Older immigrants and natural helpers

CHARLOTTE IKELS

O L D E R I M M I G R A N T S A N D N A T U R A L H E L P E R S

ABSTRACT. Since the enactment of the Immigration Act of 1965, immigrants from Europe have been replaced increasingly by immigrants from Latin America and Asia. The latter, in particular, are from societies so dissimilar from the United States that they face major adjustment problems. Many of the older immigrants come as parents of American citizens, but despite reunification with their families, they may experience a sense of isolation due to limited opportunities to interact with other people. Case studies of natural helpers (individuals who are not employed in the helping professions but voluntarily choose to spend part of their time irfformally helping others) operating within the Chinese community in Boston reveal how their services complement those of the formal sector. The characteristics which make them both approachable and credible to older immigrants as well as their possible recruitment as outreach workers are discussed.

Key Words: older immigrants, natural helpers, Chinese community, patterns of immigration.

While carrying out an anthropological study of family support for the elderly in the Greater Boston area from 1978 through 1981, we became increasingly aware of the importance of informal, non-familial helpers in facilitating the adjustment of immigrant elderly to life in the United States. The changing nature of the older immigrant population suggests that such non-familial helpers may have an increasingly important role to play. Although there has been no major increase in the proport ion of immigrants who are 60 years of age or more, the absolute number admitted per year nearly doubled between 1972 and 1981 (the last year for which we have statistics) f rom 17,427 to 33,893. Between 1977 and 1981 the United States averaged more that 30,000 older immigrants annually (see Table I). Fur thermore these immigrants are drawn largely from non- English speaking populations and become members of minority groups once settled in the United States (see Table II).

Mexico contributes many older immigrants to the United States primarily because of its very large absolute number of immigrants. The immigration patterns of the other countries, however, are more complex reflecting the intricacies of American immigration rules and the history of the particular ethnic group in the United States. Immigrants fall into essentially two categories: those subject to numerical limitations and those exempt f rom numerical limitations. The first category is restricted by law to 270,000 immigrants per year. Under this restriction no country is issued more than 20,000 imnfigrant visas per year, and most are issued considerably fewer. Within each country immigrant visas in this first

Journal of Cross-Cultural Gerontology 1 (1986) 209--222. © 1986 by D. Reidel Publishing Company.

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TABLE I

Annual admissions of immigrants aged 60 or more

Year Number Percent of total immigrants

1972 17,427 4.5 1973 18,722 4.7 1974 18,224 4.6 1975 20,320 5.3 a

1977 36,976 8.0 1978 33,365 5.5 1979 28,244 6.1 1980 32,414 6.1 1981 33,893 5.7

a In 1976 the Immigration and Naturalization Service changed the ending of the year from June 30th to September 30th for statistical purposes. The figures for 1976, therefore, are not directly comparable with these figures as they include an extra quarter year.

Sources: 1975 and 1977 Annual Reports of the Immigration and Naturalization Service, 1978, 1979, 1980, and 1981 Statis- tical Yearbooks of the Immigration and Naturalization Service.

TABLE II

The six leading places of origin of older immigrants ( 1981)

Place of origin Number of immigrants aged 60 or more

Immigrants aged 60 or more as % of per country total

Philippines 6,800 15.5 China (inc. Taiwan) 4,185 16.2 Korea 2,714 8.3 Mexico 2,586 2.6 Cuba 1,999 18.4 India 1,223 5.7

Six country totals (%): 19,507 (58% of all immigrants aged 60 or more). Source: 1981 Statistical Yearbook of the Immigration and Naturalization Service.

ca tegory are i ssued accord ing to a ' p re fe rence ' system. T h e first, second, fourth, and fifth ca tegor ies of the p re fe rence sys tem are k n o w n as re la t ive p re fe rences because they a re i ssued only to specific k inds o f kin o f A m e r i c a n ci t izens o r of legal p e r m a n e n t res idents of the Un i t ed States.

O L D E R I M M I G R A N T S AND N A T U R A L H E L P E R S 211

The first preference allows the entry of unmarried children (over 21 years of age) of U.S. citizens. Second preference covers spouses and unmarried children of permanent residents. The fourth preference allows for the admission of married children of U.S. citizens while the fifth admits brothers and sisters of U.S. citizens provided the sponsoring sibling is at least 21 years of age. The third and sixth categories of the preference system are known as occupational preferences because admission is contingent upon the skills of the immigrant or upon the needs of U.S. employers. The third preference admits members of the professions, and scientists or artists of exceptional ability while the sixth admits immigrants prepared to serve in skilled or unskilled occupations for which labor is in short supply in the United States.

Immigrants exempt from numerical limitations are those considered 'immediate' relatives according to American cultural prescriptions. Not eligible, for example, are 'consensual' spouses or wives other than the first wife (if she is still alive) of polygynous husbands. Acceptable immediate relatives are: spouses (as qualified above) of citizens, children (under 21 years of age) of citizens, parents of citizens at least 21 years of age, and orphans adopted abroad or to be adopted by citizens who are at least 21 years of age. In some years, however, special acts of the Congress allow for the entrance of large numbers of immigrants as refugees. In 1981, for example, over 100,000 refugees and 'asylees' primarily from southeast Asia were admitted, and during the previous year over 100,000 refugees (or 'expellees') from Cuba were admitted.

Thus the immigration profile of any particular country is highly dependent on the kinds of people who have already immigrated, the motivations of these people and their home country relatives which govern how they pick and choose among visa options, the political and economic circumstances of the home country, and the U.S. Government's view of those circumstances. Using the above guidelines we can begin to make some sense of the factors propelling Cuba and the four Asian nations to 'export' older people to the United States.

An examination of Table HI reveals that the six countries that lead in the proportion of immigrants who are elderly also lead in the proportion of exempted kin who are parents of U.S. citizens. Although the rank ordering of the six nations is slightly different, together they account for 68% of all immigrants who are admitted on the basis of their parental status. Logically there should be a substantial overlap between those immigrants who are parents and those who are elderly. Unfortunately the precise extent of this overlap cannot be determined from the data made available by the Immigration and Naturalization Service.

According to Table III when all countries are averaged together, spouses are admitted 2.5 times as often as parents and parents are admitted 1.3 times as often as dependent children. Looked at in these

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TABLE III

Characteristics of immigrants exempt from numerical limitations (1981)

Place of origin Exempted kin Others (largely refugees)

Parents S p o u s e s Children

AlICountries 34,220 87,221 25,707 119,043 (%) (12.9) (32.8) (10.0) (44.3)

Africa 413 4,742 226 1,931 (5.6) (64.9) (3.1) (26.4)

North America 5,615 32,336 11,168 9,691 (Inc. Caribbean (9.5) (55.0) (19.0) (16.5) and Central Am.)

Cuba 1,324 336 160 4,868 (19.8) (5.0) (2.4) (72.8)

Mexico 1,581 18,390 6,546 2,318 (5.5) (63.8) (22.7) (8.0)

South America 1,482 5,779 1,892 768 (14.9) (58.3) (19.1) (7.7)

Asia 23,153 27,244 9,767 93,588 (15.0) (17.7) (6.0) (61.3)

China 4,637 1,717 382 1,914 (53.6) (19.8) (4.0) (22.6)

India 1,851 802 393 273 (55.8) (24,0) (11.8) (8.4)

Korea 4,236 4,347 3,159 1,015 (33.2) (34,1) (24.8) (7.9)

Philippines 9,608 8,102 4,376 1,778 (40.3) (34.0) (18.3) (7.4)

Europe 3,414 15,999 2,464 12,923 (9.8) (46.0) (7.0) (37.2)

Oceania 143 1,120 190 139 (9.0) (70.4) (11.9) (8,7)

Source: 1981 Statistical Yearbook of the Immigration and Naturalization Service.

terms Mexican parents are actually under-selected in favor of spouses and children. The remaining five countries, however, clearly favor the immigration of parents. In the case of Cuba, parents exceed spouses by a factor of 4 and children by a factor of 8. Chinese parents outnumber spouses by a factor of 2.7 and children by a factor of 12. More than twice as many Indian parents are sponsored as spouses, and twice as many spouses are sponsored as children. Koreans are relatively more even-handed (though still sponsoring an excess of parents compared to the all country averages): parents and spouses are sponsored at essentially the same rate and exceed

OLDER IMMIGRANTS AND NATURAL HELPERS 213

children only by a factor of 1.3. In the case of the Philippines parents exceed spouses by 1.2 and children by 2.2.

The above figures represent the situation in 1981. In other years somewhat different patterns occur, but the general tendency of these countries to contribute a disproportion of parents and of the elderly has been evident for several years. I will here limit myself to discussing the case with which I am most familiar, that of the Chinese, and leave to specialists the task of interpreting the immigration patterns of the remaining five countries.

CHINESE IMMIGRATION

Immigration to the United States has long been a means of economic advancement for Chinese especially for those from the south coastal provinces of Guangdong and Fujian. Beginning with the California gold rush, thousands of Chinese laborers, primarily from four counties in Guangdong, came to the U.S.-mainland. Initially welcomed, they later found themselves the targets of discrimination when economic hard times resulted in public clamor for their removal and for restrictions on future immigration. Despite the passage of discriminatory legislation, Chinese men continued to find ways to enter the United States in order to earn money to support their families who remained in China.

These men expected to return to their native villages in old age to live off the fruits of their investments in the village economy. The establish- ment of the People's Republic of China in 1949, however, complicated their decisions about what to do in retirement. During the 1950s and 1960s the Beijing regime and the American government were on hostile terms. Men retiring during this period were not at all certain that they would be well treated if they returned to China after having spent so many years in the United States. They had all heard of family members or fellow villagers who had been persecuted because of their ties with relatives living in the United States. Furthermore, in many cases, family members had fled from China to Hong Kong or Taiwan, places quite unfamiliar to the retirees most of whom did not relish the idea of spending their last years among strangers. In addition relatives in Hong Kong and Taiwan, fearful of what might happen should the Communists assert control over these places, pleaded to be brought to the United States.

Consequently after the beginning of the 1950s, and greatly accelerating in the late 1960s following the reform of the immigration regulations, many Chinese came to the United States to join elderly husbands and fathers. The reforms in the 1960s abolished the discriminatory national origins 'quota' system which favored immigration from northwestern European countries and replaced it with the preference system which aims to reunite families regardless of their national origin. According to Glazer

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(1985: 7--8), U.S. officials did not anticipate the changed ethnic nature of the immigration which resulted from the reforms. They had expected the preference system to facilitate primarily the reunification of families of southern and eastern European origins.

Chinese young people whose families had no previous history of immigration to the United States also joined this flow. According to an article in the Boston Globe (Nov. 7, 1983: 8), since 1949 some 65,000 students from Taiwan have gone abroad to study -- mostly to the United States. Of these only 12,000 are believed to have returned to Taiwan. Many of those remaining in the United States were enabled through the occupational preferences to obtain citizenship and, thereby, to become the sponsors of family members. Similarly the Hong Kong Government Information Services (1984: 90) reported that more than 12,000 students went abroad in 1983, largely to Great Britain, Canada, and the United States, and many of the last are hopeful of obtaining citizenship on occupational grounds after completing their educations.

The beneficiaries of these former students are overwhelmingly their parents. Since 1977 parents have contituted between 51% and 61% of all non-preference (immediate) kin brought to the United States by citizens of Chinese ancestry. This same linkage between studenthood and subsequent parental immigration is currently important for elderly people from the Philippines and is likely to become increasingly important for those from Korea and India. Cuban elderly, on the other hand, are often sponsored by children originally admitted to the United States as refugees rather than as students.

ADJUSTMENT PROBLEMS OF OLDER IMMIGRANTS

Adapting to a foreign culture is a challenge at any age, but there is good reason to believe that older immigrants who are more often confined to the home have greater difficulty integrating themselves into the new society. A comparison of four elderly populations -- long-term and recent immigrants with long-term and recently arrived native-born residents of Southern California -- (Weeks and'Cuellar 1983) found that the recently arrived foreign-born were the most isolated elders. On the one hand they may have less incentive to involve themselves in the outside world. Many older immigrants are parents whose children attempt to meet all their needs. On the other hand they have fewer natural opportunities to interact with the host culture. They do not attend schools which have the specific objective of familiarizing the young with the language and culture of the dominant group. Since they are unlikely to be employed, they have no workmates who can interpret the economic and political peculiarities of the American system. In short unlike the young and the middle-aged, they cannot simply rely on the ordinary activities of everyday life to bring them

O L D E R I M M I G R A N T S A N D N A T U R A L H E L P E R S 2 1 5

either greater understanding of the new society or useful skills for operating within it.

If they reside in ethnically homogeneous communities, their lack of familiarity with the world beyond their immediate neighborhood may not constitute a major handicap. Indeed, as Cool (1980) points out, their ethnicity may in fact be a cherished resource. They retain importance in the community because they are links with a past still valued by younger members, e.g., elders in the Armenian community in eastern Massachu- setts are important as survivors of the Armenian genocide perpetrated by the Turks nearly 60 years ago. Their eye witness testimonies continue to keep the memory of this event alive and to stimulate political activism (of a sort they do not necessarily approve) in the young. In addition older craftspeople and performers whose expertise is needed for the proper execution of traditional folk festivals (intended either as an expression of cultural revival or as a means of attracting tourists) may find themselves the center of attraction and a source of identification for those who have never seen the homeland.

More problematic, however, is the situation of the older immigrant who is not surrounded by sympathetic or at least understanding compatriots. As children and grandchildren become increasingly adept at functioning in the wider community, the older people, no longer capable of full participation in the adult world, retire behind the windows of their homes, their social interaction restricted to their own families.

In Hong Kong I encountered several elderly parents who had gone to the United States to join children, but had returned in disappointment. Knowledge of such experiences makes many parents cautious about immigrating. If they can afford a trial trip in advance, they will take that opportunity to visit with all their children in various locations, spending a few weeks or months with each in an effort to learn which arrangement is likely to be the most congenial. Immigration is most likely to be considered when widowhood, retirement, illness, or advanced old age render the status quo untenable. In the first instance the initiative for the move may come from the children in the United States who expect a still relatively vigorous mother to take on house-keeping and child-rearing tasks while the young mother goes out to work. For a generation that anticipated relaxation and dutiful daughters-in-law in old age, this regimen often comes as a shock. They have difficulty understanding why their sons (Chinese parents usually follow their sons and not their daughters) who may be well-off do not hire servants to perform these tasks.

Living in the suburbs is particularly distressful. Several older people used the phrase '"olind, deaf, crippled, and dumb" to describe how they had felt while living there (Chan 1983:47 records the same comment from Chinese immigrants in Canada). They thought of themselves as blind because they could not read, deaf and dumb because they could not

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understand English, and crippled because they needed a car -- and usually also a driver -- to get around. Some parents felt that for all practical purposes they were residents of ghost towns when most of the adults went off to work and the youngsters went off to school. They were bored by the emptiness of the streets in their tree-filled communities and longed for the action and color inherent in any stroll along a Hong Kong street. One solution to this isolation is to live apart from the family if it does not live in an ethnic enclave, and many Chinese elderly have opted for this arrangement however alien the idea first seemed to them (see Chan 1983; Chen 1979; Ikels 1983; and Wu 1975 for fuller discussions of this phenomenon).

Joining social clubs or turning directly to formal service organizations are seldom options as newly-arrived immigrants, particularly older women, are not disposed towards participation in groups of strangers. In the case of service organizations a lack of bilingual staff may make it impossible for the immigrant to explain his/her needs and obtain appropriate assistance. It is under these circumstances that 'natural helpers' can take on great significance. Natural helpers are individuals who, although not usually employed in the helping professions, voluntarily choose to spend part of their time helping others informally. Prior to the great expansion in programs for the elderly, natural helpers probably functioned as indigenous social workers. Now their tasks are more likely to include information, referral, and emotional support rather than direct provision of services. All the same their activities constitute important and necessary supplements to the formal programs already operating in a particular ethnic community, and it is they who frequently introduce the newcomer to the more formal service organizations.

CHARACTERISTICS OF NATURAL HELPERS

Through discussions with service providers and through weekly visits to an ethnically mixed congregate housing facility during the public noon meal, we gradually learned of three individuals who functioned as natural helpers within the Chinese community. Subsequent interviews with these helpers revealed both their motivations for helping and their shared characteristics which made such help acceptable to others. Brief sketches of their backgrounds and of the kinds of services they provide are presented below. (More complete descriptions of these individuals are available in Ikels 1983.) Following the sketches is an analysis of the features which make such people acceptable as sources of help to older Chinese immigrants.

Mr. Chiang: Himself a recent immigrant, 68 year old Mr. Chiang is now officially retired from a prestigious position with an international organization. He has had many years of international living and is highly educated.

O L D E R I M M I G R A N T S A N D N A T U R A L H E L P E R S 217

All his children received their educations in the United States and had been living here for many years before Mr. Chiang and his wife arrived.

When the Chiangs first came to New York in 1975, they lived with their oldest son and his family, but they soon discovered areas of friction, particularly around issues of child rearing. After a few months they decided to move to the Boston area where their oldest daughter as well as an old friend lived. They moved into the friend's house with the expecta- tion of collaborating on a book, but soon found that the older man hoped that they would help him maintain the building. After much deliberation, they moved out and back to New York. On the one hand they wanted to return to Taiwan where they had many friends, but on the other all their five children were in the United States, albeit in five different states.

While the Chiangs had been living in the Boston area, they had been active in a Chinese language church; through a social worker there they had learned of special housing for the elderly in Boston. Several members of their church had moved to this facility, and the Chiangs decided that this might be the best solution for their housing dilemma.

They have now been living in elderly housing for several years and find it a satisfactory arrangement. Every Sunday they are picked up by a van and brought to their suburban church for services. During the week they hold a Bible study group with the other members of the church, mostly widows who know little English, who are their neighbors. The Chiangs know firsthand the difficulties of intergenerational living and can explain to other disillusioned parents that living in the United States requires special tact, that parents cannot hold on to old ways of thinking about respect and attention. Mr. Chiang has also taken a cue from the church social worker who pointed out that the other residents could benefit from his assistance. Consequently he is now involved in many activities on behalf of the Chinese residents of the building. He informs them of various programs, assists them with their travel plans, and represents their inter- ests on community boards. In addition he teaches tai chi (Chinese 'shadow boxing') and tutors people in Mandarin. Mr. Chiang has long believed that one should employ one's personal resources for the betterment of others, and he derives great satisfaction from the contributions he is able to make.

Mrs. Ng: American-born Mrs. Ng stands in sharp contrast to Mr. Chiang. Where he is gentle and diplomatic, she is abrasive and opinion- ated. Yet I had been told that 75 year old Mrs. Ng was "very influential with other old people". I wondered how such a woman, so atypical in her style, could possibly be 'influential'. Several months of observations of Mrs. Ng at a nutrition site for the elderly revealed that she is yauh sam (kind and considerate, lit. 'has a heart').

This phrase is sometimes employed as a thank you, but it also has a richer connotation, implying a person whose heart is good, who takes it upon him/herself to perform some inconvenient or unpleasant task on

218 CHARLOTTE IKELS

behalf of someone else without any calculation of advantage and without even being asked. Mrs. Ng. is one of these people, and she has been a helper for most of her life.

As a restaurant owner and manager in the southeastern part of the state, she sponsored benefits and allowed community groups to hold their meetings in her restaurant. When both she and her now-deceased husband required extensive medical treatment, she sold the restaurant and moved to Boston. She misses the social interaction her restaurant had so naturally afforded and now spends part of her time rotating among several nutrition sites within reasonable distance of her home.

People wishing her help seek her out at the nutrition sites. One day, for example, I found Mrs. Ng talking with two residents of the building that housed a nutrition site about another man, Mr. Chu, who lived out in the community. Mr. Chu had had a stroke and needed assistance in getting his phone location changed since he could no longer easily reach it. One of the residents hoped that Mrs. Ng would accompany him to Mr. Chu's home where they would wait for the telephone installer and Mrs. Ng could serve as the translator. She has also mobilized others' grandchildren to write to their hospitalized relatives and has assisted older people in gaining admission to elderly housing.

Mrs. Choi: The third natural helper, 48 year old Mrs. Choi, is an immigrant from Hong Kong. When she and her husband lived in Hong Kong, they had managed very well on her father-in-law's remittances -- he had operated his own laundry in the Boston area. With his money they had managed to purchase eight apartments. Mrs. Choi had had three servants to help her with the children and household tasks and had spent most of her time shopping and visiting with friends. Nevertheless she was plagued by a constant sense of malaise and eventually concluded that she needed to spend her time in a more worthwhile way. She began visiting people in the hospital, and when she arrived in Boston in the late 1960s, she started a similar visiting program at her church.

Mrs. Choi described the move from Hong Kong to Boston (which came about at the insistence of her father-in-law) as bringing about a 180 degree change in lifestyle. When she first arrived in the United States, her five children were still young and required attention, but she now had no one to help her. She was also compelled to seek employment in the garment industry as a stitcher. One day as the result of a misunderstanding, Mrs. Choi was told to finish the bundle she had been working on and go home for good. Her English had not been adequate to deal with her employer, but that experience made her want to be independent and to be able to help people like herself.

She now runs her own garment factory employing more than 50 workers and attempts to keep her employees informed about possibilities for improving their lives. She has hired people to teach English and has


brought instructors from the adult language programs in Chinatown to the factory to explain about the availability of night classes. Mrs. Choi is very familiar with Chinese customs and their Hong Kong adaptations. She is aware also of the difficulties involved in raising Hong Kong-born youngsters in the United States. She knows the role conflicts that a working mother with elderly relatives in the home inevitably faces. In short, she has the experience which makes her a valuable resource to other immigrants and their families.

Despite their diverse backgrounds Mr. Chiang, Mrs. Ng, and Mrs. Choi share several important features which make it possible for them to function as natural helpers in the eyes of other community members.

(1) All have established reputations within the community or a signifi- cant segment of it. A newcomer soon learns through others that they are trustworthy, willing to provide assistance, and unlikely to have a vested interest in a particular outcome.

(2) All are bilingual and to varying degrees bicultural. They are able to serve as brokers in various types of transactions. Since so many of the elderly, especially women, are illiterate in both Chinese and English, the spoken word remains the primary channel of communication.

(3) All are relatively accessible, i.e., living, working or eating in areas with concentrations of Chinese. One can just bump into them so to speak, and the encounter does not require the formality and guardedness charac- teristic of more official helping relationships.

(4) All have extensive managerial experience. For many years Mr. Chiang was a high level administrator for an international organization. Both of the women have or have had their own businesses and are confident of their abilities to solve a wide range of economic, social, and personal problems.

(5) All are old enough to be credible problem-solvers. Many Chinese believe that community service is an appropriate activity only for people who have already met their primary obligations to their own families or who have not yet acquired such obligations. Young people, however, are viewed as lacking the experience or wisdom necessary to resolve intricate personal problems and can seldom function as natural helpers. In agencies, young people often function as case managers or social workers, a fact that may inhibit older people from approaching them.

(6) All sincerely believe in the value of helping. Mr. Chiang feels the moral obligation to help those with less personal resources than himself. Mrs. Ng came through two crises in her own life largely because of the interventions of others. Mrs. Choi is upset by others' vulnerability and aims to prepare those around her to deal more effectively with everyday problems of exploitation.

In a study of natural helping in two congregate housing facilities for the elderly Goodman (1984) described a typology based on exchange theory

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of high helpers, mutual helpers, and isolates. High helpers provided help, but did not tend to receive it; mutual helpers were actively involved in providing and receiving, whereas isolates were disengaged from neighborhood helping roles. Neither demographic variables (age, sex, ethnicity, religion, education) nor scores on a personality scale differentiated among the three types. High helpers, however, frequently referred to parental socialization to helping roles. In behavioral terms Mr. Chiang, Mrs. Ng, and Mrs. Choi can be categorized as 'high helpers'. Though none of the three made direct reference to parental socialization practices, all made clear references to childhood or early adult experiences which shaped their attitudes towards helping others. Mrs. Ng, for example, lost her mother very early in life. Her widowed father succeeded in raising several dependent children with help received-from ordinary members of their small community.

D I S C U S S I O N

In theory Asian and Hispanic immigrants can participate in public programs for the elderly on the same terms as other residents of the United States. During the 1960s, however, there was a growing awareness that minority group status severely limited individual participation in such programs. Advocates charged and subsequently documented (e.g., Cuellar and Weeks 1980) that elderly members of minority groups did not receive benefits or services on a per capita basis to the same extent as Americans of European ancestry. For example, their Social Security payments were lower, and they were underrepresented in long-term care facilities. These facts gave rise to the double jeopardy hypothesis first enunciated by the National Urban League in 1964 (Cuellar and Weeks 1980: 2). According to this view, the welfare of minority elders is jeopardized first by racial or ethnic discrimination and secondly by age discrimination. Subsequent writers on this topic added a third burden, gender discrimination, borne by older women of minority ancestry.

The double or multiple jeopardy hypothesis was originally developed to describle the plight of the black population in the United States, but it was soon extended to other populations as a result of studies carried out in the late 1970s. By the end of the decade several final reports were available (e.g., Bell et aL 1976; Pacific/Asian Elderly Research Project 1978; Human Resources Corporation 1978; and Cuellar and Weeks 1980), and their conclusions were remarkably similar. Again and again the reports emphasized the need for an improved data base on the minority elderly and the need to educate planners and providers of the diverse cultural backgrounds of the minority elderly.

Many people lack even the minimal information necessary to identify the ancestry of atypical clients or patients. During a recent visit to a


nursing home in a small town in central Ohio, I was told of a Chinese patient who was unable to communicate with anyone because of language difficulties. I attempted to speak with her in both Cantonese and Manda- rin, but when she showed no signs of recognizing anything that I said, I concluded that she probably spoke a very local Chinese dialect. A member of the staff then listened to. From the writing on the tapes it became obvious the woman was not Chinese at all but Korean. Perhaps this fact had been noted at admission, but it had not been transmitted to the people directly involved in her care. On the other hand even with the knowledge there was little the staff could do to improve her social situation as there were few, if any, other Koreans in the area. According to Kim (1.981: 195) elderly women constitute the core of Korean language churches in New York, and all such churches have clubs for the elderly, usually called the Association of the Respectable Elderly. If such churches had active visitation programs, the isolation of homebound or nursing home patients, such as the one I encountered in Ohio (whose tapes dealt with Bible Study), could be alleviated.

Immigrants who enter the United States as refugees are provided with extensive help in settling in by a variety of organizations offering help with translation, language training, housing, and employment. The elderly, however, do not usually constitute a high proportion of refugees, and those few who are are likely to be approached as family members rather than as individuals. In such cases the housing needs of the entire family, jobs and language-training for the bread-winners, and education for the young take precedence over the psychological needs of the elderly who are often assumed to be doing well simply because they are with their families. Older people who do not arrive as refugees but as additions to families already well-established in the community are not automatically brought into contact with service organizations. Neither they nor their family members are likely to perceive a need for such contact, and should the older person become increasingly withdrawn (especially likely if the family lives outside of an ethnic enclave), puzzlement and resignation are common responses.

In these circumstances the identification of natural helpers, such as Mr. Chiang or Mrs. Ng, within each ethnic community to function as outreach workers seems an essential first step to discovering those less out-going elderly who are not comfortable 'reconstructing' their social worlds (see Bastida 1984) on their own. The recruitment of such natural helpers, however, should not lead to neglect of this task by formal service providers nor should it lead to exploitation of the good will of the helpers. Funding for annual efforts to reach all newly arrived elderly should be sought, and, once located, such elderly should be visited in their homes by credible resource persons, i.e., ethnic peers possessing characteristics likely to elicit trust. Given the changing nature of the older immigrant

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population, to do less is to sentence many to years of isolation and distress.

NOTE

* The research on which this paper is based was conducted between 1978 and 1981 under the direction of the author at the Harvard Graduate School of Education as part of a project on 'Cultural Factors in Family Support for the Elderly' (NIA 5 RO1 AG 01095, Robert A. LeVine, Principal Investigator).

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Bastida, E. 1984 Reconstructing the Social World at 60: Older Cubans in the United States. The Gerontologist 24: 465--470.

Bell, D. et aL 1976 Delivering Services to'Elderly Members of Minority Groups: A Critical Review of the Literature. Santa Monica, Calif.: Rand Corporation.

Chan, K. B. 1983 Coping with Aging and Managing Self-Identity: The Social World of the Elderly Chinese Women. Canadian Ethnic Studies XV: 36--50.

Chen, P. 1979 A Study of Chinese-American Elderly Residing in Hotel Rooms. Social Casework 60: 89--95.

Cool, L. 1980 Ethnicity and Aging: Continuity Through Change for Elderly Corsicans. In Aging in Culture and Society. C. Fry and Contributors. Pp. 149--169. New York: J. F. Bergin Publishers.

Cuellar, J. B. and J. Weeks 1980 Minority Elderly Americans: A Prototype for Area Agencies on Aging. San Diego: Allied Home Health Association.

Glazer, N. 1985 Introduction. In Clamor at the Gates: The New American Immigration. N. Glazer, ed. Pp. 3--13. San Franciso: Institute for Contemporary Studies.

Goodman, C. C. 1984 Natural Helping Among Older Adults. The Gerontologist 24: 138-- 143.

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Report Executive Summary. San Francisco. Ikels, C. 1983 Aging and Adaptation: Chinese in Hong Kong and the United States.

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and Naturalization Service. !978--1981 >Statistical Yearbook of the Immigration and Naturalization Service.

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Dept. of Anthropology, Case Western Reserve University. Cleveland, Ohio 44106

Documents

Older immigrants and natural helpers