by Nichi Bei Weekly/New America Media, News Feature, Tomo Hirai
BERKELEY, Calif.– With a racial and age demographic shift on the horizon, Stanford University Medical School launched a mini-fellowship to educate the public on how they can serve ethnic minority seniors.
Through it, gerontologist Laurie Ulrick developed a project for Japanese American seniors to pass on their life experiences and cultural values, but she found that working with this group was more difficult than she anticipated.
Legacy Message on Values, Ideas
Ulrick typically helps older adults with housing issues, and offers workshops to help them tell their own life stories. Although she is not of Japanese descent and wasn’t looking to work with a specific ethnic group, Ulrick developed a workbook to help Japanese American seniors write a legacy letter for future generations through Stanford’s Internet-based In-reach for Successful Aging through Education Program (iSAGE).
“It’s called ‘Letters to the Future,’” she said. “By the end of doing this they will have produced a letter to their family or friends, or even to the community at large about their values and ideas about life.”
This “ethical will,” or a “legacy letter,” is written by elders in a family or community to record and pass on their personal beliefs to the next generation. While her project focused on Japanese Americans, Ulrick said she participated in the program to learn how to better help elders of all ethnicities and offer more culturally sensitive services.
The aging population is becoming a major issue for Americans, said VJ Periyakoil, MD, director of the iSAGE program. “The term some people use is the ‘silver tsunami.’ Actually, it’s more of a silver-brown tsunami because the number of ethnic elders is increasing in leaps and bounds,” she said.
Stanford has been trying to promote successful aging for multicultural older adults by training doctors and clinicians, but found it was not enough, Periyakoil said, so university began offering a free mini-fellowship to anyone wishing to take the course.
“We have over 150 graduates in our program in less than 20 months,” she said. The iSAGE mini-fellowship considers new fellows each month. The 40-hour course is mostly conducted online, in addition to the community project.
Ulrick said she chose to work with Japanese Americans because of past experience. She was hired to compile the life story of an elderly Japanese American woman during the final five months of her life. “After that experience, I felt even more interested in the culture,” she said. “But working with a group is–radically different.”
She worked with the J-Sei Senior Center (formerly known as the Japanese American Services of the East Bay), based out of the Berkeley Methodist United Church in Berkeley, Calif., to present her project during its lunch program in the summer of 2013.
A New Approach
Considering the brief time she had to work with the seniors, Ulrick chose to do what gerontologists call an ethical will, or legacy letter. However, her initial lunchtime presentation at the center was met with silence.
“I modified my approach each time, becoming more and more indirect, until I sat at the table behind everyone else and just waited for people to come to me. And that approach worked,” she wrote in a report she presented to Periyakoil.
With few seniors participating during lunch, however, Ulrick decided instead to create a workbook to help J-Sei’s seniors write letters on their own.
Periyakoil, who mentored Ulrick’s project, observed, “I know how healing that can be. So when she talked about a culturally tailored intervention with a legacy letter for older adults to write to the younger generations, it’s very congruent with previous work we’ve done with our patients. We know how much the family values those letters.”
“I thought it was a good idea,” said Vickie Kawakami, site coordinator of the senior center. “I knew it was going to be difficult, because they don’t consider themselves writers, And, as in the Japanese community, they don’t talk about personal things.”
She noted that the seniors have consistently declined to share writing done in the center’s writing class.
Kawakami said one senior who participated in Ulrick’s program wrote a letter to her daughter. While Etsu Date did not consider herself a writer, she wrote a thank-you letter to her daughter and son-in-law, who took her into their home after she suffered a fall.
“I know it intrudes into their privacy, but I was all alone and my back was fractured,” said the 93-year-old Date. She plans to give the letter to her daughter once she is gone. “It’s just to thank her for her sacrifice.”
Ulrick said other seniors had previously written similar letters, but her work with this group did not produce any other letters, Kawakami said.
The experience, however, taught Ulrick some valuable lessons. She realized that such letters are far more effective when it is a multi-generational endeavor.
She explained, “I realized at the end of it, the best people to bring it to are the family. It would be much more effective, relieve isolation and pass down stories.” Kawakami recalled the family she worked for also explored their own Japanese American roots through their grandmother’s life story.
Kawakami said the seniors in the center’s writing class, while reluctant to share in public, seem to share their work with their families. While Ulrick’s project was not a complete success, she said she has since applied the workbook’s materials in her private practice, titled Narrative Time,
and continues to work in the Bay Area.
While Periyakoil said her mini fellowship enables its graduates to advance in their professions, she said she has had gratifying cases where the work born out of the program continued after the fellowship’s three-month timeline. The fellowship is free and Periyakoil encourages more people to apply online at the iSAGE website.