Tip Sheet: Chinese American Older Adults: A Guide to Managing Your Health

Hepatitis B is a common disease seen in Asia, especially China. It is caused by a virus that affects your liver. Chinese Americans born in China are more at risk for Hepatitis B disease than other Americans. Your healthcare provider can treat Hepatitis B and give you simple diet tips to help you feel better.

Cancers, such as breast, colon, and prostate cancer, have started to increase in Chinese American immigrants and their families. Liver cancer and head and neck cancer are more common in Chinese Americans. One possible reason for this is that many Chinese Americans who come to the US start to adopt an unhealthy diet high in fat and sugar. A low-salt, low-fat, healthy diet and exercise decrease the risk of getting cancer. Smoking and other tobacco products also increase the risk of getting many cancers. Chewing tobacco increases your risk of mouth cancer. If you smoke or chew tobacco, your healthcare provider can help you quit.

Chinese American women over age 65 who were born in China are at greater risk of having depression compared to those born in the US and to Caucasian women. Tell someone immediately—a family member, a friend, or a healthcare worker—if you are depressed or have thoughts of hurting yourself. There are many good treatments for depression.

Chinese Americans born in China are ten times more likely to have or to develop TB compared to other Americans. If you have TB, your family members may get the infection from you. If you have TB you may have a cough, blood in your phlegm (mucus), weight loss, and tiredness. See your healthcare provider if you notice these things. TB is a disease that should be treated immediately for your own health, and to protect your family and friends.

Many Chinese Americans who are 65 years or older have high blood pressure (hypertension). They may also have heart problems and blood vessel problems (cardiovascular disease). Having cardiovascular disease can increase your chances of having a stroke or developing vascular dementia.

• Stroke
  Stroke is a common cause of death. Stroke is caused by a blockage in a blood vessel of the brain. Blood vessel problems (sometimes called “hardening of the arteries”) increase the risk for strokes.
• Vascular dementia
  Dementia is an illness of the brain which causes problems with memory and the ability to do everyday activities. Vascular dementia is caused by small breaks in blood vessels in the brain. In older Chinese Americans, vascular dementia can lead to loss of mental functions that may seem like Alzheimer’s disease, another type of dementia. Having high blood pressure makes it more likely that a person will develop vascular dementia. Regular exercise and a low salt, low fat, healthy diet decrease the risk of stroke and vascular dementia.

Some people develop diabetes, a disease which causes high blood sugar. Chinese Americans who eat foods high in fat and sugar are more likely to become overweight or obese, and develop diabetes. Diabetes is a disease that can damage your eyes, heart, blood vessels and kidneys. Your healthcare provider can help you stay healthy with proper foods, exercise, and sometimes with medicines.

Certain illnesses are passed down in families. Thalassemia and glucose-6-dehydrogenase deficiency are both inherited diseases found more often in Chinese Americans than in others.

• Thalassemia is a form of mild or severe anemia that affects the red blood cells’ ability to carry oxygen to organs and tissues; it is passed down through families. You may feel very tired for no reason if you have this illness. In some cases, you may sometimes need blood transfusions or other treatments.
• Glucose-6-dehydrogenase deficiency may be caused by certain medicines, an infection, or even some foods (such as fava beans). Tell your healthcare provider if your urine turns dark or you develop yellow skin and you feel short of breath.

The number of Chinese Americans with alcoholism is increasing. Most Chinese Americans born in China drink less alcohol than the average American. But Chinese Americans who were born in the US drink more than first-generation Chinese Americans.

Many Chinese have low amounts of an enzyme called acetaldehyde dehydrogenase that is used by the liver to break down alcohol. Some people of Chinese descent may experience facial flushing (when the face turns red) and other symptoms when they drink alcohol, due to their low enzyme level. Alcohol can damage your liver. It is also dangerous to drink alcohol while on certain medications.

If you drink large amounts of alcohol on a regular basis, talk to your healthcare provider about getting help to quit. For men, heavy drinking is defined as 15 or more drinks per week, and for women, this is 8 drinks or more per week.

• Tell your healthcare provider if you do not understand or read English well.
• Tell your healthcare provider ahead of time if you will need a medical interpreter who speaks your language or dialect.
• Bring a friend or family member to the appointment who can help and support you. However, it is best that your family members don't act as your interpreter, for many reasons.

• Problems with bowel, bladder, sleep, sexual functions, and memory are common in older adults. It is important to discuss any personal and intimate problems you have with your healthcare provider so they can help you.
• Medical information is often hard to understand. Ask for an explanation for words or instructions you don’t understand. Write them down.
• Ask for written materials in your language if they are available.

• Bring all your medicines to every appointment so the healthcare provider knows exactly what you are taking.
• Always tell your healthcare professional about:
  • side effects of your medicines 
  • if they help you or not 
  • if you have stopped taking them or skip them sometimes 
  • if you are not following their recommendations 
  • how you use and take your medicine 
  • if you cannot afford to pay for your prescriptions 

This is the best way your healthcare provider can tell if the medicine is working or not.

• Many traditional approaches can be used along with Western medicine, but your healthcare provider needs to know about them.
• Please tell your healthcare provider about all the traditional medicines, herbs or foods that you are taking. Some Western medicines should not be taken with certain traditional medicines and herbs as they can cause side effects.

• You have the right to make health decisions for yourself.
• Tell your healthcare provider if you want your family to make your health care decisions.
• Choose a family member or friend who can make decisions for you in case you are not able to make your own decisions.
• Tell your healthcare provider which of your family members and friends would help to look after you if needed.

• An advance directive is a legal document that outlines your wishes concerning medical treatments at the end of life.
• Tell your healthcare provider and your family about what is important to you as you think about the last part of your life.
• If you wish to be pain-free and made comfortable at the end of your life, please tell your healthcare provider and ask their help to complete advance directives.

• Sometimes, older adults are at risk for abuse or mistreatment by people close to them.
• Mistreatment can be physical, emotional, and/or verbal (such as shouting).
• Sometimes, others may be misusing your money or property.
• Ask to speak privately with your healthcare providers and tell them about any mistreatment. They can help you.
• Some older adults feel lonely and isolated. There are many resources and opportunities in the community through senior centers and other organizations to help you. Please speak to a social worker to connect you with these community resources.