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The Aging City: In a Migrant Metropolis, When New Arrivals Grow Old, Where Do They Go?

Saturday, April 01, 2017 By Michelle Chen, Truthout | Report
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Seniors at Queens Community House practice tai chi. (Photo Courtesy: Queens Community House)Seniors at Queens Community House practice tai chi. (Photo Courtesy: Queens Community House)

New York is the youngest old city in the world. But the historically youth-obsessed metropolis now faces a "gray wave" of baby boomers, revealing generational fissures crosscutting race and class fault lines. 

While elders face soaring rents and frayed safety nets, the emerging majority of immigrant seniors -- who have increased by more than 105,000 since 2000 -- complicates the demographic landscape. Their stories attest to the city's historic social struggles, stretching from the Gilded-Age surge from Eastern and Southern Europe to the postwar wave of Asian and Latino migration.

But after journeying far in their lifetimes, aging immigrants now struggle to hold onto the roots they've put down in America. Yet their resilience serves as a social anchor for the city's marginalized communities.

Aging in Place

They've struggled through their rough working years, but what happens when seniors age into deepening hardship, especially with the Trump administration planning massive social spending cuts to agencies providing lifeline senior care services?

The median annual income of immigrant seniors across New York is about $9,900, roughly $8,000 less than that of their native-born peers. Although in general, many seniors are stabilized through retirement benefits and Medicare, older immigrants tend to receive fewer resources. About a third qualify for no Social Security payments at all. (Due to harsh restrictions on benefits for green card holders, even many permanent residents are barred for years from federal welfare programs). Many poorer seniors or later arrivals, earned too little on the books during their working years to qualify for a meaningful amount.

While all low-income seniors are vulnerable to food insecurity, immigrants face a disproportionate risk of hunger. They make up some two-thirds of local residents over 60 years old enrolled in the Supplemental Nutrition Assistance Program (SNAP, formerly known as food stamps), which immigrants can access through state programs even if undocumented. About half of community-based emergency food programs, mainly pantries and neighborhood soup kitchens, "reported serving more immigrants over the past year," according to Hunger Free NYC.

Lunch at Queens Community House in New York City. (Photo Courtesy: Queens Community House)Lunch at Queens Community House in New York City. (Photo Courtesy: Queens Community House)

Roughly one in ten aging New Yorkers live in households that struggle for adequate nourishment. In a poor multigenerational household, that means maybe mom skips dinner on some nights so both her kids and grandma can eat enough. If a senior lives alone, she might get her meals at one of city's crowded senior centers, which serve more than seven million meals a year. The centers often provide critical access points for neighborhood-based social services for seniors in their primary languages. Language gaps affect about 60 percent of the city's immigrant seniors (as well as many aging Puerto Rican migrants).

It's often not simply economic poverty, but also isolation that distances seniors from the social service infrastructure. Wariness about interacting with the government is another common barrier for immigrant seniors -- a fear that has swelled across the city amid the post-election rise in xenophobic tensions. 

Still, despite, or perhaps because of, such hardships, ingenuity and resilience have flourished, in part due to tight-knit family networks that operate more communally than non-immigrant family networks do. Overall, about a third of aging New Yorkers live alone, and a dearth of subsidized housing for low-income seniors leaves many struggling to make monthly rent on fixed incomes. But among immigrants, multigenerational households are far more common; about 72 percent of foreign-born grandparents live with grandchildren, compared to just three in 10 native-born residents, which tends to boost quality of life. Research shows that Latino elders, with deep traditions of living in extended families, often age more healthily and live longer. (The opposite pattern, however, is emerging among aging whites, who are growing increasingly socially isolated and experiencing heightened disease and mortality.)

Still, loneliness can persist even in multigenerational networks. Yesenea Esquivel, a social worker who has worked with seniors at Union Settlement, a large East Harlem housing and service organization, said that because so many immigrant seniors have lost family members, "they're the last one in the family still around.... Grandkids, great grandkids -- they're so busy with their own lives." Maybe no one has time to check in on grandma's apartment each day, to ensure she's taking her medicine. Sometimes tensions arise from grandparents living with adult children and young grandchildren being seen as an added burden on the home. Whether they live in the next room or the next block over, often, Esquivel observed, seniors can still be "very socially isolated" and "very on their own."

To fill that social gap, social workers typically do regular home visits and look for issues that might otherwise remain hidden. In addition to facing increased risks of depression and anxiety, seniors are also vulnerable to neglect or abuse, particularly by family caregivers (as when an adult child seizes control of her parent's bank account or lashes out in frustration at a grandmother with dementia).

Andlegal advocates warn that undocumented seniors might keep family abuse secret because, although city policy bars disclosure of immigration status, they fear reporting could lead to deportation for themselves or loved ones.

But intervention can be tricky. "Social workers [abide by] the value of client self-determination," said Sunny Sun, a former social work intern at Union Settlement. As a principle, "unless it's about suicide or very serious problems, you leave the space for the clients and make them decide by themselves.... The only thing you can do is to let them know that you are here. You are always here."

Even if a crisis erupts and a social worker intervenes, her primary task might be just patiently observing as relatives argue across the dinner table. There could be justifiable grievances on both sides -- over financial dependency, feelings of abandonment, or, in immigrant households, awkward culture gaps. In the Chinese immigrant community, for which Sunny and other bilingual staffers were charged with doing special outreach, there might often be language and cultural divides between elder and younger generations, along with traditional pressures on adult children to care for aging family members.

Grappling with such cultural nuances, Sun observed, "It's really hard for you to say to the client that, 'Well, I understand your feelings,' because in reality you can't understand her [unless] you really experience what she had experienced."

Generations of Neighbors

Seniors at Queens Community House participate in an art class. (Photo Courtesy: Queens Community House)Seniors at Queens Community House participate in an art class. (Photo Courtesy: Queens Community House)

Founded in the late 19th century as a social service organization for East Harlem's struggling immigrants, Union Settlementreflects the city's working-class legacy: The surrounding area has long been known as a "portal community" for successive generations of migrant families, from the Irish and Eastern Europeans of the Industrial Era to the Asians, Caribbeans and Central Americans who arrived in the postwar era. For this vibrant but historically marginalized neighborhood, Union Settlement provides a uniquely integrated system of public services for the urban poor in all age groups, including child care, English language and job training, mental health care and youth initiatives, while also engaging aging residents with community-based social support programs.

Since 2014, Union Settlement has run a Naturally Occurring Retirement Community (NORC) for about 1,000 seniors at its Franklin Plaza cooperative housing development, providing case management, health care management and onsite activities. Embodying a progressive approach to community-based aging, NORC's service system aims to respect seniors' autonomy and dignity while providing social supports embedded within the neighborhood's social structure. This holistic aging-in-place model, which the city has seeded in neighborhoods with high concentrations of older residents, is designed to keep seniors out of institutions and hospitals. That's not only less costly in the long run, but also helps preserve the community's integrity and collaboratively helps elders spend their final years with neighbors.

Jan Orzeck, director of Union Settlement's NORC, said gentrification and rising inequality across East Harlem have strained resources for aging community members.

"Local businesses are going out of business ... expensive restaurants and supermarkets are coming in, and some of our people are having trouble managing on a fixed income," Orzeck said. Many elders live on social security, but if they have pensions or savings, they might count as too "high income" to qualify for other programs like SNAP benefits.

"There are major gaps in services ... if they live on anything other than Social Security," Orzeck said. Because Medicaid is generally reserved for extremely poor households, many lower-income elderly do not qualify for government-subsidized home health attendants for long-term personal care services. "That's a major service to helping people age at home.... That makes our program all the more necessary," she added, "because we work with them to figure out a plan about how we can get their needs met," perhaps helping them cobble together personal funds to cope with such deficits.

That flexibility could help buffer urban seniors from Trump's looming budget axe. The federal government supports about a quarter of the city's total senior-service funding, including tens of millions of dollars for housing and service programs, like SNAP and home care, which could see drastic cutbacks.

A senior at the Queens Community House receives a blood pressure screening through the Naturally Occurring Retirement Community (NORC) service system.  (Photo Courtesy: Queens Community House)A senior at the Queens Community House receives a blood pressure screening through the Naturally Occurring Retirement Community (NORC) service system. (Photo Courtesy: Queens Community House)

The NORC model is intentionally nimble and self-directed, but also banks on seniors' inherent resilience -- enabling them to age in a way that, ideally, feels natural. Chinese clients practice tai chi and traditional calligraphy, and West Indian and Latina aunties schmooze at weekly meetings, where members plan the next group shopping or day-cruise outing in a symphony of accents.

Some just come in order to feel like a contributing member of a community. M. (identified here by her first initial to protect privacy), who arrived from Malaysia in the 1970s as a domestic servant for a diplomat, says she's content just helping around the office, volunteering a few hours each week, cleaning and ordering things. If she didn't have somewhere to go every day, she said, "Oh, I think I would die early."

M. has been living alone throughout her adult life, sometimes working several jobs to get by, but she recalls that the city felt safer somehow when she was younger. It feels like a less trustworthy place now, she said, and she's grown more fearful of crime, and generally, of getting close to others. Her friends have died off in quick succession in recent years: One died quietly while watching television; another, while waiting in line to cash her Social Security check.

"They just go to heaven like that," she said. "I miss them so much."

But the NORC, for which M. sees herself more as a volunteer than a client, anchors her to the city, keeps her wanting to be outside. "There is a saying, what goes around comes around," she said. "Because all my life, whenever anyone need help, I do [it for them]," and today when she's in need, "there's always someone to help me." Besides, the office keeps her frenetic work ethic well occupied: "Last one standing," she mused, "last one to lie down."

While some seniors strive to stay standing, others find renewal running in place.

In a cozy sunlit room decorated with flower collages on the ground floor at Queens Community House, a sprawling housing complex in the lower-middle-class neighborhood of Forest Hills, a few dozen elders, ranging in age from about 60 to 80 syncopate at their own pace with the brawny aerobics instructor: South Asian women draped in jewel tones bob along; others strive to balance while shuffling in pajamas and loafers.

Margarita credits the class with helping her get out of bed in the morning. After she was recently forced into retirement from her accounting job, she realized she wasn't ready for life without work, and started idling at home and sinking into despair. "I was in total shock," she sighed. "I said, 'This is death, when you're still alive.'" Her friend Gladys persuaded her to do aerobics and yoga a few times a week. Just having a routine every day now has helped her survive. Besides, she quipped, as a taxpayer, "over the years, we pay for this, so we have to enjoy it!"

Gladys, a member of the Community House's NORC, busies herself with exercise classes, a Spanish conversation group and craft workshops. She's managed to stay actively independent despite having to recently recover from a stroke. Though she is still visited regularly by her children and grandchildren, the longtime single mother goes out of her way to talk to strangers. She gathers at the daily lunch service to mingle with workers and neighbors. "[They] give you a hug," she said. "They tell you, you look so pretty, you look so nice ... We need that kind of words, we need that kind of help."

While Queens Community House generally offers meals and other social programs to all seniors in the neighborhood, since about 2000 it has offered personalized, sustained support services through its Forest Hills NORC program. A central staff helps members manage everyday tasks, staying connected while respecting "self-determination," said director Evelyn Gottlieb.

The office offers a private spot to chat with a social worker or on-site nurse. Over time, NORC members might explore free verse in a writer's workshop, or discover a latent artistic gift in a watercoloring class.

Some might venture into Manhattan for a tour of the Whitney Museum's portraiture exhibit, on a special day arranged for older viewers. In the tranquility of the gallery high above the whirring traffic, seniors can gaze side by side upon Warhol's Elvis diptych or Jack Dempsey's knockout scene immortalized in oils. Whether they're from Russia or the Dominican Republic, the visitors rediscover their adopted hometown as a community of elders.

"What I have seen changed in the time I was here ... is the unity of the community," Gottlieb said. "We are multiethnic, and it all blends together. And because they're all part of one entity ... they become friends. They're all together in building a community."

Copyright, Truthout. May not be reprinted without permission.

Michelle Chen

Michelle Chen is a contributing editor at In These Times and associate editor at CultureStrike. She is also a co-producer of "Asia Pacific Forum" on Pacifica's WBAI and Dissent Magazine's "Belabored" podcast, and studies history at the City University of New York Graduate Center. Follow her on Twitter: @meeshellchen.

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The Aging City: In a Migrant Metropolis, When New Arrivals Grow Old, Where Do They Go?

Saturday, April 01, 2017 By Michelle Chen, Truthout | Report
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Seniors at Queens Community House practice tai chi. (Photo Courtesy: Queens Community House)Seniors at Queens Community House practice tai chi. (Photo Courtesy: Queens Community House)

New York is the youngest old city in the world. But the historically youth-obsessed metropolis now faces a "gray wave" of baby boomers, revealing generational fissures crosscutting race and class fault lines. 

While elders face soaring rents and frayed safety nets, the emerging majority of immigrant seniors -- who have increased by more than 105,000 since 2000 -- complicates the demographic landscape. Their stories attest to the city's historic social struggles, stretching from the Gilded-Age surge from Eastern and Southern Europe to the postwar wave of Asian and Latino migration.

But after journeying far in their lifetimes, aging immigrants now struggle to hold onto the roots they've put down in America. Yet their resilience serves as a social anchor for the city's marginalized communities.

Aging in Place

They've struggled through their rough working years, but what happens when seniors age into deepening hardship, especially with the Trump administration planning massive social spending cuts to agencies providing lifeline senior care services?

The median annual income of immigrant seniors across New York is about $9,900, roughly $8,000 less than that of their native-born peers. Although in general, many seniors are stabilized through retirement benefits and Medicare, older immigrants tend to receive fewer resources. About a third qualify for no Social Security payments at all. (Due to harsh restrictions on benefits for green card holders, even many permanent residents are barred for years from federal welfare programs). Many poorer seniors or later arrivals, earned too little on the books during their working years to qualify for a meaningful amount.

While all low-income seniors are vulnerable to food insecurity, immigrants face a disproportionate risk of hunger. They make up some two-thirds of local residents over 60 years old enrolled in the Supplemental Nutrition Assistance Program (SNAP, formerly known as food stamps), which immigrants can access through state programs even if undocumented. About half of community-based emergency food programs, mainly pantries and neighborhood soup kitchens, "reported serving more immigrants over the past year," according to Hunger Free NYC.

Lunch at Queens Community House in New York City. (Photo Courtesy: Queens Community House)Lunch at Queens Community House in New York City. (Photo Courtesy: Queens Community House)

Roughly one in ten aging New Yorkers live in households that struggle for adequate nourishment. In a poor multigenerational household, that means maybe mom skips dinner on some nights so both her kids and grandma can eat enough. If a senior lives alone, she might get her meals at one of city's crowded senior centers, which serve more than seven million meals a year. The centers often provide critical access points for neighborhood-based social services for seniors in their primary languages. Language gaps affect about 60 percent of the city's immigrant seniors (as well as many aging Puerto Rican migrants).

It's often not simply economic poverty, but also isolation that distances seniors from the social service infrastructure. Wariness about interacting with the government is another common barrier for immigrant seniors -- a fear that has swelled across the city amid the post-election rise in xenophobic tensions. 

Still, despite, or perhaps because of, such hardships, ingenuity and resilience have flourished, in part due to tight-knit family networks that operate more communally than non-immigrant family networks do. Overall, about a third of aging New Yorkers live alone, and a dearth of subsidized housing for low-income seniors leaves many struggling to make monthly rent on fixed incomes. But among immigrants, multigenerational households are far more common; about 72 percent of foreign-born grandparents live with grandchildren, compared to just three in 10 native-born residents, which tends to boost quality of life. Research shows that Latino elders, with deep traditions of living in extended families, often age more healthily and live longer. (The opposite pattern, however, is emerging among aging whites, who are growing increasingly socially isolated and experiencing heightened disease and mortality.)

Still, loneliness can persist even in multigenerational networks. Yesenea Esquivel, a social worker who has worked with seniors at Union Settlement, a large East Harlem housing and service organization, said that because so many immigrant seniors have lost family members, "they're the last one in the family still around.... Grandkids, great grandkids -- they're so busy with their own lives." Maybe no one has time to check in on grandma's apartment each day, to ensure she's taking her medicine. Sometimes tensions arise from grandparents living with adult children and young grandchildren being seen as an added burden on the home. Whether they live in the next room or the next block over, often, Esquivel observed, seniors can still be "very socially isolated" and "very on their own."

To fill that social gap, social workers typically do regular home visits and look for issues that might otherwise remain hidden. In addition to facing increased risks of depression and anxiety, seniors are also vulnerable to neglect or abuse, particularly by family caregivers (as when an adult child seizes control of her parent's bank account or lashes out in frustration at a grandmother with dementia).

Andlegal advocates warn that undocumented seniors might keep family abuse secret because, although city policy bars disclosure of immigration status, they fear reporting could lead to deportation for themselves or loved ones.

But intervention can be tricky. "Social workers [abide by] the value of client self-determination," said Sunny Sun, a former social work intern at Union Settlement. As a principle, "unless it's about suicide or very serious problems, you leave the space for the clients and make them decide by themselves.... The only thing you can do is to let them know that you are here. You are always here."

Even if a crisis erupts and a social worker intervenes, her primary task might be just patiently observing as relatives argue across the dinner table. There could be justifiable grievances on both sides -- over financial dependency, feelings of abandonment, or, in immigrant households, awkward culture gaps. In the Chinese immigrant community, for which Sunny and other bilingual staffers were charged with doing special outreach, there might often be language and cultural divides between elder and younger generations, along with traditional pressures on adult children to care for aging family members.

Grappling with such cultural nuances, Sun observed, "It's really hard for you to say to the client that, 'Well, I understand your feelings,' because in reality you can't understand her [unless] you really experience what she had experienced."

Generations of Neighbors

Seniors at Queens Community House participate in an art class. (Photo Courtesy: Queens Community House)Seniors at Queens Community House participate in an art class. (Photo Courtesy: Queens Community House)

Founded in the late 19th century as a social service organization for East Harlem's struggling immigrants, Union Settlementreflects the city's working-class legacy: The surrounding area has long been known as a "portal community" for successive generations of migrant families, from the Irish and Eastern Europeans of the Industrial Era to the Asians, Caribbeans and Central Americans who arrived in the postwar era. For this vibrant but historically marginalized neighborhood, Union Settlement provides a uniquely integrated system of public services for the urban poor in all age groups, including child care, English language and job training, mental health care and youth initiatives, while also engaging aging residents with community-based social support programs.

Since 2014, Union Settlement has run a Naturally Occurring Retirement Community (NORC) for about 1,000 seniors at its Franklin Plaza cooperative housing development, providing case management, health care management and onsite activities. Embodying a progressive approach to community-based aging, NORC's service system aims to respect seniors' autonomy and dignity while providing social supports embedded within the neighborhood's social structure. This holistic aging-in-place model, which the city has seeded in neighborhoods with high concentrations of older residents, is designed to keep seniors out of institutions and hospitals. That's not only less costly in the long run, but also helps preserve the community's integrity and collaboratively helps elders spend their final years with neighbors.

Jan Orzeck, director of Union Settlement's NORC, said gentrification and rising inequality across East Harlem have strained resources for aging community members.

"Local businesses are going out of business ... expensive restaurants and supermarkets are coming in, and some of our people are having trouble managing on a fixed income," Orzeck said. Many elders live on social security, but if they have pensions or savings, they might count as too "high income" to qualify for other programs like SNAP benefits.

"There are major gaps in services ... if they live on anything other than Social Security," Orzeck said. Because Medicaid is generally reserved for extremely poor households, many lower-income elderly do not qualify for government-subsidized home health attendants for long-term personal care services. "That's a major service to helping people age at home.... That makes our program all the more necessary," she added, "because we work with them to figure out a plan about how we can get their needs met," perhaps helping them cobble together personal funds to cope with such deficits.

That flexibility could help buffer urban seniors from Trump's looming budget axe. The federal government supports about a quarter of the city's total senior-service funding, including tens of millions of dollars for housing and service programs, like SNAP and home care, which could see drastic cutbacks.

A senior at the Queens Community House receives a blood pressure screening through the Naturally Occurring Retirement Community (NORC) service system.  (Photo Courtesy: Queens Community House)A senior at the Queens Community House receives a blood pressure screening through the Naturally Occurring Retirement Community (NORC) service system. (Photo Courtesy: Queens Community House)

The NORC model is intentionally nimble and self-directed, but also banks on seniors' inherent resilience -- enabling them to age in a way that, ideally, feels natural. Chinese clients practice tai chi and traditional calligraphy, and West Indian and Latina aunties schmooze at weekly meetings, where members plan the next group shopping or day-cruise outing in a symphony of accents.

Some just come in order to feel like a contributing member of a community. M. (identified here by her first initial to protect privacy), who arrived from Malaysia in the 1970s as a domestic servant for a diplomat, says she's content just helping around the office, volunteering a few hours each week, cleaning and ordering things. If she didn't have somewhere to go every day, she said, "Oh, I think I would die early."

M. has been living alone throughout her adult life, sometimes working several jobs to get by, but she recalls that the city felt safer somehow when she was younger. It feels like a less trustworthy place now, she said, and she's grown more fearful of crime, and generally, of getting close to others. Her friends have died off in quick succession in recent years: One died quietly while watching television; another, while waiting in line to cash her Social Security check.

"They just go to heaven like that," she said. "I miss them so much."

But the NORC, for which M. sees herself more as a volunteer than a client, anchors her to the city, keeps her wanting to be outside. "There is a saying, what goes around comes around," she said. "Because all my life, whenever anyone need help, I do [it for them]," and today when she's in need, "there's always someone to help me." Besides, the office keeps her frenetic work ethic well occupied: "Last one standing," she mused, "last one to lie down."

While some seniors strive to stay standing, others find renewal running in place.

In a cozy sunlit room decorated with flower collages on the ground floor at Queens Community House, a sprawling housing complex in the lower-middle-class neighborhood of Forest Hills, a few dozen elders, ranging in age from about 60 to 80 syncopate at their own pace with the brawny aerobics instructor: South Asian women draped in jewel tones bob along; others strive to balance while shuffling in pajamas and loafers.

Margarita credits the class with helping her get out of bed in the morning. After she was recently forced into retirement from her accounting job, she realized she wasn't ready for life without work, and started idling at home and sinking into despair. "I was in total shock," she sighed. "I said, 'This is death, when you're still alive.'" Her friend Gladys persuaded her to do aerobics and yoga a few times a week. Just having a routine every day now has helped her survive. Besides, she quipped, as a taxpayer, "over the years, we pay for this, so we have to enjoy it!"

Gladys, a member of the Community House's NORC, busies herself with exercise classes, a Spanish conversation group and craft workshops. She's managed to stay actively independent despite having to recently recover from a stroke. Though she is still visited regularly by her children and grandchildren, the longtime single mother goes out of her way to talk to strangers. She gathers at the daily lunch service to mingle with workers and neighbors. "[They] give you a hug," she said. "They tell you, you look so pretty, you look so nice ... We need that kind of words, we need that kind of help."

While Queens Community House generally offers meals and other social programs to all seniors in the neighborhood, since about 2000 it has offered personalized, sustained support services through its Forest Hills NORC program. A central staff helps members manage everyday tasks, staying connected while respecting "self-determination," said director Evelyn Gottlieb.

The office offers a private spot to chat with a social worker or on-site nurse. Over time, NORC members might explore free verse in a writer's workshop, or discover a latent artistic gift in a watercoloring class.

Some might venture into Manhattan for a tour of the Whitney Museum's portraiture exhibit, on a special day arranged for older viewers. In the tranquility of the gallery high above the whirring traffic, seniors can gaze side by side upon Warhol's Elvis diptych or Jack Dempsey's knockout scene immortalized in oils. Whether they're from Russia or the Dominican Republic, the visitors rediscover their adopted hometown as a community of elders.

"What I have seen changed in the time I was here ... is the unity of the community," Gottlieb said. "We are multiethnic, and it all blends together. And because they're all part of one entity ... they become friends. They're all together in building a community."

Copyright, Truthout. May not be reprinted without permission.

Michelle Chen

Michelle Chen is a contributing editor at In These Times and associate editor at CultureStrike. She is also a co-producer of "Asia Pacific Forum" on Pacifica's WBAI and Dissent Magazine's "Belabored" podcast, and studies history at the City University of New York Graduate Center. Follow her on Twitter: @meeshellchen.