Wandering

Wandering became a favorite activity of my grandparents, especially my grandfather as he aged in our family home.  When we noticed my grandfather missing and couldn’t find him nearby, we would make a missing person report to the local police, who eventually found him wandering – sometimes almost a mile away from our home! At the time, we thought our wandering grandfather was “senile” and forgot his way home.  Nowadays with helicopter parenting, we probably would be accused of elder neglect but my grandparents were fiercely independent so we gave them free rein to come and go as they pleased.

Earlier this month, I participated in a caregiver focus group, hosted by Aging 2.0 meetup, to provide feedback on a wristwatch that also operates like a fashionable sensor/surveillance/medical alert system to detect falls within the home or wandering from the home.  I didn’t think the watch would have worked for my grandparents, who liberated themselves from wearing watches in favor of being present and especially after developing dementia.  And they would have been terribly upset if they learned about any monitoring that might trigger a traumatic association with Communist informants in China, which they had escaped so they could enjoy freedom and privacy, rights protected under U.S. law. 

Is the problem (dementia) the solution (being present all the time)? Since dementia symptoms include memory loss that seems to keep people present in time, it almost seems like dementia as prolonged meditation (being present all the time) might keep them living longer.  Nobel Prize-winning UCSF biochemist Elizabeth Blackburn is studying how meditation might boost telomeres and telomerase (associated with longevity), possibly via stress reduction.  I often wonder whether my grandparents, who experienced so much trauma and loss in their lives, remained physically fit well into their 90s because dementia was a coping mechanism to forget their painful past and to remain present? Depression, which adds stress to the brain, may be an independent risk factor for dementia, and treating depression includes practices like meditation and getting more sleep to calm brain activity. 

Are you there God? (prayer is my favorite form of meditation) It’s me Wandering (in Antelope Canyon, photo above).  Like my grandparents, wandering is one of my favorite activities—sometimes to prove that I could be like them and adapt to living anyplace in the world.  After completing my professional education (which included studying abroad in China), I made career choices based on travel opportunities.  Then after an employer denied my bereavement leave request to attend my grandmother’s funeral based on their view that "grandparents are not close enough family members to qualify," I quit my job to travel around the world using frequent flier miles.  From my wandering experiences to well over a hundred countries, I value cultural diversity and view dementia as a cultural experience to navigate.

When my grandparents were alive with dementia, I knew little about dementia and regarded them with a mixture of admiration (for their gutsy determination to start over again after losing almost everything in Old China) and amusement (for their frugality).  My grandparents never became invisible as they were surrounded by extended family members who reminded them who they were.  (In the absence of an adequate pool of family caregivers, see Caregiver Corps Act of 2014.)

In a recent Memory Care presentation, Christina Irving, LCSW at Family Caregiver Alliance said that the most effective intervention is our interaction and communication with someone with dementia, focusing on the relationship or personal connection based on emotions rather than content (just like my favorite Maya Angelou quote about “people will never forget how you made them feel”): 

·         Reassure by being present and doing things together based on what is retained (e.g., music, muscle memory)

·         Remain calm

·         Don’t disagree (directly) or try to reason

·         Give compliments

·         Respond to feelings

·         Use distractions

·         Avoid short-term memory questions

·         Break down all tasks

·         Respond calmly to anger, don’t contradict

Wandering in place

This month I was summoned for jury service, which involved a lot of waiting in the courthouse so I enjoyed some napping and summer armchair travel.  I read two funny books by cerebral Jewish authors who are 20 years apart, and write about aging and how we are linked to one another via underwear :-)  

Ladies first, or beauty before age J.  Pink granny panties grace the cover of comedienne Annabelle Gurwitch’s latest book, I See You Made an Effort: Compliments, Indignities and Survival Stories from the Edge of 50, a collection of essays about being sandwiched between raising a teen and helping elderly parents move to assisted living, taking inventory of her life’s regrets (“I’m Meditating as Fast as I Can”), putting health problems in perspective as she copes with her own rheumatoid arthritis at age 49 after a close friend dies of pancreatic cancer, etc.  Her book’s title refers to letting go of perfectionism (like pesky to-do lists in favor of a single item list No. 1: Free yourself from any and all Things You Should Know Lists) and the panties made headlines in her 2007 Los Angeles Times Op-Ed piece, Flee the Fire, Pack the Panties, or her lesson on what to take with her in the event of an emergency evacuation.  After reading Effort, I wanted to read more of Annabelle’s mid-life adventures; as a career changer, I especially liked her essay about reinventing herself with a new career at age 51, after deciding that writing could get lonely so she tried politics until she found herself longing for “the solitude of my writing desk. The words of a Dostoevsky character pop into my mind: ‘The more I love humanity in general, the less I love man in particular.’ I am not as much of a people person as I’d thought. Politics is not for me.” 

Political pundit Neal Milner’s The Gift of Underpants: Stories Across Generations and Place is his memoir about growing up Jewish with his Old Country grandparents in the same household in Wisconsin, living as a haole for the past 40 years in Hawaii where “being Jewish adds zest, recognition and mystery,” and visiting his in-laws in a Florida retirement community. In Jerry Seinfeld’s Florida and My Hawaii (p. 90), he writes: “My main defense against rotting away – the single item in my (I hate the term) bucket list is:  Keep life complicated.  Continue to embrace complexity.  Don’t narrow your gaze. Never give up your search for oddity and irony.” 

In Planning for the Past, he writes about his immigrant ancestors quitting work (simple) while his generation has the privilege of planning for retirement (existential).  As political science professor at the University of Hawaii for 40 years, he was already a storyteller, actor and playwright in the classroom – though his book says “none of these was ever his day job.”  (I still have the November 2000 issue of Honolulu magazine, which originally published his short story, The Gift of Underpants, about his family's tradition of gifting underpants as the "comfort food of gifts.")  Like Word Babcock in The Whore of Mensa, Woody Allen’s short story, I sought out Professor Milner for intellectual stimulation and he remains my favorite tourist attraction when I visit Hawaii -- thoughtful, funny, very easy on the eyes (worthy of red chili pepper in ratemyprofessors.com J)! He always encouraged my curiosity and idealism, and sometimes gave career advice, which I respected but mainly ignored because as a child of Chinese immigrant parents, I was steered to practical professions . . .until I decided on my latest career change, which has most people asking me, “What is gerontology?"

Wandering with the blind leading

On July 26, the 24^th anniversary of the Americans with Disabilities Act (ADA), I attended programs at Lighthouse for the Blind and Independent Living Resource Center (ILRC).  

At the Lighthouse event, we met Belo Cipriani, the official spokesperson for Guide Dogs for the Blind (GDB), and his 80-pound guide dog Oslo.  (GDB was a former client so I worked at its spacious San Rafael headquarters, 20 miles north of San Francisco, and was impressed by its ability to provide services free from private funding as it receives no government funding).  Two-thirds of the legally blind population are seniors who lost vision as a result of age-related eye diseases.  Belo became totally blind at age 26 when he suffered retinal detachment after he was beaten up by former childhood friends seven years ago.  During rehabilitation, he studied writing and authored a book, Blind: A Memoir.  A technical recruiter before he lost his sight, he is now a full-time writer, including columnist for SFGate’s Get to Work and Seeing in the Dark.

Belo discussed the value of interdependence, making friends in the community (as only another blind person can understand), learning to anticipate or plan ahead for accommodations (call in advance for Braille), navigating with a white cane (lots of memorizing and counting steps so mobility becomes a chore, people are more courteous) versus guide dog (which become the eyes and social life of the handler, bringing more public attention and engagement), applying for a dog to match his lifestyle (Oslo was pre-screened for travel to rabies-free Hawaii), his GDB training and the only guide dog school with graduate support services, bonding with guide dog to trust with your life (“what they do for love” though service dogs are not trained to protect handlers), different types of service dogs (blind, diabetic, deaf, cane companion, etc.), ADA protection for service dogs (which wear harness uniform on duty to signify no petting), calling police when his dog was denied access by a restaurant that ended up fined $2,500 for ADA violation, retiring service dogs (his first service dog Madge retired after eight years, which is equivalent to 60 human years, when she didn’t want to board a plane, indicating she was tired and didn’t want to work anymore, so she was adopted by his sister to retain health benefits), and being a volunteer puppyraiser. 

Blind leading the blind at ILRC, which celebrated the grand opening of its new street level space designed by 51-year-old architect Chris Downey, who lost his vision four years ago days after surgery to remove a brain tumor.     

ILRC Executive Director Jessie Lorenz, in appreciation, presented wine bottles to Chris, who designed building using Braille blueprint, and his wife Rosa, who picked colors.  Check out Chris’ TED talk, Design with the Blind in Mind:

“if you design a city with the blind in mind, you'll have a rich, walkable network of sidewalks with a dense array of options and choices all available at the street level. If you design a city with the blind in mind, sidewalks will be predictable and will be generous. The space between buildings will be well-balanced between people and cars. In fact, cars, who needs them? If you're blind, you don't drive. (Laughter) They don't like it when you drive. (Laughter) If you design a city with the blind in mind, you design a city with a robust, accessible, well-connected mass transit system that connects all parts of the city and the region all around. If you design a city with the blind in mind, there'll be jobs, lots of jobs. Blind people want to work too. They want to earn a living.”

And YOU can promote accessible paths of travel on all public sidewalks in San Francisco by letting Department of Public Works know where YOU need a curb ramp through its Curb Ramp Program or call 311.

Wandering into the future

This week’s White House blog announced the leader, future website and potential topics for the White House Conference on Aging in 2015, which also marks the 50th anniversaries of the Older Americans Act (July 14), Medicare and Medicaid (July 30), as well as the 80th anniversary of Social Security (August 14).  Potential topics include: retirement security, long-term services and supports, healthy aging, and elder abuse prevention.  (The Employee Retirement Income Security Act celebrates its 40th this year on September 2!)