A Guide to Assisted Living for Arab American Seniors

Aging presents unique challenges to Arab families. Traditionally, children care for their parents at home, but modern life doesn’t always make that practical or safe when there’s no one able to stay at home full-time. In many families, both spouses work, which leaves aging parents alone for many hours of the day. Alternatively, placing Arab seniors in an assisted living community is also very difficult, as it goes against traditional beliefs that their main source of support is their family.

Few assisted living communities have a multilingual staff that speaks Arabic or have the training and cultural sensitivity to provide care that meets Muslim cultural norms. While not all Arabs are Muslim, 93% share that religion, meaning the vast majority of Arab seniors likely feel more comfortable in a living situation that respects and incorporates their religious beliefs.

There are an estimated 3.7 million Arab Americans in the United States, 82% of whom are natural-born citizens. There’s a severe lack of programs that have the cultural, religious or traditional foundation to offer acceptable levels of care to this rapidly growing population as they age.

This guide offers information about the challenges people face when looking for Arab-friendly assisted living and how to find acceptable options. It also includes sources on how to cover the costs of assisted living.

Caring for an aging loved one is a hard conversation for all families, as no one wants to admit that they may not have the time or means to provide adequate care for their elderly relative at home. This is particularly true in Arab households. The Arab American perspective is clear about what ideal care for the aging looks like.

In Arab culture, seniors are expected to depend on their families for support during their golden years. Children see caring for a parent as both a responsibility and an honor. It’s an opportunity to return the care that was once offered to them during childhood. Placing a loved one in long-term care is considered a major taboo and is frequently viewed as abandonment, leaving family members feeling guilty or as if they are betraying their loved one.

Abandoning a parent has serious social consequences for Arab Americans within an already limited social network. Children of parents in assisted living might find themselves ostracized within their community or face the embarrassment of public chastisement.

Arabic culture places a duty on children to care for their parents when they can no longer care for themselves independently. Failure to meet that duty can mean that a person is looked down on or seen as untrustworthy. A person with that negative mark on their reputation might find it more difficult to find a job, build a relationship or attend community events.

Financial considerations can play a significant role in determining the optimal long-term solution, particularly when it comes to affordable assisted living. This option offers a favorable combination of low costs and additional support. Moreover, an increasing number of Arab seniors now perceive assisted living as a genuine and viable choice, thanks to the efforts of communities that are dedicating more resources to cultural sensitivity and staff training.

Financial and logistical realities make assisted living options more attractive to Arab Americans, but most still feel that aging at home is best. Keeping in contact with friends, living close to family members and enjoying a comfortable routine all make home the place where aging adults feel most comfortable.

Despite traditions and cultural norms to the contrary, many younger Arab Americans are more open to assisted living and nursing homes than in the past. They recognize that home is not always best, particularly if caring for an aging loved one would be financially or otherwise untenable.

Moreover, circumstances may not follow cultural beliefs. It would be very unusual for aging Arab Americans to live in a home with unrelated people of the opposite gender. For example, if an Arab-American mother needed a caregiver, an unmarried son with male roommates would be an option an aging loved one would feel uncomfortable accepting.

For these types of tough situations, finding alternative living arrangements such as assisted living might be an excellent option, but it’s one that comes with significant expense.

Those from an Arabic cultural background often struggle with the concept of seeking outside caregivers to provide long-term care for an aging loved one. There are few options that provide a minimal-friction transition, and even those that attempt to meet the needs of Arab seniors can fail. Some of the biggest barriers come from challenges that include communication disconnects, loneliness and lack of accessible religious observances.

While many families look at assisted living as an option that reduces senior isolation and allows more socializing, the reverse can be true for Arab seniors. Once in an assisted living community, they often lose touch with their existing social circles and may not have an easy way of communicating with staff or other residents. For seniors of Arab descent, moving to an assisted living community can be isolating.

Many first-generation immigrants have small social circles and a limited ability to communicate with the general public. In a community that’s largely staffed by English speakers, this can pose major issues. Arab seniors may not be able to communicate with the doctors and nurses when physical issues arise, which can contribute to poor health. Language barriers can also contribute to general confusion, since posters of schedules and social events are likely in English.

Even before the events of 9/11, public sentiment toward Arab Americans wasn’t kind, but racially and culturally motivated hate crimes toward them rose dramatically shortly after the attack. Unfortunately, since 2016, each year has a new peak of violence aimed at this group, which makes it more difficult for families to trust outsiders with the care of a loved one.

Arab Americans have diverse religious beliefs. While most are Muslim and may need additional support for important traditions such as washing prior to prayer, other religious backgrounds make up the tapestry of Arab American beliefs. Few assisted living facilities accommodate residents of faiths such as Coptic Christianity, Bahá’, Druze, and Yazidism.

Arab families often live in multi-generational households, and grandparents are treasured members of the family. In the absence of close contact with their children and grandchildren, the elderly who move into assisted living may experience an increase in depression and poor health outcomes as they lose their sense of connection and struggle to find ways to fill their days.

Food is another challenge that can be difficult to overcome for many Arab seniors. While more assisted living communities have Kosher food choices, halal choices are rare. It’s also unusual to see traditional Arabic recipes on the menu. Finding an assisted living community that includes food choices such as harees, a traditional Saudi Arabian dish, or kibbeh, a dish created in Lebanon, is important for aging adults to feel supported in these communities. Limited menus might add a layer of difficulty to fasting for religious holidays.

If home is believed to always be the best option, but it doesn’t work for a family, caregiver guilt is often the result. It’s not uncommon for seniors, particularly those with advanced dementia, to resist placement in an assisted living community. But there are some things that can help make the difference when balancing guilt and elder frailty.

• Honesty is the best policy: Home is only the best option when a senior can receive the care they need in a home setting. When that care is difficult, then home is no longer best. If you can’t provide an acceptable level of care, be honest with yourself and your loved one about it.
• Seek perspective from a cultural leader: Social norms play a big role in guilt, so be sure to talk with your imam, priest or other community leaders to get their advice. You may be surprised by the support you can receive when you’re honest about the situation.
• Get the medical perspective: If your parent’s doctor is recommending a higher level of care than you can offer at home, then you’re following the best medical advice you have. There’s no perfect solution, but you do the best you can with what’s available to you.
• Be a frequent visitor: Finding a community that’s close to home or work is a big part of alleviating guilt since it allows for more frequent visits. If you can stop in for an hour or two nearly every day, that goes a long way toward reducing the feeling that you have abandoned a loved one.
• Find a culturally competent mental health professional: Talk with a professional about your feelings of guilt. Make sure to find a provider that’s aware of the Arab-American perspective and how that can affect you on a day-to-day basis.

One element that can make the search for an assisted living community even more stressful is that many people feel they don’t know what they should even be on the lookout for. Use the below checklist to help guide your search and help you understand what important things you should consider.

Assisted living is often less expensive than in-home care, but it’s still a large expense at a national median of $4,500 per month. Location plays a major role in the final price, as does the type and scope of amenities provided by each community. You’ll see assisted living communities with rates that are more than double the national median and some that are substantially lower.

When moving into an assisted living community, figuring out finances is challenging for many families. Medicare and health insurance policies rarely pay for assisted living since much of the cost is from room and board. However, there are options that can help make assisted living more affordable.

Both Medicare and private health insurance may pay for short-term stays in rehabilitation, but not for a long-term transition to an assisted living community. If health care costs are billed separately, some portion of the fees may be covered by insurance for those who need them.

Arab Americans can connect with many organizations that offer assistance to the elderly. Volunteer service networks, translation assistance, advocacy, education and more are available.