Chicago ? First, Jane Ngo noticed that her mother’s few words of English were gone. Then it was her mother’s memory of where she lived, even as she stood just steps from her door.

While the idea of placing 93-year-old Mei Ruan in a nursing home filled her with shame, Ngo knew she could no longer handle the job of caring for her.

A few blocks away she found the answer in an elder care facility that could offer her Chinese-born mother the things that make her comfortable: Chinese staff talking to her, Chinese movies, Chinese music, Chinese food.

“She thinks she’s back in China,” Ngo said.

Mid America Convalescent Center is one of a growing number of Chicago-area nursing homes that assemble residents by ethnicity. Asians live on one floor, Hispanics are on another.

Each group has its own traditional food, activities and a staff that speaks its language. Within a few miles are other facilities doing the same for Poles, Russians, Indians and Koreans.

Increasingly common

There have long been nursing homes that cater to certain nationalities and religions, or become popular with different ethnic groups. But in Chicago, with the third largest number of foreign-born residents in the United States, that sort of specialization is becoming increasingly common and formalized, said Kevin Kavanaugh, spokesman for the Illinois Council on Long Term Care.

Between 1990 and 2000, the number of foreign-born U.S. residents jumped from just under 20 million to over 31 million — more than 78 percent of them from Latin America and Asia — according to the U.S. Census Bureau. About 629,000 are in Chicago.

Not everybody agrees that cultural separation is the answer, though.

“I think you get very limited in the interactions that you can have,” said Susan Mikals, clinical administrator at Ballard Healthcare in suburban Des Plaines. “If you have someone with an orthopedic trauma, do they want to be laying next to someone on a ventilator just because they both speak Spanish?”

Kavanaugh, who suspects that much of the resistance stems from the negative connotation of segregation, said nursing homes often already deal with a specific population with specific needs.

“They may be reverting back in time, perhaps speaking their native language, living in the past,” he said. “You want to have a program that meets them at their sense of reality.”

Understanding rituals

Specialized ethnic care can be helpful, advocates argue. Nursing homes must be aware, for example, of elderly Jewish residents for whom a trip to the shower may trigger memories of the Holocaust.

They also must be aware of customs and rituals, said Rosemary Gemperle, executive director of the Coalition of Limited English Speaking Elderly, an organization of community-based ethnic agencies in Chicago.

“Indian people, Hindus, won’t eat before they are bathed,” Gemperle said, offering an example. “They will starve first.”

Some Koreans won’t drink cold water, believing it can cause disease. A nursing home that doesn’t understand that can create a life-threatening situation if residents refuse to take medications because they are given only cold water, said Susan Duda Gardiner, director of clinical services with the Illinois Council on Long Term Care.

Ethnic diets

Food is often central to nursing homes’ ethnic programs.

“Imagine an older person living in a nursing home who is used to eating food of their tradition and now they are eating bland, unfamiliar food that doesn’t look familiar, taste familiar,” said Melanie Chavin, vice president for program services at the Alzheimer’s Association in Illinois. “They might stop eating.”

Vinita Parsram doesn’t think her husband, paralyzed by a stroke, would refuse to eat if he wasn’t served Indian food. But she says it’s important to him that Lake Shore HealthCare and Rehabilitation Centre has an Indian cook who prepares kheer — a rice pudding — and other dishes he likes.

“There is nothing else for him to do,” she said. “Food seems to be one of his focal points, and I’m not going to deprive him of what he likes.”

Best option

Immigrants are still more likely to care for their elderly at home, but for those who left extended families behind to move to America, nursing homes may be the best option, Kavanaugh said.

Jane Ngo brought her mother from China to live with her years ago. But Ngo herself is now nearly 70, and walking up and down the stairs day and night to help her mother left her exhausted.

She cries when she thinks about her decision to put her mother in a nursing home — until she is asked about the recent day she brought her mother, now 94, back to her home to celebrate a holiday.

“She stay only one hour; said ‘I want to come back”‘ to the nursing home, Ngo said, smiling. “She didn’t want to come home.”