If she lived in Korea, 64-year-old Yong Gagliardo would probably be cared for by her family until she died.
But in America, Gagliardo stays with four other elderly Koreans in the Emmanuel Care Center, a small assisted living home in Ellicott City.
The separation elicits powerful emotions for Gagliardo's only daughter, Cathy Ogle.
"This place really was a miracle. It let me have a life," said Ogle with a bright smile. The 30-year-old has married and started a full-time job since her mother moved into the facility about a year ago.
But a moment later, the smile disappeared.
"There's a lot of guilt about breaking from tradition," she said, lowering her chin to her chest and dropping her voice. "I know I wouldn't be doing this if we were in Korea."
Guilt is a common reaction for anyone who puts a family member into an assisted living or nursing home. But the guilt is clearly heavier for many children of immigrants who have grown up in families where honoring and caring for seniors is almost a religious obligation.
"The whole concept of nursing homes is just a head-scratcher for [immigrants], if not an anathema," said Dan Leviton, a professor of public and community health at the University of Maryland, College Park. "It basically goes against the grain of everything they know."
Despite that cultural pull, decisions to put elderly relatives into assisted living facilities are becoming more and more inevitable as immigrants assimilate into American culture, experts say.
To help ease the pain, elderly care facilities that cater to the special needs of immigrant seniors are springing up throughout the country, especially in diverse cities such as San Francisco and Los Angeles.
Traditionally, Korean sons care for their own parents while daughters help look after members of their husband's family. If the whole family doesn't live in the same house, they will often live in the same neighborhood, with separate generations walking to each others' homes to share meals.
Although Gagliardo married an Italian-American she met in Korea, Ogle said she felt the expectation to care for her parents, who settled in St. Petersburg, Fla.
And Ogle tried, even though her parents were both disabled. Her father, Vincent, suffered from Lou Gehrig's disease for nearly 20 years; Yong was diagnosed as a paranoid-schizophrenic.
Although Ogle cared for them both for nearly 10 years, looking after her mother was particularly difficult. While Vincent Gagliardo could stay in a hospital, Yong Gagliardo, who is deaf and doesn't speak English well, lived with Ogle.
Ogle would sometimes find her mother wandering down the road in the middle of the night or would get phone calls during the day, informing her that Gagliardo had been mugged while walking on the street.
"I was scared to death all the time. I'd pray, 'Please, God, let my mom be there when I get home,'" Ogle said.
Eventually, Ogle realized that she needed to put her mother in a home. But she also knew that not every home would be appropriate.
"She needs constant care, she needs special food, she needs people who are like her," Ogle said, ticking off her mother's special requirements.
"Basically, she needs to be around Koreans."
Luckily, Ogle, who lives in St. Petersburg, has relatives in the Baltimore area who found the Emmanuel Care Center.
"It's a miracle. I don't know if she could make it in any other place," Ogle said.
On the end of an Ellicott City cul-de-sac, the home is almost a step back to Korea. The owner, Eun Soon Kim, speaks fluent Korean and is a registered nurse. Shoes are left at the door, the furniture is dark lacquered wood, the satellite TV pipes in Korean soap operas and news.
Chopsticks are the utensil of choice and kimchi, Korean-style spicy pickled cabbage, is a staple at most meals.
When asked whether she likes it there, Gagliardo, who rarely speaks to strangers, nods her head shyly.
But Gagliardo keeps her suitcase packed and noticeably brightens when she knows Ogle is coming to visit, changing from a brown outfit to a pink one that she likes better, watching the window, and breaking into an ecstatic smile when her daughter comes through the door.
Still, in every visit, Gagliardo will make the same request: "Cathy, take me home."
"I know it doesn't make me a bad daughter, but it still hurts," Ogle said. "You think that they should be with you."
Such guilt is a common response for both elderly immigrants and their children, especially with such groups as Latinos and Southeast Asians who are relatively recent immigrants, experts say.
"Immigrants prefer to continue their cultural traditions and keep their elderly away from nursing homes. When they have to put [the elderly in a facility] it's the last possible resort," said Judith Freidenberg, an associate professor of anthropology at the University of Maryland, College Park who has written a book about the aging Latino population in New York City.
While Howard County officials believe Emmanuel Care Center is the only elderly care facility in the county that caters to a particular ethnic group, such institutions are increasingly common across the country as immigrant populations expand.
In Howard, the number of minority members over 65 has increased significantly since 1990, according to the U.S. Census Bureau. The 964 Asians over the age of 65 living in the county represent a nearly 600 percent increase since 1990, according to census figures. And the 229 elderly Howard Latinos constitute a nearly 200 percent jump over 1990 numbers.
Homes established for Japanese-Americans have opened in Seattle, and facilities for Chinese-Americans exist in San Francisco and Fremont, Calif.
"It's the next wave" in elderly care, said Ailee Moon, an associate professor of social welfare at the University of California Los Angeles who studies the aging Korean population.
As immigrants become more and more Americanized, even the elderly are becoming comfortable with the idea they will go to nursing homes.
"Parents are very well aware of the changing norm," Moon said. "No parent wants to be a burden on their family."
Most Emmanuel Care residents agree. For example, 79-year-old Bok Soo Chung suffered a stroke two years ago that affected the movement on her left side. Although she has family in Columbia, she said she could tell her she was getting in her family's way.
"I knew they were losing their life while I was there," Chung said.
Although Chung admits that she was sad the first several days she spent at Emmanuel Care, she says she has adjusted to life fairly well.
"I'm happy here," she said. "It's almost like being at home."
But Gagliardo still pines for her family. As her visit with Ogle wound down, she became less and less animated, her eyes suddenly staying focused on the floor. As she walked Ogle out to the car, Gagliardo clung to her daughter's arm and both began to cry.
"Don't worry, mom, I'll come see you for Thanksgiving," Ogle said.