Working with Asian immigrant elders
The population of older Asian immigrants continues to grow in English-speaking countries. By 2026, Chinese and Vietnamese are expected to be the ﬁrst and fourth most spoken languages spoken by older immigrants in Australia (Lee et al., 2011). The number of older Asians in New Zealand is also growing and is expected to increase ﬁvefold between 2001 and 2021 (Statistics New Zealand, 2006). The largest group of Asian elders in New Zealand is Chinese, and over 90 percent are foreign-born (Li and Chong, 2012). In the UK, approximately 11 percent of South Asians and 3 percent of Chinese are between 60 and 74 years of age (Evandrou, 2000). Asians are also the fastest-growing group among elders in the US, and are projected to increase from 3 percent in 2000 to 8 percent by 2050 (Federal Interagency Forum on Aging-related Statistics, 2012). When working with older Asian immigrants, it is important to understand the
aging process through a life course perspective and explore ways in which early life experiences shape late life. Diﬀerent socio-historical periods provide diﬀerent opportunity structures for individuals (Elder et al., 2003). Access to health care, education, and employment in early life inﬂuence the life course. The majority of elders from rural areas of Asia had limited access to education, which reduced opportunities for employment in their new country. On the other hand, individuals who had access to education in their home countries were able to obtain wellpaying jobs and prepare for a secure retirement in their host countries. Disadvantages in early life such as malnutrition can also result in chronic physical conditions in later life (Hertzman, 2004). A lifetime of adversity results in poor physical and mental health among Asian elders (Mui, 1993). For example, Bengali and Gujarati elders who held low-wage jobs in the UK report numerous health problems including poor eyesight, arthritis, rheumatism, and high rates of depressive symptoms (Lindbloom et al., 2012). The timing of immigration also inﬂuences subsequent life experiences. People
who immigrate during young adulthood usually migrate at the beginning of their career and child-bearing years. Migrating in young adulthood enables people to settle down and grow roots in their new environment. Those who immigrate during mid-adulthood can ﬁnd employment and receive a pension. In recent years, there has been an increase in older adults who immigrate in late life to be with their children. Although immigrants of all ages face stressors such as loss of a
familiar environment, support systems, and identity and status, it is more diﬃcult to adjust to a new environment in late adulthood than in young adulthood (Angel et al., 1999; Kim et al., 1991; Le, 1997; Phua et al., 2001). Older immigrants are less capable of learning a new language and adapting to new surroundings than those who immigrate earlier in life. Older adults, in general, have to cope with life cycle transitions such as ﬁnding
new meaning in life after retirement, and coping with physical changes. Elders who immigrate in late life not only have to cope with the aging process, they also have to adapt to a new environment, face language barriers, and respond to changes in intergenerational relationships. These changes can have negative consequences on psychological well-being (Tsai and Lopez, 1997). Financial security is a serious problem for many Asian elders in English-
speaking countries. Elders who migrated in late life are not eligible to receive pensions. Although the Social Security system is designed as a safety net to protect elders in the US, close to half of Asian elders (53.7 percent) do not receive Social Security beneﬁts because they immigrated late in life and have not paid into the Social Security system (AARP Public Policy Institute, 2004). Among the elders in the US, Bangladeshi (35 percent), Hmong (31 percent), Laotian (22 percent), Korean (22 percent), Cambodian (19 percent), Chinese (16 percent), Pakistani (15 percent), and Vietnamese (16 percent) elders also live under the poverty line. The percentage is smaller for Asian Indians (9 percent), Japanese (6 percent), and Filipino (8 percent) elders, because most Japanese elders are second and third generation, and a large number of Filipinos and Asian Indian elders immigrated to the United States in the 1970s and 1980s as professionals, enabling them to establish ﬁnancial security for their retirement years. Asian immigrant elders, on the whole, are a vulnerable group with high rates of poverty, low educational attainment, limited English proﬁciency, and low levels of assimilation into mainstream society. In this chapter, we will present an overview of aging and mental health,
followed by issues that are speciﬁc to working with older Asian immigrants. We discuss ways in which practitioners can use relational perspectives to support the psychological well-being of Asian immigrant elders and their families.