Canada based on an environmental scan of federal/provincial/territorial and community-based programs and a systematic scoping review. Findings revealed important gaps and regional disparities in opportuntiies to reduce social isolation and great active participation. Research was limited, often qualitative in nature, typically based on larger urban centres, with measurement issues related to the need for consideration beyond one's living arrangements. The results highlight the need for greater understanding Canada’s immigration and refugee system and policies, and collaboration across levels of government. Reducing issues of social isolation and enabling better active aging for vulnerable seniors require a more nuanced and multidimensional conceptualization with prioritization on addressing the unique factors of culture and geographical context.

ICT tools in breaking down social polarization and supporting intergenerational learning: cases of youth and senior citizens

ABSTRACT Conflicts between young immigrants and older native populations are widely recognized as a challenge in different parts of the world. In the European context, the following paper focuses on presenting the research results of a community-based project entitled “ICT Guides” conducted in Gothenburg (Sweden), Sheffield (the United Kingdom), Madrid (Spain), and Berlin (Germany), in which we investigated the features and functions of the intergenerational learning of immigrant youth and unrelated seniors using ICT tools. We claim that both groups perceive intergenerational learning with the use of ICT as a chance to get to know the other group despite the age and cultural differences. Through the use of ICT tools in intergenerational learning, digital tools can help those who lack a good command of language when communication problems occur. ICT facilitates mutual understanding and contributes to breaking down the polarization that can occur between immigrant youths and unrelated seniors, to the mutual benefit of both parties.

Competing challenges for immigrant seniors: Social isolation and the pandemic.

The pandemic has exposed and amplified complex and complicated health and societal challenges while offering immense opportunities to transform societies to improve health for all. Social isolation is a challenging and persistent issue experienced by many older adults, especially among immigrant and refugee seniors. Unique risk factors such as racism, discrimination, language barriers, weak social networks, and separation from friends and family predispose immigrant and refugee seniors to a higher risk of social isolation. The pandemic has magnified the unique risks and has highlighted the differential health and economic impacts. This article examines social isolation among immigrant and refugee seniors in Canada by focusing on the policy context, available programs and services to reduce social isolation, and the conceptualization and measurement considerations for advancing research to address social isolation among this growing population. Drawing on specific examples, we discuss immigration, aging, and social isolation within the context of Canada. While our article focuses on Canada as a case study, our discussion has relevancy and implications for other high-income countries with aging immigrant and refugee populations. In moving forward, we argue that a more complete and targeted understanding of social isolation is essential to informing program and policy development to support immigrant and refugee seniors in Canada and beyond. The transformation needed in our societies to create health for all requires strong equity and determinants of health perspective and a systems approach beyond health to ensure lasting change.

“They gave me back my power”: Strengthening older immigrants’ language learning through arts-based activities

Through the case of Jacqui, this article describes a community-based project called Seniors Thrive, which was intended to help immigrant seniors learn English, build social connections, and strengthen their leadership in order to support their health and well-being. The programming merged language learning and leadership opportunities through arts-based programming. Multiple classes offered through Seniors Thrive brought together individuals from all walks of life to learn together and from each other. As a result, many learners, including Jacqui, demonstrated heightened confidence in their English speaking abilities and increased their social connections. The arts-based program enabled the voices of older learners to be heard beyond their closed communities. We pose that arts-based activities have the potential to transform language learning in later life, if arts-based programs follow a flexible and community-driven design.

A Smartphone App (mDASHNa-CC) to Support Healthy Diet and Hypertension Control for Chinese Canadian Seniors: Protocol for Design, Usability and Feasibility Testing.

BackgroundThis proposed study aims to translate the Dietary Approach to Stop Hypertension with Sodium (Na) Reduction for Chinese Canadians (DASHNa-CC), a classroom-based, antihypertensive, dietary educational intervention, to an innovative smartphone app (mDASHNa-CC). This study will enable Chinese Canadian seniors to access antihypertensive dietary interventions anytime, regardless of where they are. It is hypothesized that senior Chinese Canadians will be satisfied with their experiences using the mDASHNa-CC app and that the use of this app could lead to a decrease in their blood pressure and improvement in their health-related quality of life.ObjectiveThe goal of this study is to design and test the usability and feasibility of a smartphone-based dietary educational app to support a healthy diet and hypertension control for Chinese Canadian seniors.MethodsA mixed-method two-phase design will be used. The study will be conducted in a Chinese immigrant community in Toronto, Ontario, Canada. Chinese Canadian seniors, who are at least 65 years old, self-identified as Chinese, living in Canada, and with elevated blood pressure, will be recruited. In Phase I, we will design and test the usability of the app using a user-centered approach. In Phase II, we will test the feasibility of the app, including implementation (primary outcomes of accrual and attrition rates, technical issues, acceptability of the app, and adherence to the intervention) and preliminary effectiveness (secondary outcomes of systolic and diastolic blood pressure, weight, waist circumference, health-related quality of life, and health service utilization), using a pilot, two-group, randomized controlled trial with a sample size of 60 participants in a Chinese Canadian community.ResultsThe study is supported by the Startup Research Grant from Nipissing University, Canada. The research ethics application is under review by a university research ethics review board.ConclusionsThe study results will make several contributions to the existing literature, including illustrating the rigorous design and testing of smartphone app technology for hypertension self-management in the community, exploring an approach to incorporating traditional medicine into chronic illness management in minority communities and promoting equal access to current technology among minority immigrant senior groups.Trial RegistrationClinicaltrials.gov NCT03988894; https://clinicaltrials.gov/ct2/show/NCT03988894International Registered Report Identifier (IRRID)PRR1-10.2196/15545

Association between Knowledge about How to Search for Mental Health Information and Emotional Distress among Older Adults: The Moderating Role of Immigration Status

ABSTRACTMental health literacy (MHL) provides a framework to overcome barriers to service use and reduce mental health disparities through public education. Acquiring basic knowledge about mental health problems can guide subsequent help-seeking behavior. Improving knowledge about how to search for mental health information is a critical first step in improving MHL. In this study, we examined the association between knowledge about how to search for mental health information and emotional distress among older adults. We further examined the moderating role of immigration status in this association. A sample of 605 older adults participated in the study (N = 357 Native Israelis; N = 222 Immigrants from the Former Soviet Union). Participants completed self-report measures assessing MHL and emotional distress. Our findings show that Native Israelis reported significantly lower levels of emotional distress and higher levels of knowledge about how to search for mental health information compared to immigrants. Moreover, while among native older adults, increased knowledge about how to search for mental health information was associated with lower emotional distress, among immigrant seniors there was no significant association between these variables. Our findings suggest that differences among immigrant and native older adults can impact the effectiveness of the mental health knowledge that is accessed.

Cyberspace as a place of intergenerational learning. Example of the „ICT Guides” project

This article presents the main assumptions and general results of the "ICT Guides" project implemented under the Erasmus + program. This project was initiated by the local government of the city of Goteborg in Sweden, and its aim was to reduce the phenomenon of early school leaving by children and youth from immigrant families. The project was also joined by the authorities of three other European cities, namely Sheffield (Great Britain), Madrid (Spain) and Berlin (Germany). The project consisted in organizing of intergenerational learning courses with the participation of children and young people from immigrant families and local seniors, which were supported by information and communication technologies (ICT) and Internet applications. Apart from conventional meeting places, such senior clubs, community centers, intergenerational cooperation and intergenerational learning, there was also cyberspace. The University of Lodz was the research institution preparing the theoretical framework for the project implementation and evaluated the project.

Sensor-Based Passive Remote Monitoring and Discordant Values: Qualitative Study of the Experiences of Low-Income Immigrant Elders in the United States.

BackgroundRemote monitoring technologies are positioned to mitigate the problem of a dwindling care workforce and disparities in access to care for the growing older immigrant population in the United States. To achieve these ends, designers and providers need to understand how these supports can be best provided in the context of various sociocultural environments that shape older adults’ expectations and care relationships, yet few studies have examined how the same remote monitoring technologies may produce different effects and uses depending on what population is using them in a particular context.ObjectiveThis study aimed to examine the experiences and insights of low-income, immigrant senior residents, family contacts, and staff of housing that offered a sensor-based passive monitoring system designed to track changes in movement around the home and trigger alerts for caregivers. The senior housing organization had been offering the QuietCare sensor system to its residents for 6 years at the time of the study. We are interested in adoption and discontinuation decisions and use over time, rather than projected acceptance. Our research question is how do cultural differences influence use and experiences with this remote monitoring technology? The study does not draw generalizable conclusions about how cultural groups interact with a given technology, but rather, it examines how values are made visible in elder care technology interactions.MethodsA total of 41 participants (residents, family, and staff) from 6 large senior housing independent living apartment buildings were interviewed. Interviews were conducted in English and Korean with these participants who collectively had immigrated to the United States from 10 countries.ResultsThe reactions of immigrant older adults to the passive monitoring system reveal that this tool offered to them was often mismatched with their values, needs, and expectations. Asian elders accepted the intervention social workers offered largely to appease them, but unlike their US-born counterparts, they adopted reluctantly without hope that it would ameliorate their situation. Asian immigrants discontinued use at the highest rate of all residents, and intergenerational family cultural conflict contributed to this termination. Social workers reported that none of the large population of Russian-speaking residents agreed to use QuietCare. Bilingual and bicultural social workers played significant roles as cultural navigators in the promotion of QuietCare to residents.ConclusionsThis research into the interactions of culturally diverse people with the same monitoring technology reveals the significant role that social values and context play in shaping how people and families interact with and experience elder care interventions. If technology-based care services are to reach their full potential, it will be important to identify the ways in which cultural values produce different uses and responses to technologies intended to help older adults live independently.

AGE-FRIENDLY INITIATIVES AND IMMIGRANT SENIORS: ADDRESSING SOCIAL ISOLATION USING TECHNOLOGY

Of the eight dimensions of the World Health Organization’s “age-friendly” cities initiative, the communication domain highlights the importance of information about community events and services being available in formats that are ‘appropriate’ for older adults. Although older immigrants may face pervasive language barriers in the English-speaking communities they often reside in, various forms of technology show promise for bridging communication deficits and reducing social isolation. To better understand the role of technology for facilitating communication, a mixed-methods study consisting of surveys (n=100) and two focus groups led by native language speakers were conducted with Cantonese (n=6) and Mandarin speaking (n=19) seniors (65+) living in Chinatown, Toronto, Canada. The surveys used standardized scales for social participation to measure aspects of the seniors’ lived experiences including sense of belonging, availability and access to community/ healthcare services, frequency and quality of family and social interactions, and perceived personal well-being. Both quantitative and qualitative findings indicate that technology was favoured as a primary method of communication for immigrant seniors, and that this mode of communication can facilitate significant improvement in multiple domains of age-friendly initiatives including: social participation and inclusion, community support and health services, and transportation. To maximize the use of tangible and tech-based resources available to seniors (i.e., wearables, smartphones), communities should incorporate technology such as messaging apps or electronic translation services to instantly mobilize information and knowledge into accessible language and cultural formats. Circumventing language barriers with other seniors and service providers in the community, technology may promote greater social participation.

End of Life Care for Older Russian Immigrants - Perspectives of Russian Immigrants and Hospice Staff.

This pilot study examined immigrant Russian seniors and adult children's views on end-of-life care, and hospice staff members' experiences providing care to diverse immigrant clients, in areas of North Carolina with a high proportion of immigrants. Data were collected through individual in-depth interviews with informants, including Russian immigrant seniors, Russian adult children, and hospice staff, and analyzed by qualitative techniques. Findings indicate that there is little awareness of end-of-life care options among the Russian immigrant community in North Carolina. End-of-life care is rarely discussed within the family of first generation Russian immigrants but second-generation families are more open to doing so. First generation immigrant Russian seniors in our study do not seem to want any specialized end-of-life care often due to lack of awareness, and prefer family care. Second generation seniors' attitudes are more accepting of this type of care. Hospice staff serve all those who seek care, receive training to serve diverse clients, and prioritize professional policies. There is sometimes potential for a gap between hospice policies regarding care and immigrant families' expectations for care. Results suggest a great need for community outreach to immigrant groups to raise awareness of end-of-life care, including advance directives and hospice care and the role of interpreters in health care settings.

Enoch Senior's College for Korean Immigrant Seniors: Quality of Life Effects.

ABSTRACTA community-based program is increasingly recognized as promoting health and active social participation in one's life, yet information is lacking about the use and impact of such programs among immigrant visible minority seniors. This mixed-method research evaluated the impact of a cultural community program for Korean immigrant seniors by examining participants' health-related quality of life (HR-QOL) benefits and overall well-being. In this study, 79 participants completed the SF-36v2 questionnaire twice to assess the impact of Canada Enoch Senior's College (CESC) program on their HR-QOL and well-being. Statistically significant improvement in physical and mental health domains was observed: bodily pain and role limitations due to emotional problems. Qualitative data from participants' interviews supported the survey findings with positive contributions in health and social arenas of seniors' lives. These results suggest that the CESC program contributes to quality of life and well-being of Korean senior participants and supports similar community-based cultural programs.

Family conflict and future concerns: Opportunities for social workers to better support Chinese immigrant caregiver employees

ABSTRACTThis paper explores the experiences of Chinese immigrant caregiver employees (CEs) residing in Southern Ontario, Canada. Qualitative analysis of participant interviews with thirteen Mandarin Chinese immigrant CEs revealed family conflicts due to cultural differences and an intergenerational gap between CEs and their care recipients. CEs also had future concerns in regards to their own health and the lack of long-term care facilities that offer cultural services for immigrant seniors. These findings provide an opportunity for social workers to collaborate with other service providers to provide ethno-specific and culturally sensitive health, community. and employment services to immigrant ethnic minority CEs.

Enhancing Teaching English as an Additional Language Through Playfulness: Seniors (Ethno)Drama Club in Vancouver's Downtown Eastside

This article describes the process of using an ethnodrama while working with older adults learning English as an additional language. By examining a 4‐month‐long period of Seniors Drama Club, created to offer theatre‐based language learning experiences for Vancouver's immigrant senior population, the authors draw attention to the complex learning that occurs at the intersection of drama education and additional language learning. The aim of the article is twofold. First, the authors show the benefits of using adaptable and “living” texts—such as an ethnodrama—in language teaching. Second, the authors argue that framing of language learning as a collaborative theatre project empowers learners to take agency of their language learning and future use. In conclusion, the authors elaborate on some of the promising practices developed as the outcome of this community‐based project.