Immigrants Embrace Nursing Homes
Sarah Kershaw, the
The weekly activities at a retirement home here include
bingo, shuffleboard and "ice cream social with shoulder
But also listed on the crowded schedule are Howa Kai (a
Japanese Buddhist church service), rummi kub (a Japanese version of gin
rummy played with plastic tiles), shuji (calligraphy) and kokoro kai (a
program held three times a week and loosely translated as "a meeting
of hearts and minds").
Nikkei Manor, where 46 Japanese-Americans are spending
their old age, is one of a growing number of assisted-living facilities
and nursing homes across the nation that cater to first- and
second-generation elderly immigrants. It is a fast-growing population that
has begun to embrace the very American tradition of living the last years
with peers, not family. That phenomenon is driven by two-career families
that have little time to care for their parents, increasing wealth for
some immigrant populations and gradual acceptance of a lifestyle that was
unheard of a generation ago.
Assisted-living facilities, which allow the elderly to
live independently with some supervision, became popular in
Still, places like Nikkei Manor — where miso soup,
soba noodles, red ginger and dark-roasted tea are staples of the daily
lunch and dinner menus — are sprouting up at a rapid pace, from Seattle
to the Lower East Side of Manhattan, signaling a major shift in how
immigrants in this country care for their elders.
Assisted-living facilities are becoming especially
popular with Asian immigrants, who, along with Pacific Islanders, made up
2.2 percent of the country's 65-and-older population in 2000, or about
800,000 out of 35 million, according to census figures. By 2010, the
number is expected to rise to 1.4 million.
Marie Fujii, 82, moved into Nikkei Manor three years
ago, after a year at a mostly Jewish facility near
"The family got together and discussed it,"
said Ms. Caldwell, who was working full time as a sales assistant for a
financial services company here as her mother's health was deteriorating.
"We said, `O.K., we'll try, and if it doesn't work out, we'll take it
from there.' But we have been thrilled."
Immigrant groups that have been here the longest, like
the Japanese, are the most likely to accept living in an assisted-living
facility, according to Namkee G. Choi, a gerontologist and professor of
social work at the University of Texas, who specializes in elderly
"The family norms are changing," Dr. Choi
said. "The elders are thinking, `We should enjoy our lives,' and many
would rather spend it with peers. It doesn't mean they don't want to see
their families, but I would call it independence with lots of support from
children. And it's going to be more this way in the future."
Mrs. Fujii, who has Parkinson's disease, said she was
relatively happy living at Nikkei Manor, although over a lunch of beef and
sticky noodles recently she said, "I still get homesick."
Mrs. Fujii lives down the hall from one of her childhood
friends, Tomiko Suyama, 80, who moved into Nikkei Manor two months ago.
The two, who dine together often and refer to each other as "Buddha
head," know almost everyone who lives at Nikkei Manor, having met
them over the years in the
Mrs. Fujii frequently coaxes Mrs. Suyama out of her room
for activities, and Mrs. Suyama's son Scott, who runs the
At lunch last Wednesday Mrs. Suyama said, "I like
being with the family the most." But after the meal, she agreed to
join a singing class and even went back to her studio apartment to freshen
up her lipstick for the occasion.
Dr. Choi, who is a Korean immigrant, said that
assisted-living centers and nursing homes were becoming especially popular
with most Asian-American groups, but that Hispanic immigrants have been
Hispanics made up about 5 percent of the
"Latinos tend to hold on and avoid doing
that," said Maria Martinez-Montes, outreach coordinator for On Lok
Senior Health Services, a federally financed program in San Francisco that
provides medical care and social services to elderly immigrants, allowing
them to remain in their homes.
"In my eyes, I would never put my mom in a nursing
home, ever," Ms. Martinez-Montes said. "It would kill me. It
would totally kill me. I would not sleep — and it was the same with my
There is also the question of what the elderly and their
children can afford. Experts say Asian immigrants, particularly those who
have been here longest, tend to have a stronger financial base than newer
The newer Hispanic immigrants are likely to be among the
working poor, so they and their children may not be able to afford the
high cost of a nursing home or assisted-living facility, Dr. Choi said.
While many of the assisted-living facilities accept
Medicaid clients — and under federal law cannot discriminate based on
race if they do accept them — some immigrants who do not have legal
status or who face language barriers or other obstacles to enrolling in
Medicaid would probably not seek out an assisted-living facility or a
nursing home, even if it were culturally acceptable.
The type of care provided at assisted-living facilities
like Nikkei Manor is expensive. At Nikkei Manor — where the residents
live in either studio or one-bedroom apartments — the cost is $2,700
monthly. That is relatively inexpensive compared with some other
assisted-living facilities, which can run residents as much as $10,000 a
Still, even among those who were brought up to believe
that children took care of their parents no matter what — which also
meant housing them — many welcome the move toward independent living.
As much as many children feel pressure to take care of
their parents, many elderly parents fear being a burden on their busy
children and spending too much time alone.
June Takeshita, 92, and Mitsu Kato, 96, are among many
pairs of friends at Nikkei Manor. They live across the hall from each
other, on the third floor, and Mrs. Takeshita often calls for Mrs. Kato,
who has affixed a sign to her door that says "Knock and Wait."
The two eat meals together, and virtually every night they play rummi kub,
their favorite game.
Helen Kubo, 92, who also lives on the third floor,
frequently joins them for the game, unless Mrs. Kubo's daughter, Fran
Nishimoto, who visits two or three times a week, comes to take her mother
on a gambling outing to a nearby casino.
Mrs. Kubo moved into Nikkei Manor soon after it opened
in 1998, with her husband, Frank, who died two months ago. She was born in
"We were taught to look after the parents,"
Mrs. Kubo said, while her daughter was visiting her studio apartment the
other day. "We were taught to be good to our parents. But I like it
here. Better than with family. It's more free."
She added: "We're all getting old together, anyway.
We're lucky this place exists."
of Nikkei Manor, an assisted-living center in