Oh, the places you’ll go!

A former client recently called to let me know that she has settled in San Antonio, where her niece provides home care that my client could not afford while living alone in San Francisco.  Now my client looks out into a garden, instead of the skyline from her former Tenderloin studio apartment.  Her new home is in a cul-de-sac with no sidewalks for wheelchair accessibility, but then she quickly added that it is too hot outside for her to leave her air-conditioned home anyway.  I mentioned that she missed the recent power outage caused by an electrical fire at PG&E substation in Tenderloin.  My client said she missed San Francisco, though she was mostly homebound except for outings to medical appointments.  

Last month, SF Main Library hosted a panel discussion, From Homelessness to Housing in San Francisco, moderated by San Francisco Chronicle Editor-In-Chief Audrey Cooper, and featured  BART Board Director Lateefah Simon, District 2 Supervisor Mark Farrell, San Francisco Chronicle Reporter Kevin Fagan, Department of Homelessness and Supportive Housing Director Jeff Kositsky, and Coalition on Homelessness Executive Director Jennifer Friedenbach.  Jeff proposed ending the home mortgage income tax deduction, which has been used by at least one-third of upper-income taxpayers; instead, he favored Germany’s model of tax incentives for rentals.  (Trump’s proposed tax plan to retain the mortgage tax deduction while doubling the standard deduction would likely further benefit higher-income taxpayers instead of broadening home ownership.) 

Several homebound clients, formerly homeless and now living in permanent supportive housing, appeared in a related exhibition, Everyone Deserves a Home, at SF Main Library. This exhibit showed photos of residents holding signs handwritten in response to “What does home mean to you?” and oral histories of their experiences of coming to San Francisco and their struggles (trauma, neglect, substance abuse, poverty, racism, etc.) that led them to their current home.

While home is important to age in place, the consequences of isolation and loneliness from being homebound and aging without community was the topic at the April 27, 2017 hearing before the U.S. Senate Special Committee on Aging. Experts testified on the negative mental, behavioral and physical health outcomes of isolation and loneliness, including the oft-quoted research finding that prolonged isolation is comparable to smoking 15 cigarettes a day!  (Effective April 1, 2017, California has imposed a $2 tax on tobacco products in an effort to discourage smoking, but it cannot legislate away social isolation and loneliness—though many smokers are already isolated.) 

Therefore, I encourage my homebound clients (especially if living alone and watching TV) to venture outside of their home (comfort zone) and into our communities, when possible.  And thanks to technology, I hope my blog can help bring the community (engagement, resources) to them!

SFSU Gerontology Program

SFSU Gerontology Program Coordinator Darlene Yee and College of Health & Social Sciences Dean Alvin Alvarez welcomed 160+ guests to SFSU Gerontology Program’s 30^th Anniversary Dinner held on campus. (SFSU Gerontology Program—the first and thus oldest graduate gerontology program in the California State University and University of California systems—is one of the educational trip offerings at this summer’s IAGG Congress!)

Serenaded by campus musicians 

Dinner plate 

Faculty table with Professor Brian de Vries, lecturer and California Advocates for Nursing Home Reform (CANHR) founder Pat Mc Ginnis, and Professor Annabelle Pelham

Classmates Ardath, Diane, Kay, Mary, Lois and Raenika 

Classmates May (holding up donation envelope) and Ardath 

Pat Mc Ginnis presented Distinguished Long-Term Care Advocate Award to Mark Leno, State Senator (2008-2016), for his advocacy of consumer protections for aged constituents: increase minimum wage and sick days for IHSS workers (SB 3), ban on admissions to RCFE if risk of harm (SB 1153), RCFE Eviction Protection Act (SB 897), etc.

Bayview Hunters Point Multi-Purpose Senior Services Director Cathy Davis and Aging Commission President and SFSU Gerontology alumna Edna James

Jewish Community Center of San Francisco 

I took vacation leave to attend worthwhile JCCSF’s 10^th Annual Art of Aging Gracefully Resource Fair: Stay Vital, Healthy and Fit, organized by Adult Programs Manager Shiva Schulz. 

Margaret Chesney, Director of Osher Center for Integrative Medicine at UCSF, presented “Outsmarting Stress, Enhancing Resilience & Optimizing Health in Today’s World.”  She recommended BREATHE strategy to enhance well-being:

Be present with self in the moment - slow down

Realistic goals - celebrate meeting them

Everyday events – notice positives and share with others

Acts of kindness – create positive events for others

Turn negatives around – reframe to find silver lining

Humor – smile

End each day with gratitude

Department of Aging and Adult Services (DAAS) Nutritionist Linda Lau at one of the busiest resource tables.  According to the most recent DAAS Needs Assessment, senior meals funding has shifted from congregate to home-delivered meals.  Does this reflect pattern of growing isolation of seniors at home? When clients tell me they are discouraged from eating at congregate meal sites because site staff/volunteers attempt to collect “suggested contribution,” I advise them to file complaint with DAAS!  

Health Librarian Janet Tom at SF Public Library table. I often refer homebound clients to Friends for Life to borrow books, DVDs, CDs, etc. by mail. SFPL also has its own youtube channel.

Office on Women’s Health hosted Women’s Health Leadership Institute, which I participated in almost 4 years ago, so always happy to reconnect with Regional Coordinator Kay Strawder (pictured at right) and Public Health Advisor Sheila James (not pictured at JCCSF because she was participating in Walk to Work Day).  Since women outlive men, the future is female …. but with attempts to repeal Obamacare, what is the future of women’s health?

                                  SF Public Library – Main Branch                                         

Filmmaker Felicia Lowe discussed genealogy research after a screening of her documentary, Chinese Couplets, exploring the life of her mother who assumed the identity of a paper daughter to immigrate to the U.S. during the Chinese Exclusion era.  Once settled in the U.S., Felicia’s mother reinvented herself several times through roles in her first marriage, motherhood, business, widowhood, etc. Near the end of life, Felicia's mother expressed contentment that she finally had financial security through remarriage to a wealthy man.

  

Contemporary Jewish Museum

Like Curious George Saves the Day: The Art of Margret and H.A. Rey (exhibit 5 years ago), I looked forward to this month’s opening of Roz Chast: Cartoon Memoirs – this time with the living artist in person!  

New Yorker cartoonist Roz Chast's memoir, Can’t We Talk About Something More Pleasant? is about an only child providing care for elderly parents until the end.

Exhibit included short film of Roz revealing that she wrote Can’t We Talk About Something More Pleasant? because “I didn’t want to forget how they talked, and I didn’t want to forget how they were …” 

Couch below speech balloons painted on wall provided photo opportunity

  

Lighthouse for the Blind and Visually Impaired

Frances Neer Visually Impaired Persons Forum presented Case Management with Tracy Moore and Cherie Golant of Institute on Aging.  Cherie described her case manager role as one who conducts an assessment, develops and implements a care plan, helps navigate systems and connect clients to resources.  As a private case manager, Cherie offers free 30-minute consultation by phone and then charges $135 per hour; services provided are limited to client’s ability to pay. A case manager can have different backgrounds and training (MSW, RN, LVN, PT OT, MA Gerontology).  The government also funds case management services through Multi-Purpose Senior Services (MPSS), Community Living Fund (CLF), various senior centers and non-profit agencies.

Ed Roberts Campus

 

Journalist Belva Davis moderated Alzheimer's Association 9^th Annual African American Caregiving and Wellness Forum at Ed Roberts Campus in Berkeley.

Rochelle Woods, MD, delivered keynote, “Self-Care While Caring for Someone with Dementia” reminding us that African-Americans are almost twice as likely to develop Alzheimer’s, and tend to take care of family to age-in-place.  African-Americans, especially women, have capacity to tolerate stresses, but are more susceptible to effects of taking care. She said caregivers need to put their mask on first (maintain mind-body-spirit, MBSR), educate about dementia (The 36-Hour Day) including support, have fun (old man dancing), be smart and savvy (advance directives, power of attorney, life care planning).

Heather Gray presented “Understanding and Responding to Dementia Behaviors” reminding us that people with Alzheimer’s still want independence and opportunities for participation/contribution, yet may not have language to express their needs.  Instead of stepping in and insisting something be done a certain way, let go if the person with Alzheimer’s can remain safe and content/engaged/involved.  It takes a village, so reach out to the community for support. 

“Ask the Experts Panel” Discussion, with presenters plus Rita Hartgrave, MD, addressed practical issues like when it’s time to go to nursing home, taking away car keys, bathing, etc. 

John Olichney, MD, presented “UC Davis’ Disparity in Brain Aging Research,” finding low levels of vitamin D is associated with cognitive decline.  Since the body makes vitamin D through sun exposure, many older adults (especially shut-ins) are low in vitamin D because they are not outside enough.  African-American and Hispanic subjects had lower levels of vitamin D than white subjects, as darker skin reduces the amount of sunlight absorbed. Overall, subjects with inadequate Vitamin D levels lost episodic memory and executive function more quickly. 

Cynthia Carter Perrilliat emphasized personal approaches to grief (process of healing from loss) in her talk, “Managing Grief and Loss While Caregiving.”

Asha Koshy, Program Manager at Bay Area Community Services Adult Day Health Care, presented “Connecting to Loved One Through Home-Based Activities.” She reminded us of 3 keys for failure-free activities that engage:

1. go with the flow
2. praise effort
3. acknowledge skill

Activities can include arts and crafts, music therapy, cooking, reminiscing and exercise.  Create a routine that is SPECIAL:

Schedule

Peace

Eliminate caffeine, especially at night

Cue what to expect

Include in activities

Activity

Lights

Intergenerational drumming at Berkeley Flea Market outside Ashby BART Station.

  

Black Cuisine in Bayview 

Last month, I volunteered at 37th Annual Black Cuisine Festival, fundraiser for Bayview Senior Services, at George W. Davis Senior Center.

Dance outdoors to Bobbie "Spider" Webb and make vitamin D!

Civic Center Plaza

April 15 Tax March protesters called on Chicken Don (30 foot inflatable made in China) to release his tax returns, as every U.S. President has done so for past 40 years.

"reject kleptocracy”

Dark Room Truck performs “Dump Trump Bump” protest song  

Earth Day “eye heart science” buttons 

March for Science posters 

Intergenerational March for Science from Ferry Building to City Hall

Sunday Streets

Now in its 9^th year, Livable City’s Sunday Streets Tenderloin offered live music, arts and crafts, information sharing by community non-profit and government agencies, etc.—opportunities to increase physical activity for all ages in a car-free environment! 

Curry Senior Center, providing medical and social services since 1972 to seniors who make up half of the population in the Tenderloin, gave away toothbrushes! Alisa Oberschelp, MD, and Angela Di Martino wear black Curry Senior Center T-shirts.

Central City SRO Collaborative organizes with SRO (single-room occupancy) tenants in San Francisco’s Central City neighborhoods including Tenderloin and South of Market communities. 

Permaculture is the answer

Butterfly effect: Be the change you want to see in the world! Artists transform 4 Corner Friday wall at Golden Gate and Hyde. 

“I’m at peace with myself”