Metro Detroit project focuses on culturally relevant home care for older Chinese Americans

This entry in the Nonprofit Journal Project is part of a series of articles about how Michigan health care professionals are responding to the state's health care workforce shortage. It is made possible with funding from the Michigan Health Endowment Fund.

The Metro Detroit-based Association of Chinese Americans (ACA) is developing a training program to address the shortage of direct care workers equipped to serve older Chinese Americans in Southeast Michigan. 

Serving Chinese residents of Southeast Michigan for more than 50 years, the ACA has three locations: the ACA Chinese Community Center (CCC) in Madison Heights and ACA Service Centers in Detroit and Canton. Its long list of services includes many offerings for older adults. The CCC offers wellness programs, health screenings, Medicare and Medicaid assistance, and much more for older Chinese Americans.

"I enjoy spending time with our seniors during our office hours," says Peggy Du, ACA executive director. "We help them to find resources, be their voice, and help them live a more happy senior life. We’re their eyes, their ears, and also their mouths, trying to express what they want."

Peggy Du.
One need for the older adults ACA serves is having home health direct care workers who speak their language and provide culturally relevant care. That’s the goal of the ACA’s new caregiver training project, which ACA is undertaking in partnership with Michigan State University's School of Social Work and Impart Alliance, which works to develop Michigan’s direct care workforce.
We spoke with Du about the ACA Caregiver Project and how it will grow the direct care workforce for people speaking languages other than English.
Q: How is the Association of Chinese Americans helping to address a shortage of direct care workers equipped to serve older adults from the Asian American community in Southeast Michigan?
A: Based on our survey of over 500 community members, we know there is a lack of Chinese- — Mandarin- or Cantonese- — speaking direct care workers. We are also trying to establish opportunities for some of our community members to come out to work. We decided to do a bilingual training program for our community members. There are tons of training resources, but they're all offered in English. Some of our community members have language barriers. So, even though there's materials ready to use, they don't understand them.
Our program starts with a train-the-trainer part. Our community leaders and the ACA staff will attend the training. We are all bilingual. Then we will come back and teach-back to our community in Mandarin and in Cantonese, so that our family caregivers or someone who is trying to become a direct care worker, they have a chance to learn the caregiver skills in the language they're familiar with.

It’s a very comprehensive training. Taking care of a person, there's a lot of skills you need to know to understand the needs of that person, including cooking skills, nutrition, exercises for prevention, a whole lot of things. Because I speak the language, then I can take care of someone. The Impart Alliance is open to co-develop a curriculum that specifically fits the Asian Pacific American or Chinese American seniors. We wanted to review their current materials and add or replace some pieces so it is tailored for Chinese American seniors. Dr. Fei Sun from MSU is a Chinese American professor focused on social work. He will add his insight based on his experience working with seniors.
We want there to be a very comprehensive curriculum. We hope to translate it into written language so that our students can read and understand. We are at the stage of developing the trainers’ material. Then we can start the training and recruit the community members to take the trainees’ course.

From the ACA side, we have a staff member that is Mandarin- and English-bilingual, and we have another who is Cantonese- and English-bilingual. We also have some community leaders who are also bilingual — a class of six people to eight people for the trainers’ training session.
If students already speak the language, but lack the caregiving skills, we can equip them with the skills. If they already have the skills, we can train them with basic language skills and tell them about the Chinese culture and cooking. For the Chinese American care recipient, we will create the bridge and break down the gap.
Q: How does it benefit older adults when their direct care workers are culturally sensitive and/or able to speak the client’s first language?
A: We want Chinese American older adults to have a very high quality experience during their aging lives. It's a challenge for them to express their real needs, especially the physical [needs]. By having a caregiver who is well trained with the skills and culture, they can build a good relationship on trust between each other. Then the seniors will be willing to communicate and let their caregivers know about their real needs. Students will participate in our program, and after that, find a job and create a positive impact. We see the value of the program continuing, serving a larger group of people and the broader community.
Q: Will the model translate well to other immigrant communities?
A: If we have success with the pilot program in the Chinese American community, later it could be [adapted to] the Korean, Japanese, Chinese, Filipino, and other Asian communities.
The immigrant population, especially the senior age, usually move to the United States and Michigan with their kids. The kids come here to study or to work. Their parents have spent the majority of their time in their home country, so they are lacking the skills for learning a new language, driving, etc. There's a big need. Our middle age group, they're working very hard and need to also take care of the younger generations. So we've got to help all those family caregivers to have a break, and to care about their mental health, as well.

We don't want to make money out of it. Our intention — the driving force — is our giving back to the community. That makes me feel very fortunate and thankful that we've been connected to this group of wonderful people in this area, Impart and the MSU School of Social Work, to address the direct care workforce shortage.

Estelle Slootmaker is a working writer focusing on journalism, book editing, communications, poetry, and children's books. You can contact her at or

Photos by Nick Hagen.
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