Saturday, October 31, 2015

Aging + disability: friendly San Francisco


“It is suggested that the elderly themselves have bought into an elderly mystique which holds that the potentials for growth, development, and continuing engagement virtually disappear when disabled.  The energy of formal and informal providers is directed toward maintaining activities of daily living and keeping the elderly person out of a nursing home.  This results in a perception of little or no choice by the elderly themselves, and hence diminished exercise of autonomy.”
–Elias S. Cohen, JD, “The Elderly Mystique: Constraints on the Autonomy of the Elderly with Disabilities,” The Gerontologist (June 1988).

Many older adults avoid association with disability, fearing stigma that may take away their autonomy so they end up institutionalized.  Yet individuals age 85 and older are at highest risk for disease and disability.  As a gerontologist advocating for community living, I look to disability culture for inspiration: strength, wellness, peer support, community integration, full participation, resilience, choice, access, independent living, etc.

At San Francisco Public Library

One of the most aging + disability friendly places is our San Francisco Public Library, which hosted many forums for aging + disability community engagement this month! Access Services Librarian Marti Goddard organized a series of ADA celebration events, including The ADA After 25 Years panel discussion with Bay Area disability community leaders; film screenings of PBS Independent LensLives Worth Living and Deaf Nation’s No Barriers with Joel Barish: Deaf People in Havana.

Legal Assistance to the Elderly (LAE) housing attorney Tom Drohan (bearded man in photo above; also appeared as rock star bassist in earlier blog post) presented on Reasonable Accommodations in Housing for People With Psychiatric and/or Developmental Disabilities, a public awareness seminar hosted by People With Disabilities Foundation at Koret Auditorium.  Tom mentioned how LAE provides accommodations to meet clients where they are, including making home visits, providing communication access, and collaborating with support services.
San Francisco’s 40-member Long-Term Care Coordinating Council (LTCCC) celebrated its 10th anniversary, Party With a Purpose: Making San Francisco a More Aging and Disability Friendly City!    
We were treated to performances by Dance Generators, an intergenerational dance company based out of University of San Francisco (USF).  Members on stage ranged from ages 21 to 84, using improvisation to build choreography. 
MC Mary Twomey said they were not able to get Tony Bennett and the pianist was delayed, so she gave us Rat Packer Sammy Davis, Jr. singing a cappella with the audience: “San Francisco so much to give, treat us with dignity.” 
Family Service Agency’s Senior Services Director Cathy Spensley talked about friendly San Francisco joining the WHO Network of Age-Friendly Cities and AARP’s Livable Communities last year.
Keynote speaker John Feather, CEO of Grantmakers in Aging, pointed out that the aging of America is permanent because Millennials (those born after 1985) are now the largest generation in U.S. history, and “about the time Boomers end, Millennials start to turn 65.” Quick calculation: that’s 2050, when “Boomers end” at age 84?!

When he said he liked slide photo of a person hunched over in wheelchair using a long-handled cultivator on dirt ground, Joanna Fraguli of Mayor’s Office on Disability took exception to this “one size fits all” and suggested raised-bed garden + paved pathway might be more accessible to wheelchair users.  Combating ageism + ableism are necessary to making San Francisco more aging + disability-friendly!

Next, audience broke out into small groups to Imagine an Aging and Disability Friendly San Francisco in the following areas: Technology, Social Participation, Housing, and Health & Long Term Supports.  I chose housing, which is so essential to aging in place.  My action idea to improve housing was to offer tax incentives for developers to build healthy homes free of harmful chemicals, based on Ecology House model (mentioned in my blog post last month). 
Still fresh in my mind was the prior evening’s panel discussion on Chemicals Without Harm by Ken Geiser.  As part of Breast Cancer Awareness Month, Campaign for Safe Cosmetics launched its latest campaign, Anti-Aging Secrets Exposed: Chemical Linked to Breast Cancer Found in Skin Care, which reports three anti-aging creams from household name brands contain PFOA, a toxic chemical linked to cancer.  In this case, anti-aging = anti-health.  The proposed Federal Personal Care Products Safety Act (S. 1014) would expand FDA authority over cosmetics.
Community Living Campaign Director Marie Jobling talked about bridging the digital divide to reduce isolation through SF Connected initiative providing free computer classes and Internet Essentials Senior Pilot Program providing low-cost internet ($9.99 per month) + low-cost computer ($149.99) for seniors at least 62 years old who receive state and/or federal assistance. 
Mary continued to engage us with Rap Along!: “LTCCC making San Francisco better for me, LTCCC for elders and adults with disabilities!” 
On behalf of San Francisco Municipal Transportation Authority, Board Chairman Tom Nolan accepted Friendly SF Champion Award for establishing Free Muni for low and moderate-income seniors and people with disabilities!

In SF Examiner's Being older in a youthful San Francisco”, Boomer Sally Stephens wrote about how San Francisco is being planned by millennials for people in their 20s and 30s, without taking a long-range view for older San Franciscans in areas like restricting cars in favor of bikes, consolidating bus stops for faster transit – and I would add this is done without looking out for persons with disabilities with similar concerns about getting around. 

San Francisco Sheriff’s Department presented Senior Summit to address the unique health and social needs of San Francisco’s older adult population who are part of the criminal justice system.  Sheriff Ross Mirkarimi moderated a lively panel discussion:
  • Dr. Brie Williams, UCSF geriatrician and founding Director of UC Criminal Justice & Health Consortium, talked about her recent visit to Norway where motivational interviewing is used to improve offenders’ re-entry into the community as “better neighbors.”  She also suggested a “therapeutic environment” for prisoners, like the humane prisons of Scandinavia
  • Frank Williams, Director of the Senior Ex-Offender Program (SEOP) at Bayview Hunters Point Multipurpose Senior Services, Inc., explained that SEOP concept in 2002 came from Elderly Ex-Offender Program developed by late George Davis while he was working on his dissertation at SFSU, but “Elderly” replaced with “Senior” denoting a “higher rank.”
  • Tanya Mera, LCSW, Director of Jail Behavioral Health and Reentry Services (JBHRS), talked about need to improve system of care for geriatric inmates.
  • Jeffrey Washington, 57-year-old (considered “elderly” at age 55 because age-related health problems occur early in life for prisoners), shared his experience of being released from SF County Jail and linked to case management with SEOP, which led him to employment at Goodwill and studying to be an alcohol and drug counselor at City College of San Francisco.
  • Steve Good, Executive Director of Five Keys Charter School, noted learning disabilities are ten times higher for inmate population compared to the community, where 3-5% have learning disabilities.  Five Keys was originally established by the SF Sheriff’s Department in 2003 as the first charter school in the nation to operate inside a county jail.  Based on principles of social and restorative justice, it provides inmates the opportunity to restart their education with a focus on Five Keys: education, employment, recovery, family and community. 
Prisoners of Age at Alcatraz exhibition: “You see the frailty, the forgetfullness, the universal problems of old age."

Back to school

SFSU Gerontology Celebration honored Professor Brian De Vries, who will begin FERP (Faculty Early Retirement Program), phased retirement that allows him to continue teaching part-time. Center for Age-Friendly Excellence (CfAFE) Program Director and Professor Anabel Pelham, who began her FERP two years ago, got everyone chuckling when she recalled someone suggesting that she marry Brian to help resolve his problems with immigrating from Canada so he could start teaching at SFSU!  

 
In appreciation, Brian got a standing ovation and chocolate cake! I actually had to stand in line to personally thank him for inspiring me with his scholarship and commitment to social justice, plus chocolates in his office! While Brian’s position as policy advisor to AARP is drawing to a close after 5 years, he recently joined a committee of the American Association of Medical Colleges working to ensure inclusion of sexual minorities in medical school curriculum.

USF School of Nursing and Health Director Kathy Raffel moderated a discussion on Improving Care at Home: Challenges and Opportunities at Fromm Institute of Lifelong Learning. 
  • Family Caregiver Alliance Executive Director Kathy Kelly talked about expectations of unpaid caregivers are greater now and growing due to increased life expectancy, increased complexity in health care and costs (now done in home), more women in workforce, and decreased number and sizes of families. 
  • San Francisco IHSS Public Authority Executive Director Kelly Dearman talked about independent living movement’s influence in starting consumer-directed IHSS in 1973.  Today 22,014 low-income seniors and adults with disabilities in San Francisco are served by IHSS workers (majority family and friends) who earn $12.25 per hour minimum wage, with overtime under FLSA effective November 12, 2015.  Starting January 2016, SF IHSS Public Authority will require 48 hours of basic training for caregivers through Homebridge.