Filial and Familiar Care : Culture deepens dilemma faced by children of aging Asians. But planned senior day center offers hope.

The hard decision came at last, after Frank Sun had spent months watching his father-in-law slowly deteriorate. After much agonizing, Sun and his wife finally chose to place him in a nursing home where he could get the round-the-clock help he needed.

“It was very painful,” Sun said. “But he was unable to care for himself. And we just couldn’t take care of him at home.”

His father-in-law, who passed away this year, got better care at the nursing home, but the retired McDonnell-Douglas engineer still reproaches himself for not finding a way to keep him with the family. The dilemma facing adult children with aging parents in need of more care is always a heart-wrenching one, but cultural factors make it doubly so in Asian American families.

In Asian societies, Confucian principles give children sole responsibility for caring for aging parents. But those traditional values often are at odds with modern-day American lifestyles, where two-parent-working families find it difficult to care for aging parents.

Aware of the need, the Asian American Senior Citizens Service Center in Santa Ana has plans to start Orange County’s first day-care center for aging Asian Americans. The facility would allow elderly parents who need physical or medical monitoring during the day to get the care they need and continue living at home with relatives or independently, said Sun, who is also co-president of the agency’s board of directors.

“If we’d had a day-care center back then, we would have taken that route,” he said. “It would have been easier.”

A step above the traditional senior center, which simply provides activities for seniors, a day-care center provides supervision for more frail elderly, emphasizing therapeutic activities and socialization.

Orange County has about 16 day-care and day health centers for seniors of all ethnicities. But the county, with its large Asian American population, deserves a day-care center specifically for Asian Americans, Sun said. “Asian people, by their nature, do not broadcast that they have problems at home. But we have done some surveys, and there is a demand out there,” he said.

“Simple things, like having rice for meals and having someone who can speak to you in your language, would make a difference. We’re trying to cater to old folks in the old style, so they can have a place to go and a reason to live, not just wait at home to die.”

The Asian senior center, which shares space at the downtown Santa Ana Senior Center, currently provides employment assistance, mental health services and other help but has no facilities for group recreational activities.

The group has been searching for a suitable site for the last two years and recently located one in downtown Orange. Leaders of the group are working with a developer and raising funds for the multimillion-dollar project, Sun said.

The idea already has taken firm hold in Northern California’s more prominent Asian American communities. In fact, it was the On Lok Senior Health Center in San Francisco’s Chinatown that pioneered the concept of a senior day-care center and its more comprehensive counterpart, a day health center, which provides medical and rehabilitation services along with social activities.

Created 26 years ago, the program was set up because “we recognized that we weren’t able to keep our seniors in the community,” said Doreen Der-McLeod, a social work specialist there. Families unable to provide appropriate care at home faced sending elderly parents to nursing homes outside the county, often far from San Francisco, she said.

“For seniors who were monolingual, it was a case of double jeopardy. They were being taken out of a familiar home environment and then they were isolated because of the language,” Der-McLeod said.

Although community leaders had initially wanted to build a nursing home for Asian Americans, they opted instead to create a day-care center that emphasized rehabilitation. Modeled after the British system of care for the huge numbers wounded in World War II, the center was able to help many more seniors, she said.

The benefits of such centers are clear, said Corinne Jan, executive director of the Oakland Chinese Community Council, another Bay Area group that provides both a day-care and day health center for seniors.

By offering some additional support, the center allows many Asian American seniors to avoid premature institutionalization, she said. “If they weren’t here, they’d be in a nursing home.”