Pep talk

“Knowing when to speak at the right time takes practice.  So start trying to speak your mind.  And, if you end up saying the wrong thing at the wrong time, let it go.  You are communicating.  And the people around you REALLY do want to know what you think.  The important thing is that you share yourself with the world.

Your time is precious.  Allow yourself the time that you need to do a project, and even give yourself more time.  You are hard working and conscientious, and the work takes time.  We appreciate your hard work and enrgy.  Really.  Thank you.  YAY ERIC!”—Susan O’Malley, Rapid Memo to Eric (Jul 23, 2005)

“Settling in one place for a while does not have to mean settling down, or settling for less.   Your constant generation of ideas, ingenuity, and curiosity about the world will always keep you being pulled in new and exciting directions.  So, now it’s time to choose which direction you’d like to start with.  And you know that you have a hunger to put your gallery guide together.  It will happen.  I repeat, it will happen.  Keep interviewing people, asking questions, and setting a way special time to keep it moving.  You never know who will be able to offer something—interest, time, or advice.  This is a brilliant idea—and taps into an energy and need.  Artists and people interested in art need you to help connect them.  The Bay Area will be better for it.  YAY YOU!! YAY CHRISTIAN!!!!” —Susan O’Malley, Rapid Memo to Christian (Jul 30, 2005)

These Rapid Memo treasures in display case are from SF Museum of Modern Art’s One Day at a Time exhibit featuring “radical optimism” of Susan O’Malley (1976-2015). 

Five years ago, I attended O’Malley’s Advice from My 80-Year-Old Self (2016) book release party, and this coincided with my decision to be actively anti-ageist and resign from employment under management that was oppressively ageist.  As gerontologist, let me count the ways of ageism directed at senior residents:  manager repeating “seniors are just like children” (paternalistic) and “not worth teaching computer skills to seniors” (dismissive), directing me to cancel onsite flu vaccine clinic that had been approved weeks earlier because it was more important to suddenly hold mandatory staff meeting for “youth matters” (autocratic, ill-advised), etc. Ouch! Fast forward to COVID-19 pandemic: hope senior residents have easier access to vaccines and digital technology. 

Like O’Malley advised, time is precious and keep moving…in direction that I choose consistent with my values: age-friendly employment that treats people with dignity! Robert I. Sutton, Stanford Professor of Organizational Behavior and author of The No A—hole Rule: Building a Civilized Workplace and Surviving One That Isn’t (2007), advised: If you work for an a—hole, you should leave right away, if possible! 

Anything is possible in USA!—especially if one plans ahead, embraces learning and works hard!—was pep talk from my immigrant parents, who led by example and raised me to seize possibilities in this land of opportunity. Tiger Mum instilled this infectious “can do” (don’t settle for less!) expectation at any age. 

This week’s American Society on Aging (ASA) Legacy interview featured Kathy Greenlee, former Assistant Secretary for Aging (2009-2016), who said “ageism is when we stop expecting things of older people: you’re done now, you can go away,” and this lack of expectation reveals how we value older people’s contributions. This informs how to be anti-ageist: expect that older adults continue to evolve and make contributions (of beneficial value, hopefully)!

Greenlee views the aging process as not linear, but “bouncing” as we experience challenges that require adaptation (e.g., she described her temporary disability after falling off a ladder, using a wheelchair for three months until she regained mobility function and independence).  Her mantra: “I’m more afraid to not try than to fail; more afraid to be timid, missing opportunities; being afraid of failure can hold you back; we’re all just humans trying to use our talents to do something beneficial.”

(Disclosure: My gerontology internship with Administration for Community Living began a year after it was formed by Greenlee in 2012, by consolidating three agencies for aging and disability services under U.S. Department of Health and Human Services.  In the 2015 report, A Shattered System: Reforming Long-Term Care in California, the Senate Select Committee on Aging and Long-Term Care chaired by Senator Carol Liu borrowed Greenlee’s ideas when it recommended establishing a Department of Community Living within California Health and Human Services Agency, and delivering services based on functional need rather than age.  It also recommended investing in HCBS infrastructure.) 

Everyday, a Color (2015) was Leah Rosenberg’s way of processing grief “one day at a time” after O’Malley’s untimely death at age 38.  Rosenberg “collected” colors and painted them, first color hot pink for O’Malley.

COVID-19 pandemic restrictions and wildfires/air quality index have colored (pun intended) how I view Josef Albers’ Homage to the Square series…reminding me of colored tiers: green, yellow, orange, red, purple.  SF’s fourth COVID-19 surge driven by Delta variant and wildfire season remind me so much of last year, with indoor mask mandates effective again.

Since last month’s reopening and until SF’s current Delta surge, I had not looked at COVID-19 data tracker.  I kept my mask on in the presence of other people, as I don’t want to risk becoming a breakthrough case and inadvertently pass coronavirus to immunocompromised or unvaccinated persons (like neighbors under age 12 who are not yet authorized for COVID-19 vaccination). 

Actions and mixed messaging by public health agencies like CDC and FDA have not helped ease people with institutional distrust and vaccine hesitancy. To what extent did CDC contribute to “pandemic of the unvaccinated” by issuing premature guidance in May, allowing vaccinated to unmask (in shortsighted attempt to incentivize unvaccinated to get shots?) when people were still struggling to get access to vaccines, and relying on an honor system so unvaccinated put vaccinated at risk with rise of more contagious Delta variant? Just in time for Memorial Day, Juneteenth and July 4^th holiday gatherings!

To what extent did FDA’s damage to its own credibility by last month’s approval of controversial Aduhelm (of dubious effectiveness to slow progression of Alzheimer’s disease and risk of life-threatening side effects) contribute to hesitancy over COVID-19 vaccines approved for emergency use by FDA, which also has been under pressure to expedite full approval of vaccines? 

Ageism in healthcare + how to be anti-ageist

Joined Changing the Narrative for discussion on Ageism in healthcare, based on FrameWorks Institute’s Reframing Aging campaign. Ageism (prejudice, stereotyping and discrimination against people based on their age) shows up in healthcare and leads to worse health outcomes, and higher costs to society. 

·       Internalized: ignoring symptoms (“I must be just getting old”); attitudes about aging affect life span by 7.5 years, physical & mental health, likelihood of developing dementia (49.8% less likely develop if age-positive)

·       Interpersonal: assumptions that all older people are alike; minimizing symptoms; disrespecting/demeaning patients (e.g., elderspeak, not heard, not given options); over- and under-treating (e.g., polypharmacy, dismissing pain); not recognizing elder abuse

·       Institutional/policy: shortage of health professionals with expertise on older people; Medicare not covering vision, hearing, dental; clinical trials excluding older people

Sadly, I’ve witnessed all of the above. Ignorance can be fixed by requiring gerontology training for anyone who works with older adults, and hope people’s attitudes change to embrace aging and person-centered care. Yet not enough people desire to work with older adults (or perhaps the work environments?), and those who do (like yours truly) find it off-putting to work with ageist employers.  Whenever I feel disheartened about this and need to lift my spirits, I listen to Carole King’s Up on the Roof (“when I come home tired and beat, I go up where the air is fresh and sweet…”) and You’ve Got a Friend (“when people can be so cold...And take your soul if you let them, Oh but don’t you let them”). Do not give up!

Back to Changing the Narrative: Individuals can learn more about ageism; advocate for ourselves (embrace aging as normal process, ask questions and educate healthcare professionals how you want to be treated); share information; champion policy changes. 

Combined interventions with education and intergenerational contact are most effective to combat ageism. 

Much of ageism in healthcare appears related to larger problem in U.S. healthcare system that is focused on pathology (diagnosing and treating disease)/deficit-oriented v. health promotion (preventive care addressing social determinants of health)/strengths-based.  My contributions to interactive Jamboard:

·       Train all members of multidisciplinary healthcare team (MD, RN, SW, OT, PT, etc.) about aging processes to debunk myths (e.g., mistaking depression as normal aging)

·       Adopt trauma-informed, strengths-based approach (validate lived experience, focus what people can do)

·       Focus on health promotion by addressing social determinants (access to nutritious food, safe housing, income security, reliable transportation, etc.) to change the environment so people can make healthier choices that improve quality of life at all ages

Reframing is a form of solution-oriented “we’re all in this together” pep talk: Yes, we can!!! To change the cultural narrative of aging, think of opportunities in the swamp of aging: Problems can be solved! Collective responsibility! What surrounds us shapes us (so change the environment to support collective well-being)!

This example on addressing loneliness taps into value of ingenuity and collaborative solutions.

I like Regional Geriatric Program of Toronto’s How to be Anti-Ageist Tips for Healthcare Providers, especially tip #3: “Be curious about your older patients with frailty. Ask yourself – How am I ensuring that I am open to the lessons that live within the person in front of me?” Beautiful because we need to embrace frailty that is part of the aging experience, especially if we live long enough. 

Also like Hebrew Senior Life geriatrician Sharon Inouye’s Creating an anti-ageist healthcare system to improve care for our current and future selves, especially call for more coordinated interdisciplinary care given the complexity of older adults’ health issues.

In last month’s Influencing Care: Understanding & Participating in Kaiser SF's Geriatric Emergency Department (GED) Patient Advisory Council, Kaiser Permanente emergency medicine Dr. Marlena Tang spoke of the value of listening to patients and family caregivers to improve emergency care for older adults, especially changing culture by using language to dignify their experience (e.g., say adult undergarment v. diapers, preferred name v. honey/sweetie). 

Social service v. change

Let’s talk about ageism + classism. Here much of my rant has been informed by contrasting my work experiences with older adults of different wealth levels.  My previous career in investment management and personal trust administration catered to the 1%, of all ages but mostly older people, entitled with economic power to pay for services that treat them with dignity.  Gerontologists (aka geriatric care managers) often work for affluent clients who can afford private pay, as gerontologists are excluded from healthcare reimbursement systems. 

In contrast, healthcare reimbursement to clinical social workers is possible, thanks to medicalization of social work. This leads some clinical social workers (comprising the largest group of mental health providers in USA) to impose an oppressive micro perspective to pathologize and blame low-income/unhoused people in the safety net for individual “behavioral choices” (anxiety, depression, substance use disorders, etc.) rather than address root causes and create pathways out of systemic poverty.  

“There are some groups working for social change that are providing social service; there are many more groups providing social services that are not working for social change. In fact, many social service agencies may be intentionally or inadvertently working to maintain the status quo…

Whether they are social welfare workers, police, domestic violence shelter workers, diversity consultants, therapists, or security guards, their jobs and status are dependent on their ability to keep the system functioning and to keep people functioning within the system no matter how illogical, dysfunctional, exploitive, and unjust the system is. The very existence of these jobs serves to convince people that tremendous inequalities of wealth are natural and inevitable and those that work hard will get ahead."—Paul Kivel, “Social Service or Social Change?” (updated Dec. 4, 2020) 

(Kivel wrote about Adultism, but nothing about Ageism?)

Because USA has been a reluctant welfare state, public benefit programs are designed to make access difficult. Social workers (aka case managers) often act as middle-people in the buffer zone who perform eligibility paperwork for government (e.g., means-tested programs like SSI, Medicaid, IHSS, etc.). 

“Government programs exist. People have to navigate those programs…these kinds of administrative burdens as the “time tax”—a levy of paperwork, aggravation, and mental effort imposed on citizens in exchange for benefits that putatively exist to help them…

Many programs meant to aid the poorest of the poor have demeaning, invasive, and time-consuming screening requirements…

Our country’s health system is an infuriating morass…The sick are called on to fight for insurance to insure them and carers to care for them—to negotiate what procedures are covered, investigate and interrogate billing practices, and qualify themselves for government subsidies. This system does not work much better for providers than it does for patients…”—Annie Lowrey, “Time Tax: Why is so much American bureaucracy left to average citizens?” The Atlantic (July 27, 2021)  

My pep talk:

Remember, you social workers are in a value-based profession that strives to promote both individual + social change, consistent with principles of human rights and social justice! Consider person-in-environment, and practice a strengths-based approach to change! See the glass half-full, and fill it up more! Don’t settle for less! You social workers can facilitate an older adult’s sense of empowerment and psychosocial growth when dealing with life’s challenges. You can! Do better (than status quo)! Be a change agent for the common good! You can advocate for a more holistic healthcare system to address social determinants that promote healthy living! You go! Do this! Now!  YAY YOU!!!

Medicare for all: time for healthcare that works for all of us!

While now may be a rosier time for older adults (especially if vaccinated!), we continue to live with COVID-19 and there is much radical optimism + advocacy needed to strengthen the safety net for all.  COVID-19 pandemic has shown that our health is interconnected, and one-third of COVID-19 deaths linked to lack of health insurance. 

Last month, Healthy California Now hosted virtual rally, #GavinLeadtheWay, to help make California the nation's first Medicare for All state, reminding Gov. Newsom (who faces recall election) to make good on his campaign promise for universal, state-funded single-payer health care. 

Dragana Vagic, MD, an internal medicine physician, contrasted her practice in Canada and USA.  In Canada, there are no two classes of citizens when it comes to healthcare; she was never pressured to discharge a patient from a hospital early due to insurance coverage; she had more time to discuss plan of care with patients, ongoing collaboration with colleagues; patients had anchor to own physician to see regularly so problems could be prevented or treated timely (instead of going years without access to care to point of developing advanced physical/mental problems, which end up costing more). 

Canada’s single-payer healthcare system removes “cruel anxiety so prevalent in USA” relating to access/affordability, patients staying in abusive employment environment to simply keep one’s health insurance, time constricted visits as majority of time spent with substandard electronic health records and insurance bureaucracy versus actual patient care; impersonal assembly line medicine with army of administrators who complicate care and interfere with autonomy of physicians.  In contrast, single-payer system enables more trust in healthcare that leads to continuity of care, no erratic changes in clinics/physicians due to changes in insurance or excessive time spent clarifying insurance coverage, and empowers physicians to exercise clinical judgment.

Labor organizer Dolores Huerta, who popularized phrase “Si, se puedo!” (Yes, it is possible!), shared her personal healthcare experience: In 2000, she had an aneurysm, which disabled her for seven months and her medical bill was almost a half million dollars, which she could not have paid, and grateful for Medicare which covered cost.  Now at age 91, Huerta said one pandemic lesson is we need Medicare for all, and Gov. Newsom needs to be courageous to to take a stand: it’s time for healthcare for everyone!

Call to action: Gov. Newsom start process to request Biden administration for the federal waiver (under Affordable Care Act) needed for an improved Medicare for All plan (California Guaranteed Healthcare for All, AB 1400) with comprehensive benefits (covering medical, dental, vision, hearing, mental health, reproductive health, and LTC!) and no out-of-pocket payments (e.g., Courage California reported California residents with insurance spent an average $5,503 on healthcare costs a year).  According to Healthy California Now, California could save up to $764 billion over the coming decade with a single-payer system that eliminates financial barriers to care (profits, administrative waste, high executive salaries).

Advocacy wins!

Senior & Disability Action (SDA) Executive Director Jessica Lehman summarized SF City Budget wins. 

Housing to age in place

“Our society needs to address the availability of housing, because we all say that we'd like to be cared for at home if we could be. But…if you lose your home or societal changes mean you can no longer afford to live in your home. There's got to be a solution to that because, honest to goodness, the medical stuff is easy. We can always treat diabetes, hypertension. It's how do you keep somebody at home?” –Jay Luxenberg, On Lok Chief Medical Officer, "Program of All-Inclusive Care for the Elderly (PACE)," GeriPal (July 8, 2021) 

According to an NPR report, boomers are choosing to grow old in their own homes while blocking new housing development through zoning laws that maintain stand-alone, single-family homes. Multigenerational and interdependent living is on the rise, with purchases of larger homes mostly to bring in aging parents who also share in child care, as in “The Family That Buys Together Stays Together” (The NY Times, July 9).  In contrast, older singles, mostly women, prefer living apart together (LAT) to avoid attachments in later life that lead to full-time caregiving (The NY Times, July 18). 

At SDA meeting, Kimia Haddadan of SF Planning Department presented on Housing Element, the City’s housing plan prepared by her Department, adopted by SF Board of Supervisors and signed into ordinance.  It is updated every eight years: 2014 Housing Element needs to be updated for 2022, this time with a commitment to racial and social equity.  

SF’s higher-income population exploded, replacing low- and moderate-income households that are often communities of color.

·       Median income for Black households is less than 1/4 of white households:  $30,442 v. $132,154 (2018 American Community Survey)

·       Compared to their share of the population, Blacks are 7x more likely to be unhoused, and American Indians are 17x more likely to be unhoused (2019 SF Homeless Point-in-Time Count)

·       Black (51%), Latinx (49%), and American Indian (41%) households are more likely to be rent burdened (spend more than 30% of income in rent) than white households (33%)

According to National Low Income Housing Coalition, SF is the nation’s most unaffordable metropolitan area, requiring one to earn $68.33 hourly wage to afford fair market rent for a two-bedroom apartment.  (Why can’t one person downsize to more affordable studio?!)

Wealthy older tenants represented by private attorney do well: SF couple in their 60s who had been paying $12,500 a month for a seven-bed, eight-bath apartment, received a $475,000 buyout to vacate their posh Presidio Heights home of three decades. 

Housing Element’s “vulnerable groups” include seniors and people with disabilities. 

According to SF Planning, dismantling housing inequities requires investment and structural changes to address root causes (racial and economic inequities, housing as commodity v. human right, underbuilt housing, etc.).  These investments and structural changes include: significant increase in housing targets based on existing need and projected growth (82,000 units in 2023-2031), addressing state mandates for Fair Housing and environmental justice.  Further, the City has expanded funding sources (housing bond, gross receipts tax, real estate transfer tax) to fund affordable housing and supportive housing for unhoused residents.

Four policy shifts:

·       Recognize Right to Housing: create 5,000 units of supportive housing; elevate rental assistance; expand senior operating subsidy

·       Bring back displaced communities: expand cultural districts; continue affordable home ownership for displaced; dedicate land to American Indian community

·       Priority geographies: increase housing affordable to extremely low-income to low-income households; increase neighborhood preferences for below market rate units; increase and target investments in rental assistance, acquisition & rehabilitation, community amenities, open spaces, transit service, and infrastructure; limit zoning changes to needs of American Indian, Black, and other communities of color

·       Distribute housing throughout the City: provide housing options for low-income communities of color in neighborhoods with high quality amenities and wealth; increase affordable senior housing along transit corridors

Keep calm + carry on

In Traditional Chinese Medicine, summertime is associated with joy, which comes from within and doing what we truly believe and enjoy.  Yet, seems this pandemic has gotten some people stuck in anger that is associated with spring season.  Recent headlines:

“Furious at your parents for aging? You're not alone” (USA Today, July 7) 

“Anger as French protesters compare vaccines to Nazi horrors” (NY Post, July 19) 

“As Virus Cases Rise, Another Contagion Spreads Among the Vaccinated: Anger” (The NY Times, July 27) 

During summer, better to be calm as anger exacerbates heat. So chill out! Let bygones be bygones!  

Mike Henderson (b. 1944) painted The Scream (1966) to release the confusion and anger that he felt about what was going on in the world in the mid-1960s—Vietnam War, human rights protests, police brutality, etc.  Anger in response to injustice can be impetus for change and opportunity...“you deserve better!” pep talk. Contemplate change like the scene from Network (1976) with Peter Finch character yelling, “I’m as mad as hell, and I’m not going to take this anymore!”  

Yet, 55 years later, seems not much has changed. Like police brutality in Colorado against 73-year-old Karen Garner (who had dementia and violently arrested for alleged shoplifting $14 in goods from multinational discount store) and 75-year-old Michael Clark (unarmed in his home when tasered without warning by cop). 

“…police are not generally trained to deal with dementia, poverty, domestic violence, mental health issues, homelessness, or a whole range of other social issues. While there are examples of programs aimed at training police in interactions with older adults, they are not the norm…

By narrowing the focus of policing, funding can be shifted to social services that are traditionally underfunded. For older adults, area agencies on aging, Adult Protective Services (APS), mental health services and legal services are critical lifelines that lack sufficient funding. These services are much better suited to serve older adults experiencing elder abuse who need the expertise of social workers, attorneys, doctors and advocates.”—Vivianne Mbaku, Esq., “A Call to Action: Elder Justice and the Movement to Defund the Police,” Justice in Aging (Sep. 24, 2020) 

Everyone, including police and service providers, needs gerontology expertise to work with older adults and prepare for their own aging!

Bystander intervention

In response to publicized increase of anti-Asian and xenophobic harassment, Organization of Chinese Americans (OCA) hosted virtual Situational Awareness Workshop, intended to provide education and awareness tools to combat systemic oppression.   

Given the most prominent cases of anti-Asian violence involved older adults, surprised so little mention of old age in wheel of power and privilege, media examples and scenarios? 

Take-aways: Effective bystanders leverage their power and privilege; check your own biases and prejudice before taking action; think about your own physical safety; not helpful to prioritize intent over impact.

https://www.ihollaback.org/bystanderintervention/

RESPECT strategy similar to Hollaback’s 5 D’s for bystander intervention:

REceptive (similar to Delay check-in)

SPace (similar to Distract)

Engage (similar to Delegate & Document)

ConfronT (similar to Direct)

Trainers did not address my question about reporting harassment (including unlawful violence) to law enforcement as bystander intervention…similar silence with Hollaback training, in this climate of distrust of police/defunding police.

“…modern concept of hate crimes—and the corresponding legal apparatus—emerged in the late 1970s, influenced by the civil rights movement’s campaign to protect Black people from lynching through legislation…

But the application of hate crime laws reveals how little they have to do with racial justice and how much they have to do with expanding the criminal punishment system. As sociologist Tamara Nopper noted in a lecture on hate crimes, hate crime legislation is used to protect white people… Most of the people convicted for hate crimes are the people that hate crime legislation allegedly protects: Black people, poor people, disabled people, queer and trans people…"--By Chalay Chalermkraivuth and Heena Sharma,”Policing Won’t Stop Anti-Asian Violence—Solidarity Will: Hate crime legislation and law enforcement will not protect working-class Asian communities,” The Nation (July 20, 2021) 

Hate crime laws do not recognize age as protected characteristic.  Instead, California makes elder (age 65+) and dependent adult abuse subject to criminal and civil liability.

Old people in media

With reopening and majority of COVID-19 cases impacting younger and unvaccinated, media attention no longer focused on older adults appearing frail and lonely due to heightened risk for serious COVID-19 and imposed isolation. 

Shirley Serban created several spot-on music parody videos about aging:

Dismissing me is wrong

Listen now to my song

I know things well ‘cause I’ve lived for so long

So learn from me – yeah, me

And I know more than I might let on

So learn from me – yeah, me

Singing, I love getting old!...

And now that I’m getting on, that’s okay with me

Carefree, I do whatever I want

It’s my time for me – yeah, me…

I just do what I like, can’t peer pressure me!

Yeah, my life is my own

All self-consciousness has flown

Cool to be fully grown…

I do what I like, grey hair is trendy!

I love getting old!

Speaking out my mind like a soapbox, Baby!...

I just do what I like, watch out for me!

--Shirley Serban, “I love getting old” parody song (Jul 27, 2021)   

·       “It’s aging, men” 

·       “Memory: An ode to getting older” 

·       “Menopause rhapsody” 

News report tips for optimizing healthspan/lifespan and more pep to older adults:

·       “How our emotional lives improve with age” (WaPo, July 9) 

·       “Creativity may be key to healthy aging. Here are ways to stay inspired.” (WaPo, July 12) 

·       “Researchers say the probability of living past 110 is on the rise — here’s what you can do to get there” (CNBC, July 17)

·       “It’s never too late to play the cello” (Vera Jiji, now 93, took up cello playing and wrote book about it after her retirement; The NY Times, July 20) 

·       “She's nearly 100. He's 2 and lives next door. Here's how they became best friends” (99-year-old Mary O’Neill feels like a “2-year-old at heart” with her boy-next-door pandemic companion; WaPo, July 29) 

·       “Bay Area math teacher, 63, goes viral for 'turfing' with his crew” (Mike Predovic has been dancing since 1970s, now gets attention, thanks to Instagram and TikTok; SF Gate, July 30) 

Pep walk in great outdoors

COVID-19 pandemic has popularized the great outdoors to access better ventilation and sunshine…even in an urban environment, there is constant change of scenery in streets of Tenderloin, with opportunities to admire artfully decorated Bigbelly trash receptacles.  Arts bring positivity to the neighborhood. 

Science illustrator Jane Kim of Ink Dwell brings beauty of nature into City with life cycle of caterpillar and monarch butterfly. Looks like someone who left trash out didn’t realize they could dispose trash into artsy receptacle?

Bre’nae B. of 826 Valencia declares: “I’m most definitely a loud light. Sky high, I’m from freedom, And I’m alive.” 

Painters add color to planters at Safe Passage Park in Tenderloin. 

COVID-19 vaccine roving team does one-on-one, community-centered outreach targeting geographic areas like Tenderloin, Visitacion Valley and Bayview where vaccination rates are lower than the City average. 

Portsmouth Square in SF Chinatown filled with people of all ages and tourists are back! In Chinatown, one in four seniors has yet to receive COVID-19 vaccine, for reasons that might relate to access barriers such as language and functional impairments.  Slowly, SF volunteers are outreaching to vaccinate homebound residents, who are mostly seniors and people with disabilities. 

U.S. has about 1.6 million homebound older adults age 65+ who may face barriers accessing vaccines, and they are disproportionately racial/ethnic minorities aging or stuck in place: 15% Hispanic; 7% of Black; 5% American Indian, Asian, or Pacific Islander; and 3% white. 

Food will bring us together!

“Gather friends and feed them, laugh in the face of calamity, and cut out all the things––people, jobs, body parts––that no longer serve you.”—Deborah Copaken, "3 Rules for Middle-Age Happiness," The Atlantic (July 25, 2021) 

Alum hosted retirement + reunion picnic at Golden Gate Park’s Hellman Hollow for Lisa Yamashiro, RD, MEd, who retired at fiscal year-end June 30, after 26 years at City College of SF as phenomenal Nutrition Program Coordinator, and past five years as Distance Learning & Teaching Specialist (so essential during this pandemic)! 

My eternal gratitude to Lisa, who was essential to launching my encore career in gerontology, as she facilitated my nutrition internship with SF Department of Aging and Adult Services partnering with Canon Kip Senior Center, where I was primarily interested in its CHEFS (Conquering Homelessness through Employment in Food Services) culinary training program.  The internship provided an amazing introduction to aging services network, with tasty opportunities to sample lunch + "talk story" at various senior centers, and my first exposure to social work profession.

Classmate Helen created retirement game, “Lisa would rather…” fun to hear Lisa’s answers, some influenced by pandemic like “stay home” (over “go out”).  Helen also went on to get her MSW, which is cool because social workers should take a more active role in promoting nutrition, which has direct impacts on client mental health! You are what you eat! Yet, nutrition is not covered in graduate social work programs. In my graduate gerontology program, only two hours dedicated to nutrition in Aging Processes class. 

Classmate Elaine demonstrated GoSun solar cooking of lemongrass chicken and rice. 

COVID-19 pandemic has made the act of sharing food almost perilous.  Instead of our usual carefree potluck, self-serve buffet, we cautiously practiced harm reduction by ensuring as much ventilation in outdoors setting, keeping physically distanced while unmasked to eat/drink.

At SF Public Library virtual event, Linda Shiue, MD and Director of Culinary Medicine at Kaiser Permanente SF, demonstrated backpacker’s gado-gado from her new book, Spicebox Kitchen: Eat Well and Be Healthy with Globally Inspired, Vegetable-Forward Recipes. (Yikes, Dr. Shiue was not wearing sleeves! One valuable lesson learned from Lisa’s Food Safety certification class was to always wear sleeves so you could sneeze into your sleeve – life-saving lesson during this pandemic!)

On behalf of clients requesting vegetarian diets, I asked Could you suggest some recipes for Meals on Wheels to adopt more vegetable-forward entrees? Dr. Shiue’s response: “I love Meals on Wheels!” and she would be happy to share her ideas directly with Meals on Wheels. (Exciting news for vegetarians: Berkeley City Council approved a resolution that requires vegan meals to be offered at senior centers, jails and other city buildings.) 

Like aging, changing eating habits is about balance and adaptation: instead of looking back on what you leave behind (e.g., lose animal meats, high sodium), look forward to what you still have and gain more of it (e.g., more immunity-boosting plants and flavorful spices)!

When you have control of your food system, that’s where your health starts. What did the colonizers do when they came here? They got rid of the food and the medicine of the Indigenous people. They removed them from their land, which is the medicine. So, when you talk about how “the Europeans brought over diseases, and that wiped people out,” my question is, was that it? Or did they [also] remove them from the microbiota that they were surrounded by that supported their health for 30,000 years? And in that removal from that land, were their immune systems then somehow compromised, and how did that impact how they were able to fight off new exposures [to disease]?”—Rupa Marya, “This Doctor Is Working to Build Resilience and Land Justice for Communities of Color: Rupa Marya discusses land rematriation, a new Indigenous-led farm, and the long-term effects of colonization on food and medicine in vulnerable communities,” Civil Eats (Apr. 22, 2021)