Who Will Take Care of Aging Sansei?




Maggi Yaguchi (seated, left) with her mother, Kikuyo Utsumi (seated, right) and sister Aiko Backhus (standing). (Ken Matsui Images Photography)

(This is Part I of a two-part series on the challenges associated with increased longevity among Japanese Americans.)


Sansei retiree Maggi Yaguchi of Long Beach knows well what it means to care for an aging parent. Seven and a half years ago, she helped her Kibei-Nisei mother, Kikuyo Utsumi, transition to a Keiro Senior HealthCare facility.

Utsumi is still spry at 99 years old. Yaguchi is 77 and has been widowed for 28 years.  Her husband, John, was killed in 1983 by a drunk driver.  Although Yaguchi is healthy and active today, she can’t help wondering what would happen if she could no longer take care of her mother or herself.  Would she and Mom one day live at Keiro at the same time?

As a breast cancer survivor, she knows that life can occasionally throw you a curve ball.  Her “pink journey,” as she calls it, helps her to view the uncertainties of life with new resolve.

Kimberly Nakashima

“I don’t think about age a lot, but (the fact is) I’m old,” Yaguchi says, explaining that she follows a personal fitness regimen that includes eating healthy foods and exercising both her body and her brain by golfing, getting involved at church, and volunteering at Keiro.

Still, like many young-old Sansei, she is asking, “Who will take care of me?”

The Yonsei are the logical designees, but the majority is still in school or working.  Many are raising young families. Others are already in their fifties or older.

One Yonsei, 25-year-old Kimberly Nakashima, understands what it means to be a caregiver. Nakashima had just finished college last year when she learned that her 87-year-old grandmother needed help getting around. Nakashima provided transportation and assisted wherever she could.  “I was surprised at what a big responsibility it was,” she says.

Eventually, as her grandmother’s condition required more frequent professional attention, Keiro became the best option. Nakashima had developed a strong bond with her grandmother and harbored preconceived notions about nursing homes. To continue her connection with her grandmother, she volunteered at Keiro’s Intermediate Care Facility (ICF). “Immediately, everyone knows her name and my name, too. Some of the residents hug me every time I go,” states Nakashima.

Nisei community leaders who founded Keiro in Boyle Heights 50 years ago saw a need for a senior care facility for aging Issei. Today, Keiro operates five different sectors — two nursing homes, an intermediate care facility, The Institute for Healthy Aging, and a retirement home, one in Boyle Heights and another in the South Bay.

Soon, organizers in Seattle, Chicago, Northern California, and Hawaii were creating their solutions to the aging JA communities.

Nisei in the Washington area formed Nikkei Concerns (formerly Issei Concerns) to address issues facing the older generation. In 1976, the group purchased a 63-bed nursing home in Seattle’s Mount Baker neighborhood, and then in 1987 built a 150-bed facility. To serve residents that required special care due to dementia, Seattle Keiro Garden Terrace was opened in 1997, followed by construction of Nikkei Manor, a 50-unit assisted-living facility, in 1998.

Chicago’s Nikkei community responded to the need for subsidized housing for seniors and the disabled and in 1980 built Heiwa Terrace, which is operated by the Japanese American Service Committee Housing Corporation. Heiwa Terrace is recognized by the U.S. Department of Housing and Urban Development (HUD) as one of the city’s top senior housing buildings.

The latest California complex to be completed is Nikkei Senior Gardens, an assisted-living facility that provides professional services such as wellness monitoring, medication assistance as well as assistance with everyday activities such as bathing and dressing. Located in Arleta, a San Fernando Valley residential community, the apartments are near the 40-year-old Japanese American Community Center, Buddhist church, and Nikkei Pioneer Center.

Medical advances and the proliferation of up-to-date health information mean that people are learning to live healthier and longer, and Japanese Americans, as a group, live longest of all. Nisei are surviving beyond age 80, 90 and even 100. In fact, at least 20 centenarians reside at Keiro at any given time.

Some 21.5 percent of the 1.3 million JA population is over 65, making it this country’s oldest ethnic group. By comparison, the overall number of 65-plus U.S. residents is 12 percent.

People in Japan have begun to look at how the U.S. is addressing the needs of a growing senior citizen population. One team of real estate developers has formed the American Japanese Agriculture of Los Lunas, a limited liability corporation that seeks to build a retirement community for retirees from Japan

According to a report in the New Mexico Business Weekly, developers Max Kiehne of New Mexico and Hitoshi Hoshi of Japan hope to build the retirement community on a 500-acre section of Mesa del Sol, a master-planned site near Albuquerque International Sunport.

With the high cost of homes and rental property in Japan, New Mexico presents an affordable alternative to retirees. Kiehne says that, for example, a family living in Japan can expect to pay $3,000 to $5,000 a month in mortgage or rental payments compared to $1,000 a month for the same size house in New Mexico.

Hoshi recently purchased a home in Los Lunas along with a 360-acre tract and a 150-acre tract in New Mexico’s Santa Fe County.

Despite the seeming proliferation of sophisticated and culturally-sensitive housing and health-care services created by and for Nikkei, the ultimate solution lies in looking at the complexity of issues and the community as a whole, says Shawn Miyake, president and chief executive officer of Keiro Senior HealthCare.

There is a minimum two-year waiting list at Keiro, and the residents include older Nisei, Sansei, and Shin Issei immigrants. There are mixed-race couples and transplanted seniors from Japan.

Dietary preferences have changed, and volunteers have become an essential part of the day-to-day activities.  Keiro volunteers number about 1,200.

When Miyake first arrived to lead Keiro, Issei comprised a large segment of the retiree population.  Food preferences and language were the number one and number two priorities.  “Now it’s security and transportation,” he says.

Elderly Issei enjoyed ikebana (flower arranging) and shigin (song-poems), but now the Nisei retirees are asking for poker and mah jong and want to watch Korean soap operas on television.  “In the past, there was no way the residents would want to watch Korean TV,” Miyake recalls.

Nisei are vocal yet tend to retain Japanese values. Décor in the living quarters at Keiro reflects this. The Nisei enjoy decorating with Japanese-style wall hangings, dolls, and trinkets. On the other hand, Shin-Issei and those more recently arrived from Japan prefer a more westernized ambiance.

Miyake expressed concern that the Nikkei in America may be lulled into “thinking our community has no issues.” Aging, he asserts, is a key issue “and has been for the past years.”

Those over 65 are already 21.5 percent of the JA community, Miyake reminds us.  “When the mainstream population reaches the same level — one-fifth of the population in 2050 — the country will not be ready,” he warns.

“We can try fixing the health-care system,” he adds, “but the underlying problem is health.”

Maggi Yaguchi has endured her share of ups and downs. She lost a daughter, Sharon, 47, to cancer and waged a long battle with her own illness and won. She credits her faith with guiding her through the tough times and is now committed to life balance. She has acquired long-term care insurance, determined not to be a burden to her two surviving children, Steve, 53, and David, 48.

Yaguchi agrees with Miyake, who suggests that we each take charge of our own well-being with self-directed planning. Occasionally, Maggi may still worry about who will take care of her in her waning years, but for now she is focused on taking good care of herself.


(Part II of this two-part series, “Who Will Take Care of Aging Sansei?,” delves into what science and educators have learned about the world’s aging populations.)




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