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, health and wellness programs, educational opportunities, and sometimes transportation services.
- Local Libraries: Provide access to books, computers, internet, and often host events and programs for seniors.
- Parks and Recreation Departments: Offer recreational activities, exercise classes, and social gatherings in local parks.
- Volunteer Organizations: Connect individuals with opportunities to volunteer based on their interests and skills.
- Cultural Centers or Ethnic Associations: May provide a sense of community and connection for immigrants from their native country.
- Transportation Services for Seniors: Many communities offer reduced-fare or specialized transportation for older adults who may no longer drive.
- Home Healthcare Agencies: While not currently needed, knowing about these services for potential future needs is important.
- Social Service Agencies: Can provide information and assistance with various needs, including financial aid, housing, and healthcare resources.
- Parish Nursing Program: The existing parish nursing program is a direct resource for health-related information, basic health assessments, and referrals.
- Adult Education Centers: Offer classes on a variety of topics, providing opportunities for learning and social interaction.
3. What can the daughter and her family do to address the feelings of isolation of the older couple?
- Schedule Regular Quality Time: Intentionally plan specific times for family meals, outings, or activities that include Mr. and Mrs. Arahan. Even short, regular interactions can make a difference.
- Engage in Shared Activities at Home: Involve them in household tasks they are capable of and enjoy, watch movies together, play games, or simply have conversations.
- Show Interest in Their Lives and Culture: Ask them about their experiences in their home country, their past work, and their interests. This shows they are valued and their history is appreciated.
- Facilitate Connections with Others: Offer to drive them to church activities, senior centers, or meetings of cultural groups.
- Include Them in Social Gatherings: Make a conscious effort to include them in weekend social events with the daughter and her husband's friends, even if it's just for a portion of the time.
- Learn Basic Phrases in Their Native Language (if applicable): Even a small effort to learn a few words can show respect and build connection.
- Create a Comfortable and Welcoming Home Environment: Ensure they have their own space and feel comfortable and respected within the household.
- Open Communication and Active Listening: Regularly check in with them about how they are feeling and actively listen to their concerns without judgment.
- Acknowledge Their Contributions: Recognize and appreciate their help with the grandchildren and the house, making them feel valued members of the family.
4. What health promotion activities can ensure a healthy lifestyle for them?
- Encourage Regular Gentle Exercise: This could include daily walks, gardening, chair exercises, or water aerobics, depending on their physical abilities. The parish nurse can help assess their capabilities and suggest appropriate activities.
- Promote a Healthy Diet: Encourage a balanced diet rich in fruits, vegetables, whole grains, and lean protein, while being mindful of any dietary restrictions or preferences. Involve them in meal preparation if they enjoy it.
- Ensure Regular Medical Check-ups: Encourage them to schedule and attend regular appointments with their primary care physician and any specialists they may need. The parish nurse can help them navigate the healthcare system.
- Medication Management Support: If they are on medications, ensure they understand the instructions and have support in managing their prescriptions. The parish nurse can play a vital role in medication reconciliation and education.
- Fall Prevention Strategies: Assess their home environment for potential fall hazards (e.g., loose rugs, poor lighting) and implement strategies to reduce the risk of falls, such as grab bars and non-slip mats.
- Mental Wellness Activities: Encourage activities that promote mental well-being, such as socializing, pursuing hobbies, engaging in mentally stimulating activities (e.g., puzzles, reading), and managing stress through relaxation techniques.
- Adequate Sleep: Promote a regular sleep schedule and a comfortable sleep environment.
- Vaccinations: Ensure they are up-to-date on recommended vaccinations for their age group, such as influenza, pneumonia, and shingles vaccines.
- Health Education: The parish nurse can provide ongoing health education on topics relevant to older adults, such as managing chronic conditions, recognizing warning signs of illness, and promoting overall wellness.
By implementing these strategies and utilizing available resources, Mr. and Mrs. Arahan can enhance their quality of life, reduce feelings of isolation, and promote a healthy and fulfilling later life in their new home. The active support and understanding of their daughter and her family are crucial to their successful adjustment and well-being.
Sample Answer
Here are some strategies and resources that could be suggested for Mr. and Mrs. Arahan, along with ways their family can support them and promote their health:
1. What strategies could be suggested for this older adult couple to enhance their quality of life?