CASE STUDY: An Older Immigrant Couple: Mr. and Mrs. Arahan

Mr. and Mrs. Arahan, an older couple in their seventies, have been living with their oldest daughter,
her husband of 15 years, and their two children, ages 12 and 14. They all live in a middle-income
neighborhood in a suburb of a metropolitan city. Mr. and Mrs. Arahan are both college educated and
worked full-time while they were in their native country. In addition, Mr. Arahan, the only offspring
of wealthy parents, inherited a substantial amount of money and real estate. Their daughter came to
the United States as a registered nurse and met her husband, a drug company representative. The
older couple moved to the United States when their daughter became a U.S. citizen and petitioned
them as immigrants. Since the couple was facing retirement, they welcomed the opportunity to come
to the United States.
The Arahans found life in the United States different from that in their home country, but their
adjustment was not as difficult because both were healthy and spoke English fluently. Most of their
time was spent taking care of their two grandchildren and the house. As the grandchildren grew older,
the older couple found that they had more spare time. The daughter and her husband advanced in
their careers and spent a great deal more time at their jobs. There were few family dinners during
the week. On weekends, the daughter, her husband, and their children socialized with their own
friends. The couple began to feel isolated and longed for a more active life.
Mr. and Mrs. Arahan began to think that perhaps they should return to the home country, where
they still had relatives and friends. However, political and economic issues would have made it
difficult for them to live there. Besides, they had become accustomed to the way of life in the United
States with all the modern conveniences and abundance of goods that were difficult to obtain in their
country. However, they also became concerned that they might not be able to tolerate the winter
months and that minor health problems might worsen as they aged. They wondered who would take
care of them if they became very frail and where they would live, knowing that their daughter had
only saved money for their grandchildren’s college education. They expressed their sentiments to
their daughter, who became very concerned about how her parents were feeling.
This older couple had been attending church on a regular basis, but had never been active in other
church-related activities. The church bulletin announced the establishment of parish nursing with
two retired registered nurses as volunteers. The couple attended the first opening of the parish clinic.
Here, they met one of the registered nurses, who had a short discussion with them about the services
offered. The registered nurse had spent a great deal of her working years as a community health
nurse. She informed Mr. and Mrs. Arahan of her availability to help them resolve any health-related
issues.
Reflective Questions

  1. What strategies could be suggested for this older adult couple to enhance their quality of life?
  2. What community resources can they utilize?
  3. What can the daughter and her family do to address the feelings of isolation of the older couple?
  4. What health promotion activities can ensure a healthy lifestyle for them?

Full Answer Section

           
    • Interest-Based Groups: Encourage them to explore local clubs or organizations based on their past interests (e.g., book clubs, gardening clubs, cultural associations, educational lectures) or new hobbies they might want to explore. Many community centers offer a wide range of senior-specific activities.
    • ESL/Community College Classes: Despite speaking English fluently, taking classes (e.g., art, history, technology, or even advanced English literature) at a local community college or senior center can provide intellectual stimulation and opportunities to meet new people with shared interests.
    • Volunteer Work: Engaging in volunteer activities that align with their previous professional skills or personal passions can provide a sense of purpose, structure, and social interaction. For example, volunteering at a library, hospital, or community organization.
  • Explore Residential Options for Seniors: Given their concerns about future frailty and care, and their desire for a more active life, exploring senior living communities could be beneficial.
    • Active Adult Communities: These are often designed for independent older adults and offer a wide array of social activities, amenities (e.g., fitness centers, pools, clubhouses), and opportunities for interaction with peers. This could address their longing for an "active life."
    • Continuing Care Retirement Communities (CCRCs): While a bigger step, these offer a continuum of care from independent living to assisted living and skilled nursing care, providing peace of mind for future needs. This directly addresses their concern about who would care for them if they became frail. This decision would require careful financial planning, which they could afford given Mr. Arahan's inheritance.
  • Embrace Technology for Connection:
    • While accustomed to modern conveniences, ensure they are proficient with video calls (e.g., WhatsApp, Zoom) to easily connect with relatives and friends in their home country, reducing feelings of longing and maintaining cultural ties.
    • Encourage using social media groups or online forums related to their interests to connect with new people locally or globally.
  • Advocacy and Planning:
    • Legal/Financial Planning: Engage an elder law attorney or financial planner to discuss long-term care insurance, wills, and estate planning. This directly addresses their worries about future care and finances, bringing peace of mind.
    • Advance Directives: Discuss and complete advance directives (e.g., living will, durable power of attorney for healthcare) to ensure their wishes are known and respected regarding future medical care.

Sample Answer

         

What strategies could be suggested for this older adult couple to enhance their quality of life?

  To enhance Mr. and Mrs. Arahan's quality of life, the strategies should focus on addressing their feelings of isolation, increasing their social engagement, and preparing for future needs while leveraging their existing strengths.
  • Foster New Social Connections:
    • Church Involvement: Transition from passive attendance to active participation in church activities beyond services. This could include joining Bible study groups, volunteer committees, or social gatherings specifically for seniors within the church community.