by Conchy Bretos, MIA Consulting Group, Inc.
Vera: A few years ago Vera was roaming the halls or sitting in the library of her independent elderly-designated public housing building. Vera was a real bright spot in this building, she loved to paint and play the piano, and she was a quite known artist in Cuba. She was always smiling and had cheerful comments for the staff and other residents. She had lived at Town View Terrace since 1992 as a widow living on a social security pension after many years of working. She had no family except for a nephew that only came once a month to ask for money.
The manager of Town View Terrace was called the local agency to determine Vera's needs and what services were available for her. It took more than a month for the case manager to come and visit Vera; she spoke no Spanish, although a request was made for a bilingual manager. The interview did not go well as Vera did not trust government staff and was afraid to discuss her limitations and believed she would be evicted from Town View Terrace as a result. Vera became agitated when the case manager did not understand that she did not want to undergo tests to identify signs of dementia, particularly in a clinic that did not have Hispanic staff and a waiting list of about four months to receive services. She complained to her friends that the case manager wanted her to give up her culture in order to fit in.
Vera was moved to a nursing home because she was having difficulty cooking and cleaning in addition to forgetting to take her medications daily. Her nephew was in no position to take her in and we were afraid that if she moved in with him she would most likely be exploited and neglected. Her life and her close friends were at Town View Terrace.
Several months later I had the opportunity to visit Vera in the nursing home. I found her sitting in a chair besides her bed, looking like she had lost her best friend. In fact, she had pretty much lost all her friends. She said she had been asked not to walk around and visit with other folks as they didn't have enough staff to keep track of all the residents if they didn't stay in their rooms or as a part of organized activity. While she still appeared to be healthy, she was definitely sad and lonely. My heart ached for Vera.
I was able to visit Vera only once more sometime later and was extremely saddened to see her still sitting in the same chair but with no spirit left in her. She barely smiled when I walked in the room.
Vera died in the nursing home alone and without her friends around her. They said she died after a period of declining health. I don't believe it was poor health that caused Vera's premature death. I believe it was a broken heart. The majority of our ethnic senior public housing residents are in very much the same predicament as Vera was, and many live every day in fear of the day they will be forced to move to a nursing home and lose their independence, friends and family ties.
Issues in Providing Care to Ethnic Seniors:
Issue: Language Barrier
Solution: Hire bilingual case managers/providers with cultural sensitivity and time to adequately evaluate and advise clients
Issue: Lack of trained staff with time in their hands
Solution: Caseloads for case managers and other personnel are significant. Train staff on cultural sensitivity, understanding the role of families, distrust of government because of their experience with government agencies, cultural differences in food choices, cleanliness and alternative medical treatments.
Issue: Fragmented service delivery system
Solution: It is a nightmare to navigate the fragmented service delivery system that exists in Florida and other states. Change the system's culture to one that empowers seniors to participate in the system and ensures that they will finish their lives with dignity, choice and independence. Services are targeted to the needs of the majority of the population and this, in turn, creates barriers preventing ethnic seniors from accessing services.
Issue: Increase outreach activities
Solution: Increase knowledge and information on availability of services and how to access these activities. Implement a concentrated public education effort designed with the help of the ethnic community.
