Working with Korean American Families

1
Working with Korean American Families

• Ailee Moon, MSW, PhD
• aileem_at_ucla.edu
• Department of Social Welfare
• UCLA School of Public Affairs
• 7th Annual Updates on Dementia Conference
• May 15, 2006

2
Introduction

• A relatively short history of immigration to the
  US.
• - Immigration to the US in large numbers began
  in the 70s.
• Increasing diversity within the KA population
• - of foreign-born decreased from 73 in 1990
  to
• 65 in 2000
• - of limited English proficiency dropped from
• 52 to 28
• But, these percentages remain very high for the
  65 and older age group94 (foreign-born) and 77
  (limited English) in 2000.
• Co-existence of Korean traditional and American
  values and ways of life.

3
Language and Relationship Formation

• v 1 Linguistic sensitivity
• - Be able to speak a few words in Korean.
• (e.g., dementia chi-mae
• How are you? An yeung ha se yo? )
• - Assess the patient/caregivers English skills
• - If necessary, speak SLOWLY or find an
  interpreter.
• v 2 Effective approach to relationship
  formation
• - a congenial, personal manner rather than to an
  impersonal, businesslike one.
• - show a personal interest and empathy with the
  patient/caregivers problems and be warm,
  friendly, and reassuring.

4
Trends and Issues

• Rapidly declining commitment to and practice of
  filial piety and elder care.
• - The majority of the KA elderly and family
  caregivers no longer
• believe that (1) it is wrong to place an
  elderly parent in a nursing home and (2)
  children should live together with elderly
  parents when the parents have functional
  limitations and require extensive assistance with
  their personal care.
• - They also prefer to move into a residential
  care facility, rather than becoming a burden to
  family, if they had dementia and needed constant
  care.
• - The vast majority of KA elders prefer
  independent living.

5
Trends and Issues (Contd)

• v 3 Do not assume that most Korean American
  families believe in or practice traditional
  filial piety.
• - Such assumption creates discomfort, guilt,
  shame in family caregivers and can be perceived
  as discouraging service use.
• Acknowledge the potential variability in the
  actual roles the elderly clients family is
  willing and able to perform in meeting the needs
  of the client.

6
Trends and Issues (Contd)

• Persons with dementia are still stigmatized.
• - But, the nature of stigma has shifted
• FROM traditional superstitious and supernatural
  beliefs around the family and family history (a
  consequence of bad blood, sins committed by the
  person with dementia or the family or their
  ancestors, an act of evil spirits, improper
  alignment of a house or the grave of an ancestor,
  or lack of respect for ancestors or care of their
  graves)
• TO to the individuals personality (being
  passive, stubborn, quiet, or secretive) and ones
  life history of hardship, unresolved
  personal/family problems, and immigration
  adjustment stress.

7
Trends and Issues (Contd)

• - Stigma could result in denying or concealing
  suspected symptoms of dementia and thereby delay
  seeking medical diagnosis and treatment and
  supportive services outside the family.
• v 4 Identify caregivers perceptions of what
  might have caused dementia, deal with negative,
  patient/family-blaming perceptions, and educate
  them about known/unknown causes of dementia.

8
Roles of Religion/Religious Organizations

• Many Korean Americans, especially older adults,
  believe practice of religious faith as an
  effective avenue for prevention and cure or
  alleviation of dementia. (Approx. 70 of Korean
  Americans are Christian.)
• v 5 Acknowledge that religion and spirituality
  could play an important role in coping with
  illness and stress associated with caregiving,
  and therefore, such beliefs in the power of
  religion related to prevention and cure of
  dementia should be addressed with sensitivity,
  emphasizing also the importance of seeking
  medical and other supportive services that could
  contribute to alleviating symptoms and
  progression of dementia.
• v 6 Religious leaders and organizations are
  important contact points for effective outreach
  and public education efforts in KA community.

9
Role of Traditional Medicine

• Some KAs also believe that acupuncture, herbal
  medicine, and natural food diet could alleviate
  the disease.
• v 7 Respect the traditional method of
  treatment, while discussing the Western medical/
  behavioral treatment methods.

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Meaning of Working with KA families?

• Assumption Discussion of cultural issues faced
  by caregivers aims to better serve them and
  dementia patients in meeting their needs.
• Real question challenge Where do these KA
  caregivers and patients get the information and
  services they need?
• - Survey of 114 family caregivers caring for
  dementia patients at home found that (1) only 43
  have ever heard of Alzheimers Association (2)
  83 have no or little information about services
  available to dementia patients and (3) 86 have
  no or little information about family caregivers.

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The critical issue

• Availability, information, accessibility, and use
  of dementia-related services is the most critical
  issue in the KA community!
• v 8 Consider your answers to the following
  questions

12
Related questions

• Q1. Where do/can KA families obtain written
  information (preferably in Korean) about
  symptoms, diagnosis, treatment of dementia and
  available services in your area? What kinds of
  outreach efforts have been engaged in the KA
  community?
• Q2. Where can they have a comprehensive
  diagnostic assessment of dementia and other
  concrete services (safety return bracelet,
  respite care, support group, caregiver training,
  etc.)?
• Q3. Are you knowledgeable about legal and other
  eligibility requirements of financial, medical,
  and other benefit programs that are applicable to
  dementia patients and caregivers with different
  immigration status?

13
Questions (Contd)

• Q4. Do you know an agency/service provider that
  can provide comprehensive information in KOREAN
  about available services and programs (where and
  how) for dementia patients and caregivers?
• Q5. Do you know at least one residential care
  facility for dementia patients that has at least
  one Korean speaking staff and/or serve Korean
  food?
• Q6. Is there a family caregiver support group for
  Korean Americans?
• Q7. Are you willing to assist KA families
  accessing services?

14
Resources

• v 8 The following agencies have websites with
  useful information in Korean
• St. Barnabas Senior Services, 675 S. Carondelet
  Street, Los Angeles, CA 90057 phone
  213-388-4444 fax [phone] Web site
  www.la4seniors.com/korean_st_barnabas.htm
• In Korean.
• St. Barnabas Senior Services currently has four
  Korean-speaking social workers, including an
  Alzheimer specialist. It also houses an
  Alzheimers disease diagnosis and treatment
  center and Alzheimers day care resource center
• (www.saintb-la.org/main/adc.html).

15
Resources (Contd)

• Alzheimers Association, Web site
  www.alz.org/resources/diversity/korean.asp
• in Korean.
• The Alzheimers Association has education and
  service information in Korean, such as warning
  signs of Alzheimers disease, assessment tools,
  getting a diagnosis, and available resources and
  services.

16
Resources (Contd)

• Department of Aging, City of Los Angeles, 3580
  Wilshere Blvd., Suite 300, Los Angeles, CA 90010
  phone [phone] Web site
• www.cityofla.org/DOA/pdf/SeniorFoc_Kor.pdf
• in Korean.
• The City of Los Angeles Department of Aging has
  information in Korean on a variety of services
  available to residents of Los Angeles, including
  a Family Care Support Program and an adult day
  care center for patients with Alzheimers disease
  and their family caregivers.

17
Reference/Reading list

• Moon, Ailee (In press). Working with Korean
  American Families. In Ethnicity and Dementia, 2nd
  Edition, edited by Gwen Yeo and Dolores
  Gallagher-Thompson.
• Moon, Ailee, Rhee, Siyon (2006). Social work
  practice with immigrant and refugee elders. In
  Handbook of Social Work in Aging, edited by
  Barbara Berkman. Oxford University Press.
• Min, Jong Won, Moon, Ailee (2006). Older Asian
  Americans. In Handbook of Social Work in Aging,
  edited by Barbara Berkman. Oxford University
  Press.