Therapeutic Interventions with Ethnic Elders

Health and Social Issues

Sara Aleman, Tanya Fitzpatrick, Thanh V Tran, Elizabeth Gonzalez, Sara Aleman, Tanya Fitzpatrick, Thanh V Tran, Elizabeth Gonzalez, Sara Aleman, Tanya Fitzpatrick, Thanh V Tran, Elizabeth Gonzalez

• Publisher: Routledge
• Year: 2014
• ISBN:
  9781317826811
• Edition: 1
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Provide effective services to ethnic elders with culturally competent training! Therapeutic Interventions with Ethnic Elders: Health and Social Issues provides culture-specific information to health and social work professionals. You will explore distinctive qualities that are found in ten different ethnic groups to help you better serve these populations. The historical events that have shaped these elders'often-adverse reactions to mainstream providers are also included. Ideas on how to effectively approach these situations are included to improve your skills with a diverse population of clients. The information in Therapeutic Interventions with Ethnic Elders is invaluable to health care administrators who plan services and hire personnel to work with various ethnic groups. The book also functions as a training tool to increase the awareness of staff members who currently work with ethnically diverse populations. You will learn to recognize culturally driven behaviors in ethnic elders and how to make appropriate interventions. Some of the general and culture-specific issues that Therapeutic Interventions with Ethnic Elders addresses are:

• helping ethnic elders to feel comfortable utilizing your services
• appropriately modifying therapy to meet the individual's cultural background
• reinforcing a new sense of independence for these elders by helping them understand available services
• understanding cultural inhibitions in Japan that hide, deny, or ignore mental illness
• realizing that traditional Euro-American psychotherapy techniques cannot be readily transplanted and applied to all other cultures
• addressing depression, anxiety, increased illness, intergenerational conflict, and even marital conflict combined with the stress of assimilation and acculturation among Russian emigrants
• understanding folk beliefs and the importance of the role of the church for many elder African-Americans

Therapeutic Interventions with Ethnic Elders addresses the need for practitioners, agencies, and institutions to understand and respect the different characteristics of each elderly minority population. You will examine the unique historical contexts of Vietnamese, Japanese, Chinese, African, Russian, Navajo, Yaqui, Mexican, Cuban, and Puerto Rican elders and explore the stress factors that come with immigrating, such as finding a peaceful place to live and being confronted by age discrimination and racism. This important book explains cultural behaviors to provide you with effective suggestions for providing optimum care to the ethnic elders in your life.

Chapter 1
Culture-Specific Theoretical and Conceptual Models of Aging

Sara Alemán
Tanya Fitzpatrick

In this chapter, various theoretical and conceptual models that have been utilized to explain aging in the United States are discussed. This is necessary to provide a foundation for understanding how theories may apply to ethnic and racial groups. These theories have a common thread: they all attempt to explain the process of aging in an American society that generally marginalizes elders of color. The majority of current theories on aging contribute negligible understanding or exhibit little support for ethnic elders or for the strengths that they bring from their life experiences. Further, when aging occurs within a culture that is different from the majority culture, ageist behavior may become intolerable. The following theories represent the more popular perspectives that have been developed and used to explain the aging process. The authors attempt to relate the models to aging processes in ethnic minority groups.

Some researchers believe the double jeopardy hypothesis is perhaps the best example of a theory developed to accommodate differences and disparities between whites and blacks (Butler, Lewis, and Sunderland, 1991). When developed, this hypothesis was applied primarily to older blacks, yet is applicable to other ethnic minority groups. In essence, the theory asserts that being black and old is a double problem, as prejudice and discrimination are associated with both states of being. Dowd and Bengston (1978) characterize the double jeopardy position of the minority aged as a double burden resulting from devaluation in status in our society. This hypothesis may also represent a triple or quadruple problem in discussing older ethnic people who are also females (gender issue) and poor (low socioeconomic status), whose lives contrast sharply with those who are white, rich, young, and male (Lightfoot, 1982). The theory is used to explain issues that arise with being ethnic and old and the impact of that phenomenon on the larger society.

This is important because Dowd and Bengston (1978) found no relationship to the double jeopardy theory in the area of family and social interaction or life satisfaction; therefore, one may assume that double jeopardy is particularly potent in interactions that elderly ethnic people experience with the world outside their family and same-group social contacts. As in younger years, the jeopardy for ethnic elders is not within their group or culture but with the larger majority culture that is oftentimes hostile, repressive, and alien.

Markides (1983) found a narrowing of differences from middle to old age between aging blacks and whites on income and health, thus providing evidence of nonsupport for the double jeopardy hypothesis. However, most research supports findings that elders experience a decline in resources as they age and, therefore, the double jeopardy idea gains validity when applied to ethnic elders.

Theories may focus on individuals as points of impact and study or may look at family systems, culture, or changes that occur over time and ultimately impact individuals. All of them attempt to further our understanding of how aging impacts all of the aforementioned systems. The double jeopardy theory looks at groups of elders and may be seen as a microanalysis of what the aging experience is for ethnic elders. By contrast, the theory of modernization looks at the aging experience from a macro perspective.

Modernization theory postulates that as each society modernizes and becomes more industrialized, the less status the elders' position in the family carries (Cowgill and Holmes, 1972). This theory emphasizes the fact that minority or more traditional cultures place a higher value on and give more respect to their elderly. Critics question this theory in regard to the Japanese, who continue to value elderly relatives within the family system, yet are fast becoming one of the most highly technical societies in the world. (See Markides and MindeFs [1987] discussion of Rosenthal's [1983,1986] new dimension of modemization theory.) In general, modernization theory views traditional families as providing more support to elderly members, whereas the opposite is true of more modernized families in which assistance and support has decreased. However, Rosenthal views ethnicity and culture as a source from which people may draw different meanings depending on their situation and their stage in life.

Assimilation theory, also a more macro theory, views ethnicity and minority status as a temporary situation (Gordon, 1964; Park, 1950, in Markides and Mindel, 1987). After some time living in the United States, one gradually rises up the socioeconomic ladder toward a middle-class position, producing loss of "cultural distinctiveness" (Markides and Mindel, 1987, p. 38). The expectation is that everyone will eventually become assimilated. With respect to family implications, the younger members would quickly lose their traditional values and replace them with values and patterns from the dominant culture.

The theory of assimilation is counter to research that identifies some ethnic groups who have been in the United States for generations, but continue to follow ascribed cultural norms. This is particularly true among Native American tribes in the Southwest and Mexican Americans. In many of these cultures, younger family members are educated but remain active in family ceremonies, tribal politics, and native religions. The area of health care also defies assimilation in that it is not uncommon for younger family members to go to their elders for medical advice and subsequently follow native or culture-specific ceremonies to deal with both mental and physical illnesses.

The theories that are discussed and others not discussed are important because they allow us to connect dynamics to processes which occur so slowly that on a daily basis there is little, if any, perception of what is happening. As gerontologists and service providers to elders of color, it is particularly important to put theories within the context of the culture of ethnic elders. It is important to view expected behaviors and changes with jaundiced eyes and not be prejudiced by the expectations that theories, based on the majority population, set into motion. Additionally, ethnic elders are different from the white majority elders but also from each other. Therefore, what may be an effective strategy for one may not work for another from the same ethnic group. This knowledge encourages service providers to view each elder as an individual and not as a stereotype of what has been read or heard. This is important for the reason that it will lead to relationships with ethnic elders that give them dignity and respect that is often lost when we deal with them as stereotypes of some preconceived paradigm.

References

Butler, R.N., Lewis, M., and Sunderland, T. (1991). Aging and mental health: Positive psychosocial and biomedical approaches. New York: Macmillan Publishing Company.

Cowgill, D.O. and Holmes, L. (1972). Aging and modernization. New York: Appleton-Century-Crofts,

Dowd, J.J. and Bengston, V. (1978). Aging in minority populations: An examination of the double jeopardy hypothesis. Journal of Gerontology, 33, 427-436.

Gordon, M.M. (1964). Assimilation in American life. New York: Oxford University Press.

Lightfoot, O.B. (1982). Ethnic and cultural variations in the care of the aged. Psychiatric interventions with blacks: The elderly—A case in point. Journal of Geriatric Psychiatry, 15(2), 209-223.

Markides, K.S. (1983). Minority aging. In M.W. Riley, B.B. Hess, and K. Bond (eds.), Aging in society: Reviews of recent literature. Hillsdale, NJ: Lawrence Erlbaum, pp. 115-138.

Markides, K.S. and Mindel, C.H. (1987). Aging and ethnicity. Newbury Park, CA: Sage Publications.

Park, R.C. (1950). Race and culture. New York: Free Press.

Chapter 2
Therapeutic Interventions with Elders of Japanese Ancestry

Anne O. Freed

A place in the sun for most tends to obscure the reality that for minorities that place may be in the shadows.

(Sata, 1973, p. 153)

As is true when intervening therapeutically with people of all cultures, human services providers who serve individual elderly people of Japanese ancestry in the United States must address their problems in light of that particular subgroup's unique cultural characteristics. This chapter is designed to help such providers by identifying the many special cultural features of elderly Japanese that can be pertinent when offering social and health services and conducting therapeutic interventions.

In addition to applying professional skills, human services personnel must be generally knowledgeable about the last stage of the life cycle, as well as traditional Japanese attitudes toward old age and how they may be modified by their acculturation in the United States. Although professionals of Japanese ancestry might be aware of these cultural factors, most non-Japanese professionals should become sensitive to the customs and values inherited from Japan as well as how they have been modified by their experience in the United States.

This chapter discusses several important facts about people of Japanese ancestry that effective professionals should know:

1. Who they are; how they identify and define themselves
2. Their history and experiences in the United States
3. Their inherited culture and behavior, assimilation, acculturation, and culture conflicts
4. How they handle health, mental health, and social and personal problems; what services are available; where they seek help
5. Considerations in therapeutic interventions

Foreigners in Japan inevitably hear, "We Japanese are unique; we are different from other people in every way." As evidence of their claimed uniqueness, they point out that they were isolated for hundreds of years on their small island chain; that they have unique history, rituals, beliefs, values, religions, and ceremonies; and that only since 1853, when America's Admiral Perry opened their country to the West, have they been seriously exposed to outside influences, industrialization, and urbanization, after centuries of feudalism and militarism. They hasten to add that, despite the fact that after the American Occupation following World War II, they rapidly westernized and modernized their political and economic systems, their approach to family, religion, problem solving, interpersonal relations, and emphasis on group identity and consensus, rather than individualism, remained thoroughly Japanese.

Knowledge of these factual and attitudinal differences should help American professionals recognize basic Japanese cultural values and note how much acculturation has occurred in order to help Japanese Americans.

How People of Japanese Ancestry in the United States Identify and Define Themselves

Although Japanese-American roots extend back to Japan ethnically, culturally, and historically, the strength of those roots, in the process of assimilation and acculturation, inevitably is diluted with each generation. Moreover, although the Japanese insist that they are ethnically homogeneous, Japanese Americans are actually almost as diverse as people of other foreign backgrounds in the United States. In large numbers, they are either marrying people of other Asian groups or Caucasians, or they are offspring of such unions (Kikimura and Kitano, 1980). Like other ethnic minorities, they are either immigrants or native born, and speak English with varying degrees of proficiency. Although Japanese ethnicity and culture is increasingly being diluted, they are not rejecting their Japanese identity.

Japanese Americans refer to themselves by successive generations numerically. Because their immigration to the United States started toward the end of the nineteenth century, there are four generations here thus far. They are the issei, born in Japan and, hence, the first generation in the United States; the nisei, the first generation born in this country and, hence, the second generation; the sansei, the children of the nisei and, hence, the third generation; and the yonsei, their children and the fourth generation. Those terms are derived from the Japanese numbers of ichi (1), ni (2), sail (3), and yon (4). Most of the pre-World War II issei have died, and relatively few issei have come to the United States even after the 1965 law opened immigration to Asians. Thus, the overwhelming numbers of elderly Japanese are nisei.

Demography

In 1990, there were 847,562 people of Japanese ancestry in the United States, more than half of whom lived in California and Hawaii. Of these, 12 percent were over sixty-five (Sakauye, 1993), and 63 percent were American born. California had 213,280, and Hawaii had 217,290. Forty-three percent of the elderly were men and 56 percent were women, 40 percent of whom lived alone. All but 6 percent of the elderly had been or were still married and 4.5 percent were in institutions (U.S. Bureau of the Census, 1992).

However, census figures generally understate the numbers of Asian elderly. They often are "apt to be underrepresented because they are among the most mistrustful of government agencies, suffer the greatest language handicaps, and are often poorly informed" (Kalish and Yuen, 1973, p. 9). Their World War II experiences in the United States continue to feed this mistrust.

Older Japanese women are the most proficient in English among Asian Americans in the United States (Burr and Mutchler, 1993). Primarily urbanites and suburbanites, 85 percent of the elderly now live in the metropolitan areas of Honolulu, Los Angeles, San Francisco, Chicago, New York, and Seattle (Fujii, 1980).

Myth and Reality

A common myth in the United States suggests that people of Japanese ancestry, along with the Chinese, are models of financially and educationally successful minorities and, therefore, suffer no adjustment problems, as presumably demonstrated by their apparent low juvenile delinquency rate and ...

Table of contents

• Cover
• Title
• Copyright
• Contents
• About the Editors
• Contributors
• Introduction
• Chapter 1. Culture-Specific Theoretical and Conceptual Models of Aging
• Chapter 2. Therapeutic Interventions with Elders of Japanese Ancestry
• Chapter 3. Vietnamese-American Elders
• Chapter 4. Elderly Russian Jewish Immigrants
• Chapter 5. African-American Elders
• Chapter 6. Elderly Puerto Ricans
• Chapter 7. Cuban-American Elders
• Chapter 8. Mexican-American Elders
• Chapter 9. The Yaqui (Yoeme) Elderly
• Chapter 10. Navajo Elders
• Chapter 11. Views and Visions: Moving Toward Culturally Competent Practice
• Index