After July 4th
weekend, SF DPH Director Grant Colfax, MD, returned to press conferences, calmly sharing what keeps him up at
night: SF’s reproductive rate rising above 1 (meaning each person infected with
COVID-19 is infecting more than one other person, contributing to spread that
could overwhelm our health care system). As a result of rising COVID-19
hospitalizations, SF was placed on state watch list, requiring further pause on
reopening. Dr. Colfax reported that the
average age of COVID-19 patient at SF General Hospital has been 41 years,
debunking the belief that only older people are most at risk.
Yesterday, Dr. Colfax noted rapid increases in SF’s
COVID-19 cases: took 38 days to go from 2,000 to 3,000 COVID-19 cases, half as
long to go from 3,000 to 4,000, and just 10 days this month from 5,000 to 6,000! Based on current estimates, he projected more
than 750 COVID-19 hospitalizations by October and more than 600 COVID-19 deaths
in 2020; worst case scenario projected 2,400 hospitalizations and 1,800 deaths!
Epidemiologists
estimate that
every death from COVID-19 will leave approximately nine bereaved in U.S. If data does not persuade people to follow public health orders (distancing, masking), then perhaps sharing
more personal stories of losing family and friends to COVID-19 might be more
compelling.
In just six
weeks, COVID-19 hospitalizations rose from 26 to 109, with one-quarter in
intensive care units (ICU); acute care and ICU beds have grown 15% each week
this month. As
a result of this COVID-19 surge, SF officials announced plan for temporary overflow hospital in the Presidio for non-COVID-19 patients in case hospital beds need
to be cleared for COVID-19 patients.
“Get
back to normal”?
This pause
might continue through the next year, according to yesterday’s UCSF Medicine
Grand Rounds COVID-19 update on Testing, Treatments, and Vaccines. Can we use this
pause to do better than “get back to normal”?
In Gerontological Society of America’s webinar, Aging
Native American, Rural, and Homeless Populations: Engagement and Advocacy
During the COVID-19 Pandemic, Curry Senior Center Director David Knego,
MSW (SFSU), talked about serving
homeless older adults in Tenderloin, SF’s skid row.
Lack of
coordination partly explains why it took a minimum of 2 years to house a
homeless senior in 2018!
Last year, SF
Department of Homelessness and Supportive Housing launched Coordinated Entry
system to improve response to homelessness. During this pandemic, SF made
progress in housing homeless older people (age 65+) who receive priority under
Project Roomkey. Notably, settlement from UC Hastings
School of Law’s suit against SF resulted in rapidly moving over 400 people
living in tents crowding sidewalks in Tenderloin to hotels leased by the City
with wraparound services for duration of emergency. Can this be a New Normal, making
temporary relief into permanent supportive housing?
Before COVID-19, “normal” rent for 1-bedroom in SF was $3,500
per month. Since COVID-19 pandemic, SF rents have dropped because younger people
are leaving the high cost of living, as more people lose jobs or work from home, and many
attractions (restaurants, theater, libraries, community events, etc.) have
closed. This has eased the housing
shortage for people who remain and wish to age in place.
Mask wearing
When
President Trump said wearing a mask made him look like Lone Ranger (eye mask
with peep holes?), wonder if he covered his nose and mouth? UCSF’s
Bob Wachter, MD, suggested having “sports and media influencers” instead of
politicians to persuade people to act safely. Very sad comment on who people trust?! University
of San Francisco data research scientist Jeremy Howard launched #masks4all
movement “for people and Governments to follow the overwhelming scientific
evidence that shows we need to wear homemade masks in public to slow COVID-19.”
If not homemade, one can buy a mask
(preferably tightly woven, 100% cotton, layered,
snug fit; not uncomfortable N95 mask).
On July 22, SF DPH updated
its order expanding mandatory mask
wearing to age 10+. Dr. Colfax reiterated enforcement focus on businesses/institutions, while
leaving individuals to voluntary compliance based on his belief that “best way
to change the social norm” is messaging by “trusted community members” to
provide information and support, including facial coverings. How will this “benefit of the doubt” approach
address violators who don’t care about community while they insist mask wearing
infringes on their civil liberties? SF needs to consistently enforce its own health
orders to protect health and ensure safety during this pandemic!
CDC Director Robert
Redfield said, “If
all of us would put on a face covering now for the next 4-6 weeks, we could
drive this epidemic to the ground.” SF
entrepreneur Marc Benioff said 3 weeks of mask wearing "would not have anymore coronavirus", and invited young innovators, ages 15 to 24, to submit ideas for “culturally
cool” masks in $1 million Next Gen Mask Challenge. Why limit challenge to Gen Z only? Need
to engage all ages who are not wearing masks!
#FindSomethingNew!
#FindSomethingNew
does not refer to ongoing research about novel coronavirus/COVID-19 and the
latest policies/health orders. (Huge relief to learn coronavirus is not easily
transmitted from touching surfaces, so no longer fear snail mail and ok to
bring reusable bags for shopping again!) Instead, it’s the name of White House’s American Workforce Policy Advisory
Board (AWPAB) campaign launched this month to urge Americans
who are underemployed/unemployed (especially with federal pandemic unemployment
benefits ending) to #FindSomethingNew! AWPAB co-chairs are 38-year-old Ivanka Trump, advisor to (and
daughter of) U.S. President, and 82-year-old Wilbur Ross, Secretary of U.S.
Department of Commerce.
Ivanka tweeted, "There has never been a more
critical time for Americans of all ages and backgrounds to be aware of the
multiple pathways to career success and gain the vocational training and skills
they need to fill jobs in a changing economy." Example:
Wilbur Ross told NPR that his decision to drop out of
a college English course that required writing 1,000 words a day because he ran
out of things to write about after 2 weeks, "probably saved me from a life
of poverty." You
go, Wilbur! If you can’t think to FindSomethingNew—like look at a
picture worth 1,000 words—to write about, and value liberal arts education
to expand your horizons, then go to trade/vocational school… After graduating with Harvard
MBA, he spent 55 years in banking and became a billionaire. Then he launched encore career at age 79, oldest
first-time Cabinet appointee in U.S. history!
During this
pandemic, bored homebodies #FindSomethingNew:
Got
tired of baking bread
So
I went out to build a garden bed…
The
first time now I know
The
difference between parsley and cilantro
Now
I’m growing all these veggies and herbs
And
I’m watching birds with binoculars
Bored
in the USA…
--Penn
Holderness, “Bored in the USA” (COVID-19 parody of Bruce Springsteen’s “Born in
the USA”)
#FindSomethingNew
supports a neoliberal agenda to crank out worker bees, so it misses inspiring
stories of entrepreneurship like 93-year-old Ray Boutwell, Navy cook who worked
in food service throughout his life, started boozy cupcake business and became
instant media darling.
Stop
faking “normal”
According to
ProPublica, 56% of Americans age 50+ are forced to leave “stable” jobs before
they want to retire, often suffering irreversible financial harm.
Joined Elder
Action Network’s Elder Activists for Social Justice Curious
Listening Initiative featuring Elizabeth White, author
of 55, Underemployed, and Faking Normal: Your Guide to a Better Life (2019).
Now at age 66, she
reflected on her experience over a decade ago during the Great Recession while
in her mid-50s: broke, piecing together gigs while trying to keep up
appearances like everyone else – after her career of privilege and Harvard MBA.
She learned she was not alone: 40% of people near retirement may face poverty, not due to financial struggles throughout their lives, but
middle-class facing downward mobility for the first time, hearing that she was
“overqualified” which she interpreted as code for ageism. Instead of being stuck in feeling shame, she
got practical like starting a resilience circle to find solutions for living a “richly textured life on a
modest income” and adjusting to her new reality, including downsizing.
Elizabeth’s message—stop faking
“normal” and tell the truth—was reinforced in another talk scheduled
afterwards, Noetic Approaches to Aging, with Elizabeth joining a panel about
conscious aging, or “getting closer to being the person we’d like to be.” Take-aways: People
can speak only from their own experience.
When she shares her own vulnerabilities, it allows others to share their
own truth with less or no shame. If you
don’t talk about the problem, you can’t solve it!
Marc Blesoff, retired criminal defense
attorney turned mediator, talked about gerotranscendence: bypass the monkey mind, not rely
on rational mind, better acquaint with intuition and what’s really important.
New
Ageism?
This year 2020 has been
compared to 1968 in a “shattered America” with racial, political and economic
divisions expressed in civil unrest. Add ageism, a term coined in 1968
by geriatric psychiatrist Robert Butler, who witnessed generational clashes as
a delegate to the 1968 Democratic National Convention. During this COVID-19 pandemic, social media seem
to make divisions sharper with #BoomerRemover and frustration over restrictions
to “protect older people.”
“Whatever care we extend to the aged we
consider a gift, or an act of charity, and not something we owe them because
they exist… The elderly are no more or less human than they were in their
20s. They aren’t a contagion to be sequestered, or a burden to reluctantly
tolerate. Whatever system we build from the ruins of the moment, it ought to be
as inclusive as the experience of old age itself.”—Sarah Jones, “No One Should Be Surprised That America Abandoned the Elderly to Die,” New York magazine (July 9, 2020)
Ken Stern, Chair of the Longevity
Project, moderated A New Ageism? Fallout from the Pandemic panel discussion on “how society has been responding to the most vulnerable
population during the coronavirus pandemic and what that means going
forward.” In this age of being woke to
racial equity, the program poster featured a black man, yet the panelists
appeared to be from the same tribe: Louise Aronson, UCSF geriatrician; Richard Eisenberg, Next Avenue
managing editor (who published program highlights); and Paul Irving, chairman of the
Milken Institute Center for the Future of Aging. My question in Zoom Q&A was
ignored: “If you could add a BIPOC (Black, Indigenous, Person of Color) to
diversify this panel, who would you choose?”
Moderator
acknowledged my Zoom chat comment in favor of Dr. Aronson’s remark: “We’re all
aging …Being old in and of itself should not elicit respect any more
than being young should. I think behavior should. If you have more needs, you’ve reached a stage
of dependence, which we all begin in, and most of us end in, and most us
experience intermittently in between. You need some compassion,..best way to
address is to increase our humanism, not say respect or reverence, but see
people as humans.” Yes, this why SF has
Dignity Fund! The dignity v. respect difference: Dignity refers to inherent worth as humans apart from actions (e.g., Biblical command to
“honor” parents); Respect refers to admiration for someone, earned because of their qualities or
achievements.
Gerontological
Society of America (GSA) released Understanding Ageism and COVID-19 infographic to dispel myths, such
as suggesting:
·
“only older people should
worry about getting COVID-19”
·
“age is the primary
risk factor for COVID-19”
·
“only older people are
dealing with loneliness and isolation because of social and community lives
disrupted by COVID-19”
·
“isolation is particularly difficult for
older people because they cannot use technology to communicate with family and
friends.”
The Onion satirically reported, “Teen Who Died From Coronavirus Probably Had Undiagnosed Old Age”! Notably,
during this pandemic, my email account has been filled with invites to virtual
meetings focused on loneliness/isolation and technology solutions relating to older people.
Isolation
& Technology
Motion
Picture & Television Fund (MPTF), a non-profit that provides a safety net
of health and social services for entertainment industry members in Southern
California, hosted 3-hour Social Isolation Summit. The opening panel discussion on Confronting Loneliness in a
Turbulent World presented common sense from SCAN CEO Sahin Jain, MD,
influenced by his Harvard Public Policy Professor Robert Putnam, author of Bowling Alone: The Collapse and Revival of American Community (2000) and Better Together: Restoring the American
Community (2003): everyone has power to solve problem of
isolation and loneliness, without spending $; he called for a national
conversation for a social contract that prioritizes community and connection; relying
on technology is the wrong direction as we have an opportunity to get to a
higher plane by thinking collectively, looking out for one another,
visiting/making phone calls to family/friends/neighbors, and caring for one
another the way we used to. Yes, we need
Mister Rogers’ Neighborhood!
Nora Super of
Milken Institute Center for the Future of Aging moderated all-female BIPOC panel
discussion on Identifying
and Filling Loneliness Gaps Across California through government and non-profit initiatives: maintain
connections using continuum of technology, old tech telephone (conference call,
phone tree) in diverse languages, listen to older people to design more
user-friendly online technology rather than expect them to adapt, importance of
agency in older people as “venerable” v. vulnerable, intergenerational
supports, yada yada.
Zoom chat was relevant with
contributions by people working directly with clients (not mere administrators
overseeing others’ work), and not so relevant by marketing folks trying to sell
services (which I mostly ignored):
·
Making “right” connection counts (Jon Schaeffer, Dementia
Activity Club in Los Angeles): just calling/being friendly face/offering
general activities is not what seniors truly need; instead, virtual
visit/phone call has to target and honor their developmental tasks of
maintaining control and working through their legacy; every activity should give
them the opportunity to share their life stories, or they will leave this earth
unfulfilled; and we need to hear their stories for our journey. Yes, power to older people!
·
Promote independence and build resilience (Lualhati
Anderson): older adults have lived through much more challenging times and
continue to build resilience; important to assess skills level and needs before
offering buffet of services available; sometimes offering too many services can
create dependency
·
Peer
mentoring (Clayton): The Impact of Peer Mentoring on Loneliness, Depression,
and Social Engagement in Long-Term Care (outcomes of peer mentoring show 30% drop in
depression scores); tips for peer mentoring; The Need for a Social Revolution in Residential Care (being passive recipient of care fosters
loneliness and depression, peer support and social productivity help create
valued social identities)
·
Age-friendly public health system (Jane Carmody): work with community-based
organizations—e.g., AARP’s Experience Corps, Villages, community health
workers—to provide older adults with opportunities for social interaction and
development of new friendships
·
Resilience
& connection (Len Muroff): resilience is about becoming, not overcoming; vulnerability and fracture from trauma
can lead you toward connecting to something greater than yourself, connecting
to others and to the divine; refer to Sherri Mandell’s 7 steps of resilience (Chaos,
Community, Choice, Creativity, Commemoration, Consecration, and Celebration)
·
Unlonely
Project (Jeremy Nobel, MD, Foundation for Art and Healing): sharing stories
about ourselves through creative expression to improve well-being and
connection, Unlonely Film Fest (free streaming); StuckatHome (together) community
At this
month’s SF Tech Council Meeting on Isolation, Loneliness, and Technology, UCSF
geriatrician Ashwin Kotwal presented his research based on 150 SF
community-based older adult study participants (age 60 to 96):
·
over
half reported worsened loneliness due to restrictions related to COVID-19
·
over
a third were socially isolated, driven by lower use of video communication (4/5
not using regularly, 1/4 not using internet at all for socializing)
·
“incredible
ability” to adopt new technologies
·
not
all older adults have access to technologies for social connection and many
feel discomfort with available technologies
·
recommended
including older adults with classes, volunteers, other methods to facilitate
training, age-friendly design
Maureen Feldman, Director of Social Isolation Impact Project at MPTF, talked about Daily Call Sheet, a social call program that pairs trained
volunteers of all ages with retired MPTF members for telephone chats several
times a week, and has seen a 41% increase in new volunteers since COVID-19
pandemic.
My clients have complained that
their discomfort with video technology has to do with computer vision syndrome and blue light that disrupts their sleep. SFSU Health Professor
Erik Peper, PhD, author of TechStress: How Technology is Hijacking Our Lives, Strategies for Coping, and Pragmatic Ergonomics (Aug. 2020), recommends taking momentary breaks from screens to
relax our eye muscles by looking at a far distance and in different directions—preferably
objects green in color; palming; and blinking many times.
I find that looking at myself
displayed on a screen is like staring into a mirror for periods much longer
than necessary, so I often have my video off during Zoom, and move around while
listening. Before and during this pandemic, telephone calls are more
comfortable for movement, eye rest, and usually better sound quality. Advocacy groups like Gray Panthers and Senior
& Disability Action have been awesome in offering meetings via Zoom or
telephone.
Technology ideas
to make real: Echo Silver (“Alexa for the greatest generation”) and Blacklexa (modify to be “better
ally” to old people, start video at 1:30).
As
an introverted old soul, I reframe social isolation as an opportunity for solitude
rather than loneliness. Solitude or
alone time is refreshing to cut out noisy distractions, and enjoy quiet
thinking, reading, and writing… seriously, no problem writing 1,000 words a
day!
“Loneliness is failed solitude, when the absence of company is
enforced and unwelcome…the impact of the pandemic has been to place a new
premium on solitude. Households that were spacious enough when most of their
occupants were away in offices or schools during the day now seem unbearably
crowded. Prohibitions on walks out of doors are all the more frustrating…Human
beings are social animals. But they need breaks from each other’s
company.”—David Vincent, “The Pandemic Has Raised Fears About Loneliness. History Suggests We Should Worry About the Opposite, Too,” Time (July 8, 2020)
Geriatric neuropsychiatrist Dilip
V. Jeste, Director of Stein Institute for Research on Aging at UC San Diego,
presented his related idea of wisdom as an antidote to
loneliness—during two webinars this month (Loneliness: COVID-19 Toll on Elderly and Loneliness in Seniors: Wisdom as an Antidote). According
to Dr. Jeste, increasing globalization and advances in technology causing
modern behavioral pandemics of loneliness, opioid abuse, and suicides point to
need for societal wisdom:
·
Self-reflection:
ability to look inward at one’s own behavior and change
·
Compassion:
kindness to oneself and others
·
Emotional
regulation: ability to control our emotions and remain calm despite ups and downs
of life situations; face reality and still be more contented
·
Accept
diversity: humility (Serenity Prayer)
·
Spirituality:
purpose in life (“Those who have a ‘why’ to live, can bear with almost any
‘how’.”—Viktor E. Frankl, Man’s Search for Meaning)
Long-term care (LTC) facilities
In U.S. LTC facilities, over 62,000 residents and workers have died from COVID-19,
representing more than 40% of nation’s COVID-19 deaths. In Canada, 81% of COVID-19 deaths
have been linked to LTC facilities. Hong Kong reported its first COVID-19 death in nursing home.
Popular culture
(satire or not) reinforces stigma of LTC facilities as modern-day poorhouses (congregate
settings benefit from economies of scale) for elderly who have been abandoned
by families: SF Mime Troupe presented Tales of Resistance online with 2-minute
commercial for The Palms nursing home (10 minutes after start time). The Onion headline read, “Family Left Elderly Grandmother To Die In Nursing Home But Not Like This” and reported her “inevitable death at the
assisted-living facility” (confusing nursing home
with assisted living).
In fact, families
have been advocating to visit their loved ones in LTC facilities since March
when paternalistic policies required LTC residents to isolate in rooms and
restricted in-person visits. Family members are finding workarounds, such as wife
who took job as dishwasher to see her husband residing in facility (originally
misstated as nursing home, then corrected to memory care center); or daughter who
moved into assisted living facility where her nonagenarian parents
resided during COVID-19 outbreak until both parents contracted COVID-19 and
died in hospital, while she quarantined after contracting COVID-19 herself.
During my stints in
LTC facilities, isolation in a unit might last up to a month during seasonal flu
outbreaks. With COVID-19, isolation and
loneliness (failed solitude) have exacerbated and there seems to be no end in
sight…so long as there is community spread, no vaccine, lack of rapid testing,
shortages of PPE, etc.
While California DPH and Department of
Social Services finally (on June 26) issued respective visitation guidelines (outdoor visits allowed, unless prohibited by local public health order) for nursing homes and assisted living, SF DPH maintains more restrictive visitation in nursing homes and
assisted living, unless “necessary” (“urgent
health, legal or other issues that cannot wait until later”).
DPH’s imposition of
obnoxious (however well-meaning) policies have caused harm and suffering to LTC
residents separated from their loved ones. What happened to harm reduction for
residents of LTC facilities? Rather than base decisions solely on the biomedical
model (prevent bodily deaths from COVID-19), how about a more holistic model or
collaboration with interdisciplinary (bio-psycho-social-spiritual) approaches
like gerontology, as well as consultation with stakeholders like older people
about their wants/needs? To borrow from the disability civil rights movement: Nothing
about us, without us!
Moving into
LTC facilities should not mean losing agency for residents. While no one wants to overwhelm hospitals with
severely ill COVID-19 patients, why not allow visits with precautionary
measures (distancing, masking) in place outdoors, and especially if both LTC residents and visitors have executed advance health care directives and POLST forms declining life-prolonging treatment like feeding tubes and/or ventilators? (Check out UCSF webinar, Preparing for Potential COVID-19 Infection: What are Odds and What are Options?)
Can we have a
New Normal that supports frail older people to retain Dignity with greater
agency to evaluate their own risk tolerance in decision-making?
National
Center on Elder Abuse and the National Consumer Voice for
Quality LTC released checklists:
·
Should I Take My Loved One Home during COVID-19 Crisis? First, ask if resident wants to leave?
Is your home equipped? Who will provide care; if you bring outside help, who
will pay? How will you protect from COVID-19? Will loved one be able to return
to LTC facility (find out if you can hold bed)? What led to decision to place
loved one in LTC facility in first place, what has changed?
Older
age and frailty risk for COVID-19 severity
According to
U.S Centers for Disease Control and Prevention, risk for severe illness from
COVID-19 increases with age, with older adults at highest risk. UK researchers stressed frailty as a
risk factor for COVID-19 death, as much as old age or having an underlying health
condition.
In American
Thoracic Society’s Promoting Recovery in Critically Ill Older Adults with COVID-19: Bench to Bedside webinar, Canadian immunologist Dawn Bowdish,
PhD, presented on how features of aging
immune system contribute to risk and hamper recovery of COVID-19:
·
Age,
chronic health conditions, frailty are independent!
·
Frailty
(increased vulnerability from decline in reserve and function, less resilience
to stress) is better predictor of outcome to infectious disease/hospitalization
than chronological age; this might explain COVID-19 survival of centenarians
who are not frail.
·
Frail
individuals may present different diseases, more likely to report abdominal
symptoms, fatigue, shortness of breath
·
Infections
in older people are chronic (not acute), enhance age-related inflammation; COVID-19
increases risk of stroke, cardiac damage, decreased lung function, increased frailty/disability
COVID-19 does
not follow U-shaped curve in infectious disease like pneumonia and flu, where
susceptibility high among very young (immunologically naïve) and severity high
among very old (immune senescence, co-morbidities), with mid-life ages protected;
instead, middle-age also susceptible to COVID-19. Older adults with COVID-19 less likely to
present fever and respiratory symptoms.
What older
people need to recover from COVID-19: dedicated interdisciplinary geriatrics
team; careful monitoring for emerging health issues; tailored physiotherapy – rehab
focus on building muscle, weight training gives reserve and helps mitigate
chronic inflammation.
She added
that COVID-19 outbreaks in LTC facilities are not inevitable; instead, need to
create “rings of steel” to keep out infection, minimize exposures because dose
influences immune response, and facilities have problematic air circulation.
UCSF
geriatrician/pulmonologist Leah Witt and pulmonologist/hospitalist Lekshmi
Santhosh discussed promoting recovery in critically ill older adults from
COVID-19, based on 4 Ms of age-friendly care: what Matters (advance care plan),
Medication (avoid errors after discharge), Mentation (cognitive change, effects
of delirium), Mobility (functional impairment), within holistic and multidisciplinary
integration (pulmonary, geriatrics, psychiatry, integrative med, cardiology and
neurology).
Storytelling
“Many
cultures revere old people because of their storytelling ability like the old
lady from Titanic.” –Michael’s Tutorial on Avoiding Ageism, The Office US
(satire, 2015)
During webinars about older people, saw and heard talking heads discuss
ageism as happening to “other” rather than personal lived experience; excluded
were voices of older people impacted by oppressive policies requiring cocooning. In fact, there are stories by older people—though
few from LTC residents—during this pandemic. Storytelling can be powerfully moving for
advocacy, but these personal narratives amount to “swamp,” until they can be
curated to present major themes and connect to policy proposals, then presented
in 2-minute sound bites during public hearings.
“Suddenly,
you started thinking, oh, my God, yes, I'm actually older than I think; I'm
actually older than I feel. Suddenly, people have all kind of gathered round
you, pointed a finger and said, you're old; you need minding. And you think to
yourself, ah, sweet Jesus, no, how could this have happened overnight?” –68-year-old
Jimmy Hoban, Lemon Drizzle Cakes And Radio Show: How 1 Irish County Helps Elderly During Pandemic, NPR All Things Considered (July 23, 2020)
Are these paternalistic policies, sheltering older people from risk of coronavirus transmission, actually helping them feel more vulnerable by doing things for them when they are capable? Such policies are not helpful, but dis-empowering people.
At British Gerontological Society’s virtual conference, UK-based Boomer researcher Naomi Woodspring interviewed Meredith Minkler,
Professor Emerita at UC Berkeley School of Public Health, from her home where she is “point
& click activist.” It was refreshing
to hear Meredith speak as gerontologist + older person, how COVID-19 pandemic
has magnified devaluation of older people. When Meredith began her gerontology
career 40 years ago, her focus was critical gerontology/political economy; now as
an older gerontologist, she has embraced the humanities to better focus on moral
and ethical issues, and what it feels to be an older person who’s less visible
and at future risk of having her rights slip away, particularly her
risk for dementia that has affected 3 generations in both sides of her family.
Joined
Reimagine’s Fireside
Chat with Dave
Isay, founder of StoryCorps, and Ira Byock, MD, founder of Institute for Human Caring’s
Coronavirus Chronicles, exploring how stories
build human connection during a global health crisis.
Planned
to rest my eyes while listening to stories, but this was “show and tell”
audio-visual program…so kept eyes on screen and caught “aloha” message in Zoom
chat box from gerontologist Hope Levy, who recently completed 14-day quarantine in Hawaii!
California-based
Ira (standing) and New York-based Dave (sitting) appeared to be from same
tribe, with matching blue oxford shirts and eyeglasses. In response to COVID-19 pandemic, Dave
launched StoryCorps Connect allowing interviews to “collect
wisdom of humanity” (Great Questions include 16 relating to COVID-19 pandemic) via video conference technology; he
shared a sweet video exchange between his mother Jane (whose grandmother died in 1918 flu pandemic) and his 11-year-old son Tobey who survived COVID-19. StoryCorps collaborated with LeadingAge to
create a toolkit for organizations serving older adults
and participant packet for older adult
and families. Ira’s website also offers questions
and opportunity to share stories online.
Last month,
Changing the Narrative Colorado launched On the Same pAGE series of intergenerational conversations
(on social connection, future of work, technology, health equity, arts and
culture, ageism) and provided a facilitator toolkit (questions on COVID-19 and
isolation, stereotyping, language, intergenerational relationships, etc.).
At
virtual Tucson Festival of Books, Stu Mellan facilitated conversation with Louise Aronson (SF) and Judy
Heumann (Washington, DC) about their respective books on aging and disability, Elderhood:
Redefining Aging, Transforming Medicine, Reimagining Life (2019) and
Being Heumann: An Unrepentant Memoir of a Disability Rights
Activist (2020). Louise, who disclosed her visual disability (but not age)
and writing her book as a process to come to terms with her “inner ageism,”
discussed the intersection of ageism and ableism. Judy, who disclosed being
born in 1947 (now age 72), having polio at 18 months and using a wheelchair for
most of her life, focused more on changing systems for inclusion of people with
disabilities like herself fighting to attend public school and obtain license
to teach (when education system considered her a “fire hazard”), demanding civil
rights legislation (504, ADA), never giving up when someone says no,
understanding that it may take decades before getting to yes.
Woo-hoo, way to go, yes to human rights! I’ve
already read Elderhood, now I must read Being Heumann! What
struck me was Judy owning her disability, but what does it mean to own aging (process) as “old”—which seems to
lack clear definition (chronological age, function, life stage, etc.)? For
example, some people didn’t even realize they were “old” until the invention of
policies intended to protect them from COVID-19, starting at various ages when
they fall under “vulnerable” category: 60 (SF), 65 (California), 70 (Ireland),
etc.
At another virtual book talk, Chinese Historical Society of America’s college
interns Anna (Stanford computer science major) and Chris (Berkeley math major)
interviewed 78-year-old author Maeley Tom (SFSU social work major). After serving as the first woman and ethnic
minority at the highest level of California legislature— Chief Administrative Officer of
California State Assembly under Speaker Willie Brown, Jr., and later appointed
Chief of Staff to State Senate President David Roberti—Maeley retired and
self-published her memoir, I’m Not Who You Think I Am: An Asian American Woman's Political Journey (2020). Born to parents who were traveling Cantonese
opera performers (similar to Bruce Lee’s Chinese-Jewish parents), she grew up in foster home with French
Basque family, learned to be self-reliant at an early age and graduated from
college at age 16. Maeley shared
her toughest life lesson was learning that some people wanted her to fail when
she always wanted to be liked, so she met challenges by doing “what people say
you cannot do,” stressed doing homework, and developed reputation for her people
and communication skills to get things done. However, she had no desire to run
for political office out of fear of "losing face" if she lost, and now she feels
“too old.” Say that to leading
Presidential candidates, Biden (77) and Trump (74)!
Advocacy
& Celebration
Today's California
Alliance for Retired Americans (CARA) Celebration included Call to Action by
CARA Legislative Director Hene Kelly to protect and expand safety net programs.
Hene dated classmate Bernie Sanders while they were at University of Chicago in the 1960s, and endorsed him
for U.S. President!
U.S. Postal
Service - 245 years (July 1): Congress should
support the $25 billion included in the HEROES Act to protect the USPS, which
seniors rely on to deliver their life-saving medications.
LaborFest
screening and discussion of Gone Postal documentary with filmmaker Jay Galione,
whose father was a postal clerk for 30 years enduring toxic work culture related
to privatization pressures, and employer retaliation.
Older Americans Act – 55 years (July 14)
Americans with Disabilities
Act (ADA) – 30 years (July 26)
Monthlong celebrations
included:
·
George
and Barbara Bush Foundation’s The ADA at 30: “Let the Shameful Wall of Exclusion Come Down,” taken from President Bush’s remarks as he signed the
ADA
·
Disability Rights
California's Celebration of 30th Anniversary of ADA discussion with pioneers like Judith Heumann and Dr.
Fred Schroeder, DRC advocates Yolanda Vargas, Rosy Tellez, and Eric Harris
·
Disability Action Coalition’s
ADA for Next Generation
· Senior & Disability
Action hosted Crip Camp: A Disability Revolution (2020) watch party with
audio description and discussion about power of community and diverse abilities
for civic engagement.
Medicare and
Medicaid – 55 years (July 30)
Medicare: Congress
Should Enact Lower Drug Costs Now Act (HR 3) requiring government to negotiate
lower drug prices for Medicare and provide discount rate to all payers; cap
yearly out-of-pocket spending in Medicare to $2,000 and limit drug price increases
in Medicare Part B and D to the rate of inflation; savings would be reinvested
into Medicare to expand benefits for vision, hearing, and dental. Also, SUPPORT Medicare for All Act (HR
1384) creating Improved Medicare for All system where everyone gets the
care they need, where they need at prices they can afford, choice of providers
and a comprehensive benefit plan.
All of me,
health care for you and me
Co-pay free, with a choice of providers
Eyes and teeth – Don't want to lose them!
Local clinics – I want to use them!
Co-pay free, with a choice of providers
Eyes and teeth – Don't want to lose them!
Local clinics – I want to use them!
Say goodbye to
costs that soar sky-high
Middlemen – we'll do better without them
Long-term support, you won't get sold short
With Medicare for you and me!
Middlemen – we'll do better without them
Long-term support, you won't get sold short
With Medicare for you and me!
All of me,
health care for you and me
Guaranteed from pre-birth to departure
Change your job, and you won't lose it
Unemployed? You can still use it
Guaranteed from pre-birth to departure
Change your job, and you won't lose it
Unemployed? You can still use it
Dignity, no
fear of bankruptcy
When in need, everybody's covered
Let's win the fight, good treatment is our right
With health care for you and me!
When in need, everybody's covered
Let's win the fight, good treatment is our right
With health care for you and me!
--All of Me (Health Care for All) by Hali Hammer
Medicaid: Congress
Should Increase the Federal Medicaid Assistance Program (FMAP) to help
provide for uninsured individuals during this pandemic, and adopt 10% increase
in FMAP for Home and Community-Based Care included in the House’s HEROES Act to
keep seniors in their homes and out of nursing homes.
Social
Security – 85 years (August 14)
Congress
Should SUPPORT Strengthening Social Security Act (HR 2654) to improve
the solvency of the trust fund by SCRAPPING the CAP; improve the annual COLA –
basing it on the CPI-E; improve benefits for widows and widowers. Also, support Social Security Fairness Act
(HR 141) which would repeal the Government Pension Offset/Windfall Elimination
Provision that denies certain public employees their earned benefits.
Congress
Should OPPOSE Cutting the Payroll Tax, which funds Social Security
program, to avoid jeopardizing the trust fund and benefits of current and
future retirees. Also, OPPOSE any
Efforts to Enact the TRUST Act (S. 2733 and HR 4907) that creates
closed-door commissions to cut Social Security and Medicare; provides no
beneficiary protections from benefit cuts, nor does it mandate plan adequacy
given the growing number of Americans who rely on these programs.
National
Academy of Social Insurance (NASI) hosted 4-hour Intergenerational Dialogue:
Why Social Insurance? Inspired by Why Social Insurance? (1999) essay
by E.J. Dionne, op-ed columnist for The Washington Post, a discussion of
how the nation's social contract might evolve in light of both COVID-19 pandemic
and increased calls for social justice. With
conviction of AOC, NASI intern Alexandra Allen spoke out about how social
insurance enables systemic inequality because it relies on wealth of incoming
payroll tax, whereas most wealth comes from stock capital and intergenerational
transfers; because Social Security benefits are insufficient, she proposed funding
Social Security via progressive payroll and capital gains tax, as well as
expanding Medicare to all by investing away from military and to the community!
Age-friendly
developments/”New Normal” ideas
·
Protecting community members in SF: Right to Recover Fund, would provide two weeks-worth
of wage replacement up to $1,285 for up to 1,500 SF residents who test positive
for COVID-19; another program offers smaller one-time payment to assist with
groceries and other supportive services.
·
Charles
Sabatino, director of American Bar Association Commission on Law and Aging,
proposed to defund nursing homes in favor of Dr. Bill Thomas’ Green
House Model (smaller “households” with private room/bath, flattened hierarchy,
cross-trained staff) to replace problematic institutional nursing home model of
warehousing frail older people into hospital-like buildings with high staff
turnover
·
Terry
Fulmer of Hartford Foundation proposed rethinking LTC,
calling for hospitals to return to inpatient acute care for patients who
require intensive rehab (instead of discharging to skilled nursing facilities
for short-term rehab), enhanced community based supports for people who need
help with activities of daily living and can remain at home, and nursing homes
as true LTC facilities for people who truly can no liver live at
home
·
Framework for Aging-Friendly Services and Supports in the Age of COVID-19 on strengthening person-centered
services and supports for older adults, via in-home acute and primary medical
care, expansion of video telehealth and social interaction, and implementation
of volunteer/paid intergenerational service.
·
Justice
in Aging’s What Older Adults Need from Congress
·
Media and public learn about MOCA, or cognitive test taken
by President Trump, though increasing
concern about test utility when much of content shared in media
More gerontology
conferences go online:
·
Association for Anthropology, Gerontology and the Life Course’s Aging & Social Justice
Slow Conference (June 27-Aug. 31)
·
Aging & Social Change: 10th Interdisciplinary Conference/New Ageism in
Times of Pandemic: Tensions between Active Aging & Risk-Group Definitions
(Sept. 24-25)
·
Grantmakers in Aging (Oct. 14-16)
·
Gerontological Society of America Turning 75: Why Age Matters (Nov. 4-6)
