Healing

According to San Francisco Department of Public Health (SF DPH) COVID-19 data tracker to date: 422 deaths (60.8% male; 63% age 80+, 16% age 70-79, 12% age 60-69, or 91% of deaths age 60+; 38.9% Asian, 20.6% Latinx, 27.5% White, 7.8% Black; 0.7% homeless).  Total COVID-19 deaths: 511K in U.S., over 2.46 million worldwide.

Vaccines appear to be working as evidenced by leveling of COVID-19 hospitalizations and deaths among residents and staff of long-term care (LTC) facilities and people age 75+ who were first in line to receive limited supplies of vaccine.  SF has vaccinated 20% of its adult population, and has capacity to vaccinate more when vaccine supply increases.  Recent FDA-approved one-shot J&J vaccine expected to boost rollout soon! 

As we embark on recovery from this pandemic and safely resume (pre-Zoom) to more in-person activities after last year’s hammer and dance, let the healing begin!

v. healed, heal·ing, heals

v.tr.

1.

a. To restore to health or soundness; cure: healed the sick patient.

b. To ease or relieve (emotional distress): Only time can heal her grief.

2. To set right; repair: healed the rift between us.

https://www.thefreedictionary.com/healing

After almost a year’s silence from residents of LTC facilities, so heartwarming to read The New York Times’ interviews with LTC residents finding love during lockdown. 

At UCSF Asian Health Institute’s Town Hall meeting on Vaccines and Variants, UCSF epidemiologist Monica Gandhi, MD, MPH, addressed issue of highly contagious variants of coronavirus: no worries, as no evidence yet that they cause more serious illness to those infected, and current vaccines offer protection (from severe illness and death) against variants.

Instead of panicking about variants, Dr. Gandhi called for more “vaccine optimism” to achieve herd immunity and end pandemic—hopefully before year end. (According to Dr. Anthony Fauci’s humble guesstimate, achieving herd immunity against coronavirus would require 70-90% of the population to be vaccinated.) To those already vaccinated, Dr. Gandhi provided guidance on in-person interactions with others who may or may not be vaccinated.

·       Among vaccinated: ok to drop masks and interact freely

·       Vaccinated among unvaccinated: maintain precautions like mask wearing, physical distancing due to risk of asymptomatic infection (research ongoing to determine how well vaccines stop transmission)

Amidst this wonderful progress toward ending COVID-19 pandemic (and surprising disappearance of flu!), racial inequities and ageism (elder abuse) persist. 

Vaccine inequity

Many older people living outside of prioritized LTC facilities who are eligible (and remain at highest risk for severe illness/death from COVID-19) continue to face barriers in accessing vaccines, perpetuating inequities for those without access to technology, communication (for people with vision/hearing/cognitive disabilities and/or non-English language), supports, transportation, etc. to schedule and show-up at vaccination sites. UCSF has not received enough vaccines to begin vaccinating homebound patients.  It’s like playing “So You Think You Can Get the Vaccine.”  And not all older people are like 90-year-old Fran Goldman who walked six miles roundtrip through Seattle snow to get her COVID-19 vaccine!  

Lena K. Makaroun, MD, who trained at UCSF and now geriatrics researcher at Center for Health Equity Research & Promotion at VA Pittsburgh Healthcare, presented Healthcare Does Not Equal Health: Drivers of Health Inequities in Older Adults: Promoting health equity is critical to goal of vaccinating all people age 65+, as not all have substantial time, technology, and trust. 

People age 65+ and white adults are most enthusiastic to get COVID vaccine.  However, Black, Latinx and Native American people, who experience more chronic medical conditions and decreased resiliency from a lifetime of systemic racism, are less enthusiastic to get COVID vaccine due to trust issues, and need more time. 

In contrast, those who are privileged with resources have easier time accessing vaccines or gaming system:

·       Marin residents misuse access codes meant for Black, Latino communities to get COVID-19 vaccines 

·       Two young women in Florida 'dressed up as grannies' to get vaccinated

·       A SoulCycle 'teacher' got the COVID-19 vaccine ahead of actual educators 

Some senior living facilities, which saw record drops in occupancy during pandemic, are using vaccines to entice prospective residents. (Beware of for-profit, private equity owned facilities: New study found 10% increased mortality among patients, most concentrated among those “relatively healthier,” in private equity-owned nursing homes characterized by reduced staffing especially front-line nurses, and increased use of antipsychotic drugs.) 

Sadly, vaccination rates have been lowest in communities hit hardest by COVID-19. California has 61 vaccine priority lists determined by local county health departments! 

In SF, the largest racial/ethnic group of older adults are Asians, who make up 43.9% of age 65+ population and received 38.7% of COVID-19 vaccinations by SF DPH and community partners to date. 

SF provides free Muni transportation to and from COVID vaccination sites. On Feb. 24, SF vaccine eligibility opened up to people at risk of exposure working in education, childcare, emergency services, and food/agriculture.  Beginning Mar. 15, healthcare providers may use their clinical judgment to vaccinate individuals age 16-64 who are deemed to be at very highest risk for morbidity and mortality from COVID-19, as a direct result of specific severe health conditions or disabilities. 

Black history

February is Black History Month, and California Department of Aging hosted Ensuring Equity in Aging Webinar Series: Culturally Informed Policy & Programs for Black Elders.

Jonathan Butler, PhD, researcher at UCSF’s Department of Family and Community Medicine & CeNter for the StUdy of AdveRsiTy and CardiovascUlaR DiseasE (NURTURE Center), said hypertension affects 40% of non-Hispanic Black adults, who are nearly twice as likely to die from hypertension-related heart disease than their white peers. Blacks are more likely than whites to have traditional risk factors of obesity, diabetes, and physical inactivity—as well as higher burden of stress from structural racism; controversy remains in factoring race into treatment (e.g., medication based on Blacks more likely to have salt sensitivity). He recommended sugary drink distributor tax policy.  Since sodium is dietary factor in hypertension, I asked for his thoughts on taxing high-sodium products; he said he had not considered it, so glad 😊 I made suggestion!

Senior & Disability Action (SDA) Housing Organizer Freddy Martin facilitated this month’s SDA meeting celebrating Black History Month, with theme: “If there is no struggle, there is no progress” (Frederick Douglass, 1857).  Presenters included SF COVID-19 Command Center Chief Equity Officer De’Anthony Jones about Black perspective on COVID-19 vaccine, and members of SDA’s African American Racial, Social, Equity and Justice Alliance (AARSEJA) on Anti-Racist Campaigns (addressing poverty, hate crime, homelessness, jobs, education, incarceration, health disparities; solutions include collaborating with youth, having a seat at the table for open dialogue about issues affecting Black families, reparations, etc.). Freddy also urged us to share input in SF Housing Element 2022-2030 planning process centered on racial and social equity.  SDA’s housing advocacy agenda will focus on expanding rent subsidies for seniors and people with disabilities, and winning free wifi in supportive housing buildings. (Read Justice in Aging’s new issue brief, Low-Income Older Adults Face Unaffordable Rents, Driving Housing Instability and Homelessness.) 

(Shamann Walton, first Black man elected president of SF Board of Supervisors, introduced this month a resolution calling for reparations for SF’s African Americans, whose ancestors provided slave labor.  Shamann and SF Mayor London Breed announced Dream Keeper initiative to redirect $120 million over next two years from law enforcement to invest in SF’s African American community, including guaranteed income, health and well-being, housing and home ownership!) 

Healing through Community was theme of this year’s Black History Month at Mills College, where I attended a couple of virtual intergenerational discussions after screening of Sankofa (1993) with actress Oyafunmike Ogunlano (aka Yoruba Priestess from Brooklyn) and Black Campus Movement at Mills.

I was drawn to Sankofa, filmed in Ghana where I taught grade school kids in New Akrade village and spooked out local babies who cried at sight of my foreign presence while local kids rubbed my pale arms to see if there was a darker layer of skin! Ghana was one of the first countries to welcome Peace Corps volunteers, and 70-year-old Stevie Wonder plans to move there drawn to its greater sense of community for Blacks than in U.S.  But film was difficult to watch due to graphic violence as slave masters played out racial capitalism’s divide and control.

In Sankofa, Oyafunmike starred as an African American model Mona (on photo shoot in Ghana’s Cape Coast Castle, oblivious to setting’s historical role in Atlantic slave trade) who is transported into the past, where she becomes plantation house slave Shola and ultimately “recovers” her identity to side with her oppressed people—like Moses in the Hebrew Bible, and the meaning of Sankofa bird who returns to past in order to go forward, in decolonization process. Film also explored how people can be complicit in oppression of their own people by their relative privileges, like character Joe as head slave who navigates worlds of oppression and assimilation (code switching), ultimately choosing oppressors, killing his own mother!

Oyafunmike discussed this legacy of slavery on Black people: women sexualized, men don’t stay with families; need to “get right African mind” (v. Eurocentric) with “own God and culture to celebrate” for own sanity, lots ritual and prayer to get back to wellness because otherwise "you can’t love other people if you do not love yourself, you have pants hanging down and normalize things you’re not supposed to, like no one knows who they are.”  Writer YeYe Luisah Teish emphasized decolonizing to reclaim ancestral roots and rites of passages; for example, twerking done in circle of village to celebrate sexuality in West Africa, but colonization (white America) dumbs down sacred to monetize, so need to see what has been twisted, and go back to reclaim spiritual. 

African American History Professor Lauren Araiza (whose mother is Mills alum) presented on Black Campus Movement at Mills, focused on Black Student Union’s 1969 occupation of College President’s office that led to formation of Ethnic Studies program, hiring of African American faculty and staff, and increasing number of admitted African American students.  At the time, this rejection of respectability politics and new “militant” image of “Mills girls” challenged the stereotype of a typical women’s college attendee—polite, mannered, wealthy white elite.  (In 1990, civil disobedience tradition by students made Mills the first and only women's college to reverse a decision to go co-ed!) After this presentation, Professor Araiza (who is non-Black Chicana) went silent as Black alumnae, students, faculty, and staff took over Zoom space sharing real life existential concerns. 

These were intense discussions, mostly provoked by questioning and demands of students who articulated: “Black churches afraid to speak the Truth about enslavement”; Black mental health professionals to provide counseling and therapy to Black students; revision to Mills’ Social Justice Mission statement that it is an anti-racist institution (not only social justice institution); replace Equity, Inclusion and Social Justice Committee with Anti-Racism Action Team; Black Wellness Package Proposal for equitable learning/accommodation to address racial trauma, etc. Surprised to learn that Black Mills students joined Delta Sigma Theta (African American sorority) through chapters at UC Berkeley and SFSU because Greek Life Organizations appear to contribute to racism and lack of diversity.

Given that personality disorders are developed during teenage and young adulthood years (tasked with resolving identity v. confusion, and intimacy v. isolation conflicts in search of fidelity and love virtues, according to Erikson), so precious to hear dynamic back and forth between younger (fluid intelligence) and older (crystallized intelligence) women—not just stereotypical passing “wisdom” from old to young, but younger students also pushing back in raising generational post-traumatic slave syndrome and mental health issues that might not be acknowledged by older cohorts due to stigma. 

Age diversity in discussions about healing is so important because perspectives are influenced by life stage and cohort’s life experiences.  Arguably, this pandemic has disrupted the lives of younger people, who are stressed enduring Zoom classes, working essential jobs or losing employment income, pausing on major life events (like going away for college or getting their own place, instead of putting up with roommates or boomeranging back home with parents), more so than most older people (outside of LTC facilities and prisons) who have retired from rat race with safety net.  Also, these intergenerational exchanges are especially poignant when there is shared cultural heritage and appreciation for holistic healing.

SFSU's Sutro Library hosted Critical Family History: Placing Family History Within Larger Contexts, presented by Anti-Racist Multicultural Education Professor Christine Sleeter.  She developed Critical Family History, based on critical race and feminist theories, as a way to re-examine “heroic individual” narratives by situating family history in social and cultural context to make racism visible (e.g., racial identity linked to colonization of land or exploitation of other groups).  These stories (including Joy Anderson’s What it Means to Be Black with an Interracial Family Tree, and Mica Pollock’s Flipping Our Scripts about Undocumented Immigration) are shared in an open-access special issue of Genealogy and Critical Family History. 

Policy advocacy

In latest Public Policy & Aging Report, “Do Liberal U.S. State Policies Maximize Life Expectancy?” researchers Jennifer Karas Montez, PhD, and Mateo P. Farina, PhD, answer: Yes, one’s chances for a long and healthy life are increasingly tied to their state of residence, and Hawaii and California made Top 3 for life expectancy (LE) and healthy life expectancy (HLE)!

·       Differences in LE across states are now larger than ever recorded, probably due to partisan polarization across state policy contexts; e.g., in 2017, LE ranged from 74.6 years in West Virginia to 81.6 years in Hawaii, a full 7-year difference! HLE ranged from 63.8 years in West Virginia to 70.3 years in Minnesota, a difference of 6.5 years.

·       Top 5 states for total LE: Hawaii, California (81.2), New York (81), Minnesota (80.8), Connecticut (80.7)

·       Top 5 states for HLE: Minnesota, Hawaii (70.1), California (69.9), Washington (69.1), Vermont (69)

·       During 1960s and 1970s, states became more similar in LE until the early 1980s; states that implemented more liberal policies (e.g., greater investment in education, access to affordable medical care, discourage risky behaviors, improve working conditions, etc.) in recent decades made some of the largest gains in LE.

Wonder about impact of COVID-19 policies like lockdown that focused on preventing deaths from COVID-19 but allowed premature deaths/reduced LE from other causes? Last year, liberal SF had record 699 overdose deaths (up from 441 overdose deaths in 2019; mostly from fentanyl, methamphetamine, and cocaine)—compared to 249 COVID-19 deaths.  Last month’s 61 drug overdose deaths represented nearly 60% increase compared to January last year.  UCSF estimated 30,231 excess deaths from suicide, substance use and loss of access to medical care, among age 16-64 group in U.S., linked to unemployment during COVID-19 pandemic. 

Hawaii (#8) and California (#14) landed on list of worst states for retirement, based on taxes, living expenses, health care, and Social Security. 

On Aloha Friday, joined NASW-HI for Virtual Legislative Education & Advocacy Day.  Aging is a women’s issue, so tuned into Hawaii State Commission on Status of Women Executive Director Khara Jabola-Carolus, who discussed Feminist Crisis Response to Pandemic: 

·       pandemic impacts on women: job loss due to employers’ failure to accommodate women; rise in quantity & severity of gender-based violence; destabilizing support systems that predominantly serve women/femmes; increasing unequal, unseen caregiving; etc. 

·       feminist economic recovery + legislation: harm elimination (anti-sexism education across government); harm reduction (don’t discriminate, end telework ban)

Last year, Khara’s auto-reply email message went viral: ”Aloha, due to patriarchy I am behind in emails…I hope to respond to your message soon but, like many women, I am working full-time while tending to an infant and toddler full-time.”  Instead of demonstrating ED privilege (as such a message would be blasted as unprofessional by an underling), why not model feminist leadership in challenging patriarchy so father of their two children shares in parenting?

HI Advocacy Day didn’t explicitly refer to any aging items, except Laura E. Thielen, MSW, Partners in Care Executive Director, mentioned affordable senior housing development … how about change to allow age-integration, and maybe kupuna can be employed in child care for working parents?

As the pandemic has exposed and exacerbated ageism and our broken LTC system, Hawaii Senate Bill (SB) 1398 “relating to age discrimination” caught my attention.  This SB was introduced by 69-year-old Senator Les Ihara, a career politician who stated “my top district priority is long-term care for senior citizens.”  Surprised what I learned about this pandemic-inspired bill: SB 1398 would prohibit businesses that sell “age-restricted” products, such as alcohol or tobacco, from requiring “verbal” disclosure of a customer's date of birth if the seller determines by “clear and convincing standard” that the customer has reached the minimum age required for the purchase. Based on the right of privacy, this bill seeks to safeguard “elderly customers to disclose their birthdates, usually within earshot of others.” Ok for sellers to ask for photo ID documenting birth date? (In SF, Muni fare inspectors ask for IDs from senior passengers who pay discounted fares.)  Senator, please get serious about prioritizing LTC!

Recovery in California

“When wealth is centralized, the people are dispersed,

When wealth is distributed, the people are brought together.”—Confucius

Money might help recovery from pandemic, if used to promote inclusive healing. Since government ordered lockdowns that resulted in people’s loss of employment income, it needs to do better for COVID-19 relief instead of placing safety net burden on mutual aid groups, and CEO of GoFundMe said his platform was never meant to cover basic needs.  Political will needed to invest in safety net: As of January, California state tax collections were $10.5 billion ahead of projections! This month, SF City Controller announced $125 million surplus (thanks to property and real estate transfer taxes!) this fiscal year (v. previously projected $115 million deficit).   

Justice in Aging summarized bills relating to California Master Plan for Aging (MPA). 

At this month’s SF End-of-Life Network meeting, Judy Thomas, JD, CEO of Coalition for Compassionate Care of California (CCCC), presented on California’s Final Master Plan for Aging Unveiled Palliative Care and Advance Care Planning Included in Initiatives: 

·       Initiative 49: Highlight to Medi-Cal plans and providers the value of palliative care to improve patient outcomes and support patient and family choices for care. 

·       Initiative 50: Identify ways to promote care wishes – such as Advance Planning Directives and Physician Orders for Life Sustaining Treatment – for all ages.

·       Initiative 74: Develop approach for patient representatives for residents of skilled nursing facilities without capacity, representatives, or written care wishes

Because there is no consensus on data elements for these initiatives, nothing will be reported on MPA data dashboard.  CCCC’s 2021 priorities are promoting advance care planning ecosystem and bringing POLST into electronic age (POLST eRegistry). 

SF Department of Disability & Aging Services Executive Director Shireen McSpadden noted that Washington and Colorado also have MPA, but California is unique given its large population and diversity with focus on equity; SF’s Area Plan will roll-up to MPA to ensure local planning mirrors state goals and hopes for better coordination of funding and services; and invited involvement in SF Palli Care Workgroup. 

Mission Hospice Community Education Manager Susan Barber shared this resource: Collective for Radical Death to decolonize death and dying from a predominantly white centric experience to cover all people, in particular people of color and marginalized groups. 

California Alliance for Retired Americans (CARA) hosted Fabulous Friday Forum on Seniors and the Fight for Improved Medicare for All—a topic near and dear to CARA Executive Director Jodi Reid, who turned age 65 this month, making her eligible for Medicare! Paul Song, MD from Physicians for National Health Program (PNHP) (and grandson of Kim Sangdon, 1^st elected mayor of Seoul, South Korea) discussed what’s wrong with current healthcare “system,” interspersing his provider experiences with objective data:

·       33+ million uninsured

·       No coverage for undocumented

·       No insurance rate regulation

·       No drug pricing controls: 22% of seniors don’t fill prescriptions due to cost

·       Narrow networks

·       High co-pays & deductibles: nearly a third of Americans postpone/skip doctor visits due to cost

·       Administrative waste: “time drain” interferes with patient care

·       Lack of health security with job loss: “health care is a human right, not a job perk”

·       Overall inefficient system: rationing care, while U.S. health insurers profits boom during pandemic  

COVID-19 pandemic has exposed failings of current system: Americans represent less than 5% of global population, yet nearly 20% of COVID-19 deaths; U.S. healthcare system is most expensive in world, and cost of health care discourages millions from seeking care even for suspected COVID-19; last year, 22 large healthcare companies filed for bankruptcy, as costs of treating COVID-19 patients rose while limiting more profitable procedures. 

Dr. Song said these problems remain under Biden’s public option proposal.  In contrast, Medicare for All covers everyone, not tied to employment, eliminates co-pays and deductibles, provides choice of doctor, reduces federal spending while insuring everyone, eliminates administrative waste and costs, negotiates deep discounts in drugs and costs of services, etc.

In CARA’s second Fabulous Friday Forum on Seniors and the Fight for Climate Justice, Marty Lynch, PhD, CEO Emeritus of Lifelong Medical, discussed how climate issues affect health of older adults, with disparate impacts on low-income populations who are exposed to more pollution and can’t afford air conditioning/heating; and affordable ways to heal our plant/health while eating less meat and enjoying nature.  As member of California MPA Stakeholder Advisory Committee, Marty talked about advocacy opportunities to link climate change to MPA for walkable neighborhoods and more dense and transit-friendly housing via zoning.

Paul Wermer of SF Climate Emergency Coalition talked about climate as a complex, interactive system that affects everything, environmental justice=social justice, addressing issues at local level where our knowledge/power is greatest regarding local conditions, politicians, neighbors, etc. so we can make things happen—even  where funding may come from the state or federal, it’s spent and implemented at the local level for parks, transit, housing, schools, etc.  Examples where local action has been very significant are building electrification and retrofits needed to deal with emissions from existing buildings, and electric vehicle infrastructure like charging stations and microgrids. 

When Paul started meeting with his local supervisor, he got “polite listening”; then he joined a coalition to meet with supervisors, and actually got attention and action because collaboration makes progress.  He shared groups to collaborate, bring specific skills, and help amplify our voices. 

Human activities (population density, travel, deforestation, livestock production, etc.) that contribute to climate change also contribute to emergence/spread of new infectious diseases. Time to undo damage for healing!

At this month’s OWL (Older Women’s League, though easily mistaken for Old White Ladies) meeting, Marie Jobling, Executive Director of Community Living Campaign (CLC), facilitated hour-long discussion on Patient Rights in Hospital Discharge—an update of The Informed Patient from Empowered Elder’s workshop. 

Since this was a virtual meeting, Marie referred to materials online: The Hospital Stay (Prepare & Leave Safely); Medicare Discharge Planning Checklist; How to Appeal a Discharge; Importance of Having an Advocate; Advance Directives for Health Care Decisions; and Blueprint for Change Report (2008).  Marie disclosed that her knowledge of this topic came from other people’s stories until her own personal experience, which set tone for peer support group, with members sharing their hospital horror stories. (Almost like Oprah, or The Ladies Room with Trudy Berlin!) 

During COVID pandemic, hospitals have restricted in-person visitors and it may be harder to communicate with overwhelmed staff to ensure discharge plans are in place to return home safely.  Before this happens, Marie encouraged us to practice saying out loud this sentence: “I feel like this is an unsafe discharge.  I'm going to call Livanta and ask them to review my discharge." 

Marie’s CLC worked with CARA to develop wallet cards with Livanta’s telephone 1-877-588-1123 to appeal a hospital discharge.  Livanta is the Beneficiary and Family Centered Care-Quality Improvement Organization (BFCC-QIO) that handles all Medicare beneficiary complaints, quality of care reviews, medical necessity reviews, and discharge appeals from hospitals, skilled nursing facilities, home health and hospice providers, and rehabilitation facilities. Livanta helps Medicare patients in exercise of their rights and protections.

Marie showed back of wallet card with additional resources like HICAP for Medicare coverage questions.  She also emphasized importance of getting clarification on whether you are admitted (v. “under observation”) in hospital as one needs 3-day hospital stay (2 consecutive midnight stays) for Medicare coverage of SNF if one cannot be safely discharged home. 

Changing the Narrative Director Janine Vanderburg facilitated Reframing Aging in 2021, based on Frameworks Institute teachings: avoid individualistic, appeal to collective/systems, solutions—use us/we (“as we all age…”); avoid zero sum/finite resources, use innovation; avoid saying seniors, say older people; etc. 

Frameworks Institute recommends social issue narrative to confronting injustice with concrete, systemic solutions to ageism:  

·       Workplace: eliminate grad dates from applications; train managers on implicit bias; establish better rules & systems for hiring; educate companies on business case for hiring older workers; strengthen age discrimination laws 

·       Healthcare systems: train those working in health on implicit bias & ageism; include older people in clinical trials; expose students to older adults during their professional training; include older adults in health equity discussions; eliminate age & co-morbidities in scoring criteria for triage decisions

Movies for grown-ups

Changing the Narrative hosted virtual screening of Duty Free (2020) documentary + discussion about millennial filmmaker Sian-Pierre Regis’ memory-making bucket list adventure with his single mother Rebecca Danigelis after she is fired from her lifelong job as live-in hotel housekeeping supervisor at age 75, losing both employment income and housing.   

As much as I believe in planning for the future (after all my life’s work focused on financial retirement and then encore career in gerontology/aging), I am not a fan of bucket to-do lists, which seem to encourage self-gratification than altruism. 

But in Duty Free, hardworking immigrant Rebecca’s bucket list experience is healing as she suddenly gained time off from work (hence “duty free” film title) for family relationships: to reconnect with her estranged daughter (who was raised in England by Rebecca’s older sister) and her deceased older sister (at gravesite for first time, after years of regret for missing funeral because she couldn’t take time off from work), and to bond closer with Sian (who funded bucket list items and film production costs via kickstarter).  While checking off her bucket list, Rebecca looks for employment as an older woman who was unable to prepare financially for retirement, after working to support her two sons (Sian’s private college education, other son with disability).

During post-screening discussion, the mutual appreciation between mother and son was heartwarming—doubly so when Eloisa Lynch and her mother shared their similar story of immigrant mother raising half-Black child, and when Eloisa got cancer, she wanted to spend more time with her single mom.  Sian offered bucket list advice: pick two easy, two medium-hard, then push to final big one.  Mostly discussion focused on need for safety net, particularly as many people have lost employment during pandemic; Rebecca’s son is her safety net, as they are now roommates, surviving by living together—changing the narrative of the millennial who boomerangs into parents’ basement. 

AARP Movies for Grownups switched from Variety to Eventive platform, with message sidebar for tech support and lively audience exchanges. Supernova (2020) is about gay couple, pianist Sam and novelist Tusker, who go on a scenic road trip after latter is diagnosed with early-onset dementia.  Like the linguistics professor with similar diagnosis in Still Alice (2014), Tusker considers ending his life (“I want to be remembered for who I was, and not for who I’m about to become”) but the support of a loving caregiver makes all the difference to live on. Wish there was post-screening discussion, as I wanted to explore whether suicide is more likely a reaction to how people with dementia are stigmatized (e.g., locked up in memory care units) than the disease itself; for example, in Still Alice, after envisioning her potential future in a LTC facility visit, the protagonist makes a video to instruct her future self to take pills that would end her life before she’s about to become the person she would not want to be in a facility.

https://mckinneylaw.iu.edu/health-law/_docs/2021HLConf_Ferrell.pdf

No wonder Alzheimer’s disease (AD), which begins 20 years before symptoms emerge, is often diagnosed late in stage 4, and people with AD and related dementias are not provided timely disclosure of their diagnosis.  Instead of fear or procrastination, early screening for AD can give one peace of mind: one might not have AD, but dementia-like symptoms that are treatable; or early diagnosis allows benefit of treatments (medications, lifestyle changes) and planning (advance care, support) that are more effective in early stages.

After screening of Minari (2020), AARP Movies for Grown-ups hosted discussion with its stars Steven Yeun (who plays Jacob as husband/father), Yeri Han (Monica as wife/mother) and Youn Yuh-Jung (Soonja as maternal grandmother).  Minari is an endearing intergenerational story about Korean immigrants starting anew in a strange land while trying to keep family together—similar to adapting to new normal during this pandemic while trying to maintain social connections! Dialogue spoken mostly in Korean by Korean actors gives authenticity (English subtitles provided), but just as important is what is not spoken (reading nuanced body language requiring emotional intelligence might be atrophied during this pandemic) and the pacing appropriate to draw you into the drama. 

There is tension between Jacob, who is willing to risk all in pursuit of his American Dream to farm in rural Arkansas, while Monica seeks familiarity and security; as a compromise, her mother moves in with the family and brings familiar Korean foods, like minari (water dropwort).  Mostly seen from the perspective of American-born grandson David, who initially complains “Grandma smells like Korea,” and then bonds with his new partner in mischief. David learns permaculture from his wise grandmother who plants minari seeds near creek, in contrast to his father who goes against nature by planting in a field where he has to dig a well, which goes dry so he diverts county water supply to water fields that leaves their trailer home without running water. 

Minari’s authenticity comes from its writer and director Lee Isaac Chung, who based this film on his own immigrant family’s story, waiting until he became a father himself for better understanding and perspective.  During AARP discussion, actors also spoke about being drawn to the raw honesty of the characters and their fellow actors. 

After watching Minari, I learned about creepy white gaze of Harvard Law Professor J. Mark Ramseyer who claimed that Korean “comfort women” during WWII were “prostitutes” who willingly entered into indenture contracts—while failing to produce any signed contracts as documentary evidence, and contradicting 1996 United Nations report finding that comfort women were sex slaves to Japanese military.  To counter such lies, so important for people with lived experience to share their own stories!

Amazing Grace (1972) was Friday church night with Queen of Soul, Aretha Franklin, who sang “never grow old”!  (Sadly, Aretha did not grow older than 76, when she died in 2018.)  And during this pandemic, I often find myself singing along with Aretha’s Who’s zoomin’ who? (1985), Think (1968) and Respect (1965).  Awesome to see Aretha and her preacher father in Henry Louis Gates’ excellent PBS documentary, The Black Church: This is Our Story,This is Our Song. 

Elder abuse

Generational tensions appear to have worsened during COVID-19 pandemic, with some anxious younger people feeling they have made social and economic sacrifices to save older adults most at risk for severe illness/death from COVID-19.  Now it seems as more vaccinated older adults feel safer venturing out, they are targeted for abuse. 

SF elder abuse crimes, notably against Asians (who make up 43.9% of age 65+ SF residents, as noted previously in vaccine graph), have increased particularly during Chinese Lunar New Year.  Some caught on video, harder to identify suspects who are masked during pandemic but appears all suspects are male (suggesting toxic masculinity?!) knocking older people to the ground in all parts of SF.  And one doesn’t need to be a gerontologist to know that falls are the leading cause of injury and injury death among older adults. 

(Before COVID-19 pandemic in February 2020, SF Board of Supervisors passed Crime Victim Data Disclosure Ordinance requiring SF Police to report demographic data, such as age, race, gender, etc., on victims of hate crimes, as response to escalating crimes against Chinese including 99-year-old Chinese woman who was sexually assaulted in her SF Chinatown apartment.) 

·       Two 20-something male suspects (at least one on probation) attempted to steal camera from 76-year-old Jack Palladino, retired private investigator who took their photos outside his SF Haight-Ashbury home, before he was knocked to ground and died from head injury. 

·       Surveillance video caught 19-year-old male shoving 84-year-old Vicha Ratanapakdee to ground in fatal fall in SF Anza Vista neighborhood, apparently after victim witnessed suspect vandalizing a car. 

·       31-year-old male (on probation) pushed 83-year-old Asian male to ground in SF Tenderloin, resulting in broken hip; possible hate crime. 

·       Four suspects struck 60-year-old man with disability and stole his motorized wheelchair in SF SoMa; no race/ethnicity reported; not elder abuse (age 65+), but likely dependent adult abuse. 

Media reported on assaults of older adults in Oakland Chinatown, including 91-year-old Gilbert Diaz, who was shoved to ground, and identified as Latino. 

Many of the suspected perpetrators identified as Black. Ten years ago, police chiefs in SF and Oakland characterized Black-on-Asian violence as “hazardous collision between angry young men and a vulnerable population with cash in their pockets,” and downplayed anti-Asian racism (SF Police Chief claimed incidents of victimization proportional to population size, while failing to acknowledge underreporting by Asian victims) and elder abuse (as many Asian victims age 65+).   

https://www.sfpublicpress.org/after-violent-attacks-community-groups-call-for-social-services-solidarity/

As the common response by marginalized groups, historically ignored by government, mutual aid groups emerged to solicit volunteers as community foot patrol ambassadors to establish presence on streets and to escort “Chinatown’s elders” on walks and errands. These groups also seek to advocate for Asian+Black solidarity, calling for community resources to support crime victims and investments in housing and education for crime prevention.  Yet, what do older people want for their safety and autonomy? Among Asian Americans, there is a generational divide over police interactions.

What if an older person desires time alone for an unchaperoned walk (even with physical distancing)? Even walking with a dog, like 94-year-old Leo Hainzl did on morning of Memorial Day 2020 in SF Glen Park, didn’t protect him from being assaulted by a 53-year-old man waving his crutches and “known for harassing or threatening women, children and the elderly” (marginalized groups); Hainz fell and hit his head to ground and died. 

And older pedestrians are vulnerable to traffic abuse on streets of SF: 68-year-old Larry Holman loved to take long walks in the City for exercise and respite from noise of his Mission District SRO, and was killed by a driver while crossing a street in SF Richmond District.  Despite less driving due to stay-at-home orders in 2020, SF had 30 deaths from traffic collisions (same number of traffic deaths in 2019), and older people remain vulnerable: of 12 pedestrians killed, 10 were age 50+ (ages 50, 53, 55, 58, 60, 63, 67, 68, 80, 85)! 

During neighborhood walk, some noisy construction but loved the redwood trees enclosing this portable toilet for construction workers! As SF and the rest of the world reopen, healing can come from nature, authentic intergenerational "talk story" to promote empathy, and a robust safety net that leaves no one behind.