Sarah Li Zhao


Since the 1990s, the number of older immigrants age 65 and above has increased from 2.7 million to 4.3 million or about 11 percent of all immigrants to the United States. A 2009 report in the New York Times said that “ethnic elderly are among the most isolated people in America.” A study of more than 400 Asian immigrant elders found that 40 percent of them were depressed, demonstrating the association between acculturation stress and depressive symptoms among Asian immigrant populations.

In 2010, when I was a social work intern at the St. Louis Christian Chinese Community Service Center, I worked with older adult immigrants from Asia. Dr. Harold Law, the center’s president and director, told me that older immigrants are sometimes isolated by heavy domestic responsibility for their working adult children, such as child care and housekeeping.

“As more than half of recent older immigrants have limited English language skills, families become their only social and economic support. However, when families can not guarantee a satisfactory late life, older adult immigrants often feel lonely, isolated and/or depressed,” he said.

In my research, I found that older adult immigrants’ depression is mainly associated with life cycle changes, linguistic barriers, lack of family and social support and financial difficulty. There are three major factors affecting older immigrants’ acculturation and social integration.

First, older immigrants are less likely to interact with others, but rely more on family and organizations within their ethnic communities. Second, family dependency can turn to a risk factor if families hinder seniors from building social ties beyond their families. Third, older immigrants have limited mobility due to lack of transportation service and disabilities.

Several strategies can be further developed to address older adults’ social isolation, such as civic engagement, community service intervention, creating aging-friendly communities and direct social work practice with immigrants, refugees and people of disabilities by social service agencies.

The Macklind International Senior Center, founded in 2013 by the Bilingual International Assistance Services, is a good place for non-English speaking seniors to break the social isolation and meet with other older adult immigrants. Since its opening, the center has hosted recurring Albanian, Afghan, Bosnian, Iraqi, Nepali, Somali and Vietnamese-speaking senior groups. It also provides transportation, culturally appropriate nutritious meals and supportive language and educational services to seniors.

Some organizations have developed programs tailored to the special needs of older adult immigrants. The International Institute of St. Louis acknowledges that “arriving in America as an elderly refugee is a daunting task. At an age when one would think about retirement, the individual must learn a new language and adapt to a new culture instead.”

The organization’s services for elderly refugee include independent aging and integration services, such as providing support toward attaining U.S. citizenship, improving cultural competency and language proficiency. Some activities aim to promote socialization as an alternative to isolation. All refugees who are 60 or older are eligible for free services.

Paraquad, one of the first ten centers for independent living (CIL) in the United States, provides independent living assistance services to Bosnian, Albanian and Asian older adults with disabilities. Paraquad offers five core services: advocacy, independent living, information and referral, peer consultation and transition.

Paraquad’s Attendant Services program provides onsite emergency preparedness presentations to non-English speaking residents of senior apartment buildings in St. Louis. Following the presentations, a Paraquad employee will follow up with the older adult immigrants to make need assessments and then refer them to specific social service programs according to their needs.

By 2050, there will be about 16 million older adults immigrants in the U.S. With these demographic changes, there are growing demands for social workers and researchers who are culturally sensitive and responsive to the issue of acculturation and social isolation. In the future, more cultural- and community-based senior centers will be needed to engage older adult immigrants in civic activities with the mainstream population.

To find out more about social integration programs, contact Paraquad, the International Institute of St. Louis or the Bilingual International Assistance Services.

Sarah Li Zhao, MSW, is a Consumer Directed Services (CDS) Specialist at Paraquad. Sarah can be reached at

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