This qualitative research study explores the experiences of elderly female filipino immigrantsDocument Transcript
This qualitative research study explores the experiences of elderly female Filipino immigrants. The researchaims to provide a broader understanding of how immigrants adapt to life in America. The study intends to helpensure that the individual experiences of this under-researched group is heard and examined in-depth usingthe phenomenological methodology, which is exploratory in nature.Eleven elderly female Filipino immigrants are the participants of the research, which uses face-to-face, semi-structured individual interviews. They are residents of the city of Vallejo in California, about 40 miles from SanFrancisco. In terms of characteristics, they are all widows, age 65 years or older, born in the Philippines, ableto communicate verbally, able to read and write English, living in the US for at least five years, and willing toshare their experiences and feelings about the topic of this research study. They are generally highlyeducated, three with Master’s degrees, six with Bachelor’s degrees, and the rest either with some college, highschool or elementary education.Five themes have emerged from the data: 1) Traditions in Courtship, Marriage and RaisingChildren/Grandchildren, 2) Teaching Filipino Values, 3) Faith and Belief in God, 4) Connecting and Keeping inTouch, and 5) Making the Most of Living in America. Their stories revolve around three essential experiences,namely: 1) Their Changing Roles from Wife, Mother, Career Woman to Caregivers for their Grandchildren, 2)Using their Spirituality and Psychological Resilience as Coping Mechanisms, and 3) Connecting, Reflecting andRecreating their Life in America.Though the participants experience separation from nuclear or extended family as well as social networks,research findings reveal that they do not currently show signs of psychological distress. The results also showthat their family relationships, spirituality, resiliency and social support are the glue that binds them togetherand helps them maintain stability and congruence in their adopted country, the United States of America.
Purpose of the StudyThis study is exploratory in nature, and the primary objective is to investigate the world of elderly femaleFilipino immigrants and uncover their stories using the qualitative approach of phenomenology. The results ofthis study may serve as an initial step in focusing attention on the mental health issues in this population sowe can better understand the needs of elderly Filipino immigrants.A related goal of this study is to substantially increase the knowledge about elderly Filipino immigrantsbecause currently, there is scant literature on this population. Furthermore, the results of this study can assistin developing culturally appropriate recommendations for policies and practices of mental health service-delivery systems to effectively meet the needs of elderly Filipino immigrants. By focusing on their stories, thisstudy ultimately provides this population a voice that is rarely heard.Problem Background Over the last few decades, there has been a significant increase of Asian immigrants to the UnitedStates. Concurrent with these increases, the elderly population has also increased. The two most rapidlygrowing segments of the elderly population in the United States are Hispanics and Asians. This has been aresult of immigration from Asian and Latin American countries, particularly the Philippines andMexico. Immigration has had a major impact for immigrants and the host country. Immigrants face manychallenges associated with new values, norms, traditions and patterns of interaction in their newly adoptedcountry. The usual familial ties are not always available to them (Agbayani-Siewert, 1994). A study by Bemak& Chung (cited in Weisman et al. 2005) explains that across cultural groups, the stresses or immigration aremore severe for elderly people compared to their younger counterparts. In addition, a study by Salcedo(2003) on a community sample of 203 adult Filipino immigrants living in the San Francisco Bay Area foundssymptoms of depression, anxiety and psychological distress among Filipino immigrants, prompting the needfor finding effective ways to work with this population. Skilton-Sylvester (1998/99) further explains thatelderly immigrants face more challenges in their new host country than their younger counterparts. Researchstudies on elderly Filipino immigrants are also conspicuously absent because much of the research has beenbased on the experiences of Chinese, Japanese and Korean people. It is therefore a misconception to assumethat Filipinos share identical experiences with other Asian ethnic sub-groups because not all of thesepopulations share identical experiences, histories or cultural practices. Besides, there exist within thesesubgroups variations in faith, immigration, language and experiences (Rodriguez, 2001).Research QuestionsThe fundamental research question is: What is the lived experience of elderly female Filipino immigrant inAmerica? The study also asks the following research questions: 1. Why did they immigrate to this country? 2. What is their life story? 3. What is it like living in America? 4. What difficulties did they experience as new immigrants to this country? 5. What services, support systems or community resources do they utilize? 6. How do they cope with day-to-day challenges? METHODOLOGYRationale for Research Approach and Study DesignThe qualitative approach using phenomenology is used for this study. Phenomenology is a qualitative researchmethod, developed by philosophers, Edmund Husserl along with Heidegger, Sartre, Merleau-Ponty in the early20th century. It is the study of structures of consciousness from the first-person point of view along withrelevant conditions of experience (Smith, 2003). It generates a large quantity of interview notes, taperecordings and other records used for analysis.This method offers the most effective way to capture the essence of the lived experiences of the researchparticipants as elderly immigrants. Through phenomenology, the researcher is able to uncover these unheardvoices and gain a richer understanding of their unique individual experiences. The semi-structured interviewprocess uses open-ended questions with an interview guide. Based on the literature review, phenomenology isthe method of choice by researchers conducting research on ethnic minority populations (e.g.,
Soonthornchaiya, R. (2004) on Perceptions of depression among elderly Thai immigrants; Rodriguez, D.(2003) on A phenomenological study of the realities of Filipino American college students in the Midwest; DelaPaz, M. (2004) The role of spirituality in how Filipino immigrants conceptualize and cope with crises; Faustino,J. (2003) on Perceptions and attitudes of older Filipinos Americans towards mental illness; Lee, K. (2005)Images of God among Korean immigrants; Meneley, M. (1999) on Looking at frailty: a phenomenologicalstudy of elderly women (Canadians) living alone in the community).Setting and ParticipantsThe researcher utilizes a purposive sampling procedure with select information-rich cases strategically andpurposefully. This means that research participants are of a specific population (elderly female Filipinoimmigrants), strategically living in a specific location (City of Vallejo), are members of a Filipino seniororganization and/or attend the lunch program at a specific site (Bayanihan Center). The Bayanihan Center is astrategically information-rich location where elderly Filipinos gather daily to eat lunch. The selected elevenparticipants who meet the following selection criteria: 1) female Filipino immigrant widow, 2) age 65 years orolder, 3) born in the Philippines, 4) able to communicate verbally, 5) able to read and write English, 6) livingin the US for at least 5 years, and 7) willing to share her experiences and feelings about the topic of thisresearch study. All of the participants except for one agreed to be interviewed in their homes. All interviewsare audio-taped, lasting approximately 45 minutes. Second interviews are conducted to validate transcriptsand data. Participant’s Demographic Profile Years Level of Participant Age Previous Occupation Religion in US Education#1 78 16 City Schools Supervisor & Former Non- Master’s Degree Principal/Teacher Denominational#2 76 23 Teacher/University Professor/Court Catholic Master’s Degree Interpreter#3 87 33 Teacher Catholic Bachelor’s Degree#4 81 15 Homemaker Catholic Some College#5 87 23 District Supervisor/Teacher Catholic Master’s Degree#6 82 21 Homemaker Catholic Elementary School#7 77 23 Teacher Catholic Bachelor’s Degree#8 79 23 Teacher Catholic Bachelor’s Degree#9 77 30 Teacher/ Guidance Counselor/ Keypunch Catholic Bachelor’s Degree Operator# 10 85 27 Teacher Catholic Bachelor’s Degree# 11 91 18 Midwife/ Politician Catholic High School Graduate RESULTS, DISCUSSION AND LESSONSThe results of the study are interpreted based on past and current literature review. Lessons learned arepresented in the framework of the Filipino family; characteristics, traits and values and coping strategies. Thefollowing themes and sub-themes were extracted from interview transcripts, individual narratives, andsignificant statements of the eleven participants.The Filipino Family, Its Characteristics, Traits and ValuesAndres (1981) notes that the Filipino family is the basic social unit that contributes and maintains Filipinovalues. The family is also seen as the security blanket that supports and protects its members in time of
need. The Filipino family’s most striking quality is the focus on reciprocal obligations among family members(Hong and Cheng Ham, 2001). The data collected from this research study support this as all of the elevenparticipants discussed the importance of family. Additionally, Filipino grandparents view the care-giving role asa normative process rather than a burden. This is a result of Filipino values and norms of pakikisama (smoothinterpersonal relationships), utang na loob (debt of gratitude), familism and authoritarianism (Andres,1987). The cultural value of pakikisama fosters good feelings and harmony among familymembers. Familism places a high value on the welfare and interest of the family. Every effort is exhausted tohelp family members with their needs and concerns. All of the eleven participants have positive comments andexperiences about their caregiving role. They considere it as more satisfying than stressful.Another cultural value is Folk Catholicism, which has also been described assplit-level Christianity. This consists of two or more thought and behavior systems; that are inconsistent witheach other. Gorospe (1998) notes that historically, this constitutes a blend of the pagan beliefs of pre-SpanishFilipinos combined with Christian beliefs and practices. An example is, early Filipinos believed in a Godcalled Batula, guardian spirits called anitos, high priestesses called baylans, and celebrated pagan ricefestivals. With the coming of Christianity, they substituted the Christian God forBatula, patron saints for theguardian spirits, the parish priest took the place of the baylans and the town and barrio fiestas for the paganrice festivals. Interview data results show all ten participants are practicing Catholics except for participant #1who was a practicing Catholic before she became non-denominational. The ten participants considerthemselves religious but they are also superstitious. They pray to God and the saints; they pray the rosaryand read the Bible but also believe in wearing of amulets and lucky charms and ritual dancing before saints togain favors.Interview data results also affirm that religiosity, belief and faith in God are central to their lives. Theirexperience about how their faith has been instrumental in dealing with life’s challenges and adversity cannotbe understated. Religion is central to Filipino life. It “enables people to face reality with strength andoptimism” (Tompar-Tiu & Sustento-Seneriches, 1995, p.116). Some of the religious practices reported by theparticipants are attending mass, praying the rosary and novena, devotion to saints and the Virgin Mother, HolyCommunion, reconciliation and observing religious holidays and rituals. Dela Paz (2004) has similarconclusions in her study of how Filipinos use spirituality and religion as a coping mechanism. Theseparticipants believe that certain illnesses that cannot be treated by traditional medicine can be treated throughdivine intercession, praying to a particular saint and praying to God. The participants’ strong faith in thehealing powers of prayer remains a central theme in their lives.Other characteristics that are validated in this research study are perseverance and resilience. Tompar-Tiu &Sustento-Seneriches (1995) note that Filipinos are resilient. They have been known to withstand centuries ofcolonization from Spain and the United States. It is also known that Filipinos easily bounce back from theravages of yearly natural disasters (such as typhoons, floods and earthquakes). Their ability to adapt, copeand rebound from vicissitudes is evident in the interview data results. Additionally, the term, psychologicalresilience, defined as the individual’s ability and capacity to withstand stressors, explains the absence ofmental illness or psychological distress among these participants. A research study by Nygren et al. (2005) onresilience among 125 elderly Swedish men and women supports my findings. The study shows that resilience,sense of coherence and purpose in life are the driving forces and strengths that contribute to a person’s abilityto meet and handle adversities” (p.354).All of these participants show inner strength, brave endurance, a sense of coherence, and tenaciousresilience. Their resilient nature has immunized them from developing anxiety or depressive-likesymptoms. Except for symptoms of grief due to the loss of their spouses, none of the participants have shownsigns of depressive symptoms or suicidal thoughts.Social SupportThe role of social support is a significant aspect of this research project. Strong peer and communal support isan important resource that elderly Filipino immigrants rely on. Forming social relationships and social networksthrough the Filipino senior organizations provided a safe haven for the eleven participants in thisstudy. Denison (2005) notes in her research that regular participation in leisure activities impacts the wellnessof the elderly. Several authors have also found that socialization with friends or relatives, volunteering, goodnutrition and exercise contribute to successful or vital aging. A 1991 study by Russell & Cutrona (cited inDennison, 2005) has found that high levels of social support protect a person from the negative effects ofstress. Additionally, supportive relationships are linked to good physical and mental health. The results of thisstudy validates these findings. The participants that have strong social ties and support from others are inbetter physical and mental health. Participants have also stated that socializing with their peers who speak
their language and share their same culture give them a sense of security and sense of belonging. Regularattendance at events and activities make them feel happy, relaxed and less worried.Although my research findings reveal that these eleven participants are emotionally balanced and mentallyhealthy, I will not completely rule out the possibility of some degree of psychological distress. This is due tothe cultural factors and traits of “hiya” (shame), “bahala na” (come what may or optimistic fatalism), stigmaand family loyalty which are tied to maintaining the notion of keeping things within the family. Faustino’s(2003) research study on five elderly Filipinos in Chicago found that they “perceive stress, forgetfulness andmental deterioration as factors congruent with the aging process. They are also disinclined to discuss theirproblems with other individuals outside of their close interpersonal sphere” (p.51). Furthermore, thisconclusion does not mean that this group does not need support. What it means is that mental healthprofessionals and health care providers should continue to ask questions and assess elderly Filipinos’ needsusing culturally appropriate methods. This preliminary work should lead to a more in-depth contextual study ofthis population that will look into cultural factors and norms before any conclusions can be drawn. Asmentioned in the limitations of this study, because of the small sample of participants, the results cannot begeneralized. CONCLUSIONA significant conclusion from this study is that the successful integration of the participants into the unfamiliartraditions of American life depended on their post-migration experience, communication skills, educationalattainment and awareness of the new host culture. Participants # 1, # 2, # 4, # 5, # 7, # 8, # 9 & # 11 wereall college-educated or had careers, lived in the city of Manila or a big town in the province and now liveindependently. They have supportive families and an extensive social network of Filipino friends andorganizations. They also live in a community where there is a marked presence of Filipino Americans, (Vallejo,California is home to 25,000 Filipino Americans or 20% of the total population of 116,000) therefore they areable to maintain their Filipino traditions and do not have to exert much effort in transforming their traditionsinto the new American culture. They do not report high levels of distress other than loneliness and feelinghomesick when they were new in America. Their common response was, “I had to adjust when I came here. Itwas different, but because I spoke good English, I was able to communicate. I was lonely and homesick at firstbut I was busy with my grandchildren, then I met fellow Filipino seniors. I knew I was going to take care of mygrandchildren and I wanted to help my children. That’s the Filipino culture.” They have transitioned mucheasier and have expressed feelings of being content and happy as they reflect on their experiences. The otherparticipants, # 3 # 6, and # 10, who have expressed some difficulty in adjusting as new immigrants talkedabout how they cope with the new challenges through perseverance and draw upon their spiritual and religiousbeliefs. Their common response is, “I just prayed to God to help me deal with these problems. I alsopersevered and hoped that things would get better and they did!”These findings are similar to Yun’s (1997) study of 95 elderly Korean immigrants who used religion andspirituality to gain psychological comfort and peace of mind. Yun (1997) concludes that spiritual, religiousbeliefs and social aspects of religious activities help mitigate depressive feelings. Soonthornchaiya (2004) hasfound that the practice of Buddhist teachings and meditation are the primary coping strategy for 20 Thaielderly immigrants living in Chicago.All of the eleven participants validate the results of a study of six Filipino grandparents in Hawaii by Kataoka-Yahiro, Ceria & Yoder (2004). This study notes that despite the great demands of energy required by thegrandparents’ caregiving role, these grandparents do not perceive their care-giving role as a burden. They allstate, “It is a joy taking care of our grandchildren.” They all agree that it is fun to be a grandparent and theyare lucky to be grandparents.Burt’s (1998) study of 14 elderly female homebound widows in San Diego has discovered levels of satisfactionin their lives. She has found that they identify with faith and belief in God as sources of strength. They havebeen successful in balancing dependence and independence as well as a sense of determination and ability toadapt to present life situations. In essence, I conclude that my eleven participants have achieved a successful balance between familiar andunfamiliar experiences. This study has found that all participants have found their purpose in life allowingthem to have a positive view of the future. These participants remain optimistic that they will have many moreyears of good health, although they are prepared for the inevitable, death. All of these participants fit thedefinition of good mental health as defined by Jaffe & Segal (2004) who state that good mental health is notjust the absence of mental health problems, it is also the presence of the following characteristics:
A sense of well-being and contentmentA zest for living - the ability to enjoy life, to laugh and have funResiliency - being able to deal with life’s stresses and bounce back from adversitySelf-realization - participating in life to the fullest extent possible, through meaningful activities and positiverelationshipsA sense of balance in one’s life - between solitude and sociability, work and play, sleep and wakefulness, restand exerciseA sense of well-roundedness - with attention to mind, body, spirit, creativity, intellectual development, healthThe ability to care for oneself and othersSelf-confidence and good self-esteemThese participants are a unique group of elderly immigrants who willingly shared their stories with me. Confirmingwhat have been stated, family relationships, their spirituality, psychological resilience and social support are theglue that binds them together and helps them maintain stability and congruence in their adopted country, theUnited States of America. Implications for Policy and Practice Though the findings of this study do not show any serious mental health concerns, it is important forpractitioners and policy makers to take a closer look at the underlying dynamics associated with thispopulation’s post-immigration experience. Elderly Filipino immigrants are aging and have physical ailmentsthat need attention. We know that current literature asserts the importance of maintaining social order withinAsian and Filipino families. Clinicians or health care professionals will need to be aware that elderly Filipinoswill not always seek outside help. They will exhaust all internal family resources before accessing services. Inaddition, the emphasis on filial piety and responsibility where loyalty to the family is a lifetime commitmentremains of great importance. Filipino families place a high value on cooperation among its members andprotecting them. Even contemporary Filipino Americans continue to function using interdependent anddependent relationships. These are based on extended family members, group harmony, and respect forelders and kinship that go beyond biological connections. Therefore, awareness and knowledge of who isconsidered the head of household in the family have to be ascertained at the very beginning of servicedelivery. This may not necessarily be the elderly client herself; it could be the eldest son or daughter in thefamily with whom they live.Elderly clients are also careful not to complain and talk about family concerns or problems with people outsidethe family. So it is important to establish rapport and trust in the beginning phase of treatment or servicedelivery. They are known to endure hardships and are tolerant of others and may minimize theirsymptoms. Their persevering quality and resilient nature have to be taken into consideration when assessingtheir needs and concerns. Clinicians or health care providers also need to be aware of the importance ofprayer, church affiliation and spiritual beliefs. With the client’s permission, service providers can incorporateprayer and spiritual counseling in the treatment plan.The findings also show the importance of both informal and formal social support. The eleven participantsattend events and activities at the Filipino Community Center and the Bayanihan Center. I would recommenddelivery of services at these centers where elderly clients are most familiar. These services can range frommonthly educational topics on physical and emotional health, how to access community resources andcholesterol, diabetes and blood pressure screenings. Services can also include recreational and physicalactivities; all of the participants mentioned that they enjoy ballroom dancing, folk dancing andsinging. Staffing these with bilingual clinicians and health care providers would be most effective andbeneficial. My participants echoed the need for accessible services that are linguistically and culturallyappropriate.By utilizing the research method of phenomenology, this research has made significant inroads into effectively
reaching a population that is guarded and tight-lipped when it comes to discussing personal feelings andfamily relationships. Having a basic understanding of the culture of this population and therefore, knowing“what makes them tick,” as provided by this project, help gain their trust. It encourages this particularpopulation to express their emotions and reveal relevant information that are otherwise tightly guarded.