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Creating The Right Settings for Arab American Seniors

posted on: Jun 30, 2016

Photo: Honored Arab American publisher, Joseph Haiek, 82.

Julian Do

Al Enteshar/New America Media 

In their early days in the United States, many Arab American elders found difficulty in adjusting to a new life. Fortunately, their community has stepped up to help, and a new attitude towards caring for seniors is also emerging.

In Arabic culture, elders consider the family as their foundation of support. From the adult children’s perspective, it’s both an honor and a responsibility to care for their aging parents. It means home care is the only option for older adults, and this tradition is also maintained among Arab immigrants in America.

As a result, it would be a serious social taboo if Masad Arbid, MD, allowed his parents to receive care at a nursing facility.

“If my aging parents moved to a nursing home, it’s like my family has abandoned them. It would be viewed as a disgrace by people in my community and even by my relatives back in the motherland,” said Arbid, who practices medicine in Los Angeles.

Isolation and Health Quality

Arbid also explained a practical reason for this view. Currently, mainstream senior communities and nursing homes are not capable of providing services and care in ways that are culturally and religiously sensitive to Arab and Muslim traditions and in the Arab language. And home care can yield unintended consequences for a number of Arab American elders.

In her 2008 article Social Isolation and Loneliness Among Arab American Elders: Cultural, Social, and Personal Factors, about Arab American seniors in Detroit, Mich., sociologist Kristine Ajrouch, of Eastern Michigan University, discerned that a high percentage of first-generation immigrant elders felt socially isolated due to problems acculturating to mainstream America.

Amne Darwish-Talab, director of social services at the human services organization Arab Community Center for Economic and Social Services (ACCESS), said, “Most Arab immigrant seniors speak little English and don’t have access to transportation, so their social circles tend to be pretty small.” Located in Dearborn, two-thirds of the nonprofit’s clients are of Arab descent.

“On top of that,” added Darwish-Talab, “in many cases, they don’t get to interact with their family members as much as they would like as their adult children and grandchildren are often exhausted from work and school at the end of each day.”

These circumstances, according to Ajrouch’s research, can lead to poor health quality, stress and even depression.

Darwish-Talab explained that in their home countries most Arab seniors are usually active physically and socially. They either walk or take public transportation to buy groceries, visit friends and attend local churches or mosques. But in the United States, such places are often far apart and public transportation is not always accessible. As a result, many Arab American elders find inactive, which over time affects their health.

In their 2014 study titled, “Arab Refugees: Trauma, Resilience, and Recovery,” researchers Ibrahim Aref Kira, MD, and his colleagues noted that older Arab immigrants tend to have a high level of emotional strain given their exposure to constant war and political turmoil back home.

After coming to America, their stress level often becomes more acute. Not only do they find they have to adjust to new cultural settings, but they also must deal with backlash of discrimination from the 9/11 terrorist attacks and similar recurrences in the U.S. and around the world.

“When they have these tensions and are isolated at home, it’s understandable that a number of our seniors have become so stressed out and depressed. That’s why one of our center’s main services is mental health counseling,” said Darwish-Talab.

Meeting The Elders’ Needs

Responding to the needs of Arab American immigrants, ACCESS was established in Dearborn in 1971. Today, ACCESS has grown into a national organization boasting more than 100 programs that provide health, economic, educational and immigration services in both English and Arabic. Many of these programs, including mental health counseling, cater to elders.

In Arab culture, mental health carries a serious social stigma; people with mental illness are often viewed as crazy and abnormal. After seeing how stress and depression have affected many Arab American seniors’ mental wellbeing, ACCESS decided to offer counseling.

“The counseling sessions with our clients are kept strictly confidential,” said Darwish-Talab. Being able to talk openly with an ACCESS counselor about their stress and anxieties often proves vey therapeutic, she added.

Besides researching and documenting social and health issues that many Arab American seniors confront, Ajrouch is also actively involved in the community.

Together with her academic colleagues at Wayne State University, and Darwish-Talab at ACCESS. She has studies what will be needed to create a community cultural center in Detroit with programs to assist Arab American elders obtains services, such as transportation, opportunities to socialize with other older adults, participate in healthful exercise activities and get involved in cultural events and festivals.

If its successful, Ajrouch and her collaborators hope this community model could be duplicated around the country as an additional avenue to help Arab American seniors aging gracefully at home with their families.

New Attitude Towards Aging

“There is this person in our community who has lived in America a long time but decided to live out his retirement in Lebanon where he was born,” said Abed Al-Abour, 67, a retired chemical engineer. “He thought he would be happy there with all the familiar cultures, food, language, religious traditions. But we saw him move back to Los Angeles. It seems after a while, he realized that home is really where his children and grandchildren are.”

Ibrahim Tenious, 62, a retired pharmacist teaching health science at Evergreen College in Los Angeles, agrees. There are many Arab Americans like him who have bought apartments or built houses back in their homelands, such as Egypt, Jordan and Lebanon for future retirement. But these houses are often empty. Tenious thinks eventually these properties will be sold to local residents.

Besides rethinking where their retirement homes should be, many are also becoming more flexible about their options.

Although Arbid, the Los Angeles physician, would not have his parents cared for at a nursing facility, he would not rule out that option as well as others for himself someday.

Arbid thinks it’s all about striking the right balance between having good quality of life and not burdening one’s children, while also maintaining a close-knit family relationship. If an elder develops a serious illness, such as Alzheimer’s, which can eventually require 24/7 care, he thinks the right option may sometimes be more medical than cultural.

Al-Abour agrees that he also has no problem with the idea of living in a skilled nursing facility, if he needed constant medical attention and his children could care for him at home.

He describes his two U.S.-born children as essentially American. The son, a business graduate, is on a double-A minor league baseball team and hopes to make it to the majors. His daughter, who has just earned a psychology degree, loves to attend the mega-music Coachella Festival.

Al-Abour thinks the younger generations of Arab Americans, like his children, would view aging differently when they weigh practical health and economic options alongside their cultural traditions. However, he believes family support is the one thing that will never change.

Leaving A Legacy

Joseph Haiek, 82, is among the activists who recognized early on that, besides economic advancement, Arab immigrants need to have a clear identity and strong cultural bond within the community to thrive in their newly adopted home.

Haiek, a Catholic Palestinian who brought his family from Lebanon to the U.S. in the late 1960s, formed the nonprofit Arab American Historical Foundation in Los Angeles in 1978. Under this umbrella, he has published a monthly English-language magazine called News Circle and a series of the Arab American Almanac, [http://tinyurl.com/j52m3r5] now in its sixth edition, which provides historical accounts of the Arab American journey in America since the 19th century.

Gradually, other Arab American publications have also sprung up. Together with Haiek’s media, they’ve created the Arab American Press Guild. To date, the Guild has more than 20 media members, such as Al Enteshar, and they often collaborate with other Arab American organizations and entrepreneurs to organize Arabic cultural events that bring all ages in the community together.

Haiek, the first Arab American to have received the prestigious Ellis Island Medal of Honor in 2011, is glad that his three children, particularly Caterina, have stepped into the Foundation’s leadership.

“I am happy to continue my father’s legacy, but at the same time, it’s challenging as it requires lots of hard work, dedication and resources, which are not always available,” said Caterina.

Julian Do wrote this article for Al Enteshar with support from a Journalists in Aging Fellowship, a program of New America Media and the Gerontological Society of America, and sponsored by The SCAN Foundation.