According
to Chinese Medicine’s Five Element (WuXing) system, the autumn/fall/harvest season is
associated with metal (element) and old age
(life stage). As an introverted old
soul, I identify with the metal element and embrace old age with its potential
for gerotranscendence:
“These typically include a
redefinition of the Self and of relationships to others and a new understanding
of fundamental existential questions. The individual becomes, for example, less
self occupied and at the same time more selective in the choice of social and
other activities. There is an increased feeling of affinity with past
generations and a decreased interest in superfluous social interaction. The
individual might also experience a decreased interest in material things and a
greater need for solitary "meditation". Positive solitude becomes
more important. There is also often a feeling of cosmic communion with the
spirit of the universe, and a redefinition of time, space, life and death.” --Lars Tornstam, author of Gerotranscendence: A Developmental Theory of Positive Aging
I crave
private moments to experience nature in solitude. It’s about knowing how to be with “aliveness
and newness moment by moment,” according to ancient Taoists, if we can
experience energetic balance (qi
flow) as we become one in harmony with our natural environment, and privacy gives
one the freedom to be.
In this
era of online social networking, I can seem like a Luddite because I
I don’t
participate in friending, tweeting, LinkedIn, etc. I value privacy, freedom of being off-the-grid
and maintaining my small circle of confidants.
These cherished values inform my support for aging in place since an
institutional alternative would diminish privacy and freedom that I believe to
be so essential to quality of life.
Social butterflies don’t
have deep friendship connections (Butterflies & Blooms exhibit at Conservatory of Flowers), but social introverts do J.
Maslow’s theory of motivation suggested that our most basic needs must be met before
attaining self-actualization (gerotranscendence).
Physiological: gimme shelter &
food
Senior & Disability Action (SDA) Housing Organizer and POOR Magazine co-editor
Tony Robles and Housing Rights Committee of SF Tenant Rights Advocate Jennifer Willis at last month’s SDA meeting focused on Public Housing.
Jennifer said that SF Housing Authority
is in the process of purging its Section 8 waiting list of 30,000 persons (some have been on this list for 10 years!) through the end of November, so it’s important
to respond with current address: if letter is returned to sender, then person is
removed from wait list. Housing
Authority wait list has been closed for years, and expectation is to purge
10,000 from current list and then re-order based on preferences such as
disability or no permanent address.
The
median age of America
At times,
it seems like legislation tackles the problem of homelessness as a quality of
life issue that jeopardizes public safety and aesthetics for NIMBY
residents. Homeless advocates view the
effect of San Francisco "quality of life" ordinances that make it illegal for persons to sleep in
public parks (which are now closed from midnight to 5 am)
and in oversized vehicles parked overnight in certain neighborhoods as criminalizing homelessness and poverty.
Why pick
on vulnerable people who are already suffering (sleeping in vehicles are the last refuge
from ending up on the streets), and why can’t we be just like Mister Rogers’
Neighborhood where neighbors peacefully work out their differences with
compassion? If we view homelessness as a
symptom of poverty and the larger problem of wealth concentration (99% of Americans subject to the wealthiest 1%, who control more than 40% of the
nation's wealth),
then perhaps we can look to rich countries, like Sweden and Japan, that
distribute their income the most equally have the longest life expectancy and
the highest quality of life.
California Alliance for Retired Americans supports AB 5, Homeless Person’s Bill of Rights and Fairness Act.
California Alliance for Retired Americans supports AB 5, Homeless Person’s Bill of Rights and Fairness Act.
Inclusionary
housing isn’t just about affordability but universal design access for all ages.
This month the Long-Term Care Coordinating Council endorsed the Mayor’s
Disability Council Resolution #2013-01 Recommending Guiding Principles for the
Construction, Maintenance and Financing of Permanently Affordable and Accessible Housing for People with Disabilities and Seniors.
On
Election Day (November 5), Tenderloin Neighborhood Development Corporation
hosted Home Matters for Health symposium as part of a campaign to
raise national awareness about the connections between home and health: the impact of stable affordable homes on
health, the value of supportive housing with health services provided at home,
and the cost effectiveness of health care that prevents homelessness.
Mayor Ed
Lee talked about San Francisco Department of Public Health’s Direct Access to Housing that provides on-site supportive services to low-income residents who were
homeless or at-risk; last year’s creation of the $1.5 billion Housing Trust Fund for affordable housing to low- and middle-income residents over the next 30
years; tripling the funding to Human Services Agency to provide homeless prevention and eviction defense services;
“re-envisioning” public housing by working with HUD on repairs (including
elevators)
to expand on SF HOPE model of community development;
the opening of Veterans Commons with on-site supportive services for senior veterans; and emergency services
with strong housing connections by expanding Project Homeless Connect to Every Day Connect.
According
to Dr. Joshua Bamberger (only male on panel, pictured above), San Francisco
Department of Public Health’s Medical Director for Housing and Urban Health,
living in “more beautiful” housing is associated with better health outcomes
and even lower mortality rates--“self-efficacy and beauty make the
difference.” After the symposium, I
asked Dr. Bamberger for his definition of “beauty” – did he mean housing that
includes therapeutic landscapes,
perhaps feng shui design? In response, he sent photos, which are posted online,
but the interior spaces are not visible so I couldn’t see the inner beauty.
One in
four San Franciscans is food insecure, or lacks access to healthy food,
according to the San Francisco Food Security Task Force, which presented its
2013 Assessment of Food Security in San Francisco report to the Board of Supervisors this month. The report notes that low-income households
with seniors, children or a single parent are especially vulnerable, yet the
report covers for 2010 and 2013 feature photos of young children
only.
This
month SNAP (Supplemental Nutrition Assistance Program, formerly known as food
stamps and now branded as CalFresh in California) benefits were cut by 5% due
to expiration of stimulus funding. I volunteer at Project Open Hand, which
prepares nutritious “meals with love” to 18 senior congregate meal sites in San
Francisco,
so I wanted to participate in its SNAP Challenge from November 21 to 28, by spending no more than $4.56 per day on food, which
is the average amount received by 4.1 million SNAP beneficiaries in
California.
This SNAP
Challenge week coincided with my attendance at the Gerontological Society of
America (GSA) annual meeting in New Orleans, where I couldn’t resist all the
receptions and then the Oak Street Po-Boy Festival, where I enjoyed
this amazing sweet potato, kale and pesto po-boy from Slow Food NOLA that cost me $5—exceeding
the average daily SNAP food budget.
For my
Aging & Social Policy class assignment to propose a budget-neutral policy,
I presented my poster on Improving
CalFresh for Seniors by addressing food security and nutrition. While my classmates didn’t object to my plan
for targeted outreach and marketing to enroll more seniors eligible for
CalFresh, I nearly got chewed out for suggesting a waiver from USDA’s Food and
Nutrition Service (which administers SNAP) to apply WIC-like standards to
promote nutrient-dense foods v. empty calories for low-income seniors, who have
special nutritional needs like the WIC population (low-income pregnant/nursing
mothers, infants and young children). Of
course, it didn’t help that I criticized SNAP rules that allow purchase of
“junk food” items (e.g., soda, candy, chips, etc.) that my own classmates were
eating in the classroom during my two-minute presentation. Yet, proper nutrition is especially critical
for senior health promotion and disease prevention, as malnutrition in seniors
leads to chronic conditions (heart disease, diabetes), slower healing rates, increased hospital stays, premature nursing home
placement, etc. that impair both quality and quantity of life.
Safety (net): Social Security & Medicare
National Committee to Preserve Social Security & Medicare Foundation (Board
Chair Carroll Estes, pictured above, provided introductory remarks) and Openhouse (Executive
Director Seth Kilbourn seated in middle) hosted Know Your Rights and Claim Your Money: Social Security and the LGBTCommunity at the San Francisco LGBT Center. This forum focused on the aftermath of the
U.S. Supreme Court’s rulings in June, which cleared the way for federal
benefits for same-sex married couples (finding Defense Of Marriage Act’s
Section 3 unconstitutional) and for same-sex marriages to resume in California
(rejecting Yes on Proposition 8 appeal).
The panel urged same-sex married spouses to file an application for
Social Security spousal benefits now since eligibility date is triggered by the
filing date of application. Because Social Security law looks to the state of
residence in determining whether a same-sex couple is married, it’s not clear
what happens to same-sex spouses who move to a non-marriage equality state.
At
JCCSF’s The Art of Financial Well-Being, Carroll Estes discussed how the
proposed “chained” CPI (Consumer Price Index) for making COLA (cost-of-living adjustments) to Social Security benefits will hurt
seniors by reducing benefits based on lower estimates of inflation. The current COLA already undercounts the
higher inflation experienced by seniors who spend a higher percentage of their
spending to health care costs. Instead,
Estes supports a more accurate inflation measurement for the elderly, the CPI-E
that was developed in 1982 to reflect the different spending patterns of
consumers age 62+, with a greater weight on health expenditures that continue
to rise faster than other expenses.
Kenneth
Gardner of the Centers for Medicare and Medicaid Services presented Medicare 101. Medicare focuses on acute care (doctor
visits, drugs, brief hospital stays) and short-term services for conditions
that are expected to improve – not chronic conditions, so Medicare does not
cover long-term (custodial) care. Instead,
Medicaid is the dominant source of payment for long-term care, followed by out-of-pocket
payments by individuals. The odds are
1:2 whether one will need LTC; in 2012, the national average cost of one year
in a private nursing home was $90,520.
- California Pan-Ethnic Health
Network Executive Director Ellen Wu hailed ACA’s policy to improve quality and access to health insurance coverage, with an expansion of the insurance marketplace (e.g., Covered California) and some states expanded
Medicaid eligibility. ACA improvements to Medicare coverage include expansion of preventive services such as free
annual “wellness” visits.
- SFSU Holistic Health
Institute Director Adam Burke (also a licensed acupuncturist) discussed the
role of low-tech Complementary and Alternative Medicine in health
promotion and wellness, recognizing that consistent killers are lifestyle
factors (exercise, nutrition, smoking, alcohol, stress) that can be managed with self-care.
Health
care v. insurance: “Medicare for all ages” is the motto for a single-payer
system, while Obama’s attempt at universal health care via ACA appears to be a
form of corporate welfare because it subsidizes the private health insurance
industry by mandating that individual
Americans buy its product. Under ACA, pediatric
dental and vision care services are mandated as “essential health benefits”—is this
ageism? Aren’t dental and vision care (also not covered by Medicare) essential
for all ages?
Social: community building
One-third of older Americans live alone, mostly out of personal preference; women over age 60 who live alone report more happiness than married women the same age. Moreover, older adults who live alone are more likely than their married counterparts to spend time with friends and neighbors. LGBT Aging Task Force found that 58% of gay seniors in San Francisco live alone, but they often are reluctant to use public services for the aging because they don’t feel welcome due to their sexual orientation so informal support (family, friends, neighbors) is important.
One-third of older Americans live alone, mostly out of personal preference; women over age 60 who live alone report more happiness than married women the same age. Moreover, older adults who live alone are more likely than their married counterparts to spend time with friends and neighbors. LGBT Aging Task Force found that 58% of gay seniors in San Francisco live alone, but they often are reluctant to use public services for the aging because they don’t feel welcome due to their sexual orientation so informal support (family, friends, neighbors) is important.
Community Living Campaign presented its 4-week Connections for Healthy Aging workshop series focused on challenging myths about aging and normalcy, fostering
inclusiveness through People First Language,
building social networks of care to survive a hospital stay/discharge; documenting health care decisions (vial of life kits,
advance health care directive)
to make your wishes known to others, etc.
Esteem
“My moral opposition to
prenatal testing and selective abortion flows from the conviction that life with disability is worthwhile and
the belief that a just society must
appreciate and nurture the lives of all people, whatever the endowments
they receive in the natural lottery.” –Adrienne Asch, 67-year-old bioethicist,
died this month
Future Past: Disability, Eugenics and Brave New Worlds
symposium was an opportunity to examine the debate favoring the value and
contributions of all persons versus discrediting those “not worth living” in a
utopian effort to “improve” human breeding via eugenics (like Nazi genocide, euthanasia,
sterilization, prenatal selection, etc.).
In her
welcoming remarks, Cathy Kudlick, Director of SFSU’s Paul K. Longmore Institute
on Disability, rejected the notion that disability can or even should be
erased; rather, disability remains despite scientific breakthroughs, which
allow persons with disabilities to live longer.
By accepting disability and valuing disabled persons as worth
preserving, Kudlick said we approach disability as a “generative force for
productive conversations” and consider the fundamental questions to advance
social justice: “What does it mean to be human? How do we respond ethically to
difference? Who gets to decide? What do the answers reveal?”
WHAT? Eugenics and Disability:
Past and Present panel
featured
Alexandra Minna Stern,
SFSU alumna and author of Eugenic Nation: Faults and Frontiers of Better Breeding in America Canada
Eugenics
is based on the medical model that attempts to diagnose, manage, control and
prevent differences from “normality” by reducing persons who don’t "fit in" to
labels (like defective, imbecile, mentally retarded, etc.) and then segregating
them, with disparate impact on minorities and poor. Instead of this misguided science dependent on
value judgments, a social model that offers improved access to
disability-friendly resources promotes inclusion.
After
listening to each panel, participants at each table engaged in small-group
discussions based on materials introduced by Milton Reynolds of Facing History and Ourselves,
and then voluntarily reported back to everyone in the conference room.
SO WHAT? The Consequences of
Misremembering Eugenics
Rosemarie Garland-Thomson, Emory
University
Troy Duster, UC Berkeley Chancellor’s Professor of Sociology, considered the
conditions under which society determines “what kind of people you don’t
want”—disruptive socio-economic transformations that categorize people as
“makers” or “takers” in the struggle for resources—create fertile soil for
eugenics.
Rob Wilson, University
of Alberta
Marsha Saxton (moderator), World Institute on Disability,
mentioned the challenge in funding research for drug treatments that could
improve quality of life (like one based on a drug for Alzheimer’s to help “normalize”
learning and memory in persons with Down syndrome) that compete against prenatal
testing (to prevent Down births).
NOW WHAT? Looking Ahead to Brave
New Worlds
Patricia Berne, co-founder and director of Sins Invalid, showed video clips of her performance art project that celebrates artists with disabilities and other marginalized groups within a social justice context.
Milton Reynolds, Facing History and Ourselves Senior Program Associate, highlighted the role of education, such
as California’s Fair, Accurate, Inclusive, Respectful (FAIR) Education Act that
requires teaching LGBT, disability and other traditionally underrepresented cultural
groups, in transitional justice processes that include institutional reform,
cultural response, judicial response, reconciliation, restitution and
reparations, and truth commissions.
Gregor Wohlbring,
University of Calgary Professor of Disability Studies, who joined the
conference via skype, noted that both negative (sterilization of those deemed
“unfit to breed,” selective abortion after genetic testing reveals “undesirable”
traits) and positive (somatic and germline therapy, human enhancement beyond
norm) eugenics are based on ableism (disability discrimination/oppression).
Kate Wiley, SFSU alumna and Lick-Wilmerding High School teacher, talked about her
students creating an online petition asking the State of California to include California’s history of eugenics in
its public high school curriculum.
In closing
remarks, Emily Smith Beitiks, Assistant Director of SFSU’s Paul K. Longmore Institute on
Disability, expressed her hope that in the future we will not need to hold a
conference to make the argument that certain people have the right to exist.
