Wednesday, February 28, 2018

Live from Age-Friendly San Francisco

Livestreaming has the potential to make the world more accessible, especially for homebound people.  Starting with the Great American Solar Eclipse last summer, I’ve organized a few livestreaming watch parties in an older adult residential community.  Last month’s Power to Change symposium included closed captioning and the ability to ask real-time questions.  Then earlier this month, I organized a watch party of Supreme Court Justice Ruth Bader Ginsburg (author of 1999 Olmstead decision) being interviewed by Forward editor Jane Eisler, with ASL interpreter and questions submitted by viewers in advance. Each livestream came with technical audio-visual difficulties, along with complaints from mainly oldest-old (age 85+) residents who preferred face-to-face interactions than virtual learning.

As a lifelong learner and old soul myself, I reach out to local experts who can speak live from age-friendly San Francisco on a variety of topics that engage mature adults.   

Nostalgia for comfort food
Rachel Gross, Professor of American Jewish Studies at SFSU, presented a talk on Referendum on the Deli Menu: American Jewish Nostalgia and the Deli Revival about adapting traditional American Jewish comfort foods for the 21st century, with an emphasis on sustainability and local sourcing.

Medical cannabis 
Donald Abrams, MD, Professor of Clinical Medicine at UCSF, presented a timely talk on Medical Cannabis. With the growing number of states legalizing cannabis for medical or recreational purposes, cannabis use among older Americans has increased significantly, despite a lack of biomedical, clinical, and public health research.  Cannabis remains illegal under federal law.  Because the Drug Enforcement Administration (DEA) has listed cannabis as a Schedule 1 drug (“high potential for abuse” and “no currently accepted medical use”) and has designated National Institute on Drug Abuse (NIDA)—part of National Institutes of Health (NIH)as the sole source of cannabis for scientists, NIDA will not fund cannabis studies on its health benefits but only harm.  Yet, with funding from NIH, Dr. Abrams has conducted pioneering research on the safety and pain relief properties of cannabis for patients with AIDS and cancer.
Dr. Abrams suggested that cannabis-induced euphoria is not such a bad thing: “Is it really an ‘adverse experience,’ particularly in a terminal patient? Is a single treatment that increases appetite, decreases nausea and vomiting, relieves pain and improves sleep and mood, a potentially useful tool in oncology and palliative medicine?”  
During Dennis Peron Memorial Tour in Castro District (aka LGBT mecca), Green Guide Tours founder Stuart Watts showed a photo of himself with Castro resident Peron aka “Father of Medical Marijuana” who died last month at age 71. Peron advocated for medical cannabis, which helped his partner ill with AIDS ease pain and nausea. 
“Brownie Mary” Rathbun (1921-1999) met Peron at Café Flore in 1974.  Brownie Mary was an IHOP waitress, with a grandmotherly visage, who earned extra money baking and selling cannabis-laced brownies from her home.  Her customers were mostly gay men with AIDS, who found that cannabis helped them with wasting syndrome.  Later people donated cannabis to Brownie Mary, who then began baking more brownies and distributing them free to sick people.  She was arrested several times for possession of cannabis brownies.  Brownie Mary also volunteered at SF General Hospital’s AIDS ward, where Dr. Abrams worked as physician and became inspired to conduct the first study about the effects of cannabinoids in people with HIV. 

Thanks to the efforts of Peron and Brownie Mary, San Francisco passed Prop P, the nation’s first medical cannabis bill in 1991.  In the following year, they opened the San Francisco Cannabis Buyers Club, the first medical cannabis dispensary in the U.S.  In 1996, California became the first state to legalize medical cannabis with voter-approved Proposition 215. According to Peron, “Every cannabis user is a medical patient whether they know it or not.” 

Effective January 1, 2018, Proposition 64 (passed in 2016) allows licensed medical cannabis dispensaries in California to open their doors to recreational customers age 21+ who can purchase a limited amount (1 ounce) of cannabis without a current physician’s recommendation or medical marijuana identification card (MMIC, which can cost up to $100).  MMIC holders must be age 18+, may purchase higher quantities of cannabis, and do not have to pay sales and use taxes on their cannabis purchases. 

Social insurance
At Home With Growing Older hosted a forum on Social Security, Medicare and the Campaign against Entitlements, presented by Justice in Aging Executive Director Kevin Prindiville and UCSF Sociology Professor Emerita Carroll Estes, at SF Public Library.

Lifelong mothering
At Reinhardt Alumnae House, Mills College President Elizabeth Hillman and former College President Jan Holmgren hosted It Never Ends: Mothering Middle-Aged Daughters (2017) book reading and discussion with authors, Sandra Butler (age 79) and Nan Fink Gefen (76), who explored older women’s reflections on motherhood when daughters are in their 40s and 50s. 

Reverse Aging? 
Sutter Health Institute for Health and Healing hosted The Science of Healthy Aging with 51-year-old Sara Gottfried, MD, at Sherith Israel.  As one of the first 350 to register for this free event, I received a free copy of Gottfried’s book Younger: A Breakthrough Program to Reset Your Genes, Reverse Aging, and Turn Back the Clock 10 Years (2017).  As an old soul who aspires to greater maturity, I was almost repelled by the title of this anti-aging book and its overemphasis on a youthful physical appearance rather than health.

Creative Aging 
At Contemporary Jewish Museum, met up with SFSU Gerontology Professor and Program Chair Darlene Yee-Melichar to attend Creating A New Old San Francisco, a one-day “deep dive into contemporary aging” by Creative Aging International (CAI).  She stands between journalist Paul Kleyman and fellow Gerontology Professor Emiko Takagi.
Event included resource table and networking opportunities.  Connected with Caitlin Morgan of Institute on Aging and Hope Levy of City College of San Francisco’s Older Adults Program.
Dominic Campbell, CAI co-founder and Global Brain Health Institute (GBHI) Fellow, described this mini-fest of contemporary aging about conversation, connections and “joining the complex story in the middle.”

Session 1 Overview – Issues in Contemporary Aging: “Why? Everyone attending brings expertise. To avoid telling people what they already know while articulating what makes contemporary aging unique, we asked these speakers to share knowledge from their experience, so we might begin to think together.”
San Francisco Bay Area speakers seated from right to left in photo above, and presented in the following order:

     Carroll Estes, PhD, of UCSF and Nicholas DiCarlo discussed concepts from their upcoming An Encyclopedia of Contemporary Aging (expected to be published by Routledge in late 2018/early 2019): inequality, power, resistance, abjection, trauma, destruction of the commons, right to self-development, intergenerational, interdependence, austerity, gentrification, watch-bitch v. watchdog.

     Susan Hoffman, Director of Osher Lifelong Learning Institute (OLLI) at UC Berkeleyspoke about Radical Aging: BELIEF that we can all self-actualize, KNOW that there are obstacles and limitations, WISDOM and experience to expand possibilities; our roles (pioneers & activists; researchers & translators; poets & philosophers; inventors & designers; educators; artists & amateurs); 25% of OLLI members are age 80+, calling OLLI the “4th Age Salon.”  She highlighted influences through the decades (1960s: Marian Diamond’s brain plasticity research, Free Speech activism, White House Conference on Aging; 1970s: gerontology programs, Gray Panthers, The Center for Independent Living, American Society on Aging, On Lok, California Arts Council; 1980s: Age Wave, SeniorNet, Genome Research Institute, Association for Cultural Equity; 1990s: Encore, Multimedia Gulch, UCSF Memory & Aging, Walter Bortz’s Dare to be 100, Xerox PARC; 2000s: Osher Lifelong Learning Institute, Stanford Center on Longevity, Village Movement, IDEO, Elizabeth Blackburn’s telomeres research; 2010s: Age-Friendly Cities, Aging 2.0, GBHI Fellows).  She said we need to transcend divisive generation labels because we are all perennials!


     Gretchen Addi, Consultant and Designer-in-Residence at Aging 2.0, on Technology and Business – Insider Awareness: recalled Jetsons family in 1962 living in the future—"what we take for granted today was the science fiction of the previous generation”; mentioned superpowers, like IDEO colleague Barbara Beskind who is seeking to design glasses and earbud for facial recognition as adaptive technology for her macular degeneration; new technology can improve lives of people as we age; called for shift to design with (not for) older adults, about people (not age group), interdependence (not independence); keep older adults mobile, engaged, healthy, connected; accessibility to avoid risks of exclusion and isolation if not tech savvy, privacy and security concerns. 

     Bruce Miller, MD, Director of UCSF Memory and Aging Center, on Challenges of Dementia: epidemic of age-related cognitive impairment, most costly health problem in U.S. that especially impacts poor; 70% preventable risk factors (cardiovascular disease, high cholesterol, lack of exercise, loneliness, isolation, depression, head trauma), 30% neurodegeneration by aggregate bad proteins.

Session 2 The San Franciscan View – Innovations at Home: “Why? Aging shrinks geography, all successes are, ultimately, local. Great innovations are happening. This celebration of SF projects already ‘creating a new old’ shares some of the innovation in this city.”  Choice of two breakout sessions:
Room 1 – Caring Systems – how we live where we live: “Cultures of caring community being nurtured in SF.”  This session was chaired by Tim Carpenter, founder of EngAGE, a 20-year-old nonprofit that builds and operates affordable senior and multigenerational apartment communities as “vibrant centers of learning, wellness, and creativity.” 


·     Jerry Brown, CEO of Bethany Center Senior Housing, talked about his affordable housing site’s collaboration with partners (OnLok PACE, IHSS, IOA, Openhouse, etc.) to provide a continuum of care to diverse elders representing 37 countries and 8 languages. Housed at Bethany Center and modeled after Mather LifeWays, Ruth’s Table is a multigenerational community center that provides art and wellness programs, integrating senior residents with visitors of all ages from the surrounding community. 
·     Kate Hoepke, Executive Director of San Francisco Village (SFV), talked about social networks diminishing as we get older and face marginalization; in response, the village grassroots movement began 12 years ago to create intentional communities that are intergenerational to dignify aging.  She noted the greatest barrier is reluctance to ask for help, yet one needs to ask to get help.
·     Karyn Skultety, Executive Director of Openhouse, introduced her organization as the 1st LGBT-welcoming affordable senior housing, serving over 2,300 people not living in housing last year, and a resource for cultural humility training.
·     Rachel Lovett of Thriving in Place (advocacy for IHSS) and Re:Imagine (end-of-life exploration event on April 16-22, 2018).
Room 2 – Dignity and Empathy in Place: “Dignity and empathy as drivers of creativity, generations of innovation,” chaired by Rachel Main of Alzheimer’s Association.  (Photo only, attended session in Room 1 instead.)

·     Jessica McCracken – Ruth’s Table http://www.ruthstable.org/
·     Doniece Sandoval – LavaMae https://lavamae.org/
·     Jenn Chan – Senior Shower Project https://www.seniorshowerproject.com/
·     Cathy Davis – Bayview Senior Services https://bhpmss.org
·     Adam Waskow – Memory Dog http://www.memorydog.org/team

Vegetarian box lunch prepared on-site by Wise Sons Jewish Deli 
JCCSF Adult Programs Manager Shiva Schulz and Hope Levy

Session 3A – Creative Practice as Strategy – Examples from national and international understanding of creative practice leading change.

·     Anne Basting, Professor of Theater at University of Wisconsin-Milwaukee, and Founder, CEO of TimeSlips Creative Storytelling, asked us to text someone: "what gives you a feeling of awe?" She mentioned 3 sources of awe: nature, art and spirituality.  We can facilitate awe through creative engagement: Yes, and (inviting and affirming choices through play/improv); Beautiful Questions (open shared path of discovery); Proof of Listening (radical affirmation of choices); Rigor/Value (frame in context with social capital); Connect (individual and communal purpose)
·       Arti Prashar, Artistic Director/CEO of Spare Tyre in London, promotes collaborative participatory art with hard-to-reach people (age 60+, people with dementia/learning disabilities, women who have experienced violence).  This can be done using gardens as non-verbal theater that engages in the present moment, invites in space of senses, adjusts to slower pace, elicits play and imagination.
·       Dominic Campbell, co-founder of CAI and director of Bealtaine Festival in Ireland, the world’s first (1996) nationwide arts festival celebrating creativity and aging.  He talked about Celebration as Strategy, and the need for fun festivals, with elements of individual choice (because life is about risk), empathy exchange, disruption (stereotype-smashing creative arts day club, Meet Me at the Albany) and connection.
In The Vintage Years: Finding Your Inner Artist (Writer, Musician, Artist) After Sixty (2013), author and retired SF Bay Area clinical psychologist Francine Toder, PhD, notes that later life is an exceptionally good time to study art because our mature brain has improved judgment, focus of attention, patterning, and bilaterality. Nearing age 70 as she approached retirement, she took up playing the cello and practices daily. 
Hope Levy and Darlene Yee-Melichar, holding Legacy Film Festival on Aging (LFFoA) program, meet-up with LFFoA Director Sheila Malkind.
Dance and Tai Chi with Greacian Goeke, Director of Impromptu No Tutu, and her Bay Area dance ensemble express themselves in improvisational movement outside CJM, after emergency alarm triggered temporary evacuation.
Session 3B - Creative Practice as Strategy - Evolving Innovation: Where, how and why.
·     Anne Basting of Timeslips talked about transforming long-term care with the collaboration of nursing home residents through The Penelope Project: An Arts-Based Odyssey to Change Eldercare (2016)  
·     Kate de Medeiros of Miami University co-authored with Basting The Gerontologist article, "'Shall I Compare Thee to a Dose of Donepezil?': Cultural Arts Interventions in Dementia Care Research" about the challenges of measuring interventions in dementia care based on subjective experience.
Variety Pack! a capella community choir from Oakland, with Artistic Director Lauren Carley.
Session 4 – Sustained Systemic Innovation: Planned sustained change session chaired by William Cleveland from Center for the Study of Art and Community (Bainbridge Island, WA), which builds arts partnerships.
·       Maura O’Malley and Ed Friedman, founders of Lifetime Arts in New York, provide technical assistance to support arts programming for older adults based on Gene Cohen’s creative aging research focused on mastery and social engagement.  Lifetime Arts is also a leader in library-based creative aging programs, partnering with American Library Association. 
·       Kelly Dearman, Chair of Aging & Disability Friendly Task Force in San Francisco, presented on the implementation of San Francisco’s Age and Disability Friendly Plan
·       Gavin Barlow and Annabel Turpin of Meet Me in Albany & Future Arts Centres in UK
·       Tim Carpenter – EngAGE 
Bay Area monologuist and GBHI Fellow Josh Kornbluth performed a piece from “Brain Improvsbased on his experiences with people with dementia, a disease characterized by loss of empathy.  His idea is to start a revolution through storytelling, which mirrors what people have gone through so distance is broken down for a “worldwide peaceful revolution of peaceful empathy.”  His show at The Marsh has been extended through the end of this year. 

Session 5 - Tools for Change: Moving towards deeper strategy.
·       Penelope Douglas of Culture Bank in San Francisco talked about how art helps us see the poor as communities with assets of value and opportunity for investment.
·       William Cleveland, Director at Center for the Study of Art and Community in Washington State, talked about Arts Based Community Development (ABCD) ecosystem to advance dignity, health, productivity
·       Teresa Bonner, Director of Aroha Philanthropies in Minneapolis, shared website of resources at https://www.vitalityarts.org/ to champion participatory arts education programs for older adults.  

Session 6 - What Next? A question to start and end with. When you determine the kind of old you want to be, you shape the world you want to grow older in. What’s your next step? Sharing thoughts from the room gathered over this one day – nurture and heal, inspire and mobilize, educate and inform, build and improve.
Community Music Choir Solera Singers of Mission Neighborhood Center sing songs in Spanish from Latin America.

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