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Senior immigrants are usually reliant on family, friends, or caretakers to help them navigate their health care needs, including mental health. In many cases, the adult children of these immigrants are responsible for taking care of them as they get older. This includes covering medical bills, providing emotional support, and helping them to complete practical tasks. As an immigration evaluation therapist, it’s important to consider these unique circumstances and how they can impact senior immigrants in need of psychological care.
In this week’s blog post, we’ll dive into the key aspects of an immigration psychological evaluation, specifically focusing on senior immigrants. We recognize that the senior immigrant population is made up of various cultures and nationalities. However, we’ll be exploring the commonalities among this group of people and how that informs their mental health care needs.
Emotional support from family and friends
Most immigrant families take care of themselves and only seek home care assistance if it’s deemed completely necessary. This is a commonality found among many immigrant families, regardless of their religion, culture, or origins (Simms, 2020). Before evaluating a senior immigrant, consider their relationship with family and how that might affect their emotional stability. Immigrant populations have major differences in elder care culture when compared to typical American practices.
For example, senior immigrants who belong to Middle Eastern cultures do not separate themselves from the outside world or their children. They tend to live in close proximity to their children, even if they’ve reached adulthood. This phenomenon is known as inter-generational living and it protects senior immigrants from the potential abuses of strangers and unreliable health care systems (Simms, 2020).
Ultimately, these familial relationships are an undeniable emotional support system for most senior immigrants. Nevertheless, there have been instances where mental health clinicians interpret these relationships as a taxing way to live those burdens elders or their children. In actuality, senior immigrants connecting with their families at this level can enrich the wellbeing of the entire family. It’s vital to consider this perspective when working with a senior immigrant as it greatly affects their ability to cope with mental health challenges. (Simms, 2020)
Practical/ physical assistance
Senior immigrants are usually heavily reliant on their family, friends, and caretakers to provide them with practical and physical assistance. Perhaps their adult children are responsible for taking them to medical appointments, filling out forms, and interpreting information for them at medical appointments. As a mental health clinician, you can’t overlook these factors during the evaluation process.
Additionally, senior immigrants are likely to live with their children or caretakers. This means their daily lifestyle and living situation are directly affected by those around them.
English language proficiency
The ability to speak English is an essential aspect of immigrant assimilation in the US. However, a large number of immigrants don’t speak English as a first language. In fact, approximately 25 million people in the US speak languages other than English at home and many of them are senior immigrants (Ambegaokar, 2016).
Immigrants with limited English proficiency report lower satisfaction with their mental health care and a lesser understanding of their medical situation. Those who need an interpreter and don’t receive one, find themselves in the worst position. More importantly, the quality of interpretation needs to be considered at all times. Providing written instructions in a patients’ native language is not always an effective solution either. Many senior immigrants don’t have a formal education which means they could have limited literacy in their native language too. (Derose, Escarce and Lurie, 2013)
This means you’ll need to determine the English proficiency of senior immigrants you evaluate. Otherwise, it’s virtually impossible to conduct an adequate psychological evaluation if you haven’t established viable communication channels. In addition, if there are major language barriers between you and your patient, you may need to involve a professional interpreter.
The impact of physical ailments
Elderly immigrants are likely to have physical ailments that influence their mobility, sight, and hearing. Many of them spent their younger years working in labor-intensive industries like construction and farming, making them even more vulnerable to physical injuries. In addition, long-term physical ailments might cause their mental health to further deteriorate.
Remember to ask senior immigrants about their physical health in detail when conducting a psychological evaluation. As mentioned earlier, you might need an interpreter to help you fully grasp their physical condition. You can also ask them to bring you copies of any relevant medical reports.
Financial support systems
Senior immigrants are a diverse group of people. Plenty of them had high-paying jobs as tech entrepreneurs, real estate developers, and business owners. In contrast, many of them worked minimum wage jobs at establishments like restaurants and hotels. This makes it difficult to have adequate savings for health care, especially mental health care which is already difficult for most Americans to access. About 40% of immigrant seniors belong to low-income families. On the other hand, only 30% of American-born seniors face this challenge (Farrell, 2016).
Based on the previously mentioned factors, senior immigrants generally rely on family to support them financially, and it’s difficult to fully rely on them for all expenses. The immigrant community in America is aging alongside the rest of the population and facing great financial difficulty.
The key takeaway is that mental health clinicians need to be cognizant of the various factors that influence the psychological evaluation of senior immigrants. Ask yourself: What are the special needs of senior immigrants? How can I facilitate a constructive psychological evaluation?
Ultimately, the needs of a senior immigrant in the US are centered around family, access to information, financial support structures, and physical health factors. The only way you can conduct a successful evaluation is if you address all these influences as deeply as possible.
Ambegaokar, S., 2016. Opportunities for Maximizing Revenue and Access to Care for Immigrant Populations. Advancing Public Health Through Law,.
Derose, K., Escarce, J. and Lurie, N., 2013. Immigrants And Health Care: Sources Of Vulnerability. Health Affairs, 26(5), pp.1258-1268.
Farrell, C., 2016. The Painful Struggles Of America’s Older Immigrants. [online] Forbes. [Accessed 27 October 2020].
Newswise.com. 2019. Does Age At Migration Matter When It Comes To Mental Health?. [online] [Accessed 27 October 2020].
Simms, L., 2020. Caring For Our Own: An Immigrant’S View Of Elder Care. [online] Institute for Family Studies. [Accessed 27 October 2020].
I’m Cecilia Racine, and I teach therapists how to help immigrants through my online courses. As a bilingual immigrant myself, I know the unique perspective that these clients are experiencing. I’ve conducted over 300 evaluations and work with dozens of lawyers in the various states. Immigrants are my passion, I believe they add to the fabric of our country.
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