Friday, November 30, 2018

Sustenance

Food has the power to connect and engage people, and build community.  This is evidenced by programs that center around food, such as home-delivered meals, adult day programs and senior congregate meals—enticing older adults with sustenance and access to social services that support healthy aging in community.  During my graduate gerontology studies, I worked at On Lok, Inc.’s 30th Street Senior Center location, which provides all three programs across the continuum of care in its 3-story building:
·       1st floor kitchen, where Valley Services (same contractor used by Meals on Wheels San Francisco) prepare meals for home deliveries and six community dining sites 
·       1st floor dining room for 30th Street Senior Center participants, who have access to 3rd floor’s activities, health and wellness, social services, computer lab, hair salon and snack bar
·       2nd floor dining room for On Lok’s Program of All-Inclusive Care for the Elderly (PACE) participants, who have access to activities, health and social services, and roundtrip transportation
·       3rd floor garden, which grows edible plants harvested for monthly Garden Market. The garden has views of the adjoining Pritikin Mansion estate, which is up for sale ($12.5 million price from September 2017 dropped to $5.5 million). 
Earlier this month, I returned to 30th Street Center to join the celebration of its new campaign, “Mission Nutrition.”  “Mission” campaign name is double entendre, referencing 30th Street Senior Center’s location in the Mission neighborhood, attracting mostly Latinx participants, though other sources place it in more upscale Noe Valley and Glen Park.  
30th Street Senior Center management team’s Director Valorie Villela and On Lok, Inc. CEO Grace Li welcomed guests, including San Francisco Mayor London Breed. 
Informal meet and greet before official program began.  Of course, there was food (passed around in trays by Oakland catering staff) and hosted bar. 
On Lok 30th Street Senior Center Chair Joseph Barbaccia, MD, provided an overview of 30th Street Senior Center--San Francisco’s largest multi-purpose senior center connecting 6,700 older adults annually to each other and a wide range of services to support their health, well-being and independence.  The Center is the lead agency for the City’s evidence-based health promotion programs (including Always ActiveSM, Healthier Living-Chronic Disease Self-Management Program, and Diabetes Education Empowerment Program).  All social services (Aging and Disability Resource Center, Case Management) are offered in bilingual English/Spanish format.
Hadley Hall provided a brief history of 30th Street Senior Center, which will celebrate its 40th anniversary next year!  As Director of San Francisco Home Health Service, Hadley initiated acquisition of the 30th Street building for $1 and $750,000 mortgage in 1979.  He also obtained grants from Haas family and San Francisco Department of Aging and Adult Services’ Office on Aging (OOA) to convert the 3-story former psychiatric hospital into a vibrant senior center offering activities and meal programs.  Hadley introduced Valorie, who was hired as the Center's Nutritionist in 1979. 
As the Center's Director, Valorie talked about Mission Nutrition program goals to help older adults maintain proper health with hot, nutritious meals. Last year, Mission Nutrition served over 88,870 meals in community dining sites, and delivered another 130,000 meals to more than 360 homebound older adults. 

Despite the smokey air from the Camp Fire that started earlier that day, I longed to visit the 3rd floor Garden but it was dark (thanks to daylight savings time’s fall back) and the door to the Garden was locked.  So time for … Flashback Friday Fotos!


30th Street Center's garden beds with colorful wall mural  
Monthly Garden Market sells herbs, greens, fruits and flowers 
Way back in Fall 2011 (before I began this blog), I volunteered at 30th Street Senior Center as Project SHINE (Students Helping in the Naturalization of Elders) coach.  In addition to reviewing English and U.S. history for the citizenship exam, we rehearsed singing “You Are My Sunshine” in English and Spanish for an intergenerational program with K-8 students at Synergy School, a teachers’ cooperative in the Mission District.  With City College of San Francisco ESL instructor Elizabeth Silver interpreting in sign language, Center participants provided entertainment after Synergy School's teachers, parents and students provided lunch per Thanksgiving myth.   
Synergy School's mural with wisdom by Chief Seattle: “Humankind is but a thread within the web of life.  All things are bound together.  Whatever we do to the web, we do to ourselves.” #RakeAmericaGreatAgain  
With my allergies triggered by the worst air quality worldwide after the devastating Camp Fire, I became a shut-in for a week.  (Wish I had attended Gerontological Society of America's Annual Scientific Meeting in Boston instead!)  Homebound, I forgot about the outside world as I enjoyed cheap and nourishing Depression Cooking (mostly pasta with beans or vegetable) inspired by Youtube celebrity chef Clara Cannucciari (1914-2013), nonagenarian author of Clara’s Kitchen: Wisdom, Memories, and Recipes from the Great Depression (2009).  According to Clara, people bought chapters rather than whole books “back then” (p. 170).  I was grateful to savor all six chapters in this 194-page book, co-authored with her grandson Christopher who filmed her Youtube series. 

According to a recent report by the Federal Reserve Board, millennials are killing countless industries because they're mostly poor with no money to spend... so millennials should take comfort from Grandma Clara’s lessons on surviving the Great Depression.  
During the Depression, Clara’s family rarely ate meat which was reserved for their Saturday meal, and dessert only on Sunday.  Clara wrote: “No one ever celebrated your birthday back in the old days.  Birthdays were nothing,… we didn’t have birthday cakes.  The day came and went… We went without having a lot of things, but we were happy—we didn’t know what we were missing because we didn’t think we should have it (p. 167)."  Further on, Clara continued, “During the Depression, there were no gifts or celebrations at all for the holidays.  For us, it was all about the family being together (p. 176)."  The only consumption was food, which the family took part in preparing, including working the garden and walking to the grocery store and then back carrying bags of groceries.

 Here are some of my favorite morsels from do-it-yourself Clara, who quit high school to help support her family, by walking five miles to work filling Hostess Twinkies:

“We just relied on what we did have—the ability to sacrifice and put our needs in perspective (p. 1)."

“Where there’s dirt, there’s food (p. 13)."

“If you don’t think you have time to exercise, just clean your kitchen (p. 19)."

“…when you go to the grocery store, … buy only what you can comfortably carry, which is most likely all you need (p. 105)."

Mmm, good!
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4 comments:

  1. Awe someDecember 2, 2018 at 11:42 PM

    Change in law means thousands more SF residents will receive food stamps
    By Joshua Sabatini on December 1, 2018
    A change in state law will soon give thousands of San Francisco’s low-income elderly and disabled residents receiving Supplemental Security Income, who were previously not eligible for food stamps, access to the program.
    Since 1974, under state law Supplemental Security Income, or SSI, recipients in California have not been eligible to receive food stamps, which is called CalFresh,.
    Instead, SSI recipients were entitled to an additional $10 through what is known as the “cashout” policy. However, the state legislature changed the policy this past summer to allow these recipients to start receiving CalFresh benefits beginning in the summer of 2019.
    There are 43,000 elderly and disabled SSI recipients in San Francisco. The City estimates about 29 percent of the SSI recipients, or 12,600, will meet the state’s eligibility requirements to start receiving CalFresh.
    CalFresh currently provides nutrition assistance to 50,000 low-income San Francisco residents, so the change represents a significant expansion in the food stamp program.
    To prepare, Trent Rhorer, executive director of the Human Services Agency, is asking to hire 33 more positions to help people now eligible to enroll in the food stamp program.
    The hiring plan, which will cost $4.6 million a year in salaries and benefits, was approved by the Board of Supervisors Budget and Finance Committee last Thursday. Rhorer noted that state and federal funds will pay for 85 percent of the new positions and San Francisco 15 percent. The full board will vote Dec. 4 on the new positions.
    He praised the state policy change. “It’s a positive change, of course, increasing individual’s ability to purchase food,” Rhorer said.
    Instead of getting the $10 they will get the Calfresh benefits of between $75 and $97 per month to purchase food, he said.
    Rhorer said that in addition to benefiting the person, it also contributes to the local economy.
    He said the expected enrollment will result in an estimated increase of $11 million to $15 million a year spent by recipients in grocery stores, local merchants, farmers markets and in eligible restaurants.
    A November statement from the California Department of Social Services said that “this historic change, once successfully implemented, will increase nutrition and health and reduce hunger and poverty among California’s seniors and people with disabilities.”
    Meanwhile, the agency is working to prevent thousands of existing CalFresh recipients from losing benefits under a work requirement for those aged between 18 and 49 and who are “able-bodied adults without dependents.”
    The requirement dates back to 1996. In recent years, however, San Francisco and counties throughout the state have had a waiver due to the recession beginning in 2008. But with San Francisco’s booming economy, it lost the waiver this year.
    The work requirement went into effect on Sept. 1 and gives people three months to comply. That means that benefits could be lost as soon as Dec. 1. But the Human Services Agency said no one is expected to lose their benefits until 2019 as they continue to work with the estimated 3,000 who remain at risk of losing them. There is some flexibility in the time to comply, such as if recipients are making an effort to get a job or trying to get an exemption verified.
    http://www.sfexaminer.com/change-law-means-thousands-sf-residents-will-receive-food-stamps/

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  2. Awe someMarch 15, 2019 at 6:07 PM

    At Senior Centers, Meals Become Gateways to Activities, Services, and Connections
    March 15, 2019
    ACL Staff
    HHS Deputy Secretary Eric Hargan and ACL Administrator Lance Robertson arrived at the Walter Reed Senior and Community Center in Arlington, VA just before lunch time, and the center was full of activity…Hargan and Robertson were visiting the center to help kick off National Nutrition Month®. The center is one of thousands of senior centers, churches, schools, and other community spaces serving meals through the congregate meals program established by the Older Americans Act. Together, these programs serve more than 75 million meals a year to over 1.5 million Americans.
    As many as half of older Americans are malnourished or at risk of being malnourished, and nearly 5 million Americans lack consistent access to enough food for a healthy life. With food insecurity and malnutrition associated with a variety of negative health outcomes, including more frequent and longer hospitalizations, the congregate meals program plays an important role in helping older adults remain healthy and independent.
    In fact, 58% of participants say that the meal they receive through the program provides at least half of their total food for the day. A 2017 evaluation found that participants in the program have better diets and are less likely to face food insecurity compared to similarly-situated older adults not participating in the program.
    While nutrition is the most obvious benefit of the meals programs, the older adults at the Walter Reed Center would be the first to tell you they are getting much more than lunch…80% of congregate meal participants surveyed by the National Association of Nutrition and Aging Services Programs said they had more friends after joining the program.
    "A big problem that we see is that older Americans often become socially isolated from each other," Hargan said while visiting the Walter Reed Center. "So a center like this, where people come for the food but they stay for the company, is really important."
    Like malnutrition, loneliness and social isolation can have grave consequences for older adults' health. For example, social isolation is associated with higher blood pressure and earlier onset of dementia. Older adults who are socially isolated also face a greater risk of being targeted for abuse, neglect, or exploitation.
    The meal programs also often serve as a gateway to other important services and activities. More than two-thirds of congregate meal providers also offer other activities for older adults, with more than half offering at least 25 hours of activities a week. Seniors who drop by for meals often stay for these activities and have the opportunity to learn about services and programs they otherwise may not know about, such as heating assistance or prescription drug assistance programs.
    The combination of nutrition, socialization, and connection to other resources and activities may help explain why participating in a congregate meal program leads to better health and a greater likelihood of staying in the community.
    The 2017 evaluation of the program found that older adults participating in congregate meal programs are less likely to be admitted to a hospital or nursing home. The gap was particularly stark among lower income older adults. For example, 4.5% of lower income older adults participating in congregate meal programs had been admitted to a hospital after an ER visit in the nine month before they were interviewed, compared to nearly 16% of those not participating in the program.
    These health improvements can result in a better quality of life for seniors. They also save money for programs such as Medicare and Medicaid.
    "(Seniors) want to be able to be in their homes but they also want the opportunity to be able to socialize, to meet other people, to do these activities, and also to have a meal," Hargan says…
    https://acl.gov/news-and-events/acl-blog/more-just-meal

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  3. Awe someApril 5, 2019 at 10:40 PM

    For Aging Immigrants, Food from Their Homelands Is Key to Happiness
    Stories from California’s immigrant seniors clinging to the flavors of their past
    Jaya Padmanabhan
    Mar 18, 2019
    …My mother, who immigrated to America in her late 70s from India, views the world through the lens of food. The act of eating or drinking is not only one of survival; it’s an emotional configuration. She is happiest when she has access to the foods she once ate back home, as though harnessing the taste of her memories.
    …And she is not the only one.
    For many adults who migrate later in life, familiar foods close the gap between countries left behind and countries arrived at. Remembered flavors stave off a fugue-like state of withdrawal from the new environment. So tastes are preserved carefully.
    Globalization and immigration patterns are changing the makeup of the elderly in America. As America ages, so does the immigrant population. By 2030, older adults will outnumber children. In 2010, more than one in eight adults 65 years and older were foreign born, according to the Population Reference Bureau.
    This changing population requires a rethinking and recalibrating of how we deliver elder care. While there is much research on seniors and social isolation, there’s not much attention given to seniors and the issue of cultural isolation, and, in particular, its linkage to food.
    The Migration Policy Institute reports that in 2010, California had the most number of foreign-born seniors (1.3 million) in the country. It is predicted that people of color, primarily Latinos and Asians, will make up 55 percent of California’s senior population by 2035, compared to 41 percent today.
    This changing population requires a rethinking and recalibrating of how we deliver elder care. While there is much research on seniors and social isolation, not much attention is paid to seniors and the issue of cultural isolation, and, in particular, its linkage to food.
    Despite the lack of research, however, nutrition programs in California are aware of what it takes to satisfy immigrant seniors.
    The Senior Nutrition Program (SNP) of Santa Clara county runs 38 “congregate meals sites” …menu is adjusted to suit the needs of the clientele.
    Milton Cadena, the program director at the Eastside Neighborhood Center in San Jose (a SNP site run by Catholic Charities), said…“When the food served at our centers mirrors the food [the clientele] grew up with or are accustomed to in their own culture, it is easier for them to accept it, and they appreciate it — and more importantly do not waste it,” he said.
    According to Judy Chang, a member of the board of La Comida, immigrant seniors are willing to experiment with cuisine if they’ve been in the country long enough. Or if getting and preparing hot meals is a problem. “If you have to have a full belly, then you go with whatever you get, as long as it’s not offensive to your palate,” Chang said, and for many of the La Comida patrons, this is the only hot lunch they get.
    …many aging seniors are nostalgic for the foods of their younger days. But adults who migrate later in life feel alienated if the cuisine they are accustomed to is not available to them.
    …Iggy Ignatius, chairman and founder of ShantiNiketan, a retirement community for Indian Americans in Tavares, Florida, is well on his way to building an empire on the simple premise that as immigrants age, they will want comfort food and a back-to-the-roots lifestyle… affinity retirement homes are not non-assimilative, but places where people go to confront the twilight years of life among people who share the same kinds of life experiences and are able to relate to each other.
    That relational experience boils down to food and socialization. Ignatius echoed Ghatak’s theory on seniors and their preoccupations: “Food is the major concern for Indian American seniors, in my opinion, and then comes socialization.”
    https://thebolditalic.com/for-aging-immigrants-food-from-their-homelands-is-key-to-happiness-c3715c4c3650

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  4. Awe someSeptember 10, 2019 at 11:44 PM

    Starving Seniors: How America Fails To Feed Its Aging
    By Laura Ungar and Trudy Lieberman
    SEPTEMBER 3, 2019
    …millions of seniors across the country quietly go hungry as the safety net designed to catch them frays. Nearly 8% of Americans 60 and older were “food insecure” in 2017, according to a recent study released by the anti-hunger group Feeding America. That’s 5.5 million seniors who don’t have consistent access to enough food for a healthy life, a number that has more than doubled since 2001 and is only expected to grow as America grays.
    While the plight of hungry children elicits support and can be tackled in schools, the plight of hungry older Americans is shrouded by isolation and a generation’s pride. The problem is most acute in parts of the South and Southwest. Louisiana has the highest rate among states, with 12% of seniors facing food insecurity. Memphis fares worst among major metropolitan areas, with 17% of seniors…unsure of their next meal.
    And government relief falls short. One of the main federal programs helping seniors is starved for money. The Older Americans Act — passed more than half a century ago as part of President Lyndon Johnson’s Great Society reforms — was amended in 1972 to provide for home-delivered and group meals, along with other services, for anyone 60 and older. But its funding has lagged far behind senior population growth, as well as economic inflation.
    The biggest chunk of the act’s budget, nutrition services, dropped by 8% over the past 18 years when adjusted for inflation, an AARP report found in February. Home-delivered and group meals have decreased by nearly 21 million since 2005. Only a fraction of those facing food insecurity get any meal services under the act; a U.S. Government Accountability Office report examining 2013 data found 83% got none.
    With the act set to expire Sept. 30, Congress is now considering its reauthorization and how much to spend going forward.
    Meanwhile, according to the U.S. Department of Agriculture, only 45% of eligible adults 60 and older have signed up for another source of federal aid: SNAP, the food stamp program for America’s poorest. Those who don’t are typically either unaware they could qualify, believe their benefits would be tiny or can no longer get to a grocery store to use them.
    Even fewer seniors may have SNAP in the future. More than 13% of SNAP households with elderly members would lose benefits under a recent Trump administration proposal.
    …Across the nation, waits are common to receive home-delivered meals from a crucial provider, Meals on Wheels, a network of 5,000 community-based programs. In Memphis, for example, the wait to get on the Meals on Wheels schedule is more than a year long.
    …Since malnutrition exacerbates diseases and prevents healing, seniors without steady, nutritious food can wind up in hospitals, which drives up Medicare and Medicaid costs, hitting taxpayers with an even bigger bill. Sometimes seniors relapse quickly after discharge — or worse.
    …Although more than a third of the Meals on Wheels money comes from the Older Americans Act, even with additional public and private dollars, funds are still so limited that some programs have no choice but to triage people using score sheets that assign points based on who needs food the most. Seniors coming from the hospital and those without family usually top waiting lists.
    …Malnutrition blunts immunity, which already tends to weaken as people age. Once they start losing weight, they’re more likely to grow frail and are more likely to die within a year, said Dr. John Morley, director of the division of geriatric medicine at Saint Louis University.
    Seniors just out of the hospital are particularly vulnerable. Many wind up getting readmitted, pushing up taxpayers’ costs for Medicare and Medicaid. A recent analysis by the Bipartisan Policy Center found that Medicare could save $1.57 for every dollar spent on home-delivered meals for chronically ill seniors after a hospitalization…
    https://khn.org/news/starving-seniors-how-america-fails-to-feed-its-aging/

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