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Eighty eight year old Sui Tin Ho is photographed in her room at the Yee Hong Centre for Geriatric Care in Mississauga, Ont. on Jan 16 2012. Ho has been living at the centre, which supports the Chinese community with Cantonese speaking staff and activities, for a year. The kitchen staff also prepare meals catering Asian cuisine and diets as well. (Fred Lum/Fred Lum/The Globe and Mail)
Eighty eight year old Sui Tin Ho is photographed in her room at the Yee Hong Centre for Geriatric Care in Mississauga, Ont. on Jan 16 2012. Ho has been living at the centre, which supports the Chinese community with Cantonese speaking staff and activities, for a year. The kitchen staff also prepare meals catering Asian cuisine and diets as well. (Fred Lum/Fred Lum/The Globe and Mail)

Ethnic-focused nursing homes put a Canadian face on filial piety Add to ...

It’s 11:41 a.m. and In Chung Yee’s kitchen is buzzing with the lunch rush. He pours a bowl full of cracked eggs into one of the kitchen’s “turbo woks”: a 32-inch beast with capacity for 100 servings of fried rice – which sizzles and spits as he vigorously tosses in cooked rice, shrimp and steamed vegetables.

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Earlier that day at the Yee Hong Geriatric Care Centre in Mississauga, a group of seniors gathers to perform a seated adaptation of tai chi. A few days later, they are belting out Chinese opera into karaoke microphones.



This is life at the ethnoculturally focused nursing home geared toward the Chinese population, one of the fastest-growing minority groups in Canada.



Some have endured a five-year wait (and counting) for the privilege of living here, and waited 10 years for a space in Yee Hong’s Scarborough-McNicoll location. It’s not just comforts of cultural accommodation that attract ethnic minorities to these specialized homes. Research is emerging that there’s a significant health benefit, with the familiar mitigating the culture shock, social isolation and confusion that can come with being transplanted into a mainstream nursing home.



Within the field, Yee Hong has emerged as an innovator in care, routinely boasting lower rates of depression, falls, skin ulcers and hospitalizations among its residents, compared with those living in mainstream homes. Susan Griffin Thomas, Yee Hong’s Mississauga director of care, attributes its success to high staff retention rates and a commitment to seeking out best practices from other homes across the country.



Ben So, whose mother and father-in-law live at Yee Hong Mississauga, agrees that the centre is far superior to a typical home.



“When you see an elderly person going to a nursing home they’ll say, ‘Oh, you poor thing, your kids don’t want to look after you.’ In our community, when you hear, ‘You’re going to Yee Hong’ they’ll say, ‘Congratulations.’”



Staff culture also has a lot to do with Yee Hong’s success, said Karen Kobayashi, a University of Victoria sociologist and research affiliate at the school’s Centre on Aging. “They specifically screen for care workers who have the same philosophy around care as the home does and they drill that into their staff,” Dr. Kobayashi said. “You don’t see that at other mainstream homes.”



When the first ethnic-focused nursing home for Asians opened in Vancouver in 1978, it was a hard sell to a community that followed the old model of filial piety. But attitudes among immigrants have shifted in the past three decades as second-generation children adopt North American values.



Ten such Asian-focused nursing homes now exist in Canada, focused mostly on Chinese and South Asian communities, but the growth doesn’t come close to meeting demand. In Ontario, the average wait for a spot in a mainstream nursing home is 113 days. At Yee Hong’s Scarborough-McNicoll facility, some have waited for a decade.



With the country’s senior population expected to more than double to between 9.9 million and 10.9 million in the next quarter-century, provinces are scrambling to develop care strategies. While Ontario Health Minister Deb Matthews has said the province will focus its resources on home care in the next two decades, in British Columbia the plan is to revamp mainstream homes and properly staff them to meet the needs of all ethnicities.



But researchers and seniors advocates argue ethnic-focused facilities should be a priority for all provinces as they map out strategies. The most recent projections from StatsCan suggest the country’s South Asian population could balloon from 1.3 million in 2006 to 4.1 million in 2031. The Chinese population, also 1.3 million in 2006, is expected to reach three million in the same time frame.



With culturally appropriate homes offering welcoming environments, the families of these seniors have accepted them as a way to honour their parents in old age. It’s filial piety redefined, Dr. Kobayashi said.



Accounting for Yee Hong’s excellence



Paying attention to residents’ cultural needs and innovative, attentive staff make for a winning combination



How did Yee Hong build a better nursing home? In addition to focusing on their residents’ cultural needs, its staff is constantly experimenting with projects that target specific health indicators, searching for improved care.



“We don’t actually use the provincial average as a benchmark,” said Susan Griffin Thomas, Yee Hong Mississauga’s director of care. “If we did, we’d all sit back and say, ‘Oh, our job is done here.’”



Instead, they look to other facilities that perform well in certain categories and try to figure out their best practices. This has resulted in measurable improvements in three indicators of overall health: weight loss, depression and fall rates.

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