Conference on the Well-Being of Asian American Senior Citizens – Session 3B

Rajeshwar Prasad: Hello, and welcome to Breakout Session 3B: Intergenerational Relationships with Senior Citizens. It’s my pleasure to introduce you to Prof. Maria Piña-Fonti, from LaGuardia Community College, CUNY. She’ll be discussing “Trans-cultural Nursing Concepts and Community Health.”

 

Maria Piña-Fonti: Welcome everybody. We spent all day talking about statistics, the direction of streets, and depression in very general terms. At the heart of all this is the factor of culture. We have here in this room a representation of the young Korean and Chinese people today, and I think that’s the essence of what we’re talking about. With me are some nursing students, Ming, Xiao, Young, and Sue Wang, who’ll be discussing Trans-Generational Relationships.

 

One of the speakers today mentioned trans-cultural competence. We usually think that trans-cultural means putting all the Hispanic people in one place, or all of the Chinese in another, and all of the Germans in another one. That however is very far from the truth.

 

Here in my Power Point presentation we have three circles. Each circle identifies a certain point about a human being. The interesting thing is that although Joann looks much younger than me, sometimes we have more in common than those who look alike, simply maybe because of historical information, such as the time we grew up. When we have something in common, we immediately we click together, and in that clicking, trust develops, and that trust is essential. The students here will elaborate on that a little bit later from their points of view.

 

Healthcare is affected by the lack of cultural understanding and language gap. We know that many Asians are linguistically isolated. They need to communicate in order to feel connected. The lack of cultural understanding on our part, and theirs, is absolutely huge, this leads to certain socio-economic factors, in terms of people getting health insurance, and education.

 

Education is about what they need to know to traverse the streets. It doesn’t matter how many signs we put up if they don’t have the concept of what’s going on in this nation. Literacy is important. We’re still trying to figure out what’s culture. Culture is about beliefs, morals, laws, capabilities, habits, and people. Think about how much we need to know about a human being in order to connect with them. It’s really impossible. We have to remember that to all of these things are very dynamic, and influenced by conditions, environmentally, by conditional technology and the availability of resources. We can’t define these things solely by statistics or in just these terms.

 

I want to concentrate on, for this particular conversation, the maintenance, protection, and restoration of health, including religious practices. You’ll soon realize how many of these students here have experiences that are very different in terms of maintenance, protection, and restoration, maybe even religious, when they enter the field of Nursing. This is trans-cultural conflict at its best.

 

If we want to talk about health, the Asian population has their own way in maintaining it. They only use herbs to deal with particular illnesses. You may tell them they have to take antibiotics, but they’re going to shut you right off. To be culturally sensitive, you should tell them that, maybe use both herbs and antibiotics and see if there’s a problem with the two of them together. They’ll then begin to listen to you a little bit better.

 

The Asian population is very huge on holistic medicine. The body, the mind, and environment all create forces that keep you healthy. I tell my students, that you have to connect with the mind and environment of the body of a person. It’s not entirely scientific.

 

Diversity and University, a concept introduced by Dr. Madeleine Leininger, an Anthropologist Nurse, addresses the topic of trans-cultural nursing, something others said today was impossible to implement. We need to provide specific and culture universal care. What that means is that if I have this sensitivity and concept towards people, I’ll start learning little by little about different people in this world, and when I meet them, I’ll hone some culture specific and culture universal care. One of my students said to me in clinical one day, “Professor, you just made me do something that culturally, I could have never done. You held the hand of a patient, and then you told me to hold his hand too. In my culture, we don’t do things like that, especially where a man and a woman hold hands. It’s not something that’s done.” In this case, I think the patient and the student both learned a lot. All of a sudden you’re creating a union of diversity and universality in a different environment. In that moment, culturally congruent care was being given, even though there were two different cultures involved, a young Asian and an older Asian.

 

All of us that engaged in Cultural blindness, the inability of a person to recognize their own values, beliefs, and practices, as well as those of others because of ethnocentric tendencies. We need to realize this and be aware that it’s a huge wall that can divide us.

 

Cultural imposition issue is imposing one’s beliefs onto another. What an Asian elderly person feels sometimes while walking the streets is important. There’s nothing that connects them to the environment. One of my students was saying that maybe a sign in Chinese wasn’t so bad of an idea to help them feel more at home. And, I agree with her. Let’s stop imposing things on people. If we have Chinatown, then lets make it as much Chinatown as possible. But, I also don’t like the concept of Chinatown, Little Italy, Spanish Harlem, and Little Korea, because we’re creating that concept of separation. There has to be a little intermingling. By not providing these simple things to people to make them feel connected is very improper.

 

According to Dr. Leininger, cultural care preservation is important. You can’t just go in and wipe 80 years of their generation out. See what you can preserve with them in terms of health. See what you can work out with them to establish that trust element. Let’s preserve as much of it as possible.

 

Cultural accommodation is the next step. Professional actions and decisions to help people of a designated culture achieve a beneficial health outcome. Try to accommodate things such as a sign on the street for the healthcare people such as myself, or maybe it’s the visiting hours and who can stay. Cultural negotiation is at the base of it. If I give a little, and you give a little, we’re both talking and connecting. Florence Nightingale once said, “Without knowing the wants, the difficulties, temptations, fatigues of their daily lives without a serious study of their world, we cannot help them.”

 

Xiao Yon Li is now going to discuss about intergenerational communications from different aspects including family, spirituality points, gender, and immigration.

 

 

Xiao Yon Li: Good afternoon everyone. I’ve been here in the United State for almost 13 years now. I see myself as a very traditional Chinese woman. My classmates however laugh at me and say that I don’t look very traditional, but on the inside, I really am. I’d like to share some of my personal points of view of China, in terms of intergenerational communication. A traditional Chinese family is extended, closely knit, and socially unique, in that children take care of their aging parents. This tradition and culture encourages children to be obedient, which means that whatever your parents say, you have to follow, even if you are not happy with it. So that’s how things went on back home. Pretty much everything is like a marriage, decisions were made for you.

 

My dad told me that he was once awarded a bowl of meat because of his academic achievement. Instead of eating it, he put it in cold water, because there weren’t any refrigerators, and brought the bowl of meat back home to his mom two days later. Of course, in the summer, meat wasn’t good anymore after so long, and they had to throw it away. Still, I was really impressed by that story, and I guess that’s the way I was raised where tradition is passed through one generation into another. The way our past generation treats their parents, is a role model for me to follow, and I think it’s pretty amazing.

 

Maria Piña-Fonti: Now I want to introduce Young, who’ll bring you a little bit of a different interpretation of her concept of intergenerational conversations.

 

Young Mook Lim: Hello everybody! I’m from South Korea and came here around three years ago. I come from the Korean tradition, where we’re not suppose to express ourselves, and always follow male decisions. That’s why I decided to come here to the U.S. In my family, I have one brother and five sisters. Even though my brother is the youngest one, my parents will listen to his words and decisions. The girls are like outsiders, but they still care for us, that’s our tradition. Decision making is like a family meeting, only the male family members talk about important matters. My parents had to have a son in order to keep the family going. Without a son, the history stops. That’s why sometimes female members have to sacrifice themselves for their brother.

 

I want to talk about my mom. She is sacrificing herself to raise us and support my father.

 

I just watched a Korean program the other day about menopause. Korean women don’t express ourselves or discuss changes that are sexually related. It’s taboo in my country, and not being able to bear children anymore is a shame to them, so they don’t talk about it. There’s a lot of psychological and physical changes in adults, but they don’t have access to that type of information because it’s a shame to them. Many don’t go to hospitals or seek help. Family members also are very busy with their lives, and when children grow up, they don’t have any interest in their mom getting old. As for the husband, he’s busy taking care of the whole family, so the wife has no one to talk to about her mid-life crisis. Menopause is like the first stage of their new life. If they don’t have the right primary prevention or healthcare access now, how can they prepare for a healthy life later on?

 

Maria Piña-Fonti: I’m really astounded that she’s discussing menopause in front of so many people, because she’s the same person that was nervous about holding a male patient’s hand for comfort. I think Young just went through a bit of cultural dynamism, from not holding a hand to talking about menopause, which she said was taboo. I think that’s a big accomplishment.

 

Joann Kyung: Hello. First of all, I would like to thank the Asian American / Asian Research Institute for sponsoring this event. I’m a student at La Guardia Community College. I’m a Korean American, the youngest of three in my family. All of my relatives are in Korea, so I don’t have much contact with them. Therefore, I consider myself to be very different from the rest of my family.

 

Honestly, I feel like I have two identities. The first identity is the person that I am when I’m with my family, and the second identity is the person that I am when I’m outside of the family. The reason for this is because of what they say, that your actions reflect on your family. So basically, you need to sacrifice yourself for your family. I was born here, so I was exposed to the American culture of individualism. They say that you’re defined by your actions, and confirm and validate yourself through your actions. Basically, I’m stuck right in the middle, and have the opportunity to observe interactions between both the Asian and American cultures.

 

I feel that especially in nursing, it’s important to be culturally sensitive and culturally competent. Everyone has unique things about themselves, their culture and personality. In order to give good quality care to those people, you need to understand where they come from.

 

My family is traditional. They don’t like to express their feelings and emotions. They enjoy talking about education, careers, marriage, family, and children. My parents had to slowly adjust to the Amercian ways, because I focused a lot on feelings and expressed my emotions. It was really difficult for them to relate and understand me. There was a lot of conflict and lack of communication. I would tell them how I felt, but they would never tell me how they felt. I didn’t know how to respond to that or communicate with them.

 

Many Asian elders feel betrayed because they came to the U.S. to have a better life and education for their children. When their children grow up, they want to separate themselves from the family, and those traditions that the elders have respected for thousands of years. Because of that, a lot of emotional stress and conflicts arise from that. Thank you.

 

Maria Piña-Fonti: I would like now to introduce all of you to Zhong.

 

Meng Zhong: Good afternoon. I’m a nursing student at LaGuardia Community College. I came from China to over here for almost 7 years now. To be a nurse, we have to be culturally competent. The United States is a very diverse country, and we should know some of its history.

 

My presentation is about Chinese immigration. Immigration to the United State from China began primarily in the middle of the 19^th Century. Chinese immigrants arrived to this country prepared to pursue the opportunities waiting for them. These immigrants were mostly young males. The ratio between male and female immigrants was 21 to 1 during the beginning of the Chinese immigration. They all had the American dream of getting rich and having a better life so that they could send money back to their home in China. That was during the California gold rush, and unfortunately, all these dreams of getting rich from the elusive golden mountains of California failed. Most moved into other industries, such as shoes, garment, and mining. Chinese immigrants were especially known for their work on the railroads in the West Coast. Approximately 15,000 Chinese were hired by the Central Pacific Railroad to build railroads.

 

At that time, Chinese immigrants made a great contribution to the West, and continued to contribute to the country’s progress. However, American sentiment towards the Chinese grew antagonistic. Fear, ignorance and post Civil War depression combined to create an insulated atmosphere and sudden hostel home for the Chinese. In 1882, Congress passed the Chinese Exclusion Act, based upon the belief that the immigration of Chinese labor to the U.S. endangered the good order of certain locality within the territory. This law was the first in U.S. history to ban a specific racial group from entering America. The Chinese were also denied the right to apply for naturalization. Chinese immigrant has had a hard time in America. We have this long history, and even today, many of the Chinese immigrants struggle to get legal status in America. It’s very hard for us.

 

A friend of mine, an old lady, came here four years ago to meet her only child, a daughter, who came here three years before she did. They wished for a happy family reunion, but things didn’t turn out so well after the mother arrived. At the beginning they were happy, but after awhile, the mother said her daughter had changed a lot. Her daughter became very self dependent and wanted personal space. She didn’t want to share her opinions and business with her mother, who was the authority figure in her family back in China, the one who made major decisions and took care of the husband and daughter.

 

Now, things have changed, her daughter has been here for awhile and is very independent. Her mother feels like has she lost her role and isn’t in control anymore. The mother doesn’t speak English and can’t find a job, so she depends on her daughter. This makes her sad that she needs to ask her daughter for money. After a month or two, the mother turned to me and started to complain about her daughter. Sometimes she became very emotional, and I felt bad seeing how depressed and sad she was.

 

That’s the problem Chinese elderly face, and how they arrive at mental problems. So many people complain about the mental problems in the Asian elderly population, and I think this is the reason why they’re mentally depressed. They feel they’ve lost their role in the family. Also, many younger Chinese who are acculturated don’t respect their parents. In order for other ethnic group to understand Asian people, we have to speak up. Thank you very much.

 

Rajeshwar Prasad: I want to thank Prof. Piña-Fonti and her students for giving us a wonderful and informative discussion into how we can bridge the gap between the generations.