Age-less

This month I spent two full Saturdays enrolled in a Diversity and Social Justice course on Ageism and Adultism.  Rather than compete in Oppression Olympics, these –isms are forms of age-based oppression that can result from segregation of older adults and young people who each become subordinated into “the other.”  The first Saturday (diversity education) assignment was a rhetorical triangle analysis of how the media represents youth and elders; and the second Saturday (social justice action) assignment was a paper explaining how I would intervene to stop age-based oppression.  Inspired by Martin Luther King, Jr., I have a dream that we will one day live in a world where people will not be judged by their age, but by the content of their character . . . so here’s my call to action for a healthy age-less society:

Breaking the age barrier:  This consciousness-raising course reminded me of my bargain trip to Malta just months before it joined the EU in 2004.  Merhba (hello in Malti)! Unbeknownst to me, I had joined Grand Circle Travel, which served members of AARP and continues to cater to the age 50+ set.  In Malta, entrance fees were waived for seniors, who apparently were subsidizing the cost of my tour package because the tour director often had to single me out to purchase my adult admission ticket (“I’ll pay for this one”) everywhere we went—and sometimes I got away with youth admission! As a teetotaler, I was a popular dining companion giving away my complimentary glasses of wine during lunch and dinner (night cap).  Dining table discussions centered on health concerns.  Early to bed, early to rise, my senior travel companions would remind each other to take their meds during breakfast.  One senior sent this photo of “independent, intrepid” me--our group's lone younger adult wandering up Mt. Etna, the largest volcano in Europe, during a day trip to Sicily. 

                                                                                       

Though my grandmother had dementia, she remained physically strong and energetic into her 90s.  But within weeks of my grandmother’s reluctant move into a nursing home, we noticed sudden changes in her like weight loss, lack of appetite, slower gait, uncharacteristic quietness, etc.  When we discussed our concerns with the nursing home staff, they assured us that these symptoms were “just part of normal aging so nothing to worry about.”  In my grandmother’s case, nothing was done while her condition deteriorated until she died of pneumonia.  I believe the nursing staff’s stereotyping and negative attitudes toward aging as a process of “inevitable decline” permeates American culture, which equates good health with youth, and thus fails to value health promotion among older adults.

Ageism affects how we treat older adults.  Internalized ageism affects our own behavior as we age, our will to live and even how long we live.  Based on the Cycle of Liberation, here are steps I have taken, and plan to take, to stop age-based oppression:

1.  Waking up:  The nursing home staff’s apparent ignorance of my grandmother’s true health condition (which I strongly suspect was depression, as my grandmother always said she'd rather die than live in a nursing home) and inaction (perhaps neglect) was the critical incident that caused me to really challenge assumptions about what is “normal” aging versus serious health concerns that require appropriate medical attention. 

2.  Getting ready:  My consciousness-raising included learning from gerontology courses taught by Chief Nursing Officer Dr. C at the Jewish Home (Aging Processes) and Executive Director of California Advocates for Nursing Home Reform  (Ethical and Legal Issues in Aging), which helped clarify my perspective.  After my grandmother’s experience, I simply wanted to avoid nursing homes, but Dr. C’s Aging Processes class, which included a field visit to the five-star rated Jewish Home, challenged me to see how culture change is possible to empower nursing home residents to maintain or even improve their biological, psychological and social functioning. 

I will further my gerontology studies so I can continue learning while challenging misinformation by health care providers who may not be adequately trained to understand the specific conditions of old age.  For example, weight loss through dieting is not recommended for older adults, who tend to lose muscle mass in addition to fat.  Studies suggest that being a little overweight is actually healthful in later years, with a little fat “reserve” (e.g., on hips and buttocks of pear-shaped bodies) to be used in case of illness or padding in the case of a fall.

3.  Reaching out:  Knowledge from my Aging Processes class has empowered me to speak up to challenge negative attitudes toward aging and the aged.  As I often hear laypersons stereotype conditions like hypertension and central obesity as part of the “normal” aging process, I respond by pointing to studies showing that they can be prevented through lifestyle and environmental interventions.  Successful health promotion involves sharing information about the realities of aging that can affect sensation and perception so we can recognize when and how to make adaptations and accommodations to these changes.  For example, it is liberating to acknowledge vision or hearing loss so one can take corrective actions (e.g., obtain eyeglasses or hearing aids), which help maintain a sense of balance and reduce risk for falls that could otherwise jeopardize one’s health and ability to age in community.  

Jessica and Kayi of American Red Cross’ Asian Community Preparedness with high school student volunteers visit Ageism and Adultism class to discuss their intergenerational disaster preparedness program, Youth for Chinese Elderly. 

 

4.  Building community:  Working with others of different ages toward a common purpose may decrease ageism.  For example, American Red Cross Bay Area Chapter’s Youth for Chinese Elderly program connects bilingual Chinese youth volunteers with monolingual Chinese elders to promote disaster preparedness, which fosters mutual caring between generations.

Since health status is a reflection of lifelong habits and influences or life course cumulative disadvantage, I support intergenerational health promotion and disease prevention programs—particularly as the rapid rise of childhood obesity places the current younger generation increasingly at risk for developing chronic health conditions (heart disease, diabetes) at earlier ages and even premature death, so the younger generation can learn from the experiences of older adults.  We find common ground in the universal experience of aging.  As time goes on, most of us (who survive premature death) eventually will find ourselves as older adults so everyone is a stakeholder in intergenerational health programs that increase quality of life for all ages. 

5.  Coalescing:  Through a generous grant from San Francisco Department of Aging and Adult Services, I participate in the Healthier Living Coalition with allies to promote the evidence-based Healthier Living-Chronic Disease Self-Management Program workshops that are offered to adults with chronic conditions and their caregivers, which attracts participants from age 18+.  Organizing these free workshops presents an incredible opportunity to address the intersectionality of age, disability, gender, race/ethnicity, socio-economic status, etc. to reduce health disparities in our diverse communities. 

This month’s SDA general meeting focus was on emergency preparedness for seniors and people with disabilities.  Carla Johnson from Mayor’s Office of Disability demonstrates $4,000 evacuation chair.

6.  Creating change and maintaining:  I want to improve quality of health care by creating culture change for person-centered care and gerontology training among health care providers who serve older adults.  As there is so much to do and so little time, I spread my time among different organizations involved in advocacy (Community Living Campaign, Gray Panthers, Senior and Disability Action), gerontology education (American Society on Aging, Gerontological Society of America) and health promotion for all ages (Bay Area Nutrition and Physical Activity Collaborative, Healthier Living Coalition). 

LaborFest:  age-less Medicare and intergenerational literacy

Every July I look forward to LaborFest, which celebrates its 20^th anniversary this year.  Before studying gerontology, I worked in the employee benefits field in the design, funding and administration of employer-sponsored retirement and health/welfare plans.  As my work involved consulting with employers on cost-effective ways to manage health care costs, I developed an interest in promoting health and wellness programs that emphasize self-care.    

From left: Steve Zeltzer, LaborFest founder; Charlie Andrews, healthcare writer; Brad Wiedemier, SEIU-UHW board member; and Steve Early, labor journalist. 

Today’s LaborFest program included a discussion of Healthcare, Wellness Programs and Obama’s Affordable Care Act (ACA) and Labor.  The panel discussed the impact of cuts in healthcare as a conscious program of downsizing toward privatization, especially services to the vulnerable poor and elderly: 10% cut in Medi-Cal reimbursement rates (effect is actually around 30% for nursing homes when retroactive liability included), 8% cut in In-Home Supportive Services.  They also characterized wellness programs as part of a cost-shifting trend (“if you have a health problem, you pay more”) because of the emphasis on individual responsibility over social and environmental factors, and the effect of cafeteria plans as pitting the “healthy young” against older persons with chronic conditions.  Instead of the individual mandate in “capitalist-controlled” Obamacare, they favor single-payer, Medicare for all ages.

Maestra’s DVD cover shows army of uniformed volunteer literacy teachers marching with oversized pencils symbolizing the triumph of education when the 1961 Cuban National Literacy Campaign wiped out illiteracy within one year--remarkable when one considers that almost a quarter of the Cuban nation was illiterate prior to the start of Revolution on July 26, 1953.  

In 2001, I traveled to Cuba with Global Exchange to study its universal healthcare and education systems.  So immediately following the Healthcare discussion, I stayed put in the auditorium for a screening of Catherine Murphy’s Maestra (Teacher), an empowering documentary about the 1961 Cuban National Literacy Campaign that mobilized 250,000 volunteers to teach 707,000 Cubans of all ages how to read and write (though the film doesn’t mention teaching propaganda), which meant freedom—and especially female liberation just two years after the 1959 Cuban Revolution.  Almost half of the volunteer teachers were secondary and high school students, the majority were females who left their urban homes (one forged her father’s signature on her permission slip) for the first time to teach in the countryside where they also worked alongside campesinos in the fields.  It was so beautiful to hear (actually I read the film’s English subtitles) from one teacher, who volunteered at age 7 to teach an illiterate 58-year-old man: “He never treated me like a child, nor I treated him like an old man.  We were teacher and student.”  Another volunteer mentioned that older students were proud to have their own teacher, instead of being ashamed to be taught by a young person.  In 1962, UNESCO certified Cuba as free from illiteracy. 

Maestra filmmaker Catherine and Cuban social psychologist Norma Guillard, who is featured in the documentary sharing her experience as a 15-year-old literacy volunteer in Cuba.  I found Catherine age-less, looking pretty much the same as when we were on a Global Exchange Reality Tour of a very polarized Venezuela in November 2003, during the attempted recall of President Hugo Chavez, who was implementing his Bolivarian Revolution (similar to Cuban Revolution).  Catherine grew up close to her grandmother from Havana, where Catherine studied during Cuba's Special Period in the 1990s.  

Maestra panel included college educators who discussed the privatization of community colleges like the state’s de-funding of Older Adults and lifelong education programs (SB 173) in favor of a triage-like strategic plan that focuses on training a workforce for corporate employers, instead of higher education for all. 

Catherine, Norma and Steve are all smiles.  To learn more about literacy as a social justice issue, check out Catherine's The Literacy Project. 

Old like All, My old like smile?

In the service learning component of my introductory gerontology class, I volunteered with Project SHINE (Students Helping In the Naturalization of Elders) as an ESL Citizenship Coach to 30th Street Senior Center participants from Peru, Mexico, Nicaragua, El Salvador, Colombia, China and India.  I found dictation amusing: for example, the classroom instructor would dictate, “All people want to be free” and a senior would write, “Old people one to be free,” then I would politely correct, “All, not Old” and “want, not one.”  In my reflection paper, I wrote: 

I value my SHINE experience because coaching ESL reminded me of my own roots.  My parents escaped Communist China to immigrate to Hawaii, as adult refugees with no knowledge of the English language.  English was also my second language so we were all learning English—singing along with the Carpenters, James Taylor, Simon and Garfunkel, etc.  I remember singing the opening of "The Sounds of Silence," incorrectly as, “Hello darkness, smile friend” when the lyrics are really, “Hello darkness, my old friend.”  Repeat correction:  “My old, not smile.”  I actually like both versions :-).