It can be filial piety, cultural traditions or family values. For many Asian Pacific Islander families, they have taken the responsibility as caregivers or sole providers for their ailing and aging loved ones. But within the intricate family structures, complexity of generation gaps and immigration patterns, taking care of the Asian Pacific Islander elders can become a challenging learning process.

In Seattle, non-profit and direct service organizations serving the Asian Pacific Islander elder population understand the existence of the unique cultural and language barriers that families endure. Care-giving for an Asian Pacific Islander elder requires a multi-faceted, integrated and culturally responsive approach. Therefore, mainstream organizations must also follow grass-root organizations to tailor and strengthen its services to benefit caregivers and the elders within the Asian Pacific Islander communities.

“We recognize that there are linguistic and cultural differences” says Selina Chow, Operations Manager for Seattle Human Services Department Aging and Disability Services. “It’s important to influence mainstream organizations to reach culturally competent levels in order to broaden their services to serve the Asian Pacific Islander community. “

While waiting for the mainstream community to meet the physical and psychological changes Asian Pacific Islander elders face, Seattle organizations like Asian Counseling and Referral Service, Chinese Information and Service Center, Kin-On Health Care Center, Refugee Women’s Alliance and Nikkei Concerns has already adopted culturally appropriate and relevant programs that cater to the Asian Pacific Islander elders. The roadblock however, is to build a sense of trust and a relationship with the elder’s caregiver in order for them to fully utilize and take advantage of the available services.

“In the Asian Pacific Islander community, most caregivers take on the concept of care giving as a responsibility,” says Samuel Wan, Chief Executive Officer of Kin On Health Care Center. “But we also want to help them recognize a time to call for professional help.”

Negligence, isolation, depression and malnutrition are common calamities that elders face. Often times, such calamities are signs of abuse by their own caregivers or family members. But for Asian Pacific Islander elders, the risks are even higher. According to API Legal Outreach Elder Abuse Prevention and Technical Assistance located in San Francisco, Asian Pacific Islander elders often face insurmountable barriers to getting help. For example, immigration and economic circumstances for Asian elders force them to rely heavily on their children even if continuous abuse exists inside the household. Many Asian elders distrust higher authorities; and with a language barrier, they face even more difficulties conveying their mistreatment. Due to strong cultural ties, Asian Pacific Islander elders may also avoid speaking up for fear of bringing family shame.

The role of social service agencies is to provide culturally competent programs and extend an environment that upholds their cultural traditions. But, supporting their caregivers is also vital.

“In the Asian Pacific Islander community, it is truer for them to be the caregivers,” says Chow. It is important to provide services to the caregivers to prevent them from being burnt out. Many times, Asian families don’t see them as a caregiver so it’s foreign for them to get help.”

At Seattle’s Kin On Health Center, a Family Caregiver Support program has been developed to provide referral, education, care planning and assessment for the elder’s caregivers. While programs can alleviate the potential stress and burdens on caregivers, it is also important for agencies and practitioners to work collaboratively in understanding the complexity and the inter-generational levels of the families.

“As practitioners, you have to be able to understand generation and immigration patterns to better serve the API community,” says Wan.

Responding to demographic trends and community needs is a priority. As Seattle residency becomes more expensive, social service agencies must expand their efforts to reach out to the caregivers in order to provide adequate access and services for the elders.

“Seattle is getting expensive and more people of color are moving out,” says Chow. “Therefore, case management and services are also branching out. The fiscal agencies serve as the eyes and ears for the needs of the community.”

For the Asian Pacific Islander community, the demographic trends can be affected by immigration experiences and patterns.

Seeking assistance and asking for help may be a foreign concept for new immigrant children and family members. For second or third generations that lived in America longer, they may be more receptive to resources but may find challenges in understanding their parent’s perspectives. A catch 22.

At Kin On Health Care Center that specializes in Chinese families, such dilemmas can be found.

“We are beginning to see the difference between the old and new generations and how they take care of the elders,” says Wan. “The social history and chronological experiences as a Chinese community can be very different.”

Care giving for the elders is a process. Understanding the relationship between the elder and the caregiver is a process. Establishing trust and connection with a service provider is a process. And for social workers or case managers that work with all parties, learning at multiple levels is also a process.

“I have passion and sympathy for the elder population,” says Lisa My-Trang Mooney, a case manager at Asian Counseling and Referral Service Adult and Aging Department. “Every day, life is a struggle for them both physically and mentally.”

As Mooney prepares for her in home care case management, she prides her work that enables her to improve the lives of the elders. She’s empowered when clients are hopeful for her next visit.

“I feel that my job is the enabler to understand my client’s culture and hopefully get the truth out about their needs so I can advocate on their behalf,” says Mooney.

Trang has witnessed abandonment by the elder’s children. But, she’s also witnessed successful relationships. She has experienced the challenges of retrieving information when signs of negligence, mental or verbal abuse become apparent. Sometimes, breaking the silence works. Other times, the process can take longer. For Mooney, it has become a fulfilling learning experience that has bridged a line of communication between the elder and their care giving spouse, children or family member.

“As a case manager, I feel it is crucial to deliver a workable care plan,” says Mooney. “I believe being able to understand the culture and speak their language is very important when dealing with elder’s cognitive, comprehension and psychological challenges.”

As aging elders cope with losing their identities and their sense of belonging, caregivers and their supporters try to maximize their potentials. Through nutritious meal programs that cater to their native tongues or by culturally appropriate activities that resonate to their culture, caring for the population means bringing back some dignity, some self worth and some confidence as they walk their remaining journey.

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