With the Affordable Care Act pushing the subject of healthcare into the national radar, many of us in the APIA community are dealing with the debate on a more personal front as we try to figure out the best means of caring for aging parents and grandparents. There is a delicate balancing act of preserving personal autonomy with necessary care and overall quality of life.
For many longtime Chinatown International District residents, there is a strong preference to stay within the neighborhood with familiar faces, food, and languages rather than relocating to foreign and potentially isolated homes with children or grandchildren. For the families, allowing frail or mobility-limited elders to live alone can be a source of continual stress and worry. Until recently, the conundrum seemed like an either/or prospect, but a collective of ID organizations is looking to change that.
International Community Health Services (ICHS), Kin On, Nikkei Concerns, and the Seattle Chinatown International District Preservation and Development Authority’s (SCIDpda) Legacy House have teamed up for a predevelopment study to assess the feasibility of expanding senior care in the area.
Each member is taking their decades of experience providing culturally competent care within the APIA population to design a program that provides comprehensive holistic care focused on keeping people healthy. A quick glance of Legacy House residents shows ages ranging from 64 to 103, which suggests a possible 40-year span to plan for.
One primary component is providing adult day care services, where seniors can come for social interaction, including activities and meals, plus their necessary medical and dental checkups, physical and occupational therapy, medication review, social services, and counseling.
Another consideration is determining what social programs people are qualified for after the precipitous income drop that usually accompanies retirement. For adults who have never considered themselves low-income, the realization that their fixed-incomes change their status is a surprise. Navigating insurance, government bureaucracy, and specialized care becomes exponentially more complicated with language and cultural differences creating additional barriers to access and quality of care. Having everything all in one place minimizes confusion and oversights, for seniors and providers alike.
To ensure that elders outside the ID have access, an expansion of current vanpool and transit services is also being considered, along with meal delivery and home visit nurses. Rather than treat the aging population as a problem to be solved, the partners look to expand the number of options offered to seniors and their families to maximize independent and healthy living.
This model for full service care is based on the Program for All-inclusive Care for Elders (PACE). Conceived in early 1970 when San Francisco’s Chinatown faced their own pressing need for long-term care for immigrants from China, Italy, and the Philippines, the program was the preferred alternative to the traditional (yet financially impossible and culturally inappropriate) nursing home. Rather, they looked to the British geriatric day hospital system, a combination of housing and attendant medical and social services utilized since the 1950s.
Unlike early predecessors, the implementation of multidisciplinary care will not have to be created whole cloth—each partner already provides a necessary component of the whole. ICHS has numerous clinics in neighborhoods with a high APIA population. Along with offering a multitude of Asian languages, there are a large number of practitioners who show special interest in elder care and have built long-term relationships with patients. According to Dr. Grace Wang, ICHS’s Chief Medical Officer, it is an honor to be able to help seniors. Kin On, Legacy House, and Nikkei Concerns all provide housing for people throughout the aging process, from independent living to hospice. They provide care and recreation for residents as well as assistance for families, including in-home care, family caregiver support, food delivery and transportation.
To a great extent, says SCIDpda’s Executive Director Maiko Winkler-Chin, it is recognizing a particular skill set and expanding it to include more people.
Phase I of the feasibility study is projected to finish in September 2015. Whether the findings result in new facilities or an expansion of current programs, parties agree that the ultimate goal is to help seniors live the best life possible.
“We want to make everything easier by eliminating the stress,” explains Winkler-Chin, “ultimately focusing on people instead of the process.”