Chinatown Death Triggers Worries About Isolated Elders

SAN FRANCISCO--A tragedy happened in San Francisco’s Chinatown in mid-April. Yee-Shui Mar, age 91, fell from a window in her apartment building.

The Chinese-language newspaper Sing Tao Daily reported that Mar, who was from Taishan City in Guangdong province, lived alone. She had a married daughter and grandchildren living elsewhere.

Mar's neighbors told Sing Tao that she seemed healthy and often went out by herself without her home care assistant. A parking-lot security guard who witnessed Mar's fall said he assumed she accidentally fell when she tried to hang up clothes from her window.

And a San Francisco medical examiner said they are still investigating Mar's case to determine what happened.

Mar's death deepens the fears of many Chinatown elders. Most low-income seniors living there alone worry that they are in unsafe living conditions. Some are concerned that living alone puts them in a dangerous situation.

In-Home Support Not Always Enough

Mar, like many low-income seniors and people with disabilities, had the help of a home care aide through Medi-Cal’s In Home Supportive Service (IHSS) program. But even though the aides check in to see how they are—many elders still worry that the help may not meet their needs. Unfortunately, the state has reduced IHSS services for many vulnerable people because of the budget crisis.

In addition, isolated seniors who are not experiencing health issues or home-safety concerns, may slip into depression, which, if left untreated, may lead to serious mental or physical health problems.

Soong-Kwong Yu, 91, emigrated from Guangdong to the United States 30 years ago. Yu's family, including his wife and three children, all live in the Bay Area. "I know living alone can be a high risk, but I have no other choice. I came here to reunite with my family but, ironically, they did not treat me well when I came. They kicked me out because I earned too little money," Yu said.

Yu has lived in a small room of an old Chinatown building since 1979. He receives 50-60 hours of home assistance from IHSS every month. IHSS beneficiaries saw reductions in hours in 2010-20l1, and a federal judge has blocked a plan by the State of California to slash hours by an additional 20 percent in 2011-12.

The program’s social providers would check in with Yu twice a day and help prepare food for him sometimes. However, Yu still has difficulty preparing his own meals. He used to cook with an electrical hot plate, but it triggered the fire alarm several times, Yu said.

He added, "Security told me that tenants are not allowed to use electrical devices in this building. If I do not follow the rules then I will be kicked out. Therefore, I now only use a microwave, although I'm not familiar with using it."

Falls Are Biggest Concern

Yu’s biggest concern at home is falling, a major worry for seniors nationwide.

"Walking is a tough thing for me. It takes me 20 minutes even just to walk one block," Yu said.

Moreover, he said, "Many of my friends remained healthy in their 80s or 90s, until they died from a fall. I'm worried the same thing will happen to me; therefore, I try not to walk as much as I can. For example, I do not use the shared bathroom on this floor because it is too far away. I do it in my own room instead."

Yu added, “The other way I protect myself from falling is to use a walker or crutch to support myself. When I stand up, I usually stand close to a wall in case I am unbalanced.”

Yu's chronic illness is also a significant concern. "I have a heart issue. Although the social provider checks-in with me in the morning and in the evening, I'm helpless to ask for help at night. I know my heart disease will attack me sooner or later, so I am just waiting for the day when I am taken to heaven," Yu said.

In contrast, Fai Chin, 92, doesn’t worry about his housing or health issues, although he is also a low-income senior living close to Chinatown. Chin is from Hong Kong and he came to the United States to reunite with his family. His adult children live in Bay Area, and relatives living in other states often visit him.

Chin's housing is better than that of low-income elders, such as Yu. Chin has a big room, his own bathroom, and his family covers the cost of a 24-hour caregiver.

"I live alone because I do not want to bother my family. They have their own lives," Chin stated. Safety is not an issue for him: “I have a walker to support myself, an elevator in this building and a great caregiver."

However, Winston Tseng, a sociologist at the University of California, Berkeley, said losing balance and falling down is among the most common hazards for seniors of any income level.

"Many senior falls happen at home and, generally, when they are doing ordinary things like walking on stairs, getting up from bed, or going to the bathroom,” Tseng said.

He went on, “The best way to deal with any home safety threat is through prevention: Check homes for hazards that frequently cause slips, trips or falls and eliminate as many potentially trouble spots as possible."

Examples are removing area rugs that can trip up shuffling feet, replacing tables with sharp corners or at least dulling the edges with rubber bumpers, and making sure baths or showers have grab bars.

Even Well Off Get Depressed

Even though Chin seems to be content with his living conditions and health, his biggest challenge may be loneliness and depression.

"Long life is not a good thing at all. I see my friends pass away one after another. I don't have any friend to chat with, and making new friends is not easy at my age. Sometimes I feel lonely, but I have no solution for this problem," Chin explained.

Hok Lee, a senior case manager at Self-Help for the Elderly, has been managing senior cases and providing elders services for three years. "Yu and Chin's cases are actually better than many other low-income seniors,” she observed. “There are some who live in a small dirty room, cannot walk at all and have no ability to take care of themselves.”

He continued, “Many of them have trouble taking showers because they cannot figure out how to switch from the hot water switch to the cold. Many of them face difficulties on taking food because they cannot remember if they ate yet."

Lee also noted that many social workers in her office face work with fearful elders too scared to see a doctor. "Many seniors reject seeing a doctor because many of their friends died in hospitals. Therefore, they believe hospitals are a horrible place," she said.

Also, she worries about the fate of vulnerable, low-income seniors when the State of California cuts the budget for their programs. "The government is cutting the IHSS budget heavily, and many other low-income seniors' services. I'm worried to see how those seniors can survive under these circumstances," Lee said.

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