HEALTHY AGING: Senior services for Japanese Americans in California

The Nikkei community is aging, and as Sansei and even Yonsei enter their 60s, aging issues have become all the more urgent. California, with its high concentration of Japanese Americans, has numerous services and entities dedicated to aiding aging seniors through the concept of “Healthy Aging.”

The Administration on Aging (AOA), a part of the U.S. Department of Health and Human Services, estimates that 72.1 million people will represent the 65-year-old and older demographic by 2030, more than twice the number in 2000. For Asians and Pacific Islanders, the numbers are no different. According to the AOA, the population of Asian, Hawaiian and Pacific Islander seniors increased from 0.8 million to 1.4 million between 2000 and 2010, while it projects their numbers to be 3.9 million by 2030.

The Aging Demographic

Up and down the Golden State, various organizations provide care and services that are culturally sensitive for Japanese Americans. Many of these organizations have recently adopted strategies to promote “Healthy Aging,” which addresses the increasingly complex needs that American seniors face today.

The Healthy Aging program, a major project of the Centers for Disease Control and Prevention, is studying the state of aging in the U.S. to provide information to allow seniors to live longer and healthier lives.

The number of seniors is expected grow as older generations enjoy longer lives. The baby boomers, which the U.S. Census Bureau defines as people born between 1946 and 1964, will soon join them.

EVIDENCE-BASED PROGRAMS — Keiro partners with leading research institutions and universities to offer innovative, evidence-based programs on memory enhancement, fall prevention (pictured here), diabetes and healthier living. photo courtesy of Keiro Senior HealthCare

Dianne Kujubu Belli, executive director of the Institute of Healthy Aging and the chief executive officer of Keiro Senior HealthCare, said that aging does not spontaneously begin at age 65.

Keiro, which serves the greater Los Angeles area, is a 50-year-old nonprofit health care service. It operates two nursing homes, an intermediate care facility and a retirement community. According to Belli, 560 employees and 800 volunteers (many of them residents or participants of Keiro’s services) serve the organization and its 600 residents. Belli said the emphasis on Healthy Aging began seven years ago. The focus aimed to allow seniors to live at their own homes for as long as possible before moving into a retirement home.

The Little Tokyo Service Center (LTSC), which is also located in Los Angeles, offers community programs and social services. It does not, however, have a building specifically for seniors. Director of Senior Programs Amy Phillips said the organization started as a one-stop shop for seniors. LTSC serves 250 cases each year through its caseworkers, and thousands more overall through its information directory and referral system for care providers and educational programs.

Phillips noted the high cost of moving into an assisted living community and that seniors should take a proactive approach to managing their later years to allow them to age in place as long as possible. She said that aging closer to home saves seniors from both the financial cost, and the trauma sometimes associated with the transition to assisted living.

“The Nikkei community has great institutions for seniors, but they are often far away,” said Phillips.

The LTSC is currently formulating a new framework of programs and services for the next generation of retirees. She explained that adults should start planning for their retirement — both their finances and their own care.

“[People] don’t want to think of aging,” said Phillips. “Usually, people don’t call us till it’s an emergency … which isn’t particularly healthy.”

Healthy Aging Starts Early

According to Belli, 70 percent of lifestyle habits contribute to future health. She cited a study that found a correlation between Alzheimer’s disease and high cholesterol intake during a person’s 40s. “It is about boomers, and people even younger than that.”

Similar to Keiro’s emphasis on younger people, J-Sei hopes to offer its services across different generations, as well as become a “go-to” resource for seniors in the area. The organization, formerly known as Japanese American Services of the East Bay (JASEB), has served the East Bay Area for 40 years, and operates an independent senior living community and a nursing home.

Executive Director Diane Wong explained why J-Sei recently expanded its efforts to include younger generations in its programs. “We wish to be a part of the community and a resource to people so that when people do need help with senior services, instead of going to complete strangers, people can think ‘oh, how can J-Sei maybe help?’” said Wong.

Another group that supports educating older adults earlier to encourage smarter decisions later in life is Yu-Ai Kai Japanese American Community Senior Service in San Jose’s Japantown. Yu-Ai Kai, along with its Dr. James Akiyama Wellness Center, also encourages Healthy Aging.

With a staff of 39, the organization provides care and help to 3,000 seniors, with 1,100 volunteers lending a hand every year. The group has served the San Jose community for 37 years.

“We adopted our Healthy Aging Initiative (HAI) in the fall of 2009,” said Executive Director Sophie Horiuchi-Forrester. “Designed with Yu-Ai Kai’s Wellness Advisory Committee, HAI serves as a guide to bring programs/activities/workshops that foster healthy aging lifestyles.”

To further help adults as they grow older, Yu-Ai Kai accepts memberships starting at age 55 instead of the customary 60.

Growing Older

The Asian Community Center (ACC), an independent living community, features three locations with a total of 166 units for an independent living community of adults 62 and older. Sacramento’s Nikkei and Chinese American community leaders formed the organization, which annually serves 3,000 people through multi-lingual programs, said Donna Yee, chief executive officer of the nonprofit.

Yee addressed the issue of younger elders — aged 60-70 — a group that often serves as caregivers for family members. They must face the difficulty caring for their elders as they begin to enter retirement age themselves.

“We might see two, three generations that we consider elders in our community,” she said. “When I asked what people in their 60s want to do in the next 30 years, many say they don’t know.”

The ACC also provides workshops and classes on aging, as well as support groups for caregivers, including those who are caring for loved ones who have Alzheimer’s. Yee explained that it was vital to offer evidence-based programs, such as those from the AOA to help seniors manage chronic disease and gain aid from the government. The ACC hires Asian instructors so that culturally relevant examples are given out during presentations.

Down in Southern California, Keiro also focuses on caring for caregivers. Under their “Genki Living” brand, it offers programs to help seniors and their caregivers lead an active and fuller life.

CARING FOR THE COMMUNITY — Keiro offers caregiver’s conferences, women’s wellness conferences, and other programs — through The Institute for Healthy Aging — to help its community age with confidence. photo by Kim Nakashima, courtesy of Keiro Senior HealthCare

“What we really needed to do was support… the caregivers,” said Belli. “Twenty percent of the adult population currently cares for an older adult.”
Belli explained that Keiro started to offer information and respite for caregivers at caregiver conferences in 2001. Attorneys, pharmacists and other experts provide information at the conferences on how caregivers can better perform their duties. The events also offer free massages and adult day care services for caregivers. Belli said these conferences attract anywhere from 250 to 400 people.

It Takes More than an Apple to Keep the Doctor Away

Ultimately, there are a number of similarities between the various senior-serving organizations, where advocates insist that a combination of physical, mental, financial and spiritual well-being can allow the elders to maintain their independence. The programs include exercise and cultural classes at Yu-Ai Kai, nutritional meals provided by Kimochi Inc. in San Francisco’s Japantown, or the health screenings and flu shots provided by J-Sei. The activities also emphasize on volunteerism to keep seniors active within the community.

Such programs include the LTSC’s DISKovery Center, which features computer classes for seniors. Seniors can learn how to browse the Web and learn digital media skills to create digital histories.

“We’ve had people do videos about ‘What is it like to date after 60,’ or walking tours of favorite shops in Little Tokyo,” said Phillips. The films are archived on the center’s Website, www.digitalhistories.org.

Many assisted living communities and their programs, such as Kokoro Assisted Living — a nonprofit assisted living community located in San Francisco’s Japantown — or the Central California Nikkei Foundation’s Nikkei Service Center in Fresno, Calif. — located in the Vintage Gardens Assisted Living Community — provide opportunities for seniors to socialize and keep themselves mentally and physically active.

“Our programs are designed to stimulate and exercise our residents mentally and physically,” said Kirk Miyake, the executive director of Kokoro. “We hope to maintain a place where our residents can ‘age in place’ and enjoy the rest of their lives.”

According to Kokoro’s director of activities, Naoko Jones, residents may choose to participate in activities designed to accommodate various interests and preferences that help promote “healthy living.” Along with cultural activities such as calligraphy and tea ceremony, residents are invited to group activities. For residents who do not participate in as many activities, Jones said the staff tries to implement person-centered activities with them.

“It can be just to sit down with them and have a conversation or listening to them,” said Jones.

In fact, providing culturally sensitive care offers numerous benefits, said Phillips. According to a study on Nikkei seniors in Japan, Hawai’i and Seattle, scientists found seniors had slower rates of cognitive decline by participating in cultural activities.

Lidia Loera, the director of Fresno’s Nikkei Service Center, also presented numerous classes and programs that engage seniors. The Central California Nikkei Foundation funds activities, including a hot-meal program and transportation to and from the senior center. Loera said seniors are asked to pay $2 for a ride from their homes to the senior center and receive a hot meal they might otherwise have to do without.

“You can call the senior center, or just walk in (for the hot meals). Any senior is practically welcome to walk on in — we encourage it,” said Loera.

Another organization that offers meals to seniors is Kimochi. Started 40 years ago, Kimochi is dedicated to administering ethnically sensitive care to Japanese American seniors. The organization offers programs to the San Francisco Japantown community through a lunch program, home delivered meals, caregiver support, workshops, seminars and social gatherings through its Club Nikkei program, a senior home and a lounge for reading and crafts.

Executive Director Steve Nakajo noted that its programs, such as those that promote financial stability, provide seniors with a peace of mind. Nakajo also emphasized the importance of combining social and physical activities.

“What it really becomes is re-educating and working with families,” said Nakajo. Nakajo gave the example of seniors who join the Kimochi Walking Club — even if a senior only walks with the club once, the act encourages socialization and physical health.

Another way seniors keep active is through volunteerism.

“People who volunteer tend to live longer and healthier lives,” said Keiro’s Belli.

Along with Keiro, the ACC also boasts a vibrant volunteer base among the very people it serves.

“Many of our drivers in transportation, fundraisers, and teachers are volunteers,” said Yee, who said the Asian Community Center has close to 500 volunteers. “A volunteer driving on Tuesdays [for transportation services] could be attending classes like yoga on Monday and Wednesday.”

The LTSC also provides counseling and socialization programs through the Nikkei Tomodachi Program. The program strives to prevent isolation among seniors in the community through trained volunteers — many of them seniors themselves.

Proactive Action Required

Traditionally, Nikkei families looked after their elderly themselves. J-Sei’s Wong feels that families have become more complex, however, with interracial marriages, and children now moving away geographically. Wong hopes that her organization can offer what modern families cannot provide.

However, she stresses that seniors must seek help for themselves when they need it. “I hope seniors [will] be as proactive as they can in reaching out to find out about the options available to them and be accepting of that help,” said Wong. “When they need it, they might go ‘oh well, I don’t want to bother anybody,’ but accepting the help in some cases allows for them to be more independent and empowered in the long run.”

Phillips, on the other hand, advised that Nikkei seniors should examine their culture and ask themselves, “What’s important?”

“Is it being close to kids, your temple or your neighborhood? Do you need miso soup in your diet? Cultural and personal care is important,” she said.

By providing and advocating for the needs of older adults in the Asian communities, Phillips believes their services empower older adults.

The Future of Care

While the framework for Healthy Aging is set in place, the future of these organizations are in flux.

“We have been meeting with other senior services groups to address challenges of the Japanese American community,” said Yee. The ACC, along with Keiro, Kimochi, and other senior service organizations have recently started to caucus about how these services can better serve upcoming generations.

Whereas ACC has been a multicultural organization since its inception, others, such as Kimochi, are currently developing a new strategy to offer services that will suit the changing Sansei, Yonsei and Gosei needs, which differ from that of Issei and Nisei seniors.

To Kimochi’s Nakajo, who worked with Issei to form the organization, Kimochi was a way to help the community where mainstream society had failed.

“It used to be you either stay home, or you take the Hakujin (Caucasian) model” for senior care, he said. Through the creation of a culturally relevant model based on the principle that the Nikkei community cares for its elders, Kimochi served as a concrete response to challenge the former status quo and empower the Nikkei community, according to Nakajo.

During a strategic development program three years ago, however, the nonprofit’s leaders realized that it had to change. Nakajo said the organization was ill-prepared for the future if it did not change.

He feels honored to have been able to work with Issei pioneers to establish Kimochi, but is pressed to find answers to help the organization prosper for another 40 years. Nakajo believes organizations such as Kimochi must offer programs that reflect American cultural values that inspire Nikkei heritage. Nakajo finds that offering services that are rooted in American values, but emphasize the Nikkei heritage, attracts the Japanese American community.

***

Resources for Healthy Aging

Asian Community Center
Based in: Sacramento
(916) 394-6399
www.accsv.org
Provides health and wellness classes, a Meals on Wheels program, programs on managing Healthy Aging, transportation, respite care, nursing home and assisted living services.

J-Sei
Based in: East Bay
(510) 848-3560
http://j-sei.org
Provides exercise and educational classes, a lunch program, home-delivered lunch, monthly lectures on aging issues, a case management program and transportation.

Kimochi, Inc.
Based in: San Francisco
(415) 931-2294
www.kimochi-inc.org
Provides a residential home, respite care, lunch program, home-delivered lunch, transportation, caregiver directory, caregiver support, senior activities and social programs, exercise and cultural activities.

Kokoro Assisted Living
Based in: San Francisco
(415) 776-8066
www.kokoroassistedliving.org
Provides an assisted living facility that offers meals, activities and services for residents.

Yu-Ai Kai Japanese American Community Senior Service
Based in: San Jose
(408) 294-2505
www.yuaikai.org
Provides a daily nutritional program, workshops and health screenings for Healthy Aging, classes for education and exercise, cultural performances and shows.

Nikkei Service Center
(Vintage Gardens Assisted Living Community)
Based in: Fresno
(559) 252-4036
www.vintagegardens.org
Provides Meals on Wheels, hot lunches at senior center, social activities and outings, exercise classes, health screenings and programs addressing issues that seniors face.

Keiro Senior HealthCare
Based in: Los Angeles
(323) 980-7555
www.keiro.org
Provides assisted living care, caregiver respite and support, programs to encourage Healthy Aging and resources for Healthy Aging literature and services.

Little Tokyo Service Center
Based in: Los Angeles
(213) 473-3030
www.ltsc.org
Provides referrals to other senior services, home visits, case management, cultural and continuing education and caregiver services.

— List compiled by Tomo Hirai/Nichi Bei Weekly

*This is not a comprehensive list