It seems more senior living communities are going to greater lengths – particularly in an increasingly competitive market – to serve the needs of seniors from multicultural backgrounds. Many companies are finding creative ways to customize their offerings to ensure seniors from various racial, religious, and ethnic groups feel right at home. Several senior living executives comments on their own examples …
In Hawaii, where many people come from Asian cultures,
multiple generations often live together, and cherishing and respecting
elders, a concept called kupuna, is a key
value, says Marketing Manager Gwen Trowbridge
of Kisco Senior Living. So
when the Carlsbad, California-based senior-living residence conceived
Ilima at Leihano, a 40-acre CCRC in
Kapolei, a suburb of Honolulu, they sought to embrace that connection
of ohona (family) by partnering with another developer to build
Maile at Leihano, a sister residential
community, in which adult children and grandchildren can live near
their loved ones.
Buildings are designed in the
islands’ unique architectural style, characterized by outdoor and
interior spaces interconnecting seamlessly. Amenities at the Leihano
Clubhouse will feature a pond with koi fish, symbols of love and
friendship in Japan. Activities also reflect the anticipated diverse
resident mix including not just Hawaiian ukulele, hula, and lei-making
classes, but also Chinese games of mahjong and classes on Japanese
kanji writing and Chinese tai chi. Dining options reflect Japanese,
Chinese, Thai, Filipino, Hawaiian, Asian-fusion, and Continental
cuisines, and Ilima also will offer “Pau Hana,” a Hawaiian happy hour
with “pupu” appetizers. Holiday celebrations will include Hawaii’s
Kamehameha Day, Kuhio Day, and Lei Day; Chinese New Year and Lantern
Festival; and the Japanese Obon Festival to commemorate deceased
ancestors and Keiro No Hi to show respect for the elderly and celebrate
longevity.
“Our associates, also at the heart of
our ohana, will no doubt be sensitive to the various cultures
represented at Ilima,” Trowbridge says. “Not only will Kisco Senior
Living hire local residents of Hawaii who will encompass this
sensitivity, but it will also be part of their training for all levels
of care.”
While most senior living communities
don’t go so far in serving the needs of seniors from multicultural
backgrounds, many companies are finding creative ways to customize
their resident-care strategies and offerings to ensure seniors from
various racial, religious, and ethnic groups feel right at
home.
Caring for Customs
Nonprofit religious organizations have long established
communities in which people of the same faith can retire together. A
handful of specialized communities also have sprung up for ethnic
groups, such as several Japanese residences in San Francisco and Native
American communities in Alaska and Canada. However, in most cases,
seniors from diverse cultural backgrounds are minorities in a larger
community, so cultural sensitivity should be integrated with a
company’s core values and incorporated into staff training from day-one
staff orientation, says Jim Concotelli,
vice president of resident programs for Tampa, Florida-based
Horizon Bay Senior Communities, which
operates 74 senior living communities in 13 states.
At Horizon Bay, those values are integrity,
respect, responsibility, professionalism, and teamwork, and the two
most connected with diversity are respect and professionalism. “Out of
respect for our residents, we feel it’s our responsibility to provide
care that meets the integrity of the resident and also honors their
history and background,” he explains. “In terms of professionalism, we
make sure that our staff understands a resident not only at their
cultural level but also [through] their background and history.”
Concotelli says he has not seen a lot of prejudice
by other residents for their neighbors from different backgrounds.
Instead, most seniors enjoy learning about other ways of life, he adds,
noting that residents of private-pay retirement communities such as
Horizon Bay tend to come from well-educated professional backgrounds
and have had previous exposure to a variety of cultures and individuals
different from themselves.
To ensure that
everyone’s traditions
are respected, Horizon Bay lets seniors take the lead in deciding what
multicultural activities they would like to see in their communities.
Learning what cultural traditions are important to a resident is a key
part of the initial interview and move-in process.
“Generally, we’ll have a resident group take a
leadership role in designing and offering what they feel is
appropriate,” Concotelli says. “Then staff supports them to provide the
space they need or any particular types of menu items. Even if there is
only a small group, we provide the support to honor their traditions as
we would for anyone in our communities.”
One reason
why fewer Asians and Latinos may live in senior living is the value
those cultures place on younger generations caring for their elders,
Concotelli observes. However, Carrington P oint
in Fresno, California, is an exception, with a growing
Asian population. “One family’s loved one moved in about five years
ago, and word spread within the Buddhist community that this was a nice
place,” he says.
Since many of the residents belong
to a specific Buddhist group, Horizon Bay turned to its leaders for
in-service and education for staff. With their help, the company added
an outside meditation garden and has incorporated Buddhist ceremonies,
customs, and cuisine into programming and dining.
Celebrating Differences
At Chicago-based Brookdale Senior
Living, observing multicultural traditions is at the
heart of the “Celebrations” program, which incorporates dining,
socializing, themed activities, events, and entertainment at all its
approximately 419 communities, says Joska
Hajdu, senior vice president of dining services and a
key player in creating the program. “[Celebrations] is all about
celebrating cultures and our differences, not just of residents but
also associates,” he adds. “It’s more an event than a program and
really ties together the entire programming of all our activities and
programs that happen at the community level.”
Each
year’s activities are centered on an overarching theme, with
mini-themes for each month. For example, in 2004, Celebrations focused
explicitly on cultural origins with “Journeys to America.” Each month
celebrated a different geographic area from which residents or their
ancestors immigrated and included an Italian month, an African-American
month, an Asian-American month, and a Jewish month. “Celebrations
Around the World” (2007) centered on international holidays such as
Brazil’s Carnival or Germany’s Oktoberfest. Another program, “Music of
Our Lives” (2008), celebrated different musical genres, such as soul in
February, which provided a chance to link activities to Black History
Month.
While Celebrations may seem more about
entertainment and continuing education for all residents, it also
affords opportunities for residents and staff from different cultures,
religions, and ethnicities to feel honored and share their unique
experiences with others, says Sara Terry, vice president of Optimum
Life, which administers Celebrations.
“[Because of
Celebrations], every day, directors of lifestyle programs have an
opportunity to recognize and utilize residents’ cultural experiences
for programs and events,” she adds. “We can tap residents to share
their cultural or historical perspective based on a theme and use them
as teachers.”
Accommodating the needs and desires
of people from different cultures and religions is also a priority in
Brookdale’s dining program, Hajdu says. The company has developed an
in-house, proprietary menu-planning tool for 10 different ethnic menu
regions, including Southern, Tex-Mex, and Old World, which incorporates
many Jewish specialties such as matzo ball soup, Gefilte fish, and
matzah brei. While communities are initially assigned a menu category
based on region, they can choose to switch to another one better suited
to their resident breakdown. For example, a Florida community assigned
the Sunbelt menu can opt
for Old World if it has a substantial Jewish population.
Brookdale’s menus also are not hard-and-fast rules,
but rather starting points, Hajdu emphasizes. A New England chef can
prepare a Tex-Mex recipe and vice versa. Finally, to be absolutely sure
that all residents have a say in what’s served, seniors can make
special requests, including their own cultural favorites, at the host
stand, and Brookdale will fulfill all reasonable ones within 10 days.
And residents can submit their favorite recipes to be added to the
national database.
“This is where my job becomes so
much fun,” Hajdu says. “It also teaches our managers and associates
that it’s all about a resident’s choice.”
Hajdu
warns, however, that ethnic specialties such as kosher or Asian food
preparation are not typically taught in mainstream culinary schools. “I
hired a new chef at one of our large, mostly Jewish communities, and he
had never made a matzo ball,” he adds. “Each culture has its own eating
and drinking preferences and holidays. A Jewish resident may expect to
get a Seder meal. Residents in the Southwest may definitely look for
Southwestern or Tex-Mex food. It does require extra training and
understanding.”
Multicultural Memory Care
Involving families is particularly important when it comes to
cultural issues for Alzheimer’s and dementia-care residents, says
Stephen F . W inner, cofounder and chief
of culture for San Juan Capistrano, California-based
Silverado Senior Living, which operates 20
memory-care communities in California, Utah, and Texas. Because people
with dementia live in their long-term memories, their experiences
growing up in a different country, church, or cultural environment may
be among their most vivid recollections, he explains. They often
remember the words to old-time songs or the Lord’s Prayer, and customs,
ceremonies, and cuisine may provide comfort in what is now a confusing
world, Winner says.
Silverado communities make just
as much of an effort as any other assisted living residence to stage
holiday celebrations, provide religious services, and serve culturally
familiar meals. Residents are encouraged to share stories about items
in their memory boxes that pertain to their cultures. When activities
with a cultural bent are planned, such as a cooking club where
residents learn to prepare a dish from another country, every effort is
made to evoke a complete ambiance of that culture. For example, a
Mexican meal will be accompanied by such props as maracas, sombreros,
and mariachi music.
Discussing cultural issues and
potential conflicts with families upfront can be particularly important
in a memory-care environment, Winner says. He cites a possible example
of a Jewish family who wants their loved one to maintain Jewish
religious services but then observes or learns that the resident
wandered into a Christian event.
“It’s an
educational process with the family that [the resident is] just
enjoying the music and the socialization, not the philosophy or some
sort of soul-saving,” Winner says. “Most families get it when you spend
the time to explain that it’s not a conversion.”
When Silverado staff invite outside clergy to
visit, they take the extra step of asking that they not deliver a
sermon and instead just include a general open prayer or hymn that
anybody of any religious background could join with comfort. “If a
family really says they don’t want the resident involved, we always
make sure that there’s another activity planned or that we direct them
to another area,” Winner stresses.
In another issue
with some Jewish residents with dementia, seemingly difficult behavior
during activities such as bathing may have their roots in concentration
camp experiences, Concotelli says. Horizon Bay offers caregivers an
educational in-service at communities with Jewish residents not only to
help them understand Jewish traditions but also to teach them to
identify such behaviors appropriately and take special
care with personal care activities for Holocaust survivors. To teach
the class, the company reaches out to local Jewish groups and aging
services.
Some small touches can go a long way,
Winner says. Because Alzheimer’s and dementia-care residents already
are confused by normal communication, it’s more essential that staff
speak English, so that is a firm requirement for staff from all ethnic
backgrounds, Winner says. Likewise, when a resident doesn’t speak
fluent English, family members are asked to help assemble communication
boards with key phrases from that person’s native language. However,
when Silverado is able to assign a primary caregiver who comes from
that same culture, a truly special connection often transpires.
“It’s really neat to see residents share their
memories and then see staff from the same background share their
memories,” Winner says. “It’s often a real mixing of ages, too.”
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