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
- What strategies could be suggested for this older adult couple to enhance their quality of life?
- What community resources can they utilize?
- What can the daughter and her family do to address the feelings of isolation of the older couple?
- What health promotion activities can ensure a healthy lifestyle for them?
Full Answer Section
2. What community resources can they utilize?
- Senior Centers: Offer social activities, meals, exercise programs, educational workshops, and sometimes transportation services.
- Public Libraries: Provide access to books, computers, internet, and often host free events and programs for seniors.
- Community Centers: May offer a variety of recreational activities, classes, and social gatherings for all ages, including seniors.
- Volunteer Organizations: Numerous organizations rely on volunteers and can provide meaningful engagement opportunities based on their interests.
- Local Colleges and Universities: May offer senior citizen programs, discounted courses, or opportunities to audit classes.
- Cultural Organizations: Groups focused on specific ethnicities or cultures can provide a sense of belonging and connection to their heritage.
- Transportation Services for Seniors: Many communities offer reduced-fare or specialized transportation options for older adults.
- Home Healthcare Agencies: While not for immediate use, knowing about local agencies can provide reassurance about future care needs.
- Social Service Agencies: Can provide information and assistance with potential financial concerns, housing options, and access to healthcare.
- Parish Nursing Program: The newly established program at their church is a direct resource for health-related information, basic screenings, referrals, and emotional support. The community health nurse background of the volunteer nurse is a significant asset.
3. What can the daughter and her family do to address the feelings of isolation of the older couple?
- Prioritize Family Time: Make a conscious effort to schedule regular family dinners during the week, even if it's just a few times.
- Include Them in Weekend Activities: Extend invitations for them to join some of the daughter's family's social outings and activities with their friends, when appropriate and comfortable for everyone.
- Dedicated One-on-One Time: The daughter and her husband could each schedule dedicated time to spend individually with Mr. and Mrs. Arahan, engaging in activities they enjoy or simply having conversations.
- Create Shared Activities at Home: Engage in activities together at home, such as playing board games, watching movies, cooking, or gardening.
- Show Interest in Their Past: Ask them about their lives in their home country, their careers, and their family history. This shows respect and acknowledges their experiences.
- Encourage and Support Their Engagement Outside the Home: Actively support their participation in church activities, senior centers, or other community groups by providing transportation or simply expressing enthusiasm.
- Open Communication: Maintain open and honest communication about everyone's feelings and needs. Create a safe space for Mr. and Mrs. Arahan to express their sentiments without feeling like a burden.
- Small Gestures of Inclusion: Involve them in daily family life, even in small ways, such as asking for their opinions or help with simple tasks.
4. What health promotion activities can ensure a healthy lifestyle for them?
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Regular Physical Activity:
- Encourage daily walks or other forms of light exercise suitable for their age and health status.
- Explore senior-friendly exercise classes offered at senior centers or community centers (e.g., Tai Chi, gentle yoga, water aerobics).
- Promote activities they enjoy, such as gardening or dancing.
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Healthy Diet:
- Encourage a balanced diet rich in fruits, vegetables, whole grains, and lean protein.
- Limit processed foods, saturated fats, and excessive sugar and salt intake.
- Consider consulting with a nutritionist or accessing senior nutrition programs if needed.
- Involve them in meal planning and preparation.
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Regular Health Check-ups:
- Ensure they have regular appointments with their primary care physician and any necessary specialists.
- Encourage adherence to recommended screenings and vaccinations for their age group.
- Utilize the parish nursing program for basic health screenings, blood pressure checks, and health education.
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Mental and Cognitive Stimulation:
- Encourage activities that keep their minds active, such as reading, puzzles, crosswords, learning new skills, or engaging in stimulating conversations.
- Promote social interaction to combat isolation, which is linked to cognitive decline.
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Adequate Sleep:
- Discuss the importance of good sleep hygiene and address any sleep-related issues.
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Stress Management:
- Encourage relaxation techniques such as deep breathing exercises or meditation.
- Promote engagement in enjoyable hobbies and social activities.
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Fall Prevention:
- Ensure their home environment is safe, with good lighting, removal of tripping hazards, and grab bars in appropriate areas.
- Encourage regular vision and hearing checks.
- Discuss balance exercises with their physician.
By implementing these strategies and utilizing available resources, Mr. and Mrs. Arahan can actively work towards enhancing their quality of life, fostering a greater sense of belonging, and maintaining their health and well-being in their new environment. The daughter and her family play a crucial role in providing support and facilitating these positive changes. The parish nurse can also be a valuable ongoing resource for health guidance and connection to other community services.
Sample Answer
Reflective Questions: Mr. and Mrs. Arahan
Here are some suggested strategies, community resources, actions by the daughter's family, and health promotion activities for Mr. and Mrs. Arahan to enhance their quality of life:
1. What strategies could be suggested for this older adult couple to enhance their quality of life?