Posted on October 11, 2004

More Nursing Homes Grouping Residents By Ethnic Groups

AP, Oct. 10

CHICAGO — Jane Ngo noticed first that her mother’s few words of English were gone. Then it was her mother’s memory of where she lived, even as she stood just steps from her door.

The idea of placing Mei Ruan in a nursing home filled her with shame. But Ngo knew that caring for her 93-year-old mother, who had followed her years ago from China, was a job she could no longer handle.

A few blocks away she found a place that would ease her conscience and give her mother one thing that would make her comfortable: China.

“Here there is Chinese movie, Chinese music, Chinese staff talking to her,” Ngo said. “She thinks she’s back in China.”

Mid America Convalescent Center is one of a growing number of Chicago area nursing homes that group residents by ethnicity. Asians live on one floor, Hispanics are on another. Each group has its own traditional food, activities and a staff that speaks its language. Within a few miles are other facilities doing the same for Poles, Russians, Indians and Koreans.

There have long been nursing homes that cater to certain nationalities and religions, or become popular with different ethnic groups. But in Chicago, with the third largest number of foreign born residents in the United States, that sort of specialization is becoming increasingly common and formalized, said Kevin Kavanaugh, spokesman for the Illinois Council on Long Term Care.

Between 1990 and 2000, the number of foreign born U.S. residents jumped from just under 20 million to over 31 million — more than 78 percent of them from Latin America and Asia — according to the U.S. Census Bureau. About 629,000 are in Chicago.

The numbers can add up to more business for nursing homes — if they can attract immigrants and convince them they’re not abandoning their loved ones.

“They can feel incredible guilt because their families have always cared for their elders at home,” Kavanaugh said.

In some cultures, a nursing home is seen as mental institution or “a place where you go to die,” said Charlene Wells, assistant administrator at Glen Elston Nursing and Rehabilitation Center in Chicago, where Hispanic and Polish residents have their own services. In other cultures, she said, nursing homes simply don’t exist.

To attract people from various ethnic groups and cultures, “You have to create an environment they’re used to living in,” Wells said.

Not everybody agrees that cultural separation is the answer, though.

“I think you get very limited in the interactions that you can have,” said Susan Mikals, clinical administrator at Ballard Healthcare in suburban Des Plaines. “If you have someone with an ortho trauma, do they want to be laying next to someone on a ventilator just because they both speak Spanish?”

Kavanaugh suspects much of the resistance stems from the negative connotation of segregation.

But nursing homes are often dealing with a specific population with specific needs and for whom the idea of America as a “melting pot” has little or no meaning, he said. Chicago has enclaves where the culture has such a firm hold they could almost pass for neighborhoods in Mexico or Poland.

People who suffer from Alzheimer’s disease or other kinds of dementia may no longer even know they are in the United States, Kavanaugh said.

“They may be reverting back in time, perhaps speaking their native language, living in the past,” he said. “You want to have a program that meets them at their sense of reality.”

Nursing homes must be aware, for example, of elderly Jewish residents for whom a trip to the shower triggers memories of the Holocaust.

They also must be aware of customs and rituals, said Rosemary Gemperle, executive director of the Coalition of Limited English Speaking Elderly, an organization of community-based ethnic agencies in Chicago.

“Indian people, Hindus, won’t eat before they are bathed,” Gemperle said, offering an example. “They will starve first.”

Some Koreans won’t drink cold water, believing it can cause disease. A nursing home that doesn’t understand that can create a life-threatening situation if residents refuse to take medications because they are given only cold water, said Susan Duda Gardiner, director of clinical services with the Illinois Council on Long Term Care.

Food is often central to nursing homes’ ethnic programs.

“Imagine an older person living in a nursing home who is used to eating food of their tradition and now they are eating bland, unfamiliar food that doesn’t look familiar, taste familiar,” said Melanie Chavin, vice president for program services at the Alzheimer’s Association in Illinois. “They might stop eating.”

Vinita Parsram doesn’t think her husband, paralyzed by a stroke, would refuse to eat if he wasn’t served Indian food. But she says it’s important to him that Lake Shore HealthCare and Rehabilitation Centre has an Indian cook who prepares kheer, a rice pudding, and other dishes he likes.

“There is nothing else for him to do,” she said. “Food seems to be one of his focal points, and I’m not going to deprive him of what he likes.”

Immigrants are still more likely to care for their elderly at home, but for those who left extended families behind to move to America, nursing homes may be the best option, Kavanaugh said.

Jane Ngo is among them. She is now nearly 70, and walking up and down the stairs day and night to help her mother left her exhausted.

She cries when she thinks about her decision to put her mother in a nursing home — until she is asked about the recent day she brought her mother, now 94, back to her home to celebrate a holiday.

“She stay only one hour; said ‘I want to come back”’ to the nursing home, Ngo said, smiling. “She didn’t want to come home.”