Older Pakistanis, who migrate to the United States to be with their children, often find themselves isolated and lonely in an alien culture because of linguistic and cultural barriers.

Rehana Bashir believes Pakeeza should forgive her sister and her ex-boyfriend.  She also thinks Pakeeza should forgive her dead mother who tried to poison her, because to spite the dead is pointless. Only, Pakeeza isn’t real and neither is her dead mother. She is the protagonist of a drama series running on a Dubai-based Pakistani entertainment channel, one of the many to which she is hooked.

She spends a large part of her days keeping track of these tv series, flicking through Pakistani news and entertainment channels, deconstructing the nitty-gritties of the plots, and commenting on social issues usually discussed in the morning shows. When she is cooking for herself and her daughter in their one-bedroom apartment in East Orange, New Jersey, she catches up on more dramas. When she eats, alone mostly, she prefers to watch the episodes she hasn’t seen before. "That’s the most fun."

Bashir may thrive on these fictional characters but says her own life is no less dramatic. Now 65, she left Pakistan for the US in 2000 with her late husband on his brother’s sponsorship. The initial plan was to live there until their two children were settled and then move back to Pakistan, where most of her family still lives. But her husband’s diabetes led to the amputation of his right foot after which he lost the energy, and the will, to work. Depressed and bed-ridden for nearly eight years, he died five years ago because of kidney failure. "I was always by his side. We couldn’t afford to pay for his treatment in Pakistan and so we stayed. Now, I stay for my kids."

Bashir has one biological daughter, who is now 27. After Bashir’s daughter was born, she was told she couldn’t have another baby. Heartbroken, the couple decided to adopt a poor relative’s boy, pinning their hopes on him for their stable future after the daughter was married. Once again, things didn’t turn out the way Bashir had hoped. Her daughter got divorced after a few years of marriage, whereas her 34-year-old estranged son lives in Washington D.C with his family. Bashir now has to live on what her husband left her, which, she says, isn’t much. "But at least I don’t have to ask anyone for money."

The rare and awkward phone conversations with her son last around ten minutes. She believes it’s his job to take care of his mother, like every other Pakistani man, but he avoids the topic and usually hangs up after talking about his three children and how they’re doing in school. "It’s his wife", she says. "It’s always the wife." She is a staunch believer in women’s financial freedom but is equally cynical about the way women put each other down.

Bashir is among the less than one per cent Pakistanis who make up the United States’ foreign-born population, with the largest number in New York, followed by Texas and California. Compared to other diasporas, Pakistanis have comparatively higher rates of higher education and better-paying jobs, according to a 2015 study by the Rockefeller Foundation-Aspen Diaspora Program (AARP).

The study also found that only five per cent of these Pakistanis are aged 65 and older, a tiny minority but one that is steadily increasing. Most of these older Pakistanis live in the US to stay closer to their children, who are working and living there with no plan of returning. Unlike their children who usually migrated to find better opportunities, the parents just tagged along. But once they arrive, they become part of a larger picture -- a socially isolated minority unable to assimilate, sharing their loneliness with an aging population nationally.

Over one-third of adults aged 45 and above in the US are suffering from ‘chronic loneliness’ according to the AARP research, based on the 2010 census. The reasons for that include poor health and financial constraints. Fifty-six per cent of these lonely people have fewer friends compared to five years ago, a number expected to increase. The most common reason for loneliness among seniors is a lack of social support, which is loosely defined as having hobbies, a group of trusted friends, close family members or being a part of a group, either religious or otherwise. In an age shaped by technology, the issue of social isolation goes beyond geographical boundaries.

Take the United Kingdom for instance, where loneliness is now such a major public health concern that the country recently appointed a ‘minister of loneliness’. UK Prime Minister Theresa May says that loneliness is "a sad reality of modern life". Researchers have started to view loneliness as a growing epidemic. Isolation, many of these studies contend, is closely associated to early deaths. So much so, that it increases their chance of early demise by loneliness, rather than, say, obesity. Ironically, old people living in modern, individualised societies are more likely to be isolated than those living in predominantly dominant cultures. Those who feel they’re misfits have it worse, like old immigrants.

Bashir ties her hair in a small bun after washing her face. She is going out to buy groceries on this cold March day in New Jersey. She rarely leaves the house and when she does, remains within a few miles of her building. In Pakistan, she had what she calls an army of domestic help. "I had someone clean the house, help me in the kitchen, a driver and a watchman."  In the US, however, she is a one-man-army.

At the local grocery store, she picks up a green bell pepper from the shelf. "This is green capsicum like the one we have in Pakistan, and I’ve tasted yellow and red. I think, they all taste the same." In her mind, everything American is comparable to everything Pakistani, even the colour and flavour of vegetables. Wearing a light blue printed long shirt with off-white trousers; Bashir walks around the narrow aisles at the grocery store, picking up random things and reading the labels-- her basket only filled with three green bell peppers. She only understands elementary English and yet likes to look at the ingredients. For older immigrants like Bashir, linguistic barrier plays a big role in daily routine. Unlike Canada, where immigrants are required to take a language course, the US citizenship exam doesn’t. "Sometimes, I buy things I don’t need because I know it will take forever to explain what exactly I’m looking for. Then I ask my daughter to return them."

Back in Pakistan, Bashir ran a household including her children and in-laws, who lived with them. She is proud she took care of her husband’s parents in their old age. "My house was like a tavern for the whole family. There were days when I was cooking for around twenty people, including servants and surprise guests. And it never occurred to me they’re a burden. It was so normal."

When she isn’t watching tv, Bashir scrolls down her newsfeed and plays Bubble on her phone. The rest of her day is spent "worrying about my daughter". She says her daughter is both her biggest support and biggest concern. Her first marriage was arranged by Bashir, her late husband with disastrous results. "This time she won’t listen to me, says Bashir.

Asma Humayun, a psychiatrist who writes columns on issues of elderly, says "displacement is traumatic for elderly people, even if it’s from one city to another. It can also mean losing autonomy, a sense of community and, most importantly, a sense of belonging. All these go away immediately." She says that the likelihood of depression among older immigrants is twice as likely as a native.

Also important is the role grandparents have in a communal culture like that in Pakistan, where they continue to remain family heads and run the household. That loss can lead to deterioration of mental health. "The feeling of being useless is reinforced when people are left on their own," says Humayun.

Eleven million people got green card between 2007 to 2016 and seven million of those got it through family-based system, according to the Department of Homeland Security. It is the same system that enabled Bashir and her family to migrate to the US. Under it, US citizens and permanent residents can bring family members to the United States. Donald Trump criticised the system during his presidential campaign. He wants to restrict sponsorship to spouses and children under 21. With stringent immigration measures, the number of parents left behind has also increased. Sabiha Butt 67 is a mother of four. Her two sons live in the UK and Canada. However, she lives in Lahore with one of her two daughters because she can neither go to UK or Canada. Her application for the Canadian super visa-- a ten-year multiple-entry visa to Canada for grandparents-- was rejected last year because, as a parent, she was eligible for permanent residency. She is now waiting for her PR card, the equivalent of American green card.

Butt’s elder son applied for asylum in the UK for being an Ahmedi, a persecuted community in Pakistan.  Since he is an asylum seeker, he can neither go back to Pakistan nor bring his mother to the UK to live with him. "It’s a feeling of helplessness, for sure, Butt says. "You want to be with your children, but you don’t want to leave your home. Here, I’m my own person. There, I’m living in my son’s house."

Salman Malik, 64, and a widower, was living with his brother, his sister-in-law and their three children while working full time in Lahore, Pakistan. He moved to the Bay Area last year to live with one of his three sons, Shehzad Salman, a scientist at a university in Florida. Salman sponsored his father on a parent visa to join him and his wife. Malik’s life back home revolved around his work and family. "This is it," he says. "My three sons are here hence I am here as well. I feel like this is the end for me. I will live between Florida and Michigan and will now see the world through the eyes of my children and their children."

Malik’s day starts with video calls with his family back home. "Sometimes when my son is busy, my day just drags on. I think this is the first time that I’ve realised that I actually don’t have a hobby. I never thought I would have so much time on my hands, and now I do."

Getting old and feeling redundant, he says, is a part of life, but "America is very different from Pakistan". "Life revolves around weekends here. It’s all about the weekend. I think if I live here too long, my mind will also start processing the weekend as the only time when you are allowed to eat a lot and sleep a lot." He laughs. Yet Malik doesn’t want to go back to Pakistan because he feels it would be embarrassing for his sons if he still had to live with his brother.

Bashir’s dramas are not just a break from monotony; they also keep her in comfort zone, her idea of Pakistan. But the make believe world of her tv series could also be a cover for the intrinsic need to meet people like herself. She doesn’t think there’s a cure for this feeling of in-between where you’re not home but there are times you feel you are.

Cultural constraints sometimes tangle with psychological issues, especially when it comes to caring for the elderly. In some cultures, for instance, Pakistani, frank discussion of mental health issues is looked down upon. Ironically, the aging immigrants are more vulnerable to mental health issues. By 2020, the majority of New York City’s seniors will be immigrants, according to a study by Centre for an Urban Future in New York. The non-profit recently published a study on aging population in the city. The study projects that at present, immigrants make up nearly a half of the city’s senior population. With limited language proficiency and financial constraints, immigrant seniors are almost twice as likely as native-born seniors to be poor and in need of social support services.

Christian Gonzalez-Rivera is a senior researcher at the Centre for an Urban Future. Talking about isolation and depression among older immigrants, he said that mental health is among the most neglected aspects of social services and needs more attention. He says that negative attitudes discourage older immigrants to seek out the services they need. "The fear of risking their privacy and safety keeps these immigrants from engaging with the system and seek services they’re entitled to."

He pointed to a study that showed the exponentially high number of suicides among older Korean women, who felt they were not strong anymore and hence, were holding back the family. Social services offered by the government need to be culturally-sensitive, and should include senior centres and healthcare assistance.

He disagrees with the accepted notion that older immigrants are a burden on the system. "It’s the opposite." He says that older immigrants are playing a crucial role as grandparents and childcare providers, common in most migrant communities.

Outside her apartment building in East Orange, Bashir is strolling before the evening prayer. An app on her phone will tell her when it’s time to say the fourth and second-last prayer of the day. Taking small slow steps, she talks about teddy fashion in Pakistan -- a flamboyant street style popular in the 70s and 80s when she was in her twenties and thirties. She sewed her own clothes at night, hiding them from her religiously-conservative mother. A neighbour walks past with his dog and they nod to each other as she makes way for them. "I hate dogs but my daughter told me not to say that. Americans love their dogs."

It’s almost dusk. The azaan on her phone reminds her it’s time for her ablution and prayer -- followed by another episode of her favourite show.

* Names of old people

interviewed for this piece have been changed to

protect privacy