The Forgotten Wounds: Senior Abuse Needs Urgent Attention


Although she immigrated to the United States from Canton, China 13 years ago, Cai E Yu still remembers the meaning of September Ninth on the Lunar Calendar.

The day is the traditional Double Nines Festival, which is also legally designated as the Seniors' Festival in mainland China and Taiwan because the digit "nine" is associated with longevity in the Chinese culture. Young people are supposed to show particular reverence to seniors on this day.

But Yu, 70, is not expecting any kind gestures from her only daughter, who is now 50. Since Yu arrived in the United States on a green card sponsored by her daughter, the daughter has been living with Yu in her rent-controlled apartment in New York's Chinatown. But their relationship started to go sour two years ago, when Yu tried to stop the daughter from idling around day after day with a semi live-in boyfriend whom Yu thought a bad influence.

Since then, her daughter has said things like: "Why don't you die now?" and "Why don't you just go to live in the hospital?" She has also withdrawn money from her mother's bank account without authorization. And she even threw the mother's belongings out of the apartment in an attempt to force her out.

"Sometimes, when they (the daughter and the boyfriend) are at home, I don't dare to go to bed. I am afraid they'd kill me when I fall in sleep," said Yu, who got a court restraining order against her daughter with the help of a community-based organization.

In New York City's Asian community, the population of seniors 60 or older is 93,000 and will more than double in 10 years. It shows the fastest growth among all racial groups in New York, according to the City Council. And the population growth is likely to be accompanied by a growth in abuse cases such as Yu's.

Familial piety is so highly valued in the Asian culture, contributing to the image of Asian Americans as a model minority, that many people, including Asian Americans themselves, don't even realize that senior abuse exists in this community.

"The more a culture emphasizes a certain value, the harder for people from this cultural background to openly talk about behaviors that go against the value," said Peter Cheng, executive director of Indochina Sino-American Community Center, which operates the only senior protection program in the Chinese community in New York.

A Vague Picture

Cheng sensed something wrong two years ago when one of the elderly members of his organization asked social workers there to help him fill out an application for government housing.

Cheng remembered that the man had purchased a co-op apartment just several years ago, and the Center had even hosted a celebratory party for him. "I was very curious why he needs government housing, so I asked. And he told me he spent his whole life savings to buy the co-op apartment in his son's name, (that he) only wanted to get the son a good life. But now his son doesn't want to live with him, and he was evicted," Cheng recalled.

A rough survey among other members found this was not a unique case. In response, Cheng launched the Chinese Americans Restoring Elders (C.A.R.E.) Project, the first and only senior protection program in New York City's Chinatown. The program is run mainly with funds raised by the Center and is operated by one social worker and several volunteers; it takes about 30 cases annually. "There are definitely more cases in the community, if only we had funding to hire more staff," said Cheng.

But nobody knows how many more cases are out there. Even in the mainstream community, the picture of senior abuse is at best vague. Differing definitions and reporting processes among states make it all but impossible to compile national statistics. According to the National Center on Elder Abuse (NCEA), one to two million Americans age 65 or older have been injured, exploited or otherwise mistreated by someone on whom they depended for care or protection. And only one out of six such cases is reported to authorities. (These estimates come from studies completed in or before 2003.)

In New York state, 25,000 senior abuse cases were reported to the Adult Protective Services of the Office of Children and Family Services (OCFS) in 2009. But at least five other government agencies also take senior abuse complaints, and one person could call several agencies to complain, so the number is not considered reliable. State Senator Jeffrey Klein proposed a bill last year calling for the state to establish a consolidated data system for senior abuse cases, but the bill failed to pass.

Data on abuse against Asian seniors is even scarcer. A report released by the NCEA in 1998 found Asians were involved in fewer than 1 percent of the domestic elder abuse cases reported in 1996, the least of all races; whites were involved with 66.4 percent of the cases, the highest percentage. In San Francisco, Adult Protective Services of San Francisco found Asians were involved in about 10 percent of the 2,121 cases reported in March 2001. New York State OCFS doesn't track the racial backgrounds of the victims.

"Issues that affect the general public are often paid more attention than those that affect people at certain ages or ethnicities," said Sharon Merriman-Nai, the manager of the ACEA. "Senior abuse is the type of social issue flying under the radar."

Cultural Conflicts

Certain elements of Asian culture may blur the picture of senior abuse in the Asian community.

"Everyone knows revering seniors is a significant part of the Asian culture, so the other side is easily neglected. In many Asian countries like Japan, people hadn't known the existence of senior abuse until the recent years. And in the U.S., abuse cases are reported and discussed much more among seniors in the mainstream community than in the Asian community," said Tazuko Shibusawa, an associate professor of social work at New York University who studies issues affecting Asian seniors.

Studies specifically focusing on senior abuse in the Asian community are scarce due to inadequate statistics. Still, some comparison has been done between the incidence in the Asian community and that in the mainstream community. For example, in his study of seniors in Nanjing, China and Chicago's Chinatown, Xinqi Dong, a researcher at the Rush Institute for Healthy Aging, found neglect is the most common type of abuse among Chinese seniors, followed by emotional abuse and financial abuse. Physical abuse is rare. Abuse often happened in the victim's home, and adult children were the most likely abusers. The findings are no different than among whites.

But many factors that trigger abuse to Asian seniors are unique, for example, stresses around immigration. "The more seniors rely on their adult children, the more likely they are to become abuse victims," said Cheng of the Indochina Sino-American Community Center. "Many Asian seniors hold green cards sponsored by their children, and they don't speak much English and have few other relatives or friends they can go to. This makes them more vulnerable than seniors in the mainstream community."

Dong added that against the backdrop of immigration, filial piety, although highly valued in the Asian culture, could become a fuse for abuse. "Filial piety requires children to obey the parents and support the parents financially. These are not the obligations of children in the American culture. When the young people cannot meet the expectation of the seniors, it often leads to conflicts," said Dong.

The strong influence of traditional culture also brings challenges to prevention and protection. "The Chinese culture gives higher value to the unity of the family than the individual themselves. It is uncharacteristic for Chinese parents to formally charge their children for abuse. So it is more difficult to discover such cases and provide help," said Dong.

Silent Victims

This has created a group of silent victims, among them 75-year-old Jinfu Liu. Skinny with receding gray hair, the quiet Liu would just look like an ordinary Asian man, except for the scar on his cheek. The scar makes him extremely embarrassed in front of his elderly friends because it was put there by his own son's fist.

In the past two years, his son has beat Liu five times. "Once he punched me, and I fell on the floor and fainted. When I woke up, it took me a long time to figure out why I way lying on the floor," said Liu.

Every time he was attacked, Liu told himself that he'd call the police next time. But he never did. If the latest attack had not left him with a bleeding cheek, he would not have called Gin Lee, a specialist of the C.A.R.E. project at the Indochina Community Center, to seek help. But when Lee suggested helping him apply for a restraining order from the court, Liu declined. "I don't want leave my son a bad record. It will affect his future," said Liu. "My son was actually a good boy when he was young. He respected me a lot, and I also secretly favored him over his siblings."

Lee was not surprised. "Many Asian seniors like to keep silent when they are abused by their children. Even when they have to ask for help, they won't like the cops or the court to get involved. No matter how they are treated by their children, they always think for the children," she said.

Pauline Yeung, an attorney with Grimaldi & Yeung, a New York law firm specializing in aging and disability, agrees. Yeung's firm has handled a lot of cases of financial abuse against seniors, but compared with mainstream seniors, Asian seniors are much less likely to contact an attorney voluntarily. "In most of our senior abuse cases, the victim is exposed during the dispute among siblings over the assets of the senior's. Few Asian seniors would come to us themselves," said Yeung.

Adult protection specialists in other cities voice the same frustrations. For example, Self-Help for Elderly, a senior services organization in San Francisco'sChinatown, takes on about three senior abuse cases every month, but most cases are referred by the city's Adult Protection Services, to which social workers are mandated to report such cases. "It's very rare to see Asian seniors come to us to make complaints," said Vivien Wong, the organization's director of social services.

The Responsibility of the Community

Other than the "face issue" and the concerns for their children, the silence of Asian victims also stems from their ignorance of the concept of senior abuse. Many times, they don't even realize it when they become victims. Cheng, of the Indochina Community Center, said sometimes, when the children don't talk to the older parents for days, this could be construed as neglect. But most Chinese seniors would just think the children were too busy.

Akiko Takeshita, an attorney with Asian Pacific Islander Legal Outreach, a social justice organization that provides legal assistant to senior abuse victims in the Bay Area, agrees. "When abused, many Asian seniors would think this is their fate, or they'd say, my children are rude to me. But if your children take away your jewelry or beat you up, it is not simply 'being rude,'" Takeshita said.

This makes raising awareness an urgent task in the community. But it is not an easy task. Many seniors don't like to attend workshops on elder abuse because of concern that it might signal their friends that they are victims—a "face losing" in their perspective. Service providers have to be creative. "When we offer a workshop, we always tell the audience that this may not be for them, but they can help others after they learn more about senior abuse," said Vivien Wong of Self-Help for Elderly.

A culturally competent approach is the key to victim protection. "Many abusers are family members, and the Asians believe what happens in the family stays in the family," Takeshita said. "Many times the victims don't want to punish the abuser. They only want the abusing to stop. So we have to not only work with the seniors, but also the children, and help them to communicate. So when we are out of the picture, they still can live together."

Sometimes, a social worker's understanding of the victim's language and culture can save a life. Ask 67-year-old Yuying Sun. After she married a Chinese American and moved to the United States five years ago, Sun said her husband and his children treated her like a servant.

After her husband beat her, she was sent to a mental health evaluation institute in a hospital in the Bronx, thanks to his son's 911 call and false report to the police. Sun, who doesn't speak English, was placed in a locked unit with mentally ill patients and no interpreter. Lee, of the Indochina Community Center, heard about her case through a services organization in the Bronx and went to the hospital to see her. Sun told her she was thinking of hanging herself. "I thought my life was totally collapsed and could not see any hope. If she hadn't rescued me, I'd have been dead now," said Sun, who has since been fighting in court for her rights.

"We may only be a small program, but we want people in the community to understand, if you and I don't stand up to fight against senior abuse, many lives of the seniors would be withering in silence," said Lee.

(This story was supported by a Dennis A. Hunt Health Journalism Grant from The California Endowment Health Journalism Fellowships, operated by the USC Annenberg School of Journalism. Names of abuse victims have been altered at the request of the interviewees.)