Saturday, September 27, 2014

Aging in place: home and community

The ability to live in our own home and community is a prerequisite to aging in place.  Yet lack of affordability and accessibility are challenges to staying in home and community as long as one can in the later years. 

Home-less

This month Flyaway Productions presented Multiple Mary and Invisible Jane, a 30-minute aerial dance performance about the struggles of older homeless women.  As part of a trilogy about urban poverty, this work was based on local investigative journalist Rose Aguilar’s article, “Old, Female and Homeless,” published in The Nation last year.  Set against an 80-foot wall of the YMCA in San Francisco’s Tenderloin District, dancers are suspended by rope around their waist, with no safety net below.  They are strong but vulnerable in this environment and circumstance as we learn the oral histories of the older homeless women whom they represent. 
Sleeping in chairs: “You couldn’t lie down, you had to sit up.”
 
Carrying your stuff: “It’s so hard to push pride aside to tell someone I was homeless . . . but people notice it.” 
Living on the streets is dangerous, with homeless women experiencing high rates of physical, sexual and emotional violence.  A recent UCSF study found much of the violence on homeless and unstably housed women was inflicted by acquaintances and strangers.  In this context, researchers found that social isolation protected them from experiencing violence. 
Multiple Mary (Poppins) umbrellas represent shelter.  The increase in homeless older women is related to the rising cost of living and evictions.
 












After the performance, Flyaway Productions Artistic Director Jo Kreiter and dancers touch ground for Q & A session.  Their goal is to give light and inspire compassion to the plight of the growing numbers of older women living on the streets of San Francisco.  

Single Room Occupancy (SRO)

Chinese Historical Society of America (CHSA)’s exhibit, “Living in Chinatown: SRO,” featured artist Frank Wong’s miniature diorama and a life-size version of a Chinatown Single-Room Occupancy (SRO), and a panel discussion on affordable housing.
This Frank Wong miniature was inspired by a SRO containing all the possessions of a bachelor resident of the International Hotel at the edge of Chinatown.  SRO housing, originally intended for low-income, immigrant workers, are typically rooms measuring 8 by 10 feet with a communal bathroom down the hall.  San Francisco has over 500 SRO buildings with more than 19,000 units located mainly in the Tenderloin, Chinatown, Mission and SoMa districts.  About 8,000 seniors and persons with disabilities live in San Francisco SROs, which are regarded as important housing stock to support their independence to age in place.  In addition, more than 450 families live in SROs, most built right after the 1906 earthquake and intended for bachelor living.  Many seniors move in with families living in Chinatown SROs. 











Life-size SRO contains bed, sink, and rice cooker.  A 2010 survey found that more than half of SROs in San Francisco had no access to a kitchen in the building.  In SROs, crowded conditions mean 40 people sharing a kitchen, toilet fights, and electrical problems.

Tenants in SROs are being evicted to create vacancies for tourist rentals, so it was disturbing to hear District Supervisor David Chiu talk about investing in SROs and legalizing “in-law units as variations of SROs” to address affordable housing crisis because he has introduced legislation to legalize and regulate short-term rentals through online social networking platforms like Airbnb, which has the effect of removing SRO units intended for lower-income residents, while flagrantly violating existing leases, local rent control laws and prohibitions against converting residential units in buildings with four or more units to tourist or transient use, and failing to pay the City’s 14% transient occupancy or hotel tax.  Further, these laws have not been enforced, including the failure to collect an estimated $25 million in back hotel taxes
CHSA hosted a timely affordable housing discussion with CHSA Executive Director and former San Francisco Planning Commission President Sue Lee, Chinatown Community Development Center (CCDC) Executive Director Norman Fong, and San Francisco Planning Commission President and CCDC Community Planning Manager Cindy Wu.  Cindy talked about families crammed into SROs for affordability with an average stay of 7 to 10 years until they have saved enough to move to Visitacion Valley or Excelsior. 
SRO residents work as peer organizers through Chinese Progressive Association to improve living conditions in SROs.  The recent college graduate said last year's Ellis Act eviction of Lee family (elderly couple with disabled adult daughter) from their low-rent apartment of 34 years empowered her to fight for “just and fair living.” While some people consider SROs as transitional housing, they are permanent housing for others and thus worth taking action to improve habitability.


Affordable housing initiatives

Last month, California Housing Partnership Corporation released its report, How San Francisco County’s Housing Market is Failing to Meet the Needs of Low-Income Families.  It found more than 50% of extremely low-income households are elderly or disabled, and San Francisco is short about 40,845 housing units affordable to the poorest, which means a third of household income; in response, the Mayor’s Office of Housing said it was committed to supplying 10,000 units at below market rate, or just a third of the 30,000 housing units that the Mayor has promised to build or rehabilitate by 2020.

At the top of San Francisco Planning and Urban Research (SPUR)’s 8 Ways to Make San Francisco Affordable Again is protect the existing rent controlled housing stock.  San Francisco is about two-thirds renters and has about 172,000 units of rent controlled housing.  As housing prices go up, owners have an incentive to Ellis Act evict tenants (often seniors and persons with disabilities) and get out of the landlord business so they can sell. About 60% of Ellis Act evictions in 2013 were issued by property owners who had owned for less than one year.
Eviction Free San Francisco (EFSF), a direct action group for housing justice, has organized public protests against the displacement of long-time San Franciscan seniors by serial evictors.  This rally and press conference outside San Francisco Superior Courthouse took place before the hearing that quashed the attempted Ellis Act eviction of seniors Patricia Kerman and Tom Rapp based on improper service of their eviction notice by their landlord Kaushik Dattani, who has used Ellis Act on 24 households in the Mission District.  
Demonstrators carried signs, “ELLIS ACT IS ELDER ABUSE” and “STOP EVICTING SENIORS.”  Earlier this month, the Ellis Act eviction of 63-year-old teacher Benito Santiago was rescinded after protests by anti-eviction activists.

Senior and Disability Action (SDA), winner of this year’s n4a Aging Innovations Award for advocacy, kept busy advocating for affordable housing  
At SDA’s July meeting on Housing, longtime community activist Calvin Welch and Housing Rights Committee Community Organizer Fred Sherburn-Zimmer discussed housing balance and anti-speculation tax legislation. 
Angelica Cabande, Organizing Director of SOMCAN (South Of Market Community Action Network) presented Healthy SoMa (South of Market) about the impact of the 1990s dot-com resulting in gentrification and displacement of mostly seniors, veterans, homeless, low-income residents and Filipino community.  Now this second tech boom is impacting not just SoMa and Mission Districts but the entire City of San Francisco.  Between 2012 and 2013, evictions went up by 115%! Angelica discussed the need for Housing Balance between market rate and affordable housing, with public participation, in order to increase the City’s accountability for meeting its housing goals.
 
SDA University Organizer Pi Ra and Housing Organizer Tony Robles provided advocacy training on Protect Affordable Housing: Stop the Flipping Speculators at the International Hotel Manilatown Center. Tony’s uncle Al Robles was a poet-activist involved in the almost decade-long fight against eviction of the original I-Hotel Manilatown tenants to preserve low-income housing and their community. 
Fred talked about support for anti-speculation tax (Proposition G), which is an additional transfer tax on certain multi-unit residential properties that are sold within 5 years of purchase:  up to 24% then scaling down to 14% on the fifth year.  
Calvin explained that San Francisco has a shortage of land available to build housing:  of its 46.7 square miles, 23 square miles is developable (not beach, parks) and only 13 square miles zoned for housing.  He also provided a history of San Francisco development, blaming today’s housing crisis on ill-conceived land use policies for the past 30 years that favored office buildings over housing, assuming workers would live in suburbs. But most people want to live in San Francisco, including tech workers in Silicon Valley.  In fact, San Francisco’s population has grown to an all-time high of 837,442 in 2013.  To address affordable housing, he favors policies designed to control housing costs and conversions, and investment in public and subsidized housing.  
April Veneracion was former SOMCAN Director before becoming District 6 Supervisor Jane Kim’s legislative aide to focus on land use and redevelopment.  April worked on the initial Housing Balance proposal that included mandated conditional use approval for developments if construction of units fall below the 30% below-market-rate unit threshold.  However, the Mayor’s Office believed this would slow development so the "compromise" measure resulted in a housing policy statement (Proposition K) that sets a goal of providing 33% below-market-rate units and annually reporting on the cumulative ratio between below-market-rate and market-rate housing.


Building home and community through design
 
The 2014 Architecture and the City festival theme, Home: My San Francisco, included panel discussions about affordable housing beyond shelter and our relationship with the built environment.
At the San Francisco Chapter office of American Institute of Architects (AIA), Home Matters convened a panel for a conversation about The Future of Affordable Housing: How Do We Create Affordable Housing Beyond Just Shelter? Panelists included Russell Krummow of Opportunity Nation, Susan Neufeld of non-profit BRIDGE Housing, architect Lisa Gelfand, and neuroscientist Pireeni Sundaralingam.  Defining home as beyond shelter, it provides a sense of place and relationships to feel connected and engaged as part of a community.  Designing home with a view of the individual as part of an ecosystem provides opportunities for interaction with the natural environment (daylight, fresh air, healthy materials, spaciousness) and access to resources like transportation and social capital to enhance emotional well-being and health benefits.
Mapping the home: The roles of subjective and objective in the design process panel of architects and UCSF neurologist Zachary Miller repeated theme of our brains responding to the built environment, nature as healing and creating spaces that feel good to reduce stress.  However, hospitals (nursing homes) may not be healing environments when the wrong science causes problems like sick building syndrome, with sealed windows intended for infection control, but trapping indoor air pollution that is worse than outdoor pollution from operable windows that allow natural ventilation.


Community engagement

Aging in place is about growing old in one’s own home, as opposed to nursing home placement, and facilitating this process by making home safety modifications.  However, this focus makes aging in place limited to physical and safety needs.

Aging in community is a more holistic approach that considers our need for connection.  San Francisco’s compactness, relative walkability and extensive public transit system facilitate connections with others face-to-face. 

Because loneliness is independently associated with functional decline and risk of nursing home placement that jeopardizes aging in place, it’s important to identify loneliness and interventions.  Patrick Arbore, Director and Founder of Center for Elderly Suicide Prevention and Grief Related Services at Institute on Aging, presented a talk about loneliness in gerontologist Hope Levy’s Staying Engaged for a Lifetime, offered through City College of San Francisco at our Main Library. 

According to the U.S. Census Bureau, the number of Americans living alone in 2010 was 29 million – a 30% increase since 1980.  However, Dr. Arbore mentioned that introverts, like himself, prefer solitude so we should not assume that living alone means loneliness.  Instead, loneliness is a feeling of longing and emptiness that is caused by the lack of emotional attachment and/or social ties – and thus a subjective experience. Loneliness expert Louise Hawkley proposed loneliness has three dimensions: isolation, connectedness and belongingness.  Ageism contributes to feelings of being invisible and ignored.

Loneliness interventions include:
  • ask about loneliness
  • spend time with the person, in silence or in conversation
  • assist the person in keeping contact with people important to them
  • explore the nature of loneliness with the person
  • develop community support for the person 
Practice Oprah’s Just Say Hello! Dr. Arbore urged us to be more welcoming and less suspicious in our fear-based culture:
  • connect with people
  • be as present as possible with people who are lonely
  • empathize with people’s losses and suffering
  • EASE our way to social connection: 
Extend yourself to others
Action plan
Selection – solution is quality, not quantity, of relationships
Expect the best – we have more control over our thoughts than we think

San Francisco’s diversity offers many opportunities to find community and dialogue. This year's Legacy Film Festival on Aging (LFFOA) and Aging While Black events took place on the same weekend, yet I couldn't be at two places at the same time so . . .
I didn't buy an all-fest pass to this month’s 4th annual LFFOA, but I attended Friday's Opening Night and Sunday's afternoon screening. With its mission to inspire, educate (including CEUs for MFTs and LCSWs) and entertain intergenerational audiences about the issues surrounding aging, LFFOA builds community.  Opening Night featured Three Perspectives on Aging:  Burn the Clock (UK drama short about septuagenarians who smoke, drink and have sex), Beauty Before Age (documentary about fear of aging in gay male community that values youth/beauty; one older interviewee mentioned that he used physical attractiveness to compensate for his emptiness because he was really seeking validation and connection) and Fabulous Fashionistas (UK documentary about 6 women, whose average age is 80 who show us that style and attitude is not just clothes but knowing what you want like “live in color, don’t wear beige—it might kill you,” being comfortable in “faithful clogs—Crocs,” and making the most of whatever time is left including self-care and being interested).  
Afterwards, LFFOA Executive Director Sheila Malkind moderated a Q &A with Beauty Before Age director Johnny Symons and Dazie Rustin Grego, 19-year-old who said “life is over after age 26” in 1997 documentary.  Now a 37-year-old performance artist, Dazie said he is more thoughtful, less about “look-ism, pretty doll image” and he was just telling his truth at age 19 though this offended some people.  
LFFOA’s Opening Night was also a celebration of Sheila turning age 76! In her interview with KALW’s Your Call host Rose Aguilar about What does it mean to be an elder todaySheila said she wishes women would stop worrying about aging and stating their age because we should be proud to get to that stage and do wonderful things.  Sheila is a fabulous fashionista herself by embracing aging -- “no botox, plastic surgery” plus no hair dye! 


Sunday afternoon screening of Forget Me Not (Vergiss Mein Nicht), a documentary by German filmmaker David Sieveking about the home care of his mother who had Alzheimer’s disease, showed his use of music, travel, and reading his mother’s diaries (revealing his professor father’s infidelity, which reminded me of the drama Away From Her) to maintain personal connection.  At times, his mother simply wants to retreat in response to attempts to engage her in activities—scenes that resonated with me because I can relate to just wanting down time at home.  After all, home should be a place of retreat—a break from the programmed activities of an institution like a senior center, assisted living, nursing home, cruise ship, etc.  

In Wendy Lustbader’s It All Depends on What You Mean by Home, her study of elders who did not feel at home after moving to continuing care retirement communities (CCRC) to receive supportive services, she found that discontented elders sought: 1) access to dignity, privacy and choice inherent in normal life (versus reminders to “keep busy” through a program of activities like staying at a perpetual resort), 2) the capacity to form significant relationships (versus age segregation that leaves one disconnected from the outside world), and 3) the means to contribute to other people’s lives (reciprocity versus being served all the time).

Community Living Campaign (CLC) uses the power of relationships to build connections of support that we need to age in community.  CLC’s Aging While Black Forum returned to Pilgrim Community Church (panel) and IT Bookman Center (reception).  IT Bookman Director Jackie Wright is seated with panelists Dr. Raymond Tompkins (Aging in a Toxic Environment), Lorenzo Dill (Aging as an African American Veteran) and Anne Warren (Aging with Bills and Legislation).
 
Senior Assembly Member E. Anne Warren represents Older Californians in San Francisco County at California Senior Legislature (CSL).  During CSL's 2013-2014 Session, Legislative Committee Chair Warren introduced Assembly Proposal 43 for a tax credit under personal income tax law for family members providing long-term care.
Pilgrim Community Church Pastor Harold Pierre recognized CLC Community Connector Deloris McGee for founding annual Aging While Black Forum and her community connecting work to support healthy aging in place.  Deloris is retiring and leaving San Francisco to return to her hometown in MississippiI'll always be grateful to Deloris for her inspiration and letting me tag along to learn first-hand about her grassroots community organizing work for my public health classes.  San Francisco will not be the same without Deloris, but she has left a tremendous legacy with her achievements in helping us to age in community by founding OMI Food Network, Breast Cancer Support Group, Fog Walkers, Aging While Black Forum, etc.