Sunday, September 30, 2018

Wellness

Due to my work with mostly homebound older adults over the past three years, I have been missing-in-action from many community events.  Last Friday afternoon, I caught up with former colleagues when I returned to campus for Department of Aging & Adult Services (DAAS) Community Training and San Francisco State University (SFSU) Gerontology Program’s inaugural Silver Lining Lecture Series: Aging, Health & Wellness in San Francisco.  When people ask where have I been “hiding”, I respond that I’ve been working with older adults in facilities.
fa·cil·i·ty (fə-sĭl′ĭ-tē)
n. pl. fa·cil·i·ties
2. often facilities
a. A building, room, array of equipment, or a number of such things, designed to serve a 
particular function: hospitals and other health care facilities.
b. Something that facilitates an action or process: The region has very poor transportation
facilities.
3. facilities Informal A restroom or public toilet.
facility. (n.d.) American Heritage® Dictionary of the English Language, Fifth Edition.(2011). Retrieved September 30 2018 from https://www.thefreedictionary.com/facility

My response was a surprise to some who knew me as a gerontology student, focused on home- and community-based services to facilitate aging in place.  But as a gerontologist three years after graduation, I decided to be intentional in gaining experience at every level in the continuum of care which includes facilities, such as Residential Care Facilities for the Elderly (RCFE, aka Assisted Living) and Skilled Nursing Facilities (SNF).  I have avoided working at for-profit facilities because resident care means more than profits (though I was fine working at for-profit accounting and financial organizations prior to launching my gerontology career).  Also, I have observed how residents with complex medical needs are underserved at RCFEs, and ought to receive more appropriate care at SNF.  In any case, I have remained focused on health promotion and wellness throughout the continuum of care. 
SFSU Gerontology Program Coordinator Darlene Yee-Melichar and San Francisco Aging & Adult Services Commission Advisory Council President Leon Schmidt welcomed attendees in Library Special Events Room filled to capacity.  (Took photos from front row, where I was seated next to fellow SFSU Gerontology alumna and solo ager Betty Burr.)
Keynote speaker Scott Wiener, State Senator, discussed his Legislative Agenda for Seniors in the SF Bay Area: his authoring of SB 219 LGBT Bill of Rights in Long-Term Care (LTC) and SB 2021 Extending Prescription Drug Co-Pay Limits; ongoing efforts to ensure all seniors have access to housing, nutrition and health care; livable wage for IHSS workers so seniors can age in home; and “if they’re in assisted living or nursing home (facilities), make it a positive experience.” He also commended 30th Street Senior Center for its meals and supportive services so seniors are not isolated. 
SFSU Gerontology Advisory Council President and alumnus Tom Berry, with Openhouse co-founder Marcy Adelman and Darlene Yee-Melichar, presented Distinguished LTC Advocate Award to Senator Wiener.
 
Close-up of LTC Advocate Award 
30th Street Senior Center Director Valorie Villela and Beth Macleod, LCSW.
SFSU Gerontology alumna and Eldercare Advocacy Bay Area Founder Cristina Flores with her mother and daughter – three generations, though they appear to be from the same generation?! 
Professor Yee presented Developing Gerontology Workforce Competency to Promote Healthy Aging & LTC.  She predicted growth in nursing home care because demand will drive supply, as baby boomers age into the oldest-old (age 85+) with higher level of care needs in the next 10 to 20 years.  Graduate gerontology students can complete 480 hour internship as SNF Administrator-In-Training (AIT); without a master’s degree, the state requires completion of 1,000 hours SNF AIT. 
DAAS Program Analyst and urban planner Valerie Coleman presented Age & Disability Friendly SF, noting San Francisco is unique in including “Disability” to Age-friendly initiative that began implementation this year.
Hey, that’s my photo of Dance Generators (with Beth Macleod) performance at 2015 Party with a Purpose celebration of Long-Term Care Coordinating Council's 10th Anniversary, from blog post at http://geronature.blogspot.com/2015/10/aging-disability-friendly-san-francisco.html! 
Gwen Harris, SFSU Gerontology alumna and Geriatric Care Manager, presented on Palliative Care & Quality of Life.  She recommended that every 18 year old should be given voter registration and Advance Care Directive. 
At this month’s SF End-of-Life Network meeting held at Cypress Golden Gate (RCFE), Art for Recovery Program Director Cindy Perlis discussed her 30 years of art therapy with cancer patients at UCSF. 
Eat a rainbow of colorful doughnuts for breakfast at Pathways to Improved Care: Rehabilitation Symposium at Laguna Honda 
Paul Christopher Focht, Aud.D., presented The Diagnosis and Treatment of Hearing Impairment.  He conducts otoscopic inspection of the ear canal for cerumen (aka “earwax”) buildup that can cause problems with hearing and balance, which increase risks for cognitive decline and falling.  When we age, cerumen impaction is more common because the cerumen is much drier so it gets hard and creates a plug.  As many as two-thirds of residents in LTC facilities may suffer from cerumen impaction, and Medicare covered nearly 1.7 million impaction removal procedures at a cost of more than $51 million in 2016! 

Older Americans (age 65+) continue to make themselves heard during elections.  In 2016, their turnout rate was 70.9%, the highest of any age group.  The majority (51%) voted for Trump, with the strongest support from older white men (59%) and older white women (53%). 
Ian Haney Lopez, UC Berkeley Law Professor and author of Dog Whistle Politics: How Coded Racial Appeals Have Reinvented Racism & Wrecked the Middle Class (2014), talked about The Future of Whiteness at Rights and Wrongs: A Constitution Day Conference at SFSU.  He presented a crash course on how political strategists have exploited racial pandering to build resentment toward government, manipulating voters into supporting policies that favor the wealthy.  Starting with the 1964 Southern Strategy, they could appeal to rising anxiety/fear among whites to break the New Deal coalition, bringing race into politics—not in name, but “code” such as law and order, state’s rights, Silent Majority, Real American, end welfare as we know it, etc.  
Similar to Reframing Aging, Ian seeks to reframe the Race-Class Narrative for cross-racial solidarity and shared prosperity.  High levels of inequality negatively affect even the affluent, possibly because inequality reduces social cohesion so everyone suffers.
Check out video, “We Must Talk About Race to Fix Economic Inequality.”  
Cal State University (CSU):"As the CSU got darker, funding got lighter"
When I invited Marc Dollinger, SFSU Richard and Rhoda Goldman Chair of Jewish Studies and Social Responsibility, to speak at a RCFE about his new book Black Power, Jewish Politics: Reinventing the Alliance in the 1960s, he cautioned that he sometimes found that “older crowds are not as excited or engaged” with his presentation because “it could represent a revision of their own memory,” and offered a less risky topic based on his three other books.  My response was bring it on! with excitement that Marc’s new book presented a challenging perspective that would take us out of our comfort zone and stimulate brain connectivity! We learned new vocabulary, filiopietistic (ethnic self-congratulations, like aren’t Jews great?) historiographic analysis (the interpretation of the writing of history over time).