Overview to the Needs of Asian American Elderly

David Cheng: Good morning. I’m David Cheng, a clinical psychologist, Director of the counseling center here at Baruch College. We’ll go right into our first general session which is on the “Overview to the Needs of Asian American Elderly.” I feel very honored today that we have Commissioner Edwin Mendez-Santiago with us. Commissioner Mendez-Santiago is the commissioner for the NYC Department for the Aging. Prior to his appointment, the commissioner was the President / CEO of the Spanish Speaking Elderly Council, where he also served as Executive Director. Please welcome, Commissioner Mendes-Santiago.

Hon. Edwin Mendez-Santiago: Thank you, Prof. Cheng. I want to thank everyone who’s responsible for today’s event. We’ve heard introductions this morning from all the different groups that are involved in co-sponsoring today’s conference. It’s really important that as we come together not only to recognize the effort that went into organizing today, but to hopefully as you hear in my discussion this morning, keep this kind of effort and momentum moving forward, so that we can create the kind of climate change that we really need to see not only in our city, but across the country, to ensure that we can reach and serve the Asian elderly community. I want to thank Betty Lee Sung, Maggie Fung, and Thomas Tam, for their leadership, coordination, and for inviting the department to be a part of this process. I know that in our next session, we’ll have presentations of some demographics, so I won’t go into them at length. I do however want to share with you a couple of numbers just to put into perspective my comments for you this morning.

The Asian American population as we’ve heard is the fastest growing segment of the over 60 population in New York City. Between 1999 and 2000, the percentage of the older population of the city almost doubled, going from 3.8 to 6.9%. The New York metropolitan area has the third largest Asian elderly population in the country, and we know that this trend is continuing.

What I want to speak to you today about is really looking at this tremendous growth through the lens of what I refer to as, “the need for a paradigm shift,” the way that we think about the aging process and what it means to be old in America. Research has really contributed to the emergence of this new concept which looks at aging not as a disease, but really as a normal part of life, and begins to use words that try to take away from that negative stereotype of growing old as something bad by using terms like “productive aging”, “healthy aging” and “successful aging”. These terms paint the picture of growing old with health, and we know that people are making better lifestyle choices. However, to be able to make those lifestyle choices, you have to really have the right opportunities in order to keep your health, vitality, and creativity into your eighth and ninth decades. This year we had the first wave of the baby boomers begin to hit 60. We anticipate seeing a healthier, better educated population with higher incomes and more resources than any previous generation of older people in our country. But the question that we need to ask as we celebrate this wonderful longevity with health is what happens to other groups, in particular to the minority population, immigrants and people who have lived all of their lives in poverty and perhaps have not had those opportunities to be healthy and maintain their health as many boomers have? Unfortunately when we do look at many of these groups including the Asian elderly population, we see that they’re at risk and that the patterns of inequality associated with minority status really don’t support successful aging. Educational, income, and health disparities really do affect the current health of the Asian population, and those disparities will continue to suggest a far bleaker picture for the Asian population as they continue to age in our city and in our country.

Looking at some issues for example, 24% of older Asians in New York City live in poverty. Compare this to the poverty rate nationally, which is just 10%, and in New York City where we have the highest poverty rate in the nation among the elderly, it’s at 17.8%. 94% of those in poverty are in New York City. 73% report having limited English proficiency and more than half have no high school diploma. Again, while we want to be culturally competent and celebrate the extended family, 19% of Asian older adults live alone. This is really a continuation of those concerns to look at for specific health issues. We know that the Asian elderly population report higher instances of high blood pressure, 28% report higher cholesterol. Diabetes is almost at an epidemic level particularly among some South East Asian groups, and as we read in yesterday’s New York Times, we do have concerns now with greater risk for cancer and cirrhosis of the liver due to undetected Hepatitis B.

Part of our challenge today as we begin to have this discussion is to really highlight the fact that the Asian elderly population is in jeopardy, and that we have an obligation to try to level the playing field so that we can ensure that this population, like the boomers, can also age with physical, mental and spiritual well-being. So the question is, how do we do that? How do we together begin to reduce the risk of aging poorly in this particular population?  I’d like to share just a couple of suggestions. We need to focus on targeting services that are culturally and linguistically competent to the population that need that service. As we’ve seen in Asian American studies, mental health services that are culturally competent are needed in order to be targeted towards Asian elders. In the study by the Asian American Federation of New York (AAFNY) with Brookdale in 2003, they noted that 40% of their sample survey showed symptoms of depression. Yet, while we celebrate the passage of the Geriatric Mental Health Act in New York State for the first time last year, will that Act specifically demand the delivery of culturally and linguistically competent services? I don’t think it’s in there, but we have to continue to really push for these kinds of issues. In my own experience as a social worker for more than 25 years, focusing particularly early in my career on similarly at risk older Latino populations, I’d like to talk about what we can do to link elders who are at risk with existing services.

We are blessed in New York City that through the support of all levels of government that we have one of the richest arrays of services available for older people anywhere in the country. New York City is a wonderful place to grow old and to retire if you have the right income and the right health insurance. We don’t really need more new services, but can make our existing services accessible. One way to do that is by building ethnic grants, and making our services culturally and linguistically competent. I want to talk about a few of those services because we do have excellent examples including the Charles B. Wang Community Health Center that is presenting a model of comprehensive and holistic health, that not only looks at the physical health of the individual, but also the mental health of the individual as well. We need to take those existing models and really promote them throughout the rest of this city.

I am very pleased to compliment the effort being promoted throughout the city to make all of our senior centers as culturally as linguistically competent as possible. We are blessed in New York City to have fourteen senior centers that focus specifically on the Asian population, and we have many others that are serving Asian seniors throughout the city in great numbers. While we celebrate those numbers, we need much more. When we look at the population throughout the city we know that we can’t do this alone. Government will never have the resources to be able to address all of these disparities alone. One strength in the Asian community that we need to take advantage of is the tradition of family. By targeting public education messages so that the entire family can be educated about the aging process, they can begin to recognize that aging is a positive thing. We need to celebrate longevity, and if we take those simple steps to address lifestyle changes, we can see all of the members of our family grow old with dignity and maintain their health.

Another route is through physical activity. Over the last four years, we have challenged the existing senior centers, more than 320 of them in the city, to really change or transform them from what I call a passive senior center. We have a negative image of senior centers as a place to play bingo and trips to Atlantic City. We have now challenged our centers to become what I refer to as senior vitality center, where over 140 walking clubs throughout the city take place and physical activities. In fact, we have a contest every year in a big senior stroll where over 4,000 seniors join us to demonstrate that they are active in their centers, with the winners getting recognition.

We want our centers to explore yoga and Tai Chi. We want them to explore not just physical health but mental health as well, linking our programs with mental health services. I want to compliment the New York State Office of Mental Health for its leadership in showing how to specifically target groups by launching its Chinese suicide prevention outreach campaign with materials in Chinese. Another example is, Hamilton Madison House and the Mental Health Association of New York City for their Asian LifeNet, which again begins to help spread the word about the services available particularly to address suicide prevention among the city’s Chinese residents. These are just two examples of the many kind of programs that already exist that stop blaming the victim and start addressing the change that the agency needs to take to be able to speak the language that we want to reach.

Now before I conclude, I would like to mention an area where we do need support. We need to develop a new cadre of future social workers and other health professionals who come from the Asian community and can help us in completing this transformation so that we have workers across the city who can speak the language, and understand the culture of the population we are trying to reach. In saying that, I do not want to minimize the fact that there can be cross-cultural counseling, and that you don’t have to be of the same ethnic group to provide services to that population. However, we do need social workers of every ethnic group. Since we are here together, I want to encourage all of the different schools who are present, to join many groups across the city including the New York City Chapter of the National Association of Social Workers. I want to really look at how we can again create opportunities so that the students who are coming to your campuses can look at gerontology and see it for what it is, and not the old stereotypes of negativity and nursing home placement. I want students to see that social work in the gerontological field, is about community organizing. We need those kind of skills to address some of the concerns that I have briefly mentioned to you today.

I tend to be always very optimistic, and I know sometimes when you are running a senior center you don’t have enough funding or you are running any other kind of agency, the difficulty you experience day to day, but I still see a lot of positive things out there. We are turning the corner. We are seeing government beginning to address these issues. I believe in being organized and prepared, because sometimes the tone of the current debate on immigration reform is something that we should be concerned about. This debate is going from addressing issues of border control and immigration reform, to debates about English only and even going backwards in time, and we have to stop that pendulum from slipping back. We know it didn’t work in the 40s and 50s when we tried to have a homogenized view of America, and we need to continue to work together to ensure that we are not only celebrating diversity through our rhetoric, but ensure that we are working towards cultural competency, to make our services more effective than ever. I thank you for this opportunity and look forward to working with all of you.

David Cheng: Thank you Commissioner for starting our conference on such a high note. I think it’s a very positive start. I’d like to now introduce our second speaker, Ms. Carol Peng, who is the Deputy Director of Research at Asian American Federation of New York. Ms. Peng directs the research department including Census Information Center. She has served as a project director and co-principal investigator of the Federation research studies in the areas of health and mental health and community economic development. Please welcome, Ms. Peng.

Carol Peng: Thank you very much, David. Good morning everyone and thank you very much for coming. I want to just start off by thanking the AAARI, and Betty Lee Sung, for inviting me to speak today along with this distinguished panel. It was very inspiring to hear Commissioner Mendez-Santiago’s remarks. This Commissioner has really, over the years, demonstrated a true commitment to representing the diverse communities of New York City, and has really emphasized that the outreach to Asian American senior population is especially critical given the rapid growth of our community here in this city. As a community, we’re very lucky to have his partnership.

As mentioned, I’m from the AAFNY. We are a non-profit leadership organization of 39 health and human service agencies, serving the Asian American population in the New York metropolitan area. Our mission is to promote the economic, social and political equity of Asian Americans in this region, and we do that in three primary ways: Through service capacity, developing programs primarily through our members and agencies as well as other constituent community view based organizations, cultivating philanthropy efforts within our community into our community, and public policy research.

Today, I will be presenting some of the work that we’ve been engaged in and that has been cited. I will start off with a demographic profile of the Asian American community, based on Census 2000 data, followed by findings from our 2003 report “Asian American Elders in New York City”, a study of health, social needs, quality of life and quality of care, which was a collaboration with the Brookdale Center here at Hunter College. Finally, I’ll conclude with the discussion about our current research initiatives in the area of senior care and engagement, which is getting off the ground now in Flushing, one of the fastest growing neighborhoods here in the city.

The statistics that I’ll be presenting are from our Census Information Center. The Federation is designated by the U.S. Census Bureau as a repository for Census data. There are fifty-seven Census Information Centers across the country, twelve focused on Asian. The Federation is the only one in the North East that is looking at Asian American data, but in its capacity as a Census Information Center (CIC), our role is to connect communities and underrepresented population with the Bureau. Our goal is to disseminate Census data in the form of data reports and profiles, and to also provide data services for members of the general public in our specific constituencies.

Starting off at the national level, the Asian population is projected by the Census Bureau to quadruple in the coming decades from 800,000 in 2000, to over 3 million in 2030. Here in New York State, the Asian population is projected to triple by the year 2025 from 100,000 to 320,000. It’s important to know that within New York State, the Asian population is primarily concentrated here in New York City; three quarters of the Asian population resides in the New York City area.

Here in the New York City metro area, there’s just over 100,000 seniors of Asian descent, and within the 5 boroughs, 63,000 as of the 2000 Census. The growth rate is very high. Between 1990 and 2000, the Asian senior population grew by 91%, a figure that was higher than the various fast growth rates of the Asian general population at 71%. Also, it’s a marked contrast from the 2% increase in the city’s general population. Of the Asian seniors, it’s interesting to look at the age break down within the senior group. Within senior services there’s a tendency to look at services that are geared towards the younger old, which are categorized by age 65 to 74, and the older, elder population, which is 75 and over. Here in the city, tow-thirds are 65 to 74, while the younger senior population and the remaining 37% are over age 75. The five largest Asian groups are Chinese, Indian, Korean, Filipino and Japanese. They basically follow these general patterns of the total adult population with the exception of the Japanese, which is seventh.

Where do Asian seniors live? The highest concentration is in the borough of Queens, 45%, followed by Manhattan, Brooklyn, the Bronx and Staten Island. Their populations are contrasted with the general population. 30% of the general population resides in Queens versus the 45%. In Manhattan, 20% of the general population resides there as opposed to a quarter of the Asian population. So, these are the two boroughs where there are more Asians, percentage wise, relative to the general population, and you have fewer Asians in the other boroughs relative to the general population.

Looking at immigration and education attainment, according to the Census, the vast majority of Asian elders are immigrants, 94%. This is in comparison to 76% of the general Asian population, and 37% of the overall citywide senior population, who are foreign born. Of the Asian senior population, more than half came to the U.S. after 1980, which fills a lot of the recent population growth here among the senior population. Concerning education, almost 60% do not have a high school diploma, a stark contrast to 30% of the general adult population, and 43% of all seniors in the city, the general senior population. When you look at the group that doesn’t have a high school diploma, 45% do not have a ninth grade education. We see a low level of educational attainment amongst the city’s largely immigrant senior population. Looking at the other side of the educational spectrum, we do have one-fifth of our seniors with a college degree. That’s still lower than the 40% of the total Asian population that has a college degree and is roughly comparable to the level of seniors in the general population that have earned a college education.

English proficiency is a very important issue, with a very high rate of limited English proficiency in our population. 73% of Asian seniors do not speak English, are not able to speak English well or not at all. This is substantially higher than roughly half of the total Asian population that has limited English proficiency, and just over a quarter of the general senior population. Half of Asian seniors reside in a linguistically isolated household, which means that one out of every two seniors lives in a home where no person over the age of 14 speaks English well enough so that presents a challenge in terms of language access issues. When you look at the other groups you’ll see that 35% of the general Asian population, slightly lower, but still a substantial size, over a third of the Asian adult population is linguistically isolated. At the city wide level, across all groups, just under a fifth of seniors live in such a situation.

Looking at income, the mean per capita income is generally lower for Asian American seniors, $17,000 versus $37,000 for all Asians, and $30,000 for all seniors. When we’re looking at the older senior population amongst Asians, this is even more pronounced. Looking at the mean per capita income, it is just about half of what the income level is for the same general senior population of the same age group. Examining the main income of households headed by Asians, 65 and over, it also is substantially lower than the Asian headed household’s general figure as well, about $6,000 lower than the general senior population. Again, looking at the older population amongst seniors, we’ve got about a $20,000 difference in the annual mean income of the households between Asians and the general population. There are some significant economic disparities here that are presented through the data.

Now looking at poverty, as was mentioned earlier, a quarter of our Asian seniors here in the city are living under the poverty level. When you’re looking at the Asian general population, it’s about a fifth, so seniors actually, do have a higher rate of poverty. In comparison to the general senior population, it is also significantly higher. Looking at the older Asian population, the poverty level increases, showing the income vulnerability of our older seniors. Economically, 27% of Asian seniors live under the poverty level. It is interesting, in terms of household composition, more than half, are renters, compared with 66% of all Asians, so we actually have more home owners amongst the Asian senior population than amongst the general Asian population, which it is pretty much comparable to the general senior population at 56% renting here in the city.

Now looking at household composition patterns, you will find an interesting trend with Asian seniors in that a fairly large portion, 68% of seniors live in married couple households, compared with the general senior population which is at 44%. You then see some differences between the younger and the older age groups with 72% of the younger seniors living in married couple households, and in the older senior populations, 59% living in this arrangement, which contrasts with the 51% and 37% respectively amongst the general senior population.

Looking at the number of seniors that lived alone, we actually have fewer Asian seniors living alone as compared to the general population, 14% versus 34% of the overall senior population. Again there are some differences that you see when it comes to the different age categories amongst the senior population. Asian women were two and half times more likely than men to live alone, which is reflective of patterns in the general population. In the older senior population, 75 and above, 15% of Asian women and 5% of Asian men, lived alone. This is very different from 50% of women in the general senior population, and about a quarter of men in the general senior population who lived alone.

Moving on to the physical and mental health, and formal and informal supports of Asian seniors, the findings here are from our study that was conducted in 2000 in collaboration again with the Brookdale Center. Our principle investigators in the study were Angela Shen Ryan from the Hunter College School of Social Work; Ada Mui from the Columbia University School of Social Work; and Peter Cross from Brookdale. In the sample that was covered of the six major Asian groups here in the city, we had over 400 seniors who were interviewed on their health, social status, economic conditions and quality of life issues. This was a randomized city sample from a 1990 U.S. Census list of block groups. The data was collected in the spring of 2000 and the interviews were conducted in the homes of these seniors in English and the primary Asian language of the seniors.

For health, we utilized the SF-36 Health Survey instrument, which was validated for use in a wide range of settings, clinical and research settings and in countries around the world. What the SF-36 allows us to do is to compare our sample data with national norms and we’re also able to look at the two different populations, the younger and older adult population. Using this tool is helpful because it’s been validated for a number of different cultural groups. What the SF-36 looks at is eight different domains of physical well-being for seniors. These domains are physical functioning; role limitation due to physical reasons; bodily pain; general health; vitality; social functioning; role limitation due to emotional issues and mental health. It should be noted that of these eight domains, our sample had lower scores than the national norms on six of them, on all but the role limitation due to physical reasons, and bodily pain. For our younger senior group, the 65 to 74 years old, you can see basically that the higher the score the better the health. The blue line is the bar for national norms. In almost every domain, the national norms exceeded the outcomes of the report of the seniors in this survey. Again the exceptions for the younger group were in the area of bodily pain, and all the other areas they function are lower than the national sample.

Looking at the age 75 and over group, again, Asians fared worst than the national population with the exception of the role limitation due to physical reasons, and bodily pain. In the area of mental health, 40% of our seniors reported depressive symptoms ranging from mild symptoms to severe symptoms as indicated through the geriatric depressive scales. Poor mental health was associated with perceptions that their health was poor, a greater perceived cultural gap between themselves and their children, a greater number of stressful life events, an inability to read English, less religious, having higher level of assistance from children which may indicate greater dependency on their children for help, and not having children living in close proximity to them. The stressful life events that were experienced by these elders in the previous three years were pretty significant. About 40% suffered from serious financial problems, and over one-fifth of seniors had experienced death of a family member, personal fears of illness or injuries, family discord, illness or injury of a family member. There are some pretty significant stressors that were prevalent in these seniors’ lives.

The study also allowed us to look at the informal and formal supports of seniors, one positive finding in the study, that our seniors in the sample were relatively well connected to informal supports in the community, close friends and neighbors. Half of the seniors saw their children daily and received assistance from their children. Elders living with others tend to have more help from their children as compared to those living alone, either because they live with their children most likely or maybe because those living alone have a personal tendency towards social isolation.

The report set out recommendations to address these needs. Based on these findings it’s very important to improve economic conditions for Asian seniors and their families, enhance formal support services by increasing access for cultural and competent care, and integrate informal social support systems into program development and service delivery. There is a lot of work to be one. Commissioner Mendez-Santiago has mentioned that the community is very interested in seeing a lot of these current initiatives to advance workforce development, to enhance training, to serve seniors in different health care and social service settings, to work with policy makers to advance the economic conditions and levels of resources for this population. It is a broad community effort. We hope that this information can be useful toward service planning initiatives, and further research to promote general understanding of who Asian American seniors are and what their needs are.

David Cheng: Our third speaker today is, Ms. Isabel Ching, who’s currently the Director of Hamilton Madison House.

Isabel Ching: Hi! I want to thank Betty Lee Sung and Thomas Tam for coordinating this conference. I’m very happy to be here. I come from the practicum side, not the research side, and have been a senior center director at Hamilton Madison House for the last 9 years. I was just promoted to be the assistant Executive Director to oversee our senior services. We have a new satellite program, a senior center, a Natural Occurring Retirement Center program, a caregiver program, adult day program, and a Section 202 residence for seniors. Most of our programs are funded by the New York City Department for the Aging, and have been running since 1991. The City Hall Senior Center is one of the first Asian American senior centers on the East Coast, started in 1951 with the Golden Age Club. For senior services here, we’re trying to have an integration of providers to continue services and programs, improve the lives of members and families. It’s important to work with the families, including extended families because a lot of people just think of immediate families, but we’re also talking about aunts, uncles and everyone else as part of the whole.

What we’re trying to do is decrease social isolation and increase social integration among our elderly. I would like to talk about some of the causes for isolation; including “role loss.” In some of the studies we’ve just heard these causes include, loss of employment, intimate relationships, dependency on children, living alone, widowhood, health problems, poverty, also as the Commissioner had mentioned, baby boomers. Yes, they have a larger income, but the boomers are actually the population that has fewer children, and tend not to be married, so their extended families are not there as they age. What we’ve found is that with the declining of health and chronic disease, there is the increased risk of social isolation as people age, and the replacement of relationships are often difficult. This is why we have these programs in the community to help people re-establish these intimate relationships.

The senior center is where they come and socialize, to meet other people, get out of the house, have something to do during the day. As a normal process, we all come to work, have a goal in what we do as adults. But, as you start to age you don’t have anymore goals, unless you have an incentive to do something.

I’m just going to delve a little bit into the details about some of our programs, at our senior centers. We provide meals, with a membership of approximately 7,000 seniors city-wide. We have ESL, citizenship, computer, exercise and dancing classes. What we try to do is listen to the seniors, because actually they are the ones who tell us what they want. We’re just there to coordinate the service and make sure that we can have it there for them.

I have a funny story about citizenship. Our citizenship classes have been funded by the New York City Department for the Aging since 1997. One day I was watching Jay Leno on T.V., and he goes out to interview people in the community. One of the topics was on citizenship, and he was telling people how hard it was for immigrants to answer some of the questions. At an amusement park, he randomly picked passersby and asked them simple questions like, “What are the three branches of the government?” You’d be very surprised that many people didn’t even know. I said to my husband, my seniors know the answers, because that’s what they study at the senior center.

Citizenship is very important to seniors. They come to the U.S., and haven’t had the opportunity to study, worked all their lives, and then finally they have the chance to get together and be among their peers to study. We’ve had at least 70 seniors that have come to our program and became naturalized. It’s a very important service that we provide for our seniors.

In terms of other programs, we have a new caregiver program, and as the Commissioner said, we’re talking about focusing on specific populations. We received this grant almost two years ago specifically for the Asian American population, for Chinese and Korean speaking seniors, and our contract is to serve city-wide.

I’ll give you an example of what we have to do, and how we integrate services for the family through the caregiver program. We have a Mrs. L, 70 years old, Chinese, and referred to our program by our own agency’s mental health services. She has two daughters. One is 41, we’ll call her Y, and J is 38. Mrs. L has been living with her older daughter and her family since immigrating many years ago. Her younger daughter J, just came to New York two years ago, and is currently living with her mother in her sister’s house.

Mrs. L relates closely with her two daughters, but they are very distant from each other. Mrs. L’s main source of income is SSI, and J, the younger daughter, is unemployed because she is a new immigrant, and is financially dependable on her mother. The presented problem here is that Mrs. L is an elderly suffering from deteriorating health due to aging. She’s been diagnosed with major depression and is receiving psychiatric treatment. J, her younger daughter, is a mental patient diagnosed with chronic schizophrenia. She has psychotic symptoms of visual and audio hallucinations.

J has low self-esteem because of the social stigma, and currently receives psychiatric treatment. She’s also participates in what we have in the agency called a Psychosocial Club, based in Queens. Y, the older daughter, can’t tolerate J’s limitations resulting from her illness. Her attitude towards J is very negative. Y was recently diagnosed with terminal stage lung cancer. She has two children in their teens, her husband is unemployed, and the family is in financial distress. Y, the older daughter, puts the blame on the younger sister for bringing bad luck to her.

These are some of the very typical ways Chinese deal or cope with certain stresses. Mrs. L is emotionally overwhelmed with her two daughters’ illnesses. She worries about her older daughter’s death, and is concerned with J’s pessimistic future. She feels upset with Y’s resistant acts toward her younger sister. Mrs. L tries to support both of her daughters, but what she can do is very limited, and she feels very helpless and depressed. Through our caregiver program, we are able to help her with the support of counseling.

With counseling, we try to refer her to support groups. What we’re trying to do is also introduce Mrs. L to the senior center so she can be out and more active. This story happened a few months ago. Since then, the older daughter has passed away, and the family is still in our program. There’s a lot of coping and a lot of issues that still need to be worked out with the family, but that’s just one of the stories that we get in terms of serving, and how we integrate mental health, senior centers, meal programs, counseling, and support groups to help the family.

At Hamilton Madison House we really do believe in the fact that we need to work as a community to help the seniors. I definitely love what I do, and love the fact that our seniors come every day, treat the senior center as their second home, know their friends very well, and are very appreciative of what we provide. Thank you very much.

David Cheng:  We have some time for questions for the panelists.

Edward Ma: My name is Edward Ma, a community board member. On February 14^th, I was at the borough president’s office, and I did two testimonials. One was for transportation, and the second was for elder abuse. Even before the public hearing and testimony, I was very bothered and annoyed by the number of cases I received in my private practice about elder abuse. Cases about stories of children stealing from their elder parents making them sign documents they don’t understand. I know that the Department for the Aging has done something already, but I wonder what we can do to prevent such problems.

David Cheng: So the question is addressed to the Commissioner.

Hon. Edwin Mendez-Santiago: I’m glad you asked this question. I didn’t speak about that in my brief presentation, but it is an issue that I happen to also focus on. Even in the worst physical times, four years ago, when we were threatened with budget cuts, at the Department we ensured and protected funding to start for the first time in New York City, to do education and prevention work on elder mistreatment, and provide direct counseling and support as well.

We know that most cases of mistreatment are generally not reported. The Department has started a major initiative, which won a very prestigious national award to be part of a new program to create a coalition that’s aimed at prevention. I’ve developed a new taskforce that represented all of the various ethnic communities and different professional service models from health care, mental health, and aging services, so that together with the Department, create a number of initiatives to increase our day-to-day services for victims of elder abuse.

You mentioned one thing that we’ve already identified and we hope to begin working on rather quickly, which is to begin looking at the issue of financial abuse by reeducating banks on existing rules and regulations, and also training tellers and bank personnel to look for certain at-risk behaviors. When they see a customer who’s elderly withdrawing a large amount of money, they can question that and also know who to call for follow-up support. We are working very closely with the City’s adult protective services, which is part of our coalition. It is important that all of us do need to be aware, that as much as we celebrate the good things in aging there are some of these hidden realities such as elder abuse and mistreatment and self-neglect to which we have to also pay attention to.

Audience: I have a simple question. I’m a case worker and deal with a couple of families. There are family patterns about being Chinese, that the man is head of the family. When the man loses his job, the woman, would go work. For the seniors, some are coping with this pretty well, but I met someone yesterday who wasn’t. The thing is, Commissioner, is there an outreach group for situations, where the woman works, the man has to stay home to take care of the children and becomes depressed? The wife told me that her husband might have some mental problems, and I don’t know what to do. A lot of men have no work, especially with the garment factories closed.

Hon. Edwin Mendez-Santiago: I’ll try to address your question. We are focusing at the department on mental health issues. It’s not traditionally been a part of our portfolio, but we do believe that mental health is an important issue, and are working throughout the city in partnership with the Mental Health Alliance, and the New York City Department of Health and Mental Hygiene. We’re starting in the Bronx with developing a pilot program to train the personnel of our senior centers to be able to screen every senior that comes to the center, as well as some of the homebound by using the PSQ-9 Form to begin to look at who may be at risk of depression, which is the number one functional illness that older people suffer from.

We’re working on a number of other initiatives to look at culturally competent methods of reaching into older populations and avoid the stigma of mental health by developing a program that we call “helping encounters.” We’re testing in Brooklyn and Manhattan some of these approaches to see whether the seniors would take more advantage of mental health services if they all were provided in the home, senior centers, or a formal clinical setting.

In terms of the scenario that you discussed about the unemployed man, we do believe that employment opportunities are really key for low income populations. We have an employment center, that you can call 311 and get information about. We’re located at 220 Church Street where we do train older adults to be able to go back to work, particularly if they were low skilled. They learn a skill with computers for example, or other kind of positions, so that they can become employed. While income is important, what we need to fight in this city is social isolation. The worst thing any older adult regardless of ethnic group can do, is stay home alone. Staying home alone just exacerbates the problem. That’s why we would like our senior centers and other programs to be as creative as the ones we’ve heard from this morning who really have a comprehensive view of working in the community.

The department is pushing a concept called liberal communities, where programs don’t to see themselves as open from 8 to 4, or 9 to 5, but become a part of the fabric of a community, to look at issues that I know your conference will look at today such as traffic patterns, pedestrian safety, and look at something that I know Brookdale is working on, looking at older people as social capital. How do we also create opportunities so that the older people in the community can continue to be meaningfully active, volunteer, or working for pay within that community?

Isabel Ching: You mentioned before that the wife is having a difficult time. Hamilton has a consultation family, and you can speak to someone there who can help them. I can hook up with you later and we can talk about it, and discuss what other services are there.

David Cheng: You can actually follow up with your questions if you have any personal situations that you want to address with the panelists during the break.

Betty Lee Sung: You all have the conference booklet. The biographies of all of these distinguished panelists and centers are listed in the back, so if you have further questions just call them because you can see that they are very accessible. We’re extremely grateful that the Commissioner himself from the Department for the Aging came down to join us, and to give us his sage advice. I have to mention that you’re also an alumni of Hunter College, and you are also former faculty at New York City College of Technology, so you are one of us.

We do want to mention that the study by AAFNY is available online.

Carol Peng: You can go onto our website, www.aafny.org, and purchase a copy, or download a copy of the report for free, as well as our other Census profiles. The Census data that I presented today was from a data profile fact sheet on the New York Asian senior population. We have a number of other profiles, the same demographic characteristics for different ethnic groups across the city, also different regions. We’ve got a lot on our website, so I encourage you to visit it.

Betty Lee Sung: Thank you, Carol! I also want to thank Isabel Ching and the Commissioner for supporting all of these senior centers. You do not realize what a valuable service these senior centers perform for our elderly, especially for the Asians who are such a predominant percentage of our population, are isolated, and because of the situation in this country, their families are working and don’t have time to take care of them. Seniors go to these centers. Of the fourteen Asian American senior centers we have in New York City serving their population alone, those seniors there are having a ball doing all kinds of activities and enjoying the company of other seniors. They have really performed a wonderful service, and we do thank the Commissioner, Isabel, and the others.