This week, Southeast Asia Resource Action Center (SEARAC) Executive Director Quyen Dinh travels to Chicago to talk about the needs of Southeast Asian American refugee elders with the Diverse Elders Coalition (DEC) at the American Society on Aging conference. The DEC is the only national coalition dedicated to raising awareness about the unique needs of LGBT elders, American Indian/Alaska Native elders, immigrant elders, and elders of color.
The seniors program of the Chicago-area Cambodian Association of Illinois (CAI) demonstrates that while many of the needs of Southeast Asian American elders are similar to those of other diverse seniors, they also have very specific needs: culturally, linguistically, and as survivors of war.
CAI was founded by Cambodian refugees in 1976, in the middle of the brutal Khmer Rouge regime in Cambodia that forced the country’s entire urban population into reeducation camps and prisons. In only four years, the regime wiped out around 20% of the country’s population through starvation, torture, and murder in what is now known as the Cambodian genocide. Hundreds of thousands of Cambodians eventually made their way to the United States as part of the largest resettlement of refugees in U.S. history in the wake of the conflicts in Vietnam, Laos, and Cambodia.
CAI houses the National Cambodian Heritage Museum & Killing Fields Memorial, which commemorates the more than two million lives lost during the Cambodian genocide and celebrates the resilience of refugee communities.
Today, CAI serves approximately 130 seniors with in-home services like preparing meals, running errands, and house cleaning, as well as health education and access. Often the caregivers are family members who would otherwise be forced to take care of their aging loved ones without financial support or training.
Cambodian American elders face many challenges that are similar to other low-income older Americans, including nutrition, transportation, and poverty. Nationally, 19.3% of Cambodian American seniors live under the federal poverty level, compared with 9.5% of seniors generally – twice the national average.
But Kaoru Watanabe, Associate Director of CAI, has found that Cambodian elders also face some very specific challenges as survivors of war and genocide. “A lot of times, as these seniors’ cognitive competency declines, we see their genocide memories start to come out,” Watanabe explained, “Some suppressed them a long time, over many years, but as they begin to show signs of dementia or Alzheimer’s, the memories start coming out unpredictably.”
Watanabe says this can be difficult for caretakers. “One of them told me, she takes care of her in-law, who now constantly talks about their experience during the genocide.”
Data on post-traumatic stress disorder in the Cambodian American community is sparse, but a 2005 study of 490 Cambodian refugee adults in Long Beach, CA, found that 99% had suffered near-death from starvation, and 54% reported having been tortured. Of the 490 adults, 62% suffered from PTSD, and 51% suffered from major depression. Among the general older population, the rate of PTSD is between 1.5% and 4%, and research on how to manage PTSD in older populations is scant.
The effects of PTSD may be subtle. Watanabe explained that in her conversations with survivors, many Cambodian survivors will explain their pain psychosomatically, in the form of physical ailments. “They’ll say, ‘My neck hurts,’ and so on. So we start with those complaints and move on to more mental health kinds of things. Instead of saying ‘I am depressed,’ many people say, ‘I think too much.’”
She continued, “We also really have to look at the effects of secondary trauma on caregivers and Cambodian staff. One of our staff members who works closely with survivors told me that when she has to help with her clients’ mental health, she has nightmares, because she also lived through the genocide.”
Though Cambodian seniors can access basic services across the Chicago area for other providers, these providers often call CAI for advice and assistance on providing culturally-relevant care.
But programs like these are being threatened at every level of government. In fiscal year 2016, the governor of Illinois completely eliminated its Immigrant Services line item, which supported CAI’s interpretation and translation services, as well as services to help community members access public assistance programs.
At the federal level, the Trump administration’s budget would eliminate the Community Development Block Grant and the Community Services Block Grant, grants to states that support in-home care programs like the one that CAI provides. The Republican-proposed American Health Care Act would also eliminate the Racial & Ethnic Approaches to Community Health (REACH) program, which funds community-based, culturally-appropriate health interventions.
Watanabe says despite the challenging political environment, CAI will continue to do everything they can to serve their Cambodian seniors. “Being here in this building with the Killing Fields Memorial downstairs, you really feel the deep meaning and significance of our work for these survivors. The work really gives you a sense of purpose.”
The opinions expressed in this article are those of the author and do not necessarily reflect those of the Diverse Elders Coalition.