How Ethnic Background & Upbringing Has Shaped My Perspectives About Elder Care In Positive Ways

The most vivid memory I have of my grandfather, Koichi Aoyama, an immigrant from what was called then Nakaizumi-machi, Shizuoka-ken, Japan is a mental picture of him from the late sixies calling out to his single, unmarried second daughter, Anne Kazuko, while lying in his bed in the South Seattle apartment they both shared.

He asked her in Japanese, "Who are these people?" referring to the family of his youngest child and second son, Frank Susumu, who had come to pay their respects to the eldest living member of the family on that particular afternoon. Although we'd all stopped by Grandpa's room at the beginning of our visit, on the way into the living room for a cup of tea and crunchy Japanese rice crackers, he had all but forgotten.

This visit stands in my mind as of the most significant ways my brother and I were introduced to old age. Our grandfather was born in 1881. We had come into the world in the mid-fifties. Although grandfather had learned to speak English following his immigration to the United States in 1905, during the period I relate what conversation he attempted was in Japanese.

My aunt frequently told us it was a blessing that grandfather didn't remember much about what was happening to him spending more of the few waking hours of his day reliving his youth. I remember my mother telling us that the whole family could be thankful that Dad's sister, our aunt, was willing to take-on the full-time job of caring for grandfather 24/7, a project that would eventually span some fourteen years.

If memory serves, placing grandfather in a nursing facility was out of the question. Where would we find an institution who would serve portions of rice and salted pickles that he liked daily and attend to the small requests when spoken in his native tongue?

While attending college I became aware in my Asian-American studies class at the university that older men and women who shared grandpa's immigrant past, the Issei (first-generation) often did not thrive in commercially run care institutions partly due to the same preferences.

S0, there was talk about concerned people in the Japanese-American community in Seattle to set up and run their own ethnically sensitive nursing center as was being done by equally concerned community members in the State of California to allow our elders who needed such services to spend what remaining days they had in comfort and dignity.

It was our duty we were frequently reminded, to take care of our elders the way they had unfailingly taken care of us. There wasn't a month that didn't go by when I was reminded what a hard life the grandparents had endured in order to make a future for their children and grandchildren in this country. We took pride in their efforts as well and were encouraged to do the same in return.

In such an environment Seattle Keiro (keiro in Japanese means respect for the elderly) at http://www.nikkeiconcerns.org/seattlekeiro.html was born. Seattle Keiro is under the umbrella of a yet much larger organization known as Nikkei Concerns. According to its website the mission of Nikkei Concerns is to "provide health and related services in a traditional atmosphere to primarily elderly Nikkei (Japanese) in the Pacific Northwest. Over the years the organization has maintained a distinctly Japanese-American identity while welcoming members of diverse ethnic communities."

It is a model that has been emulated in years since by equally concerned local citizens in the both the Chinese and Korean communities. It may well still stand as a model of how contributions from the diverse citizens and nationalities who have come together in our multi-cultural society may offer variations upon the standard to future consumers of tomorrow.

Growing up in such a climate was a blessing for myself in more ways then one. When the day came to celebrate grandfather's life after he died at the age of 95 during the bicentennial year celebration of his adopted country, my family and I were comfortable when a perfect stranger was asked to officiate at a small memorial service.

This stranger was a native of Japan and immigrant to the United States just as grandfather. He began his address admitting he knew very little about the man whose life he was asked to celebrate. After which he launched into a short speech about his own life and experiences in this country.

I used this anecdote in an essay I wrote later that year and concluded the paper with the remarks it was a fitting address, and though the circumstances were startling to me at first,

by the conclusion of the stranger's remarks I believed whole-heartedly that my grandfather would have understood.

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Readers are invited to share their own educational curve of the general topic. There is not enough conversation during most days about how we intend to address those matters that go along with getting old and even less about how we will make them happen. Whatever your age and life experiences please feel welcome to post your own thoughts, hopes, worries and impressions.

Middle-Agers, When You Need Elder Care Will The Market Offer The Shopping Choices That You Want?

After years of talk lagging behind the actual needs, even the most reclusive members of my own Baby Boomer generation are becoming aware that funding and services for the elderly have not kept up with the times. It is becoming increasing evident in a personal way to friends and acquaintances in my middle-aged circle who have been drawn into this area by the evolving needs of family members, friends and colleagues in our parent's age group that there are large gaps in the kind of resources offered and actual care available.

Much of this has occurred on our watch when the bulk of our time, energy and talents which ought to have been put to good use was frittered away while we were out dreaming about the purchases of bigger homes with faux French manor accents and gas guzzling SUV's in order to embrace all of what our generation has been conditioned to believe life had to offer.

And while many of those dreams did not pan out and not all of us uniformly embraced such dreams in the first place, the kind of thinking and long-range planning that would necessitate some dramatic changes in the area of elder care that we would like for our elders and certainly even demand for ourselves has not for the most part taken place.

As the years pass and our impending golden years come closer and closer this lack of attention and the intervening years of build-up neglect may very well bite us in the posterior in a very painful way!

Back in the late seventies I was introduced to some of the interesting developments in the area of elder resources as an intern for a editor who published a newspaper for senior citizens in Seattle. My editor was well aware of the gap in services then as a middle-aged only child of a senior mom well into her late eighties and nineties.

Just out of college myself, it was an eye opener to even be introduced to the world of elder care as like so many of those growing up in the 50's and 60's, older people were no longer always living at home with the family. Old folks homes were a part of the community in the areas where we grew up that youth in our age group seldom saw unless a family member or friend had been placed there.

Furthermore unlike the traditional Japanese immigrant family where my parents were raised, youth not the elderly, was the byword of society and the emphasis was on thinking and staying young which made it all the more easier to push gently aside or even forget all-together issues which affect all of us towards the close of our lives. Unfortunately, this behavior and mind-set does not make the challenges which go hand-in-hand with this era go away.

Is it realistic, for example, to expect a family which may not even entertained the idea of housing options for an older member of the family to find the ideal placement for their just discharged relative in assisted care in 24 hours or less?

This is exactly what happened to my brother and myself two years ago when our mother who had been going hale and strong for over 70 years, came to the point in her life's journey where she ran headlong into a full-blown health crisis.

While the home we were able to place her for the short period advised for by her physician, she was not pleased with the result. We had just received the news the recent signs of memory loss he had been investigating on her behalf could possibly be early onset Alzheimers.

The facility most nearby my brother was able to located for her in this narrow time frame specialized in caring for patients with memory losses more severe than Mom's. It appeared their afternoon activity time consisted largely of watching soap operas.

In her younger years, Mom never enjoyed this kind of programming and more often than not declared it a complete waste of time. She had not changed her opinion. When my family was able to visit her during this time period she greeted us on several occasions with a fully packed suitcase and firm request to be "let out of there right now" and go back home.

During one point she was in and out of the hospital three times in a month. Her medications were stopped then restarted. Somewhere along the line the balance was lost and her heart actually needed to be restarted. Subsequently, she made a decision with her doctor that in the future, she did not wish to be resuscitated for which my sibling had been informed.

Unfortunately, I was inadvertently left out of the loop and discovered only after the episode where mom's heart was re-started that had it happened a second time, I would have most likely learned of her choice after she died. And while mom is absolutely within her rights to make these decisions, it is a good example of the kind of emotional turmoil that can occur because one is not prepared.

How about finding yourself in a nursing care center while recuperating from a major stroke in your thirties or forties at the same time close family members just happen to be dealing with some personal and health issues of their own?

Just imagine no one is available for a short period to support you in the way family could and you have no Plan B. Unfortunately, the well-meaning but overworked staff at the center are not able to act upon your concerns with the rapidity that you desire and frustration soon becomes your best friend.

It's not a perfect world by any means, but so many of the difficulties encountered by patients, residents and families along the way did not have to happen if time, money, resources and personnel had been employed with the same enthusiasm that was dedicated to developing personal communication devices and increasingly portable packable entertainment centers.

We cannot undo the past. Indeed, the start-up time alone to effectively address many of the overflowing basket of needs has past for many of us. However, I would argue it is even of more pressing import that we and fellow members of society (who may well end up paying for our inattention) including our children and grandchildren spend at least 2 or three hours of our time each month boning up on what resources such as the Long Term Care Ombudman Program (LTCOP) discussed in my earlier blog entitled "Thinking About Accessibility & Resources For Our Elderly/Disabled Neighbors" are on hand while taking a good look at what the community might be able to do in the near future.

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Readers - If you have any thoughts or experiences along these lines and would like to share them with me, I encourage you to do so by leaving your comments! We are only as strong individually as we are collectively.

Thinking About Accessibility & Resources For Our Elderly/Disabled Neighbors

Last week, I accompanied a good friend of mine who had errands in the rapidly growing neighborhoods around the City of Kent's East Hill. While my friend drove, I enjoyed the passing panorama of the area and could not help be struck by the placement, location and number of advertisements along the street in front of this or that local adult residential care center or adult boarding home.

In one such area, I counted three to four such facilities within what seemed to be a two mile or so radius, which gave me pause just to consider how many facilities of a similar nature are sited in my own community of Federal Way. And despite the fact I am over a twenty-year city resident, I was appalled by the fact I was at loss to recall the location of all but a few.

It is quite likely, that due to different restrictions on zoning and promotional signage between the two communities, may be responsible for the fact it is far more difficult to be as easily familiar with the actual presence of these facilities in Federal Way as it is for those residents in Kent's East Hill.

Fortunately for myself, a few weeks ago I had the pleasure of being introduced to Mary Fogh, the able volunteer coordinator for King County's Long Term Care Ombudsman Program (LTCOP), who staffed a most professional-looking information table alongside about a dozen or so organizations and community groups in the lobby and hallways at Decatur High School, prior to the City of Federal Way's annual Martin Luther King, Jr. Celebration on Monday, January 21st.

According to Fogh, there are four nursing homes, five assisted care facilities and 69 adult family homes in the vicinity of Federal Way. Additionally, there is at present a critical need to fill up to fifteen volunteer slots in the area to assist the program and serve some 1,200 seniors and other disabled residents in this locale.