Once, I had the privilege to serve a large family who had lived in a refugee camp for 20+ years in another country before immigrating to the United States. The family came to America with the hopes and dreams of so many other immigrants—they wanted a chance to be free, to enjoy prosperity, gain an education, contribute to the greater world and be with their family. As this family began their integration into U.S. society, they were faced with the unexpected—an elderly family member became ill with terminal cancer.
Without a doubt, the family faced many hurdles—an elder’s terminal
illness, language and cultural differences, and employment and financial
concerns.
In the refugee camp the family learned to deal with illness without much
medical care. Now, they had a whole hospice team sent to their home to help
them manage their loved one’s care. It was overwhelming for them at first.
The family was now facing end-of-life issues, and they expected to care for
their loved one at home. In their culture, the role of the eldest local
son was to be primary caregiver, financial provider and overseer of the entire
family. Other family offered support and contributed to the patient’s care, but
this eldest son had the greatest cultural pressure.
The son worked a part-time job outside the home to sustain the family,
and was also the Medicare paid, part-time primary caregiver. He eventually
became a certified caregiver.
The final challenge for the family was how to provide cremation
services for their elder after his passing. The cost of the lowest cremation service
would absorb 3/4 of the total family monthly income. A solution was found, but the
cost of final arrangements is still a dilemma many families face in hard
economic times. (Editor’s Note: See our previous entry about making plans for final arrangements. If you do not yet have plans in place, ask your hospice
social worker to guide you in making funeral arrangements.)
I was touched most by how the family found creative ways to survive and
how strong their family was in supporting each other. They showed a high level
of adaptability and resilience. They
were eager to share their cultural hospitality with the hospice staff by making
a special chai tea when we visited.
This family was not afraid to ask for help, but was also determined to
find ways to help themselves. They continually expressed “how proud we are to
be Americans.” They moved halfway around the world to realize a dream, and in
the midst, had to persevere through the loss of an elder. They showed me the
ultimate level of humanity—how we love, how we adapt, how we continue to
persevere through the most difficult of challenges.
By Christy Noriega, Hospice Social Worker
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