A Community of Caregivers – In Times of Need, Family Members and Agencies Provide Welcome Support

Often called the “silent population,” the number of seniors, as well as those with Alzheimer’s disease, is rapidly increasing. According to the Alzheimer’s Association, the numbers of Asian Pacific Islanders with the disease, a kind of dementia that is associated with memory loss, will almost triple between 2009-2030, from about 72,075 to 194,266.

In the midst of a community whose population is increasingly aging, many Japanese American families must come to terms with identifying and meeting an aging loved one’s needs.

However, one benefit of having an aging society is that “there are community resources out there that exist for the sole purpose of helping our elderly (as well as caretakers). You don’t have to do this alone,” Dr. Kimberly Kono said in an e-mail.

In addition to encouraging people to take advantage of community-based resources, Kono, who holds a Ph.D. in clinical psychology from the California School of Professional Psychology, emphasized the importance of ensuring open communication between the parties before there is even a need for caregiving.

“As well as you may think you know your loved ones, you may not always know what their priorities and preferences are when it comes to aging,” the Yonsei added.

Kono said that before one should suffer a debilitating illness or injury and become unable to express their needs, it is crucial to determine who should be in change of their medical care, finances, and even determine whether or not they’re able to continue living safely on their own. She suggested that families involve a geriatric case manager or social worker into the discussion.

Meanwhile, seniors, with their loved ones by their side, continue to navigate the confusing and tumultuous road of caregiving as best as they can.

Siblings Come Together to Care for Mother

On any given day of the week you will find 90-year-old Yae Yorozu in the Seattle area, at the home of one of her four adult children. Yorozu and her children devised this plan after her late husband, William Yorozu, suffered complications during surgery, and moved to a skilled nursing facility for seniors. Yorozu, who had spent “all day, every day” with her husband, did not want to live in an empty house, explained her daughter Christine Yorozu.

This arrangement was perhaps for the best: about nine years ago the younger Yorozu noticed that her mother was repeating herself quite frequently.

In addition, the Nisei spends many hours a week at Kokoro Kai, a program for seniors that is operated by the nonprofit Nikkei Concerns in Seattle.

Christine Yorozu meets with her siblings, two brothers and a sister once a month — usually over a meal — to discuss their mother’s health, upcoming schedule (participation in Kokoro Kai and upcoming doctor’s appointments), finances and other matters.

While the meetings are dictated by an agenda, meeting notes, a master calendar and assignments, these get-togethers also allow the siblings to catch up with one another.

Yae Yorozu has a bed, clothes, and all of her necessities at each of her children’s homes. She lives with her daughter and her son-in-law two days a week.

Flexibility, Christine Yorozu said, is crucial to making her siblings’ approach to caring for their mother work.

Each child has their own specific task or responsibility — from taking their mother to the doctor and dispensing her medication, to handling her estate — as a caregiver. Christine Yorozu pays some of her mother’s bills.

Although Yae Yorozu hopes to remain in her children’s homes, she recognizes that a time could come where that may no longer be a possibility, said daughter Christine.

For now, someone, typically one of her children, is with their mother at all times.

Christine Yorozu, a former board member of Nikkei Concerns, acknowledged that coordinating her mother’s care may take some time and effort, but she does not view it as obligation. “It’s just what we’re supposed to do,” said Yorozu, who recalls having two of her grandparents living with her family when she was young.

A Chance to ‘Really Know Someone’

Jennifer Wong’s situation as a caregiver is not quite as stressful as that of others, she thinks.

Wong and her husband care for her 90-year-old grandmother, Dorothy Masuda.

Wong, who was born and raised for several years in the Bay Area Peninsula, said that when she was a child, she saw her grandmother on special occasions.

Several years ago, she, along with her family, learned that she was in the early stages of Alzheimer’s disease, Wong said.

About three years ago, Masuda began leaving notes to herself all over the house. Wong recalls finding nine address books, all of which held the same information.

Masuda, who was active in the San Mateo Japanese American Community Center, was becoming less social, and instead started spending more time watching TV. Even more troubling, Masuda started suffering from dizzy spells. It turns out, Wong said, that this was because her grandmother was forgetting to eat.

Upon learning of her diagnosis, and after being told that she should relinquish her driver’s license, Masuda’s family members asked her whom she wanted to live with. Masuda picked Wong.

Jennifer and her husband Steve Wong found a house — incidentally, next to her uncle’s home — in San Jose.

Today, everyone, including her cousin, helps to care for her Nisei grandmother, Jennifer Wong said.

Steve Wong often drives his mother-in-law to Yu-Ai Kai senior center in San Jose’s Japantown, where Masuda participates in chair exercises, arts and crafts, and also does simple math problems to stimulate her brain, Wong said.

Masuda, her granddaughter said, is particularly fond of the food. Snacks include hot tea and arare (rice crackers).

The five hours a day (Monday through Friday) that Dorothy Masuda spends at the senior center allows Wong, the co-founder of Motor Music Mag, to have some time to herself.

While Jennifer Wong likens caring for her grandmother to having a child, she believes that the responsibility is less taxing on a grandchild, than it would be a child.

As a grandchild, the caregiving relationship is devoid of the parent-child conflicts that other caregivers and seniors experience, Wong said.

“If I was going to care for my mother or father, there might be more tension,” she said, adding that there’s a different level of respect and “fondness” that she and her grandmother share.

There are, however, obstacles that she has encountered. Should Masuda answer the phone, she won’t remember to relay the message to the appropriate person. Wong believes that it is possible to find the humor in such situations if one looks for it.

It’s OK, Wong said, if Masuda makes a mistake or has an accident. She similarly believes that part of her role as a caregiver entails preserving Masuda’s dignity. Wong and her husband call the adult diapers that the Nisei wears, “super pants.” Whenever Masuda goes out, whomever she is with carries a bag that contains an extra set of clothes, along with extra diapers.

Ultimately, Wong has found her experience as a caregiver, which she describes as “having the opportunity to really know someone,” to be rewarding.

Among her grandmother’s past times is playing hanafuda, a Japanese card game.

When Masuda moved in with the Wongs, she was surprised that her granddaughter knew how to play the game.

“She forgot she was the one who taught me,” Wong said.

Finding Joy Along the Journey

Born in Kobe, Japan, Michiko Hokumen has spent the last 11 years with her son in Osaka.

She was since subsequently diagnosed with Alzheimer’s disease, said her daughter, Kazuko Hokumen Jones.

This April, when Jones paid her annual visit to her mother, Hokumen revealed that she wished to live with her daughter and her husband in San Francisco.

Jones has since enrolled her mother in activities at Kimochi Home, in San Francisco’s Japantown.

Much to Jones’ surprise, the 80-year-old Hokumen was one of the first on the dance floor at the nonprofit’s Sansei Live fundraiser in September.

Jones, who works as a real estate broker, is grateful for the opportunity to live with her mother.

“It’s like getting to know her again,” said Jones.

At the same time, however, Jones concedes that “physically, I feel I have another child,” the mother of two grown daughters said.

While at a Cantonese restaurant, Hokumen was displeased with the food and repeated, “I hate it.” Upon being reprimanded, Hokumen told her daughter that she would no longer go out to such functions. She gets depressed, Jones said. Ten minutes later, however, all was forgotten.

Hokumen has been able to find joy in her artwork. Jones enrolled her mother, an artist, in a Chinese painting class, and made postcards out of the Shin-Issei’s paintings, which they sold at two separate Alzheimer’s Association Memory Walks.

As pleased as Jones is that her mother is able to continue to take pleasure in her work, there is one thing that continues to bother her: Hokumen talks about the past, but never the future.

“I’d like her to think about the future,” she said. “I keep trying.”

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TIPS FOR CAREGIVERS:

• Lower your expectations when addressing and serving those in need. It takes patience and perseverance. You can’t get upset when someone is unable to remember something from two years ago.

• Put yourself in the person’s shoes and think: What is really of value to them — even if it short-lived? If even for a moment, something brings happiness to the person, it is worth is.

• Encourage your loved one to read, watch TV, listen to the radio, or do any number of things to keep their mind active.

— Lillian Hayashi, who has worked with seniors for some 35 years, is currently employed by Emerald Heights, a life care community located in Redmond, Wash. She has served more than 25 years with both the Aging Services of Washington and the Alzheimer’s Association. She has also been affiliated with the Retired Senior and Volunteer Program for six years. Hayashi also serves as her 95-year-old mother Tomiko Ueno’s caregiver.

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