- Social isolation, cultural alienation, coupled with dependence on their children who are preoccupied with their own busy lives are the main reasons that not only leave them unhappy but also result in adverse health effects.
The Indian diaspora comprises around 4.8 million people, according to the United States Census Bureau, 2018. Indians have come a long way since the 1965 Immigration and Naturalization Act, which opened up doors for their higher education and employment opportunities in the United States. In 2014, Indians became the largest immigrant group and are also known as the most prosperous ethnic minority. After establishing their roots here, they have been sponsoring their parents to join them to live close to their grandchildren. Traditional Indian values place importance on family and emphasize the intergenerational reciprocity between parents and children and moral and spiritual value of offering care or service (seva) to older people.
Parents expect to be taken care of and be with their children when they grow old. Some parents have come to help with the care of their grandchildren; some have joined their children after retirement and in many cases widowed parents have moved in with the adult children. When these seniors migrate to a new world, they feel disconnected from their familiar way of life, traditional resources and family relations.
According to the Migration Policy Institute report in 2019, 17% of the Indian Americans in the U.S. are 65 and older compared to one in every seven, or 15.2%, of the U.S. population. Many of them are aging parents of naturalized American citizens, reunited with their families. Yet as reported in the New York Times in 2009, experts say that America’s ethnic elderly are among the most isolated people in the country. Dr. Neha Jain, a geriatric psychiatrist at the University of Connecticut says, “even before the corona pandemic, isolation is really one of the biggest issues for the older Indian immigrant population.”
The Changing Role of Family
In more than a dozen interviews, experts, community leaders, and elders have shared their stories of how they are trying to adjust to the different ways of life in the diaspora. Contrary to the stereotyped imagery that only sons take care of their parents, many senior parents come to live with their daughters.
A friend’s 78-year-old mother lives with her family in Fremont, California. She suffers from diabetes, high blood pressure and cancer. After her husband passed away, her children did not want her to live alone in Bhubaneswar. Her son in Connecticut visits her in Fremont occasionally. She is a fantastic cook but cannot use her right arm because of cancer. Besides doctor’s appointments, watching Odia TV is the only way she can get by day after day. She misses her home in Bhubaneswar — seeing her friends, interacting with the hawkers coming to her door, taking an auto rickshaw ride to the marketplace and temple. She says that the hospital is next door back home, but her children did not want her to be alone. Now she is very anxious that with her failing health, she may never be able to go back to be with her family and friends.
Lonny Shavelson, writer, photojournalist, and physician, in his 2009 report “Elderly Immigrants Need Special Help,” says that Hardev Singh, 75, was invited by his daughter who petitioned for him to come over to Fremont, so they would stay together as a family. Singh found out that his daughter and her husband worked the night shift at a medical supply factory. His adolescent grandchildren had no time for him. Then his son-in-law’s parents moved in, and Singh had to move out to a shared living across town and now works odd jobs to pay rent and buy his food.
In Indian culture, family as a core unit is prioritized whereas in the U.S. individualistic culture, personal independence, privacy, competition, self-fulfillment, and achievement are valued. In a traditional Indian family setup, adult children provide financial support for their aging parents and are in charge of providing food, tea, washing clothes, and nursing during their ill health. In America, the elderly complain that the children are too busy and have no time to take care of them. They realize that there is no domestic help, and they end up taking on the household activities and do odd financial jobs, ending up serving their children in their old age.
Kasturee Mohapatra, a longtime resident and well-known community organizer in Long Beach, California, said that one elderly Bengali mother came to her looking for shelter as she didn’t receive adequate care from her son and daughter-in-law she was living with. Both of them worked full time and had no time to prepare the special food for her diabetes and resented that she waited for them to serve her. Elder parents’ expectation of spending time with their children and receiving seva are conspicuously scarce in the United States.
Elżbieta M. Goździak in her 1989 study of the Older Refugees in the United States: From Dignity to Despair, states that upon migration to the U.S., the elderly lose their social roles tied to power and prestige in their home countries. This “role emptying” places the elderly in an unfavorable position, and they are seen to have very little to offer to the younger generation.
Parents and grandparents who come here expecting to join an extended family as it exists back in India, are at a loss. Octogenarian Gita Das, a long-time board member at the Indo Canadian Women’s Association, Alberta, Canada, who has written extensively on elderly care, says that it is harder for women to adjust. Homebound, the elderly women feel like being in prison and are confined. Adult children work during the week and weekends are the only time for their socializing. She describes one woman who became ill — acute arthritis along with diabetes and hypertension — and had to be taken back to India because her children in Edmonton had no time to take care of her.
Sarita Bajaj, head of the Department of Medicine at MLN University in India, writes in her co-authored article about South Asian women with diabetes that South Asians are four times more likely to develop diabetes than other groups. Frans Leenen and his colleagues in their Survey on the Prevalence and Control of Hypertension in Ontario,2008, found out that hypertension is more prevalent among certain ethnic groups including South Asians.
According to these studies, women develop more medical issues — diabetes, high blood pressure, or high cholesterol. They have set food habits, cannot go for long walks and do not tend to take care of themselves. Since many of them do not drive here, it affects their mobility. Jamila Bookwala, Jennifer L. Yee and Richard Schulz in their 1997 study, on Caregiving and Detrimental Mental and Physical Health Outcomes Of the elderly, observe that taking care of the grand children as a routine may be taxing for the grand mothers. This load of domestic work, which is increasingly challenging for older women due to their age and physical fitness, is now being more publicly acknowledged as a form of exploitation – the multiple burdens that continue to drain older women.
A Sense of Isolation
The loss of social circle may have serious consequences leading to somatic illness in the elderly. Dr. Jain, says that in many of her elderly patients, she sees ailments like stopping talking and eating, developing unreasonable fear and chest pain which simply are not chemical disorders and cannot be dealt only with medicine. She speaks of a patient who developed dementia. He was highly accomplished in his own life and time in Pakistan. After his wife passed away, he immigrated to America early in his 50s with his son and his family. Here nobody knew him and he barely had a chance to connect with people of his time and life back at home. He was terribly lonely and was depressed. He was losing his short-term memory, an early form of dementia. Now all he remembered were things from 20-40 years ago.
Dr. Jain recommended visits to familiar places like a place of worship or a community time with people he could relate to. But the children did not have time. As he was dependent on his family for transportation, he was left alone. Dr. Jain suggested a psychotherapist but no specialist with an understanding of his culture was available. The children justified that they had provided for the parent — food, TV and all the comforts. But the real issue is loneliness, isolation, a sign of disconnect between him and the cultural environment.
In their articulation of exclusion by isolation, Paul Littlewood and Sebastian Herkommer in their study on Social Exclusion in Europe Problems and Paradigms in 1999, note that it is “manifested by the restriction and circumscription of social contact, social relationships and group identity.” In case of the elderly parents, loss of relationships and insecurity are tied to their heightened isolation.
Abul Hossen in his 2012 study, Social Isolation and Loneliness among Elderly Immigrants: The Case of South Asian Elderly Living in Canada, discusses the impact of physical confinement / exclusion of the interviewees in their homes: “Especially in winter, I feel like a prisoner here”; “It’s like being trapped”; “I can’t get out.” He says that 70 percent of recent older immigrants speak little or no English. Most do not drive. Some studies suggest depression and psychological problems are widespread, the result of language barriers, a lack of social connections and values that sometimes conflict with the dominant American culture, including those of their assimilated children.
Sushma Malhotra, who has been actively involved in the community organizations for many years helping the distressed women in Dallas, Texas, reports a case of dependent parents who were routinely left in a mall from morning till evening when the children are at work. Dependent on their children, late-life immigrants are a defenseless group. “They come anticipating a great deal of family togetherness,” Professor Judith Treas, a sociology professor at the University of California, Irvine, told New York Times in 2009: “But American society isn’t organized in a way that responds to their cultural expectations.”
The city of Fremont, California introduced the Community Ambassadors Program for Seniors (CAPS) in 2007 to help the elderly immigrants out of isolation. In collaboration with San Jose State University and the Stanford Geriatric Education center, the city trains community volunteers as ambassadors to work with the elderly in different activities — ranging from active listening to information on housing, legal and cash assistance and health issues. It partnered with the local India Community Center to organize culturally appropriate activities for the elderly immigrants in the community. More than 100,000 elderly arrive in Fremont every year which has turned out to be the most ethnically diverse city in California.
Mary Ann Mendall, Fremont’s Administrator of Aging and Family Services in a 2008 National Public Radio report on “Elderly Immigrants Flow into California” says that seniors in a meeting reported that they “feel like we are parasites on our children. We depend upon them for money, for shelter, and for socialization. And we’re all depressed.'” Mendell says that in the American society, “husband and wife are working, children are in school, the neighborhood’s deserted. They’re home alone.”
American society is not old age friendly. Americans’ attitude toward the elderly is very negative. Marita Grudzen, with Stanford University’s Geriatric Education Center, in a 2008 National Public Radio report explains that in the United States the larger society does not value being old. “They go out and they’re not respected or welcomed in the way they were in their country. And so, it’s a hundred little ways where they experience a great loss.”
Studies suggest that culturally appropriate intervention programs like reading in one’s language, engaging in social service and sports activities and meeting people from one’s culture has its positive impact on the elder’s well-being and health. Even though the Indian senior population has topped 300,000 in 2015, according to the U.S. Census data, the number of community centers catering to the elderly is miniscule.
The Role of Places of Worship
Places of worship play a very important role providing social space for the elderly to congregate, offer their services with free food and meaningful religious services. In Alberta, the Hindu temple community provides safe space for elderly women and offers counselling to the elderly. In 2018, Hindu Society of Alberta held a Seminar, Swarga Rohan – Preparation for the End of Life — for the elderly. The seminar was focused on detachment from family, which is the hardest task for the elderly. It is one of the most popular programs introduced by the Hindu temple in Alberta.
Annapurna Devi Pandey teaches Cultural Anthropology at the University of California, Santa Cruz. She holds a Ph.D. in sociology from Jawaharlal Nehru University, New Delhi, and was a postdoctoral fellow in social anthropology at Cambridge University, U.K. Her current research interests include diaspora studies, South Asian religions, and immigrant women’s identity making in the diaspora in California. In 2017-18 she received a Fulbright scholarship for field work in India. Dr. Pandey is also an accomplished documentary filmmaker. Her 2018 award-winning documentary “Road to Zuni,” dealt with the importance of oral traditions among Native Americans.