DEARBORN — Despite cultural norms and prevailing challenges, more Arab American families are embracing retirement and assisted living housing for their elderly relatives.
There is a common consensus among health care professionals and researchers that most people— regardless of ethnicity— prefer not to admit their loved ones to a retirement or assisted living institution. Most of the time, families choose that route only when other options are impractical. The cost of care and living outside the home, as well as language and cultural barriers, make considering such housing arrangements troublesome for the elderly.
Shaqiyah Halil, 64, said her sons and daughters all have their own families and that staying in an independent retirement home is the only affordable option she has. At the Dearborn Heights retirement home where she lives, doctors are always on call to care of her health.
However, she complained that there are few Arab American residents to communicate with. Her doctors and nurses don’t speak Arabic, either.
She said the home’s staff take the residents out to shop and run errands, but she always feels out of the loop, because she doesn’t understand them or the home’s posted announcements.
Mariam, 73, who wished to be identified by her first name only, said she lives in an independent retirement community because she is eligible for the housing arrangement as a low-income resident. Besides, her only relative— her grandson— lives with two of his male friends. It is not customary for a woman her age to live with men who are non-relatives.
After she sipped on her Turkish coffee in her room, she welcomingly opened her arms, looked at her neighbor and friend and said, “see, I always have company. We’re comfortable here.”
Mariam said that there are many Arabs, especially Iraqi immigrants, who reside in the 300 room retirement community in Dearborn.
She said instead of paying $700 per month for an apartment with added costs, she only pays $25 per month.
“It’s more calm here than it is back in Lebanon,” she added.
Mariam said the doctors who visit her twice a month don’t speak Arabic, but she always finds someone to help her translate.
Kristine Ajrouch, professor and interim head of Eastern Michigan University’s sociology, anthropology and criminology department, published a study on the needs of aging Muslims in Metro Detroit in 2013. Her research determined that although Arab households strive to keep their elderly at home, many families will eventually realize that in order to provide a better quality of life for their loved ones, they will need external support that they can’t provide.
“There’s not a lot of acceptable options for the Arab American community,” Ajrouch said. “They do feel that they have specific cultural needs and values that perhaps are hard to find in other places, but it doesn’t mean that they don’t access the places that are available.”
John Palmer, an administrator at Oakwood Commons, an independent living and assisted care campus for seniors in Dearborn, said the institution actively aims to be sensitive to residents from varying cultures. Matching the residents with the right physicians and nurses who can properly communicate their needs and health performance, as well as provide them with desired dietary needs, are one of the most important aspects of care, according to Palmer.
He added that of the 39 long-term assisted living beds available at Oakwood Commons, nine of them are occupied by Arabs.
A social worker of Arab American descent, who wished not to be identified, said plenty of Arab Americans seek treatment from Oakwood Commons, mainly because their children cannot provide the required care. She said this reflects a shift in the newer generation’s attitude toward the elderly and added that half of the residents she interacts with cannot speak English.
Mary Zapinski, a nurse at Great Lakes Home Health Care, said it would be unnerving for a non-English speaking senior to live in a retirement or assisted living home that doesn’t recognize his or her cultural differences.
“It would go downhill, quickly, I’m sure of it,” Zapinski said. “That would be devastating for someone. Could you imagine living all your life and all of a sudden you’re in a foreign nursing home and you don’t understand the culture and the food?”
Ajrouch said foreign assisted living residents encounter many challenges, like the inability for families to receive updates on their parents’ health, as the residents don’t understand the physician’s reports.
“Language is a huge barrier,” the researcher said. “Language is the basis, in many ways ,of culture; and if you can’t communicate very well with people who are supposed to be caring for you, it creates a lot of challenges.”
Khalid Alrifai, a Syrian-American college student, said he would never consider admitting his parents into a retirement or assisted living home, a topic he frequently discusses with his wife.
“My parents raised me with the utmost care and love,” Alrifai said. “How could I, at their time of most need, just throw them to somebody else to take care of them?”
Ajrouch said that with people living longer than ever, the need to seek external medical support often arises.
Hiba Krisht, an Arab American translator, said she would not be comfortable with an assisted living arrangement if it were contrary to her family’s preferences and beliefs. However, she recognizes the pragmatism of such establishments.
“It sounds more doable than having them in my home to begin with,” Krisht said. “I don’t have the resources or the compatible beliefs to make them comfortable.”
In a study that Ajrouch conducted on ethnic identity development, she interviewed adolescents of immigrant families. She said the teenagers thought that one of the traits that makes them different from Americans is that they would never put their parents in a nursing home. That “struck a chord” with the sociow logist.
“They’ve never dealt with the reality of growing older,” Ajrouch said. “Their parents are immigrants, so they don’t have grandparents here and their parents are relatively young.”
According to Ajrouch, one of the challenges of establishing cultural retirement centers is that the Muslim community is more concerned with retaining the youth, than addressing the needs of the elderly.
However, that does not mean that the conversation has not begun. The sociologist said she believes there is a growing realization that there is a demand to address the needs of older adults in the community.
She added that progress should happen in small steps so developments are not so jarring for Arab immigrants.
“There’s a real fear in terms of wanting to hold on to their culture,” Ajrouch said. “In many ways, the culture they came here with is frozen in time from when they left, so they have a more static image of what should be.”