Mindfulness

In this age of 140-character tweets, my biggest academic adjustment over the past year has been to adopt the “SF State of Mind,” which seems to emphasize brevity, or KISS (Keep It Simple Sweetie, as one gentle professor reminded my class): course assignments were typically 2’ x 3’ posters; research papers ranging from 5 to 8 pages (like executive summaries); and oral presentations allowed only 2 to 5 minutes on average, and 10 minutes maximum.  

For an introvert like myself, who prefers gray matter – complexity versus black/white simplicity, deep discussions versus chit-chat or sound bites, I had to constantly remind myself to be less intense and think like a blogger instead. . . Now in my second (and, I hope, final) year in graduate school, I felt rewarded upon learning that my culminating experience assignment would be 30 pages! 

Outside SFSU, I use this blogspot for freely wandering and wondering -- without paying attention to length and time restrictions :-)

Senior & Disability Action: Putting the "D" in SDA! Mind your manners

SDA staff use popular education in this skit to cover what to do and what not to do in interactions with persons with disabilities.

Moderator Donna held up a STOP sign to de-brief after each scenario of Jessica (in wheelchair) and Tony (standing as her companion) when they encounter Sarah and James at a meeting.

• Don’t treat a person in a wheelchair as though she's not able to speak for herself 
• DO speak directly to the person in a wheelchair, on the same eye level if possible
• Don’t assume low expectations of a person in a wheelchair by making over-the-top comments like “wow, it’s so inspiring how you actually got up and left the house to come here,” as if doing everyday activities is exceptional
• DO remember the person is not a disability
• Don’t be patronizing or pity a person in a wheelchair by offering to “pray so you can be a whole person”
• DO treat all persons with respect and dignity

More at http://geronature.blogspot.com/2012/09/october-is-disability-awareness-month.html

Aging While Black Forum

Deloris McGee and Marie Jobling of Community Living Campaign organized their second annual Aging While Black Forum at I.T. Bookman Community Center.  OMI Community Connector Deloris initiated last year’s Forum in response to her community’s request for a culturally sensitive program in the OMI community because blacks are “sicker, poorer, and have more issues to deal with when born into a pre-existing condition of racism and discrimination.” 

Highlight was hearing from Dorsey Nunn, Executive Director of Legal Services for Prisoners with Children (LSPC), who didn’t find humor in a previous speaker’s “joke" about sending seniors to prisons where they can get their basic needs met including video monitoring and guards.  Some audience members actually laughed at this "joke," which made me uncomfortable to think that the invisibility of persons in institutions like prisons and nursing homes might lead to insensitivity and ignorance about true conditions.

Formerly incarcerated as a 19-year-old, now 61-year-old Nunn said that depicting prison as a luxury vacation is like characterizing slavery as good for jobs – the reality is no freedom in prison and slavery.  He invited us to celebrate LSPC’s 35^th anniversary next month with Michelle Alexander, author of The New Jim Crow: Mass Incarceration in the Age of Colorblindness, which presents evidence that more Blacks are enslaved behind bars today than were enslaved on plantations in 1850, a decade before the Civil War began and the Emancipation Proclamation was signed.

Nunn also talked about the realities of aging in prison, like a 70-year-old struggling to climb to the top of a bunk bed, defecating on himself, not being able to defend against younger prisoners who play loud hip-hop, falling inside a cell with no one to check on him, etc.  Read LSPC’s report, Dignity Denied: The Price of Imprisoning Older Women in California, by Heidi Strupp and Donna Willmott (note: same Donna as the SDA moderator above).  Consistent with the program’s theme of community building, Nunn also brought attention to the recent prisoners' hunger strike to protest solitaryconfinement.  

On Lok Lifeways Sustainable Long-Term Care: Matter Over Mind?  

Mind matters! Raised in the holistic (mind-body connection) practice of Traditional Chinese Medicine (TCM), I find the Cartesian mind-body split puzzling.  I also find puzzling the notion of emotions being either “positive” (encouraged) or “negative” (discouraged).  According to the Nei Jing (Chinese medical text), the seven emotions—joy, anger, sadness, grief, pensiveness, fear and fright—all appear in healthy individuals, and cannot be separated from the physical.  In TCM, moderation and balance are key, so emotions are acknowledged and expressed appropriately; but when an emotion is either excessive or suppressed, then this disharmony results in compromised health. 

On Lok Lifeways CEO Bob Edmondson welcomes 300+ conference attendees

When I received this year's invitation to the 6^th annual On Lok Sustainable Long-Term Care Conference focused on “the latest developments and innovations in meeting the mental health needs of older adults,” I was intrigued by the “Matter Over Mind?” theme, but somewhat disappointed that this emphasis on the “latest” meant there was no presenter representing the “traditional” Chinese medicine perspective.  (Nonetheless, I registered for the conference—just as I did last year because I couldn’t resist the student discount rate!) 

After all, the holistic Chinese perspective influenced On Lok to pioneer the model of coordinated care for older adults with chronic care needs in community settings, rather than institutions, in San Francisco’s Chinatown over 40 years ago.  Based on traditional Chinese “it takes a village” and preventive health services model, On Lok (which means “peaceful, happy abode” in Cantonese) provides high-quality, culturally appropriate one-stop shopping:  medical and social supportive services, like nursing and physical, occupational and recreational therapies; meals; nutritional counseling; social work; home health and personal care; prescription drugs; respite care, etc.  On Lok’s model was so cost-effective while reducing nursing home admissions for participants that it was replicated under a new name, Program of All-Inclusive Care for the Elderly (PACE), in 1987 and then made a permanently recognized provider type under the Medicare and Medicaid programs in 1997.  (In 2006, On Lok renamed its PACE program to On Lok Lifeways.)  

AgeSong CEO/Founder Nader Shabahangi's conference moderator role was rather limited to introducing presenters and fielding questions from the audience.  I thought he would be an interesting presenter himself – especially as I was interested in learning more about AgeSong’s new partnership with University Mound Ladies Home.

Pop psychiatrist Daniel Amen on Preventing Alzheimer's Disease - Former X-ray technician Dr. Amen said the important question is: how do you know what’s going on in the brain unless you look?  He uses single-photon emission computed tomography (SPECT), a form of nuclear imaging test that measures blood flow to the brain.  His belief is that the brain does not deteriorate, but behavior can accelerate or deteriorate the brain, so we have a choice how fast the brain ages and can reverse brain damage.  But often we do not care because we can’t see.  Dr. Amen said we need to start by knowing the health of our brain, as revealed by SPECT scan, and losing belly fat because “the obesity epidemic is the biggest brain drain.”  The rest of his presentation was common-sense advice to reduce risk factors (avoid anything that hurts brain, engage in regular brain-healthy habits).  Yet, Dr. Amen remains controversial due to his use of SPECT to diagnose individuals, and the lack of peer-reviewed studies of his work. 

The next two speakers provided an interesting counterpoint with their emphasis on peer-reviewed research.  Psychotherapies are about as effective as medications in reducing symptoms of clinical depression or anxiety disorders, but without meds’ side effects. 

UCSF clinical psychologist Patricia Arean, on Behavioral Interventions for Late Life Depression, Anxiety and Chronic Illness Management, talked about the evidence-based research to support psychotherapy for older adults: cognitive behavioral therapy, interpersonal therapy, and problem-solving.

On Lok Lifeways Chief Medical Officer Jay Luxenberg on Drugs and Other Therapies for Mental Illness in the Frail Elderly: What is the Evidence?

Next up was a more touchy-feely presenter, Khatera Aslami, who is President of the Board of Directors at Copeland Center for Wellness and Recovery, on Wellness and Recovery Action Plan (WRAP) and Eldercare.  WRAP is a strengths-based approach founded on the principles of hope, personal responsibility, education, self-advocacy and support.  WRAP includes wellness tools, daily maintenance, action plans for triggers/early warning signs/when things are breaking down, crisis planning and post-crisis planning.  Aslami didn’t really address eldercare, other than to briefly mention that Alzheimer’s might prevent new learning to make good decisions about lifestyle, relationships, health care, leisure, etc., and isolated older adults might find it more challenging to have at least five key supporters to call upon when needed.  But her presentation was a good WRAP review as last year I took an introductory class on this recovery model at City College of San Francisco, where I continue to take coursework in its Community Mental Health Worker program. 

Engineer Joseph Choi founded TheraBaby, life-sized baby dolls that serve as companions for seniors living with dementia.  His own mother, who had late-stage Alzheimer’s disease, had dramatically improved her quality of life after bonding with the first TheraBaby, which also sparked social interaction among other residents.  In July 2012, Choi launched TheraBaby as a social good project by finding sponsors to adopt TheraBaby into senior care organizations in the Bay Area and Hawaii.  At this time, TheraBaby appears with blue eyes only, though Choi says he would consider different looks as his project grows.

Brain-friendly Mediterranean lunch of salmon on bed of greens: what's good for the heart is good for the brain

Psychiatrist Roberto Mezzina on An Open Door/No Restraint System of Care for Recovery and Citizenship in Trieste, Italy, reported that Trieste was able to dramatically reduce hospitalization/institutionalization with community services to promote aging in place, even when more than 27% of the population is over age 65! 

Stanford research psychologist Philippe Goldin on Science and Practice of Mindfulness Meditation, began a meditation exercise when I excused myself to head over to my late afternoon gerontology research class at SFSU.   

I also missed the last presentation on Harnessing Neuroplasticity of the Older Brain to Enhance Cognition, by UCSF neuroscientist Adam Gazzaley.  However, I’d read about Gazzaley’s study suggesting that older adults can improve cognition by playing video games, which are fast-paced and unpredictable, adaptable in difficulty, and challenging to working memory, attention and processing speed.  Sure, this might be one of the “latest developments and innovations,” but I prefer to engage my brain from traditional social interactions in the real world rather than games in the virtual world.  The former is intrinsically rewarding, while the latter is just a means to an end—much like how I prefer getting my nutrition from traditional whole foods, rather than supplements or fortified foods.

Brain Fitness

Psychologist Charles Vella presented Aging, Dementia and Brain Health in gerontologist Hope Levy's popular Brain Fitness series at the Main Library through City College of San Francisco's Older Adults Program.  Here are Dr. Vella’s Ten Commandments for Brain Fitness:

1.     Thou shall exercise daily.

2.     Thou shall minimize risk factors for cerebrovascular disease (hypertension, hyperlipidemia, diabetes, overweight, smoking)

3.     Thou shall eat Mediterranean diet.

4.     Thou shall choose thy parents wisely.

5.     Thou shall maintain intellectual engagement throughout life.

6.     Thou shall cultivate and sustain friendships and good company.

7.     Thou shall obtain restful sleep.

8.     Thou shall enjoy only one drink of alcohol.

9.     Thou shall manage stress effectively.

10.Thou shall not text or use cell phone while driving.

Mindful Eating 

Neuropsychologist Nancy Hoffman on Food and Mood: How the Food You Eat Affects the Way You Feel, at Life Planning Network meeting, hosted by Lee Abel, at AgeSong's rooftop garden.  Hoffman based her talk on nutritionist Elizabeth Somer’s book, Food and Mood, focusing on food sources of neurotransmitters like mood-enhancing dopamine (meat, milk, eggs, fish, beans, tofu), calming serotonin (tryptophan with complex carbs), pain-killing endorphins (high protein, daily exercise) and acetycholine for memory/new learning/attention (egg yolk, wheat germ, soy, cauliflower, chicken).  It was very similar to Marin County psychotherapist Julia Ross’ The Mood Cure, which I read while studying holistic nutrition.

Moving Meditation 

I get my qi flowing during Da Yan Qi Gong class at Botanical Garden inside Golden Gate Park.