Madness, Demons, or ‘Loss of Soul’: Dementia in Asian Elders

New America Media, News Report, Viji Sundaram Posted: Nov 29, 2007

Editor’s Note: The Hmong view it as a “loss of soul,” Chinese call it a form of madness, and Vietnamese believe it is a sign of possession by spirits or demons. Dementia in Asian elders must be treated in the context of their cultural beliefs, researchers say. Viji Sundaram is the health editor for New America Media.

SAN FRANCISCO -- When elderly Hmong, Chinese or Vietnamese people become demented or chronically confused, family members attribute the condition to a normal part of the aging process, something they would have to live with. Admission to a long-term care facility is unthinkable because of the shame it would bring the family.

This was the observation made by researchers who have worked with the three immigrant populations in the United States. They shared their findings at the Nov. 19 symposium on “Working with Asian American Families in the Context of Dementia.” The event was one of several dozen symposia held at the Hilton San Francisco during the three-day 60th Annual Scientific Meeting of The Gerontological Society of America.

But there are also significant differences in beliefs in the three ethnic groups about the disease that affects in one form or another over 40 percent of people over the age of 85, but can occur in people over the age of 55. The most common cause of dementia is Alzheimer’s disease. Because of the cultural differences in the three groups, health education programs need to be tailored differently, said researchers.

Researcher Linda A. Gerdner of the University of Minnesota School of Nursing said that Hmong viewed dementia as a “soul loss.” Family caregivers generally sought treatment by a shaman, or traditional healer, to satisfy the spiritual needs of the elder.

Gerdner lamented that dementia and family caregiving in the Hmong community have not been on the radar of most American researchers, despite the great contributions of the Hmong people to the United States during the Vietnam War. Most of the older Hmong people living in the United States today came as refugees in the 1970s.

Gerdner’s own research shows that Hmong elders generally lived in multi-generational homes, where grandchildren often feel anxious and fearful about communicating with demented elders. This increases the stress in the household.

To overcome this, Gerdner recently co-authored an illustrated storybook for children that she hopes will serve as a “teaching tool” for them and their family members. The book, titled, “Grandfather’s Story Cloth” is due out next March.

Weiling Liu, a researcher at the Older Adult and Family Center, Stanford University School of Medicine, and Jane Nha Uyen Tran, a researcher at the Older Adult and Family Center at Stanford University School of Medicine, shared their research findings on the Chinese and Vietnamese elder communities, respectively.

Although the Chinese American community often view dementia as a form of madness, and many Vietnamese Americans speak of the disease in religious terms – the demented are possessed by spirits or demons – both communities generally believe that the disease is a retribution for past deeds.

In recent years, two in-home-based, culturally sensitive intervention programs for the Chinese community have been started in California – the Chinese Caregiver Project and the Chinese Caregiver Assistance Program. Other community-based Chinese American organizations do outreach to churches to educate the congregation about the disease, including how to recognize dementia, Liu said.

Family members of both Chinese American and Vietnamese American communities believe that because elders are to be respected, they need to be cared for no matter what the difficulty is.

“The filial piety among those interviewed was very strong,” noted Tran. “And they accept the sacrifice of time and material resources.”

Said Liu: “There is a shame and guilt attached with not caring for family members.”

Related Articles:

Labor of Love Can be Financially Draining

Caring for My Caretaker -- When an Elder Gets Alzheimer's

Rethinking Senior Services as Demographics Change



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User Comments


Kathy Hatfield on Dec 01, 2007 at 03:54:40 said:

My name is Kathy, and I am the primary caregiver for my 79 year old Dad who has Alzheimer's disease and lives with me in North Carolina.

I am writing a daily blog on my Alzheimer's caregiver website that shows the lighter side of caring for someone with dementia.

Please pass this link along to anyone you feel would enjoy it.

www.KnowItAlz.com

Thanks,

Kathy


Ser Khang on Nov 29, 2007 at 14:01:20 said:

11/29/07
Hi, My name is Ser khang, I read this Articles it very interest. I remember when I was young back in Laos, Most the Hmong chlidren we have to respect the adult. when their get old, the Older son or the yonger son it the one should take care they parent.
but this country is change. but we have to help than the best we can. because their are our parent.
thank you.
Ser Khang

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