Aging Arab Americans: The Invisible Elders

DEARBORN – It is 3:00 pm on the
first Saturday of the year. January’s sun makes this cold afternoon more inviting
for a social family visit. But the traffic in front of the Kennedy Center
building on Bingham Street in East Dearborn is dead. This is a nine-story residential
building for low-income elders in the heart of the Arab American community. The
high percentage of Arab Americans in this center (occupying about 78 of the 117
units) makes it safe to assume that many residents will be visited by their
family members on a day like today.

Fifteen minutes of empty
waiting reminds me of the famous “never assume” line. I am here to observe the relationship
dynamics between Arab American elders and their loved ones. I made this “field
trip” in lieu of an organized visit, after leaving several messages to request
an informal interview for my project on the lifestyle and well-being of Arab American
elders.  But the administrator never
bothered to return my calls.

About 3:30 pm.  As I prepare to leave, a woman in the
traditional Islamic hijab enters the parking lot of the center and heads
to the main door where I approach her with caution. I introduce myself, not
mentioning my occupation, and ask about her visit to the center. When she says
that she has come to visit her “poor” mother-in-law, I explain the nature of my
project and she agrees to talk to me if I promise to not use her real name.

Let’s call her Lila.  She is a mother of three, two boys and one
girl; the oldest is a high school senior and the youngest is in the seventh
grade. “Why a ‘poor’ mother-in-law?” I ask. “Because she has to face the rest
of her life alone,” Lila replies.  The
answer is more frank than expected, but the story makes it understandable.

“I got married to her son
in 1992 in Lebanon. I met him during a visit to our town and his mother was
behind this arrangement. When I got my visa I moved to Michigan and two weeks
later I started to help him with his work at his gas station. One year later I
became a mother and I couldn’t help in the business as much as it was needed.
When I got pregnant with my second baby he decided to bring his mother to help
us.

“At the time it was a
great idea. She was a widow for five years and most of her relatives and
friends had left the town in South Lebanon either to go to Beirut or to immigrate,
following their kids. Her help was great, especially after my third baby. I was
able to work more hours while she took care of the kids and the house. She was
not able to go to school for English. And the only time she did something for
herself was when she went to ACCESS (Arab Community Center for Economic and
Social Services) for the citizenship classes.

“Although her social life
was extremely limited, she never complained. The only activity she was able to
do was attend funerals or memorials for people from our town, because I don’t
like to attend and my husband used to take her with him. The only time she left
Dearborn was to visit Lebanon with me and the kids in 1999.

“As the kids became older
and more independent she started to get more bored and agitated. She asked to
do the pilgrimage to Mecca, but couldn’t, because she needed a male relative to
accompany her, and her son told her that he cannot afford to go.  He also refused to let her go back to Lebanon
because she would jeopardize and possibly lose her government assistance.  Since my husband is her only son in the U.S.
(he has a brother in Australia and a sister in Saudi Arabia), she had no real
options.

“Three years ago, after a
lot of arguments and confrontations with him, she reached the end of her rope.
She told him that she is going to ACCESS to find a place to live. He did not
take her seriously until she announced one day that she is leaving. My husband
threatened to not see her or talk to her as long as he lives because she will
bring shame to her family by allowing people to say that he is like the
“Americans” who send their parents to shelters.

“I was not able to do
anything. In principal, I agreed with her. Actually I felt a kind of solidarity
with her. After all, my own experience with her son was not what I was promised
or what I was expecting. This business drive that everyone in the community
seems to be hooked on has no meaning if it is not translated into better
conditions at home, but as you know our men have their own world and they
measure success by the size of their houses and their cars.

“It took me a few weeks
to figure out the situation when she left then I decided to visit her against
my husband’s will. I cannot forget her help and her role in raising my kids;
even if she was a nanny or a maid she should be treated better. Only one of the
kids visits her secretly and she tells me that he brings her back to life when
she sees him. She is now in a better condition. She feels that she has her own
space and she doesn’t regret her decision to leave.  But she never says a bad word about her son.

The stifling heat in the
foyer of the center has pushed Lila to end her story.  I thank her for her time and for sharing her
story- a story that is emblematic of much of the current state of affairs for
Arab American elders. 

Then it was time to turn
my attention to the next step in the inquiry.  
This would be my first undercover journalistic mission in this country:
visiting an elderly woman at her son’s house. The encounter was arranged with
the help of a social worker, with the same promise, that no names would be
used.

To appreciate the reason
for this requirement of anonymity, we should look at the big picture. This is
an emerging ethnic community trying to balance the old way of life in the
motherland with the new facts of life in the new world. Moral claims aside,
most Arab Americans emigrated from states where aging is not an issue. The life
expectancy is a couple of years more than the retirement age at best, and like
most underdeveloped countries, the level of social services and programs
doesn’t extend to the elder population. The same is true for social services in
the community.

Amne Talab, the Director
of Social Services at ACCESS, confirms this parallel. “Our plate is overflowing
with other pressing issues such as refugees, new immigrants, legal, social,
employment, health, mental health and emergency services,” she explained.
“However, the elders are becoming a pressing issue as well, due to the fact
that people are benefitting from the other available services, and are consequently
living longer and requiring elder care services. That’s why we are now working
on a project to address this new area of need.”

Talab is applying for a
grant to start programs for the community elders.  Her main goal is to establish a center to
host activities and services.  She adds,
“At this point we are willing to start with any program, because we don’t have
anything yet.”  But even in the absence
of an exclusive program for elders, ACCESS and similar organizations, such as
The Arab American and Chaldean Center, do have something substantial to offer.

The city of Dearborn, as
well as Southfield and Farmington Hills, which are home to a large number of
Arab Americans, are relatively rich cities and they provide several programs to
serve the elderly segment of their populations.  Social workers in the Arab American community
organizations work with their counterparts in those city governments to access
all the available services for elders. However, the benefits are not distributed
equally for practical and cultural reasons. 

The obvious growing needs
have pushed elder Arab Americans to find their way to available services. But
the numbers tell a different story. The two low-income housing centers in East
Dearborn host a large number of Arab Americans. As in the case of the Kennedy
Center, the Arab American occupancy in Freda Center comprises 79 of its 90
units. However, the proportion differs drastically in the other three
retirements centers in the area that require higher out-of-pocket expenses.
Only 3 units of Hubbard Center East’s 137 units are occupied by Arab Americans.
The number in Hubbard Center West is 7 out of 214, and 31 out of 135 in Sisson
Manor on Mason Street.

While having a home in
residential centers addresses part of the elders’ problems, it also presents
new challenges. The high illiteracy rate among elders, especially women, makes
understanding the rules and communicating with management and providers very
difficult. This issue gets some residents into trouble of their own making.
Some elders use their units to babysit their grandchildren. Others cook and do
laundry for their kids in the centers. The management complains of other
infractions such as receiving guests for sleepovers, using the hallways and
balconies for storage, and misusing the available utilities.  

Most of the elders are in
poor health and lack adequate treatment for their ailments due to the lack of
information about health services.  The
lack of preventive care exacerbates this situation.  But the salient issue is social isolation
which is fed by infrequent visits from loved ones and feelings of guilt for
being away from their families. What makes this problem worse is the tendency
to view isolation as a normal stage of aging and not seeking help to deal with
it.

“This kind of problem can
be dealt with easily if there is someone to help elders understand the rules
and learn about available health and mental health services,” says a non-Arab
American social worker who assists the elders in the low-income housing
centers. “Some problems can be solved with a simple translation or some
orientation in Arabic, but no one is doing it,” she added. 

A similar complaint is
expressed by a healthcare provider who visits the centers to conduct routine
health screening. “A lot of the residents don’t bother to show up for some
basic testing for their vital signs like blood pressure, heart rate, and screening
blood tests,” she explained. “Even the elders who do the tests often will dismiss
the importance of conditions such as high blood pressure, high cholesterol,
bone thinning, and eye and ear problems.”   

Religious and cultural
differences leave some available programs out of reach for Arab American elders
and stigmatize other activities. The city of Dearborn provides a wide range of
recreational and entertainment services such as swimming, cardiovascular
work-outs, movies, dance, music, theater, card and board games and day trips.
The Islamic code on dressing and mixing between genders prevents Arab American
elders from participating in most activities. 
Social perceptions make a simple musical event or watching a movie with
a group a source of embarrassment.

There is no shortage of
sad stories of individual elders residing in housing centers. Each case
deserves a separate article to understand the tragedy of facing the rest of
your life alone. Dying alone to be found days later, being stripped of all
their belonging and assets, and losing their benefits contract because “someone”
changed the information on the application or hid important mail and
notifications sent to the old address are some of the sordid tales. But when everything
is considered, they are still in a better situation compared to those who do
not make the move to independent living.

In front of a typical
Michigan colonial house, a social worker who works with the elderly in addition
to her primary task of helping needy families with their applications for
public assistance is waiting for me in her car.  As I approach her to take me in for my “covert”
mission to meet an aging woman, she looks around to make sure we are not being
watched as we walk up the driveway. “The residents of this street are all Arab
Americans and I don’t want any neighbors to see us coming in. I don’t want to
get the lady in trouble with her family,” she explains.

At the side door of this
three-bedroom home we are welcomed by Hajji Fatimah who ushers us downstairs to
the basement. The Egyptian soap opera is muted on the wide screen television in
the corner of the neatly furnished basement that serves as a living room on
weekends and a family room on weekdays.  Hajji
Fatimah is known by the name “Um Kassem” (mother of Kassem, her first son), a
traditional Arabic way of addressing parents. Quick introductions are made, but
before beginning the interview she insists on making coffee in the corner
kitchenette next to the added room she uses as her bedroom.

Once we are settled with
our coffee, Um Kassem opens the conversation. 
“What do you like to know about me, my son?”  To break the ice, I ask half-jokingly, “How do
you like America, Hajji?”

Her response is earnest.

“God bless America, it is
a great country. They respect people and help them. But nothing is better than
your own country,” she replies. “But isn’t America your country now?” I ask. “Well,
I wish I came here much younger, maybe then I can say yes.  But when I don’t see outside this house unless
I go to the doctor, the social service office, or to a funeral, I cannot say
it.  Back in Lebanon I was free to go
anywhere I wanted in the town, I know everyone there. Here even I cannot visit
the few people I knew from back home. No one has time to take me or to bring
them over.”  

Didn’t you know that
before you moved here?

“We don’t have a lot of
immigration to America in our town,” Um Kassem explains.  “But what I had heard before I moved from
people especially from neighboring towns was mostly lies and exaggerations
about their big houses and big cars and successful kids. No one talked about
being unemployed or on public assistance. I got the impression that they are
living in heaven, which is true but for a small number of people only.”

Why did you move here?

“I lost my husband and my
home during the Israeli attack on South Lebanon in the spring of 1996. My son,
the owner of this house who used to send us some money to survive back home
asked me to join him and his wife (who’s my niece) and kids instead of staying
alone. It took a few months to complete my papers and here I am.”

Do you regret this move?

“It was not up to me. But
I would have been better if I didn’t come. I feel like a captive here. I have
nowhere to go, nothing to do besides babysitting and house chores. My niece
doesn’t work but as soon as I arrived she started to rely on me to help with
her kids, then cooking, then laundry, then everything else. She had two more
babies on top of the other two, and it was normal for me to help. In the
beginning I was occupied with the kids but as they got older and went to school
I got more and more alone, and my daughter-in-law is busy with her friends and,
if not, she is driving the kids to their school and events.”

What are your activities
in your free time?

“I mostly watch Arabic
T.V.  But when the kids are home I cannot
because they watch their own shows or play their games on every set in the
house.  In the summer I walk down the
street to see an old friend of mine. Besides this I go to the doctor and the
social service office when I need to update my papers.”

Have you considered
moving to your own place?

“When I asked my son
about that, five years ago, he got very upset. He accused some neighbors of
trying to start trouble in our house. The second time I mentioned the subject
he brought in a clergy man who told me to stay home.  He said, ‘it is the right thing to do, so we
don’t expose ourselves to strangers, and we don’t destroy our family structure.’  By the way, this clergy man is divorced more
than once and his bad relations with his family are on every tongue in the community.”

Would you be willing to
move out if someone helped you to do so?

“No, I don’t want to
upset my son or embarrass my family.  After
all, I don’t have so many years to live and I’ll be O.K.  I wish that one of my other kids move back to
Lebanon so I can join them there.  Other
than that I am here until God takes back his gift of life.”

Throughout the visit Hajji
Fatimah never mentions her son’s name without saying “God bless him.” It is a
different tone when talking about his wife who “forgot that I was behind the
arrangement of her marriage.” As she walks us back to the door she begs me to
make sure that I don’t make her son look bad in what I am going to write.

Before parting with the
social worker who accompanied me to Um Kassem’s home I ask her what is being
done for people in this situation. “So far, very little. We don’t have programs
or resources. We try our best to help them to get the services that are available,
but the cultural barriers make it difficult even for the little that we can do.  As long as we don’t have a tailored program
that takes into consideration the religious and cultural aspects, our role will
be very limited.”

Such a program requires
funds. To obtain the needed funding, several pieces of data must be compiled:
first, the number of potential beneficiaries; second, the scope of service;
third, establishing the need for a specific program outside the general available
services; and finally, sufficient public support for the issue. None of this
data is available currently.  According
to Amne Talab, there are no surveys or studies concerning Arab American elders.
Fortunately, ACCESS and the University of Michigan are working on a joint
venture to fill this gap.

The lack of information
in this field is what drew the attention of Dr. Sonia Salari.  When she participated in the GSA (Gerontological
Society of America) conference in 2001, just a few months after the terrorist
attacks of 9/11 when the community was under intense media attention, she was
surprised to find nothing about Arab American elders in the program. Dr. Salari,
whose PhD dissertation explores the difference between family and social
support for African American elders, was quick to author a paper on Arab and
Middle Eastern Americans entitled, “Invisible in Aging Research.” It was
published in The Gerontologist in 2002 and was the first article of its
kind, shining a light on this forgotten segment of the community.

Writing this paper was
not an easy task according to Dr. Salari. 
She had her own impressions on the subject from personal experience being
married to an Iranian American man and the good relationship she enjoyed with
her mother-in-law. “I was surprised to find the lack of information not only
about aging issues but about most of the social issues facing Arab Americans in
this country.”

Dr. Salari, who is a Professor
in the Department of Family and Consumer Studies at the University of Utah, Salt
Lake City, made her paper an introductory piece in the absence of any data on
the subject. Since then she became the leading expert in the field helping
scholars and students alike in academic and non-profit circles to better understand
the issue.

“The notion of the strong
familial relationship among Arab Americans families hides the fact that elders
are deprived of some basic services,” she explains. “Although there are a lot
of similarities in issues for all elders, cultural and religious considerations
make it harder for Arab American elders to benefit from the available programs.
On the other hand, the pressing issues facing immigrant communities put the
emphasis on the youth and related needs.”

Dr. Salari considers social
isolation to be the most profound problem facing Arab American elders.  For women in the elderly population, it is
especially challenging if they have gone through the process of obtaining a
divorce.  They often then face further
ramifications from this choice in the form of stigmatization and isolation later
in life.  She encourages more studies to
be done on all these issues in order to understand the problems and formulate
ways to address them effectively.

At this juncture, Dr.
Salari crosses paths with Arab American scholar Kristine J. Ajrouch, PhD.  Dr. Ajrouch is Professor of Sociology at
Michigan State University, Ypsilanti. As Dr. Ajrouch was working on her fellowship
program, “Defining the Ethnic Identity,” she encountered the same vacuum
of information: no data sets, no surveys, and no studies. One of the issues she
addressed when she started her own original research was to critically examine
the recurring notion that “Arab Americans refuse to send aging parents to
shelters, but at the same time, the same people could not define the meaning of
having a grandparent or the role of a grandparent in the family structure.”

Dr. Ajrouch’s work has
been an uphill fight. On an individual level, her effort have been dismissed by
Arab Americans as “a waste of time, because we don’t have a problem.”  On an organizational level, she has been frustrated
with the standard reply, “Even if we define the need, we cannot do anything
about it due to the lack of funds.” Dr. Ajrouch believes that the fact that men
monopolize power and leadership positions in the community organizations
compounds the difficulty in garnering attention and support to this problem.  The male-dominated leadership enjoys the
privileged position of having women continue to cater to them as they age, so
there is little incentive to change the status quo.

Knowing the elders and
interacting with them is the most important step needed at this time, according
to Dr. Ajrouch. She calls for more studies and surveys so that concrete data
can be compiled. However, she believes that community organizations should not
stay idle on the subject because there are small steps that can make a
difference, starting with bringing the elders to the table and listening to
their stories.

There are too many stories
to tell. But as long as aging is not considered an important issue in the
community, those stories will remain personal and will create more frustration
and isolation. It is time to get out of our ‘moral” comfort zone to tackle this
growing need. We can start by bridging the obvious needs with the available
resources.