Saturday, March 30, 2013

Aging conference: Part 4 living & dying, Moody & green

Living retirement with purpose


Monsignor Charles Fahey and Bay Area-based aging marketer Ken Dychtwald shared their views of Transforming Retirement: Timing, Roles, Funding, Challenges/Opportunities and a New Purpose.  Fahey summed up retirement as time to use energies we have and accept limitations, set relationships right, forgive and be forgiven.  Dychtwald reviewed five stages of retirement
1.     imagination: 15-5 years before retirement
2.     anticipation: 5-0 years before retirement
3.     liberation: living the dream honeymoon lasts one year
4.     reorientation: 1-15 years after retirement, characterized by asking who am I now?, growing concern about health problems and insufficient savings
5.     reconciliation: trying to come to terms with entire lives, anxiety about cost of living, legacy
According to Dychtwald, retirement needs to go beyond self-indulgent R&R, away from mindless leisure entitlement of 1970s, to live with higher purpose and contribution.  This new definition of retirement means staying engaged, re-invention and freedom to reflect/sleep/play/maybe work.  Our lives are no longer based on a shared linear timetable focus on education, work & family, and then leisure—but now they happen throughout our ”cyclic lifeplan.”

Dychtwald returned with his power point in New Vision for 21st Century Aging: Five Course Corrections Needed for a Century of Healthy, Active and Successful Aging (Policy & Advocacy), which repeated much of his earlier presentation: re-set markers of aging; foster healthy aging; financial wake-up call; institute flexible life scheduling; and catalyze marketplace.
I found it disconcerting to watch a Big Pharma commercial before a panel appeared on Leadership for Global Population Aging (which might be a reason why I can’t remember the names of the two men seated on the left in photo, other than one was from a multinational retailer and the other from Big Pharma).  Beginning in the middle seat is Michael Hodin (former Big Pharma exec and now Global Coalition on Aging Executive Director), Joyce Gallagher (Chicago Area Agency on Aging Executive Director) and John Beard (World Health Org Director of Age-ing and Life Course). 

When the retailer asked, what’s the new 65 or retirement age? Beard quickly responded that there was no fixed or defined age because our transformed life course demands a flexible approach.  Gallagher said physical disabilities make one feel age so we must invest to maintain independence but not isolation, and view aging as a continuum focused on what we are able to do; for example, one could be age 13 online when we don’t see the person :-)  She talked about identifying people who need help via “boots on the ground”—from sandwiched caregivers of parents and kids, who are never off their mind so they can’t be fully focused without respite services and employer caregiver support beyond FMLA, to isolated older adults who become curmudgeon hoarders because they don’t want their independence taken away and need to be brought back into society.  Beard offered an Asian solution where older people form self-help groups for mutual care and support. 

Dying your way

The conference’s general sessions tended to be upbeat discussions about longevity, so it was refreshing to attend What is Person- and Family-Centered Care (PFCC) and What Happens When We Fail to Provide It? session focused on end-of-life care.
Lynn Feinberg, formerly with Family Caregiver Alliance in SF and now AARP Senior Policy Advisor, introduced PFCC as culture shift in the delivery of LTC that addresses an individual’s needs, goals, values, preferences, cultural traditions, family situation, etc.  (see http://www.aarp.org/relationships/caregiving/info-03-2012/moving-toward-person-and-family-centered-care-insight-AARP-ppi-ltc.html).  Compassion & Choices Chief Program Officer Mickey MacIntyre (wearing bowtie) discussed why patient-centered care does not include unwanted treatment and why it’s important to ensure the full range of medical treatments are available to patients, improve quality of these discussions between patients and health professionals, ensure compliance with advanced directives and Patient Self-Determination Act (see Good to Go resource guide at http://community.compassionandchoices.org/document.doc?id=425).
Passages author Gail Sheehy shared her own experiences with end-of-life care for her late husband.

Tongue-in-cheek
The Second City skits included improv musical of audience-inspired Granny Lost Her Depends!

Moody at last!

I admit that I’m a bit of a Moody groupie, after studying his textbook last semester and meeting him at the last GSA meeting.  (About 10,000 of Moody’s friends, including myself, stay in touch with him by subscribing to his free e-newsletters at http://www.hrmoody.com/newsletters.html.)  At GSA, Moody didn’t prepare any power point presentations and sitting in his workshops were more like salon gatherings.  Of the six workshops at ASA involving Moody, I was able to attend three:
Ethics and Aging in the 21st Century (Policy & Advocacy) workshop focused on caregiving with perspectives from Martha Holstein, Larry Polivka and Rick Moody.  Holstein challenged the myth that women are natural caregivers who actively choose that role, because the lack of alternatives results in the exploitation of women, who are expected to be super-Samaritans who drop everything to become full-time caregivers, and their marginalization in public because their duties are performed at home.  Polivka criticized privatization and the commoditization of LTC as threatening the quality of TLC in the community, reminding us that nations fail when we move from institutions of inclusion (social welfare) to extraction (predatory Wall Street).  Moody saw basis for hope in the moral economy, where we act collectively to leave a legacy of caring for the future. 
Longevity and Wisdom (Spirituality & Religion) workshop with Robert Weber, Andy Achenbaum and Rick Moody, explored the question:  Why did I live so long?  When Weber asked what were our hopes in coming to this workshop, one woman answered for me when she said she knows she can learn a lot from Moody and Achenbaum.  Philosopher Moody responded to the workshop’s question based on his recent experience of caring for a dying 98-year-old friend, who asked a similar question (why does it take so long to die?):  “for people to come to thank you, so I could meet you, and then stay with each other because we will not always have this time together.” 
The Invisible Face of Aging: Can We Look in the Mirror? with Connie Goldman and Rick Moody.  When someone in the audience asked how can we combat ageism, Moody responded:  “Change the word.”  He explained that he submitted workshop called Invisible Face of Ageism, but “Ageism” changed to “Aging” in all the conference materials. 
Helen Kivnick from the audience spoke about co-authoring Vital Involvement in Old Age with Joan and Erik Erikson while they were in their 90s, so she’s had positive views of old age.

Goldman mentioned that health becomes more important as one ages, so she goes to the Y in the morning and pays more attention to what she eats because”your body is like a car.”  Huh? At this point, I will interrupt coverage of the conference to share this health promotion announcement because I thought about my friend’s book titled, Your Body Is Not a Car (http://almondpublishing.com/docs/Your_Body_Is_Not_A_Car_excerpt.pdf).  In his book, Hoenie explains you can’t repair your body as casually like a car:  1) your body can’t be fixed by replacing defective parts like a mechanic does a car (organ transplants aren’t so easy), and 2) your body stays with you for your whole life so to keep using the same body, you can’t rely on quick fixes that don’t address the root causes of health problems.

Going green
During a perfectly timed break between workshops, I stepped out of the windowless conference rooms for some fresh air . . . and to see Chicago River dyed green as part of St. Patrick’s Day celebration, a tradition since 1962 (http://greenchicagoriver.com/story.html)!

Finally, I attended conference’s last workshop, War on Ageism: The Human and Economic Consequences.  Irene Nielsen discussed ageism from a terror management perspective, which posits that "mortality salience" increases in-group favoritism, so do the old fail to identify with their own group resulting in prejudice? When she asked us to fill-in-blanks to COFF_ _, I immediately thought COFFEE.  Was my failure to think COFFIN a denial of old age/death?  I think not, as I'm just more obsessed about food than death.  Another presenter talked about being physically active to stay “young” as if she meant to stay “healthy” as we age? 
 
March is National Nutrition Month (http://www.eatright.org/nnm/), so I enjoyed Good Food Festival (http://goodfoodfestivals.com/) at U of Illinois-Chicago campus before heading over to airport. 
At the airport, age has its privileges:  kids age 12 and under can keep their shoes on during airport security check, but passengers age 70+ can keep both their shoes and jacket on during screening.

Save the date

ASA will celebrate its 60th anniversary at the 2014 Aging in America Conference in San Diego, March 11–15!

Aging conference: Part 3 inspiring community living

Kathy Greenlee, Administrator and Assistant Secretary for Aging, Administration for Community Living at U.S. Department of Health and Human Services, presented on Aging and Disability: The Alliance of the Future, discussing the rationale behind last year’s creation of the Administration for Community Living.  She identified the following issues common to aging and disability:  Older Americans Act and Developmental Disabilities Act involve advocacy for people’s self-determination; coordination of health care and community resources; functional limitations are not based on age; housing; “transportation, transportation, transportation”; direct care workers; and family caregivers who are the backbone of LTC. 
 
In Long Life in 21st Century, Stanford Center on Longevity Director Laura Carstensen discussed how public health improvements added 30 years to U.S. life expectancy in the 20th century.  Now in the 21st century, six generations may be alive at the same time.  However, in this “stunning cultural achievement,” there is a mismatch between the length of our lives and the culture that takes us through life; for example, medicine continues to focus on curing acute versus chronic diseases, and environments are built for the young and people with physical endurance.  Carstensen opined that we need to change culture:  understand how to change lifestyles so chronic diseases do not develop, and work toward a good death at the end of long, satisfying lives.

Home & Community Based Programs (H&CBP)


In Aging Your Way: Boomers Creating Communities for All (H&CBP), we learned how Senior Services in Seattle apply asset-based community development to leverage strengths in community due to government cuts (http://seniorservices.org/agingyourway/Home.aspx).  They focus on eight themes (community connections/village, arts & entertainment, housing, local economy/timebanks, built environment, transportation, health, lifelong learning) based on principles (intergenerational, multicultural, interdependence, sustainable, tech-supported). 

In Beyond the Health Care System: Promoting Health for Individuals and Communities (H&CBP), we learned how Atlanta Regional Commission’s Lifelong Communities Initiative provides a framework for “aging in place” while addressing determinants of health by promoting housing and transportation options, encouraging healthy lifestyles, and expanding information and access to services

In The Live Well Summit: Engaging Older Adults to Solve Pressing Health and Social Issues (H&CBP, Aging 101), San Diego’s Aging and Independence Services (http://www.sdcounty.ca.gov/hhsa/programs/ais/) shared success stories of intergenerational programs like pairing foster youth with affordable senior housing, seniors mentoring youth in work/life skills, college students teaching English and health literacy to immigrant elders, etc.  Since 2000, San Diego’s AIS has employed a full-time intergenerational coordinator and in 2012, Generations United named San Diego as one of the best intergenerational communities. 
 
Portland-based Elders in Action’s Age Friendly Program Manager Joan Corella(http://eldersinaction.org/programs/agefriendly/) began Engaging a Community in Making Businesses Age Friendly (Business & Aging) workshop by asking why a business would want to be age-friendly.  I responded that it’s like doing business with China:  the tremendous potential to reach huge numbers of consumers! While statistics aren’t available, Corella said there was anecdotal evidence that businesses have benefited from increased sales after earning Age-Friendly Business certification, which includes directory listing and referrals.  When certification began in 1993, there was no fee to participating businesses, but now the volunteer-run program charges a sliding scale of fees based on employee count.

SCAN presented Health Literacy in Action: Developing a Community-Based Health Promotion Program for Seniors (Physical Health & Aging) workshop with tips to improve oral and print communications by adopting a universal precautions approach.  Some helpful sites to evaluate readability: 

Aging conference: Part 2 paying attention to STEP

As the second day of the conference began on Wednesday at 8 am, I was torn between workshop choices: 
  • Launching Leaders: Getting a Head Start on a Career in Aging, hosted by Students to Emerging Professionals (STEP), or
  • Healthy Environments Across Generations: A Life Course Approach to Health (Aging 101, Physical Health & Aging) with Rick Moody
I’d already missed Moody on my first day due to volunteer duty.  Now I’d miss him again, this time drawn to the former workshop in hopes that it would address some of my concerns about starting all over again as I launch my encore career as gerontologist.  Malcolm Gladwell said it takes 10,000 hours to be an expert, and I feel like I’m building on my employee benefits background as issues of retirement income security and health care are universal throughout the life course. 

The five panelists discussed networking (LinkedIn), researching opportunities (LinkedIn), effective resumes, cover letter, interviews and professionalism (be careful what you post on LinkedIn).  I heard LinkedIn so often that I wondered if they were investors?  After the presentations, I was pleased to be paired up with Amy Eisenstein, the only one of the five panelists who has MA Gerontology (as well as PhD in Public Health and Aging), to review my resume.  She encouraged me to attend STEP Networking Event that evening, where I chatted and ate with others in-person until 10 pm.  I could never spend that much quality time and enjoy food through LinkedIn.
Agora’s headless and armless sculptures milling about anonymously in Chicago’s Grant Park

I wondered whether MA Gerontology would make me stand out like being an ERISA geek.  When I worked in the employee benefits field, not only could I charge my firm’s premium billable rate to delve into the arcane intricacies of the Employee Retirement Income Security Act (ERISA), but even laypeople wanted to talk shop, like ask me variations of Whitman’s 7 Unsolved Mysteries in Aging Policy, especially how could they be financially independent so they could retire by age 40 and then really live the life they want? (Sure there were jokes about ERISA standing for Every Ridiculous Idea Since Adam, and ERISA hotties at http://abovethelaw.com/2006/09/erisa-hotties-the-winners/, but at least ERISA practitioners were valued and I miss having recruiters find work for me.)  Now when I say that I’m attending an aging conference, older persons will say, hey, I can teach you about that!
 
Where’s the respect for gerontology? When I say that I’m studying gerontology, some people assume I’m preparing for a career in assisted living or nursing home.  I suppose I can’t fault them for thinking that way because most scholarships available to SFSU gerontology students are awarded to those who intend to work in institutionalized settings.  Is gerontology unpopular because it’s associated with institutionalization, which most people would like to avoid?  My interest is in health promotion and aging in place through home and community-based programs.  However, it seems employers in these programs prefer hiring graduates in social work or counseling. 

While I’m on my soapbox, seems I also can’t fault people when they assume my membership in Sigma Phi Omega is the Asian-American sorority (dot-com) founded in 1949, rather than the gerontology national academic honor society founded in 1980 (http://www.sigmaphiomega.org/)?
 
STEP Career Trajectory Panel (left to right) was moderated by Jarmin Yeh (PhD student at UCSF). 

  • Kathy Sykes (MA Public Policy) came into the aging field through serendipity, as the daughter of advocate Jim Sykes, who brought to their home visitors like Arthur Flemming (U.S. Commissioner on Aging during Nixon administration), Bernice Neugarten (gerontologist) and Claude Pepper (former U.S. Senator from Florida who championed elderly rights).  As Senior Advisor at the Environmental Protection Agency’s Aging Initiative, she was one of few federal government representatives attending the conference due to sequestration.  She also told us about Older Americans 2012 databook and other useful publications that can be ordered via her office at http://epa.gov/aging/resources/factsheets/order.htm.
  • Mauro Hernandez grew up helping his father who developed assisted living housing, which led to an academic career (BS Business, PhD Sociology) before returning to the family business as CEO.
  • Cathy Spensley (who has sought-after MSW, LCSW credentials) encouraged me with her mid-career change from journalist to Senior Services Director at Family Service Agency in SF. 
  • Alan DeLa Torre (BA Sociology, PhD Urban Studies) is Project Manager for Portland’s Age-Friendly Cities Project.
While I found them awesomely inspiring, I wondered about the absence of MA Gerontology credential – an endangered species?

SFSU Gerontology Professor Brian de Vries convened Gerontology and Geriatric Education Peer Group, which opened up with an almost existentialist discussion about defining gerontology as a field of study.  SFSU’s own MA Gerontology Program consists of ten required “gerontology” courses (http://www.sfsu.edu/~bulletin/current/programs/geronto.htm), which I’ve decided to list on my resume since people often ask me, “what exactly do you study?”  Since gerontology is interdisciplinary, some topics are repeated in different courses and one classmate seemed to find her calling as she made identical final presentations on legalizing physician-assisted suicide for the three classes that we took together last semester.

SFSU Gerontology Professor Anabel Pelham and others recommend raising the stature of the gerontology field by accreditation of gerontology programs and the credentialing of gerontology graduates (read “Professionalizing Gerontology: Why AGHE Must Accredit Gerontology Programs” at http://www.ncbi.nlm.nih.gov/pubmed/22289063).

Aging in America conference highlights: Part 1

Part 1:  Being present in Chicago
When I learned that American Society on Aging (ASA) was holding its annual Aging in America conference in Chicago (http://asaging.org/aia12) a week before my mid-terms, I immediately signed up.  While my classmates wondered how I could afford the time and expense to attend another out-of-town aging conference (http://geronature.blogspot.com/2012/11/charting-new-frontiers-in-aging-at-gsa.html), I wondered how I could afford not to attend this leading aging conference for practitioners?  As a full-time grad student, I qualified for the discounted $120 conference registration fee as Volunteer Student ASA Member!

ASA Program Coordinator Nancy Decia asked me to show up for my volunteer shift at 9 am on Tuesday, so I took the red-eye flight from SFO for arrival at ORD before 5 am that day, boarded CTA Blue Line train ($2.25) to check-in my carry-on bag at Hostelling International (HI) in Chicago ($30 per night rate including breakfast).  I’d briskly walk a mile, past the Art Institute and Millennium Park, to and from the hostel and Hyatt Regency conference site (so I passed on its $209 per night rate).
Colombia theme dinner prepared by local high school students at HI-Chicago:  sopa de maize (corn soup), papas chorreadas (creamy cheese with onions, potatoes & tomatoes), molde de papa y carne (meat & potato pie), and torta de coco (coconut bread pudding).  The students seemed initially disappointed to learn that I was American, instead of an international visitor, until I told them that I’m originally from Hawaii, which seemed exotic to them.  We debated on whether Obama Presidential Library should be located in Hawaii (Obama's birthplace despite naysayers) or Chicago (where Obama got his start in politics).  After our delightful intergenerational exchange dinner, the students delivered a presentation on the history, politics and culture of Colombia. 

Eating community

Far from being a starving student, ASA conference offered many opportunities to fill our stomachs at receptions for exhibit hall opening, networking, awards, leadership academy graduation, etc.
  
  
During ASA’s Network on Multicultural Aging reception, ASA Chair Louis Colbert presented Award for Excellence in Multicultural Aging to Hawaii Healthier Aging Partnership for its adaptation of Enhance Fitness and Chronic Disease Self-Management Program (CDSMP) to the multicultural population in Hawaii. 
 

















During New Ventures in Leadership (NVL) Graduation & Reception, ASA Chair Colbert presented certificate to NVL graduate Fang Huang of San Francisco.  Her project sounded like a PhD dissertation:  Sustainable Approach to Implement CDSMP (Healthier Living Workshop) in Affordable Housing Settings.  San Francisco has offered CDSMP in six languages:  English, Cantonese, Mandarin, Russian, Spanish and Tagalog (http://www.cahealthierliving.org/?location=san-francisco).

ASA also honored San Francisco-based Patrick Arbore with the Mental Health and Aging Award for founding Center for Elderly Suicide Prevention and Grief Related Services at Institute on Aging (http://www.ioaging.org/documents/news/Patrick_Arbore_Award_March2013.doc)

Behind the scenes with ASA

ASA is based in San Francisco, but I didn’t have the pleasure of meeting its staff until volunteering at the conference in Chicago.  Our volunteer training with Nancy included a review of our assigned duties (including wearing pageant-style volunteer sashes) and a 45-minute tour by Hyatt staff of the maze-like site, which many attendees found challenging.  Instead of referring to floor levels by numbers, Hyatt refers to floor levels by colors using the following association in descending order: 
Every cloud has a SILVER lining,
the sky is BLUE,
the vegetation below is GREEN,
the soil below is BRONZE,
dig below for GOLD,
and then PURPLE at the bottom. 
Only BLUE and BRONZE levels have bridges to cross to and from the East Tower (partly under construction) and West Tower; in between these floors, take escalators or elevators to access bridges to the towers.  Got it?   

At 10:30 am, I headed over to the East Tower’s PURPLE level to assist with Poster set-up led by Steve Moore, whose voice I immediately recognized.  Throughout the conference, I had fun pointing him out like a celebrity sighting to other attendees who were curious to see the face of ASA’s popular webinar host, so now we have an informal Steve Moore fan club!
While on volunteer duty, I refrained from taking photos.  At a later poster session, I took this photo of SFSU Gerontology Professor Brian de Vries and 2nd year grad student Loren Meissner in front of their poster, “HIV and Aging: A Survey in the San Francisco Area.”  Their preliminary findings identified issues related to isolation, stigmatization, housing, economic security and transportation challenges; for more information, join http://health.groups.yahoo.com/group/hivaging/.  de Vries is on ASA’s Aging Today Editorial Advisory Committee; check out his profile at http://www.asaging.org/brian-de-vries-phd.
  
Diversity workshops

Name badge ribbons for ASA Constituent Groups



After lunch break, I began duty as room monitor on BRONZE level for a workshop, U.S. AoA: A Toolkit for Serving Diverse Communities (Multicultural Aging), which held great interest for me and 40 attendees (http://www.aoa.gov/AoAroot/Press_Room/For_The_Press/pr/archive/2010/June/DiversityToolkit.aspx).  While on the lookout for my workshop presenters, standing outside my assigned room and appearing like a beauty contestant with my gold “Ask me, Volunteer” sash, Harry (Rick) Moody approached me to ask for location of his workshop Public Policy and Livable Communities for a Lifetime (Policy & Advocacy), so I directed him to escalators down for GOLD level.  After calling Nancy 10 minutes and then 20 minutes following the 90-minute workshop start time to report that we were waiting for presenters to show up, she advised me to announce cancellation. Yet, a few attendees were hopeful that the speakers would show up so they remained in the room—as I did, though I was very tempted to check out Moody’s workshop. 
 
For next workshop, Religious Affiliation & Successful Aging Among Transgender Older Adults (Aging 101, Spirituality & Aging), attendance was smaller but at least the presenters showed up!  UMass-Boston gerontology grad students, Kristen Porter and Corina Ronneberg, plan to publish their research in a special LGBT issue in Journal of Religion, Spirituality & Aging (http://www.tandfonline.com/loi/wrsa20), which they said has stirred a bit of controversy with some people objecting to this special issue by canceling their subscriptions.  (They also told me UMass-Boston’s graduate gerontology programs are thriving, despite suspension of undergraduate gerontology program due to low enrollment.)

As a foodie, I was interested in the workshop that Kristen presented earlier on Diversity and Inclusion in Congregate Meal Program: A Lifeline to Isolated Elders (H&CBP).  For example, San Francisco’s senior congregate meals program offers an amazing nine different cuisines, including vegetarian options, which reflect the diversity of its residents (http://www.sfhsa.org/356.htm).  Kristen’s research on LGBT meal sites (offered in only 10% of states) reminded me that the value of a congregate meal program is not just about culturally appropriate nutrition that targets specific ethnic preferences, but also about building community—a place where people can feel they belong, to reduce isolation and need for institutionalization.  San Francisco leads with a LGBT Aging Task Force (http://www.sf-hrc.org/index.aspx?page=201) and services for LGBT community (http://www.sfhsa.org/DAAS.htm).

Coming together

My last assignment was to hold a “General Session (with pointed arrow)” sign and direct traffic on the GOLD level to the Grand Ballroom, which rocked with the musical Chicago on stage.  When the music ended, my volunteer duty ended so I took a seat in the second row and brought out my camera.

Debra Whitman, AARP’s Policy EVP, quoted economist Paul Samuelson’s “good questions outrank easy answers,” before presenting her 7 Unsolved Mysteries in Aging Policy, and inviting us to respond via email to askwhitman@aarp.org: 
1.     how do we encourage more people to save for retirement?
2.     how do we make sure people’s nest eggs will last for the rest of their lives?
3.     how do we encourage people to work longer, while taking care of those who cannot?
4.     how can we help consumers play bigger role in managing their own health & wellness?
5.     how will we pay for LTC services & supports?
6.     how can society best deal with growing numbers of people with diminished mental capacity?
7.     how can we get politicians to look at the needs of an aging society? 
Then in a moment of impeccable timing, which made me wonder if this was scripted, such a politician arrived with his entourage, taking reserved seats in front of me . . . and I was tempted to ask Chicago Mayor Rahm Emanuel what he thought about his brother Ezekiel’s new autobiography, Brothers Emanuel (http://www.vanityfair.com/online/daily/2013/01/ari-ezekiel-rahm-emanuel-book-preview#), but then he was called to the stage.  
Robert Blancato presented ASA Leadership in Public Policy Award to Mayor Emanuel for his role in securing passage of Elder Justice Act as part of the Affordable Care Act.  Emanuel mentioned that he introduced the Act when he was a Congressman seven years ago, and got it passed after he got inside the White House as Chief of Staff.  Always the fundraiser, he encouraged us to “spend some money” in Chicago, and mentioned that Chicago was working to get recognition as age-friendly city by WHO.