Wednesday, September 30, 2015

Aging + disability: equal opportunities

Americans with Disabilities Act (ADA) and Older Americans Act (OAA) are equal opportunity laws that support full participation in community living. Americans also have equal opportunities to become Americans with disabilities and older Americans.
                                             
Aging with disability

Americans, including those with disabilities, are living longer.  As Eli Gottlieb wrote in The New York Times opinion piece, “Adult, Autistic and Ignored,” parents of dependent children with disabilities fear: What will happen to them when I’m gone?  After his mother died, Eli became guardian of his older brother Joshua who has autism and lives in an institution.  Like his mother, Eli became an advocate critical of the disability cliff when children with disabilities age-out of “special education” and the need for more attention to elderly autistic people like Joshua.  
At 5th Annual Legacy Film Festival on Aging (LFFoA), LFFoA Director Sheila Malkind facilitated Caring program discussion with Dr. Toni Miles and Mimi and Dona documentary filmmaker Sophie Sartain. 

Sophie began filming her documentary in Dallas six years ago when 92-year-old Mimi (Sophie’s maternal grandmother) was no longer able to care for her 64-year-old daughter Dona (Sophie’s aunt) who was diagnosed with “mental retardation” in the 1950s (though Sophie suspects undiagnosed autism).  When Dona was asked to leave public school after 2nd grade, Mimi sheltered Dona at home instead of the prevailing practice of sending her “retarded” child to a mental institution. 

Mimi makes the difficult decision to place Dona into Denton State-Supported Assisted Living Center, a long-term care facility that serves people with intellectual and developmental disabilities.  While Mimi thrives as she continues to live at home in the community, Dona deteriorates precipitously in the institution.  Spoiler alert: Dona’s condition improves, but she is also diagnosed with early Alzheimer’s; documentary ends with death of one.  Save this date: On November 23, Mimi and Dona will have its Independent Lens premiere on PBS. 

Family caregiving theme is constant: Sophie’s mother provided care for Sophie’s father who had multiple sclerosis during the last 20 years of his life; Sophie’s brother has a son with autism (“you need to live forever or outlive your kid”); and back in Los Angeles, Sophie learns that her own son is diagnosed with autism.  The main difference between Dona’s generation and today’s children with autism are disability civil rights laws, such as Individuals with Disabilities Education Act (IDEA) ensuring that children with disabilities have an opportunity to receive free appropriate public education in the least restrictive environment.

Now there is greater public awareness of disabilities that survive into old age. In The New York Times article, "Is It Old Age, or A.D.H.D.?", Judith Berck reported on the dearth of research on older adults with A.D.H.D. and the challenge of treating them with the same drugs given to children.
At 19th Annual Golden Gate Self-Advocacy Conference: Give It to Me Straight! Current Happenings in Our Developmental Disability Community, keynote speaker Santi Rogers, Director of California Department of Developmental Services, holds up Lanterman Act, California law passed in 1977, that gives people with developmental disabilities the right to services and supports to enable independent living.  He previously announced decision to close the remaining state-run developmental centers in California and transition participants into community living. 

More ADA celebrations! Doing disability justice

Steve and Lillian Gonzalez Brown, co-founders of Institute on Disability Culturegreeted me at Disability Rights Education and Defense Fund (DREDF)’s 36th Anniversary Celebration Honoring the 25th Year of ADA & Charting the Next 25 Years of Disability Rights at Ed Roberts Campus. 
Thanks to DREDF Director of Development Ingrid Tischer, I was able to attend the Celebration fundraiser as volunteer. 
Caramelized chocolate ganache with sea salt bars welcomed guests to tables. DREDF Senior Policy Analyst Marilyn Golden urged us to sign cards (on tables) opposing HR 2646 because “it would take away legal representation for people with mental illness, reduce privacy rights, and promote institutionalization.” 
Celebration co-sponsor Google Impact Challenge: Disability hosted Bay Area Makeathon weekend to design a more accessible world. 
Google also unveiled portraits and videos of disability rights leaders like Ed Roberts. 
ACLU attorney and DREDF Board of Directors President Claudia Center called for donations, suggesting $25 in honor of 25th anniversary of ADA; she said her personal donation formula was doubling 25, for her birthday this year, times ten! 
Evening’s program capped with intergenerational discussion about ADA’s impact 25 years after its passage, and advances we want in next 25 years, particularly on issues affecting people who live with invisible disabilities and intersectional effects of race, gender and disability. Christina Mills, Deputy Director of California Foundation for Independent Living Centers, moderated the discussion among all-women panelists: Maddy Ruvolo of Marin Center for Independent Living; Yomi Wrong of Palo Alto Medical Foundation/Mills-Peninsula Health Services; Nubyaan Scott, DREDF 2015 Summer Intern; and Mary Lou Breslin, DREDF Co-Founder/Senior Policy Advisor.


Yomi discussed her concerns about aging with disability, long-term care and still being in charge of her life, who will care for her as she has no plan to "go quietly to an institution, but if I do, what will it look like?" She noted ADA's influence on the built environment, yet need to reduce health disparities, adding that “death with dignity is such crap because if people have better choices, they don’t think to kill themselves.”
Disability Organizing Network (DOnetwork) presented California#ADA25 Conference: Access, Availability, Advocacy and Civil Rights! at UC Hastings College of Law.  This multigenerational view of disability justice covered:
  • access: equal opportunity to participate in all aspects of everyday life;
  • availability: options and choices which increase independence and freedom; 
  • advocacy: our history and courageous actions of leaders that lead to today's inclusion; and
  • civil rights: our just claim to equal citizenship
The conference's lunch program featured video clips of Alice Wong’s Disability Visibility Project: “Recording disability history, one story at a time.”   
ADA: Reflections on Success panel moderated by Yomi Wrong:
·         Arlene Mayerson, DREDF Directing Attorney, was a principal architect of ADA 25 years ago.  In order to have equal opportunities for people with disabilities (PWD), they had to have accommodations which meant they have to be treated differently. After ADA, PWD no longer asked for charity or favors, but for accommodation as a matter of right.
·         Paul Grossman, education civil rights attorney talked about Lau v. Nichols (1974 U.S. Supreme Court case finding that lack of language appropriate accommodation denied Chinese students equal educational opportunities because same treatment is not equal opportunity) and the 504 sit-in laying the groundwork for ADA.  He added that the second most exciting moment in disability rights has been since ADA Amendments Act of 2008 expanded the definition of disability (medication and other interventions that deal with effects of disability cannot be factors in determining whether individual is disabled), so disability-based discrimination cases can be heard on their merits.
·         Jim Patterson talked about “associational discrimination”: being pushed out of foreign service career because his employer viewed his daughter’s disability as a liability.  After The New York Times published an article, “Whose disability is it anyway?” he returned to work as a full member of the diplomatic corps and became an advocate for employment equality.
Do You Know Your Disability Civil Rights History? HolLynn D’Lil, author of Becoming Real in 24 Days: One Participant's Story of the 1977 504 Demonstrations, took over 350 black and white photos chronicling the takeover of the San Francisco Federal Building to demand that President Carter's administration implement regulations to Section 504 of the Rehabilitation Act, the first federal civil rights law for people with disabilities. At the time, Congressman Phil Burton said, "To have to demonstrate during a Democratic administration to fulfill a Republican promise is a painful irony."
Ted "can I get an accommodation?" Jackson, Community Organizing Director at California Foundation for Independent Living Centers (CFILC), moderated discussion during Breakfast with the Author Tony Coelho, who entered politics as his ministry after he was denied from pursuing Catholic priesthood based on his epilepsy. While serving in U.S. House of Representatives, he was principal author of ADA, which got bipartisan support due to supporters' personal relationships with PWD.  He noted 52 countries now have disability laws based on ADA.
Indigo Mind features artists celebrating the work of neurologist Dr. Oliver Sacks.  
Connie Barker founded Environmental Health Network (EHN), which provides support, advocacy and information to the chemically and electrically injured: “If it’s not healthy, it’s not green.” In addition to her own site http://ehnca.org/, she offered the following resources:
Access Kids perform on entertainment stage

Aging + disability-friendly communities 

Under disability laws, the person with disabilities has the burden to disclose his/her disability and ask, "can I get an accommodation?"  Sometimes, people with "invisible disabilities"--like chemical sensitivities--might resist disclosure to avoid stigma ("it's all in your head").  As a more proactive approach to move beyond individual accommodations, universal design creates inclusive environments for everyone by placing the burden for accessibility on architecture. 
ADA Conference workshop included Homesick Living with Multiple Chemical Sensitivities: Finding Accessible, Available, Affordable Housing, presented by Connie Barker of EHN.  Connie talked about 11-room Ecology House, the nation’s first HUD-funded housing for people with multiple chemical sensitivities (MCS) that was built over 20 years ago in San Rafael, and then showed documentary, Homesick (2013) about director Susan Abod’s road trip to discover how people with MCS find safe housing and cope with their disability. 
Ed Roberts Campus was ideal to host At Home With Growing Old (AHWGO) program, Dementia-Enabling Spaces: Bodies, Networks, Environments.  Panelists were:
  • Susan Stadler, architect and AHWGO co-founder, substituted for Clare Cooper Marcus and discussed gardens for people with dementia like Portland Memory Garden 
  • Dr. Mehrdad Ayati, geriatrician and author of Paths to Healthy Aging (2014), prescribed social interactions (“live like an Italian: engage brain in conversation, talk with hands”), value and respect elderly because “You cannot replace experience with knowledge (internet),” more geriatric training (completed by only 3% of U.S. medical students) and interdisciplinary teams in geriatrics 
  • Debora Tingley and Patricia Ris discussed Memory Care CafĂ©, a weekly social club for people with forgetfulness and their care partners.
The shift from the medical model of aging and disability continues to end-of-life: life and death are natural v. medical events.  UCSF Osher Center for Integrative Medicine hosted a screening of the PBS Frontline documentary, Being Mortal, followed by a discussion on end-of-life planning with Shelly Adler, PhD, Osher Director of Education, and BJ Miller, MD, palliative care physician and Director of Zen Hospice Project.  They discussed when cure is not possible at the end of life, we can reduce suffering for a “better death.”  BJ said a doctor can tell the truth in a supportive way that does not rob hope, but informs. In BJ’s TED talk, What Really Matters At the End of Life in March, he talked about patient meaning one who suffers, so we are all patients, and how most people fear, not death but, suffering; yet suffering unites us when we share this experience.