“New
Normal”
Last year,
Pew Research surveyed experts who believed COVID-19 pandemic’s impact on new
normal life would be
·
worse
in terms of greater inequality (tech privilege), rising authoritarianism and
rampant misinformation,
· better in a “tele-everything” world where workplaces, health care and social activity improve (remote processes).
Others speculate another Roaring 20s of decadence and frivolity, like after trauma of 1918 Flu Pandemic/WWI, which might suggest greater prosperity to wealthy whites, while “others” (farmers, immigrants, labor unions, etc.), are left behind? Will “post-traumatic growth” (feeling more appreciative, spiritual and resilient) continue?
When California’s indoor mask mandate expired on Feb. 15, CA Public Health tweeted: “A mask is no longer required for vaccinated individuals but is still strongly recommended to protect you and others from #COVID-19.”
Almost
overnight, gains from two years into the pandemic—like mask mandates (though
barely enforced, given SF Mayor’s disdain for fun police micromanaging mask
wearing) and remote work intended to protect
the common good—are being cast aside…until the next coronavirus variant/COVID surge
and communal call to do our mindful part to flatten the curve?
Hope “new normal” is better than normal, like individual risk decision-making in larger context of shared responsibility for collective well-being, especially looking out for most vulnerable (immunocompromised, older adults, unvaccinated under age 5, etc.)? Like during early months of pandemic, with focus on greater community care such as mutual aid beyond charity. And, wow, SF government taking responsibility for housing and welfare of its unhoused older adults… even if motivated to mitigate social unrest and pacify population (inspired by Piven & Cloward’s Regulating the Poor?) by prioritizing seniors as more “deserving poor” with their projected shorter remaining life expectancies to fund housing and supports. (In contrast, SF Mayor’s defunding police plan proved unsustainable, short-lived from February 2021 until December 2021.)
Consider more silver linings during pandemic, like re-examining what is “normal” workplace and reducing carbon footprint while working remotely from home; promoting fresh air ventilation and nature’s restorative effects (e.g., Slow Streets and car-free JFK Drive in Golden Gate Park to encourage people of all ages to get out of vehicles in more equal footing and face-to-face engagement in the Great Outdoors); getting “woke” to confront inequities and foster greater DEI (Diversity, Equity, Inclusion) and belonging, especially advocacy with marginalized communities like unhoused people (estimated 50% of unhoused in SF are age 50+), older adults and direct care staff in long-term care (LTC) facilities at disproportionate risk for severe COVID-19 and deaths.
“a
community is also built on trust and trust is the expectation that
you're going to do what you ought to do. That we have the same set of values
and that we understand what the right thing to do, that we have a set of norms…
in America, our trust levels have just, just declined, precipitously…
the crucial skill in the center of any healthy community is the ability to see each other well, make them feel seen and understood…You have to ask questions to really know someone.” –David Brooks, “Being Seen, Social Trust and Building Relationships” (Dec. 10, 2021)
When WHO
declared COVID-19 pandemic on March 2020, I thought of the potential of
emerging from the collective experience of this pandemic from individualistic
self-care to generous community care as a matter of survival. Instead, the
outcome of USA’s personal responsibility approach is reaching 1 million deaths
from COVID-19.
Since the
onset of COVID-19 pandemic, California’s population of 39 million declined by
almost 300,000 due to increase in pandemic-related deaths and residents moving
to other states (at its highest level since mid-1990s), declines in birth rates
and international migration (at its lowest level in at least 40 years). According to CDC, USA had more than 1 million “excess deaths” since the pandemic began, with majority of deaths
caused by coronavirus directly, and remaining deaths attributed to disruptions
caused by pandemic (e.g., canceled health screenings and treatments, drug
overdoses). Who’s ready to return to normal after
the trauma of these premature/excess deaths?
The inhumane
lockdowns and casualties of people segregated/isolated in LTC facilities during COVID-19
pandemic has given impetus for expansion of home and community-based services (HCBS) so more people can access community
living integration as an alternative to institutionalization. Yet, declining population,
particularly in California, means workforce challenges in HCBS supports like
caregivers and community case managers.
Caregivers
Age-Friendly Insights Poll: Direct Care Workers Are Underpaid, Lack Support and Oversight (Feb. 9, 2022)
According to Profile of the California Medicare Population (Feb. 2022):
·
In
2021, 1 in 6 Californians had Medicare
·
More
than 1 in 5 California Medicare beneficiaries are dually eligible for Medi-Cal
·
Nationwide,
2 out of 3 Medicare beneficiaries living in the community have difficulty with
an activity of daily living (ADL) or use an assistive device; of those, half
use caregiver assistance and/or have 2 or more ADL limitations
California Direct Care Workforce Current Investments (Feb. 1, 2022)
NPR reported “The pandemic pummeled long-term care – it may not recover quickly, experts warn” (Feb. 22, 2022). Assisted living facilities experienced 50% staff turnover, despite wage increases. Biden Administration has proposed nursing home reform initiatives to establish minimum nursing home staffing requirement and create “Pathways to Good-paying Jobs with the Free and Fair Choice to Join a Union.”
Caregiver assistance remains critical for older adults who wish to remain in their homes and communities. (See “Pandemic-Fueled Shortages of Home Health Workers Strand Patients Without Necessary Care,” Kaiser Health News, Feb. 3, 2022.) This month California Department of Aging hosted Direct Care Workforce Current Investments webinar focused on Master Plan for Aging (MPA) Goal 4: Caregiving that Works! To reach target 1 million high quality caregiving jobs, strategy is to maximize existing staff, systems, structures and build new career pathways; fund $150 million for training and stipends to recruit, retain and promote staff; improve web-based training in multiple languages; build capacity, expand HCBS infrastructure, deliver on vision for more options.
Community
case managers
California
MPA doesn’t address community case management workforce, other than indirect
reference to programs that provide case management, e.g., CalAIM’s Enhanced
Care Management and Community Supports (Initiative 36 under Goal 2: Health
Reimagined), and expansion of older homelessness assistance and prevention
programs (Initiative 118 under Goal 5: Affordable Aging), such as HomeSafe and
Housing and Disability Advocacy Program.
“California’s unhoused population is aging and increasingly composed of older adults: Roughly 45% of unhoused Californians in adult-only households who came in contact with the homelessness response system in the 2020-21 fiscal year were aged 50 and older. Financial and medical emergencies later in life can push those who were already struggling to make ends meet into homelessness. Challenges in accessing support and social safety net programs for older adults in crisis and inadequate benefit amounts are also a driving factor. Older adults are more likely to have underlying health conditions and disabilities that may be exacerbated by the additional stressors of being unhoused…unhoused adults develop similar rates of geriatric conditions as housed adults who are 20 years older. The distinctive circumstances older adults face will require more assistive services to obtain and maintain housing. Due to this, these Californians have significant implications for current homeless intervention practices as specific service needs should be integrated with other service systems and funding sources.”—Monica Davalos and Sara Kimberlin, “Who is Experiencing Homelessness in California? Tailored Housing Interventions are Needed for California’s Diverse Unhoused Population,” California Budget & Policy Center (Feb. 2022)
The existing
safety net system (staffed with neoliberal social workers) pathologizes poverty,
by diagnosing people based on a
deficit framework, “othering” them as permanent cases of dependency and placing them in “supportive” housing
that employ case managers who are supposed to connect them to “supports” to
provide stability (public benefits, in-home care, food, healthcare,
transportation, etc.).
When this
doesn’t happen, SF attorney Martha Bridegam (self-described “advocate for very
poor people”) observed that “disabled supportive-housing tenants are neglected
and allowed to fail” so she has handled some of her clients’ case management to prevent their eviction because their assigned case managers didn’t. Attorneys can be more effective
advocates than case managers without legal training to properly inform clients
of their rights/legal processes, especially under Americans with Disabilities Act.
More anecdotes about safety net case managers: Margaret Stawowy worked with a nonprofit social worker for more than a year to access safety net programs for her mother with dementia and living in low-income senior housing, and did not succeed until a social worker in private practice helped her apply successfully. Veteran Del Seymour became his own case manager to get himself housed.
“…the path from
homelessness to housing can take as long as two years, and that’s for someone
lucky enough to make it onto the waitlist.
San Francisco’s struggle
with housing its unhoused population is notorious across the nation…
The City’s software to track
vacant units is error-prone, unit maintenance problems take a long time to
resolve, case managers quit and it can be impossible for people who have
been living on the street to meet document requirements. (The homelessness
department said that the city is currently working on the software and
documentation issues, and has put a raise for case managers into its budget
request for next year.)
…a shortage of case
managers, who are the crucial link between vacant units and the hundreds of
people approved for housing. There is frequent turnover in the high-stress
positions, and nonprofits struggle to fill new job openings.
Stroud said she has been assigned six case managers in two years. To figure out who is assigned to her, she regularly checks a piece of paper taped to a wall in her hotel, which lists the name of the case manager assigned to each floor. She describes calling her case manager repeatedly to set up an appointment and not getting through.”—Nuala Bishari, “In San Francisco, Hundreds of Homes for Unhoused People Sit Vacant,” ProPublica (Feb 28, 2022)
CalMatters
reported on “a severe worker shortage in the California homeless services field
threatens the state's ability to massively expand services. Many homeless
service workers – who make low wages for high-stress jobs – are burned out.” Last year’s SEIU survey found that
nonprofit workers, on average, made 45% less than City workers with equivalent
positions. In SF, low starting wages (e.g., $21-$35
hourly) are paid to homeless service workers in nonprofit agencies that outbid
each other for contracts with the City, while the City pays its own homeless
service workers more competitive wages (e.g., SF Department of Public Health/SF Department of
Homelessness & Supportive Housing 2920 medical social worker/2930
behavioral health clinician positions pay start at $46.225 hourly rate).
As a result, the City was able to quickly hire 100 workers to respond to the Tenderloin state of emergency, plus plan to hire 100 more workers at the end the 90-day
emergency declared by SF Mayor in December. (This month staff at nonprofit
agencies, contracted by SF Department of Disability and Aging Services,
received $500 as hazard pay for working the past year during pandemic.)
Will proposed pay raise for case managers address high staff turnover? Maybe, but will pay raise improve employee engagement/morale so staff genuinely show up for older clients? (See Lincoln Mitchell's “Opinion: S.F. Police Chief Bill Scott’s complaints of low morale are code for something else - ‘Asserting that police will not do their job if morale is low is a form of blackmail’’, SF Examiner, Feb. 28, 2022.)
Seems easier to throw money (higher pay) at “problem” than address root causes like toxic work culture/autocratic supervisor and trickle-down effect on staff and clients?
“Being supported, valued, and heard were all things that frontline staff reportedly did not feel in the study…What’s really upsetting about this is that these three feelings are what human services work to achieve with their clients. Often this issue stemmed from the staff’s perceptions of management - they felt that management did not support, respect, or appreciate the work the staff did. Frontline staff often said that they were never recognized for the work they did with clients or the extra hours they always put in.”—"What’s Happening to Human Services? Why Employee Attrition is Off the Charts,” ANCOR (Oct. 18, 2016).
“As employees return to the office and are confronted once again on a daily basis with annoying personalities and the grievances of office-life, they may also decide the money just isn’t worth it. Gallup research found that 50% of employees leave their jobs "to get away from their manager to improve their overall life at some point in their career."—Nicole Goodkind, “Some companies can’t get employees to stay even when they throw millions at them. Here’s why,” Fortune (Feb. 11, 2022)
Use of self
to help build community
SCW © 2020 https://www.syracuseculturalworkers.com/products/poster-how-to-build-community-during-a-pandemic
In social
work practice, the use of self is a therapeutic tool that enables the social
worker/case manager to integrate aspects of personality, belief system,
relational skills, and personal experience to engage clients in the helping
relationship. The idea of professional self-care is
to heal oneself to be in a position to heal others. And healing takes place in the context of supportive relationships, like community building to create a sense
of belonging. Aspire to be person-centered social work community builders like
Marie-Louise Ansak, who co-founded On Lok’s Program of All-Inclusive Care
(PACE) in SF, and Yvonne van Amerongen, who co-founded Hogeweyk village to care for people with severe dementia.
Ideally, use of self in collaboration
with like-minded folks who challenge the status quo to improve quality of life
for people who want to age in community!
Social Work
Practice 101: social work/case management doesn’t happen until trusting
connection/relationship develops between worker and client, and this takes time; when there is high turnover, trust deteriorates. Case managers/human
services workers were quitting long before the Great Resignation prompted “rethinking
what work means to them, how they are valued, and how they spend their time” so
they do not work just to pay bills but work needs to accommodate their life? Challenging enough at non-profit agencies where case managers are expected to use own mobile phones and vehicles for client work, while
trying to maintain boundaries between work and personal life—and reimbursement process
adds to paperwork.
https://www.dukeupress.edu/the-revolution-will-not-be-funded
Awkward experiences
with the non-profit industrial complex (NPIC), as I reflect on my non-profit work
serving older adults as similar to muckraker Barbara Ehrenreich taking low-wage
jobs (to investigate impact of welfare reform on working poor, as reported in
her 2001 book, Nickel and Dimed: On (Not) Getting By in America). After
I accepted case manager position that was non-exempt under Fair Labor Standards
Act, agency changed my position to exempt and explained this elitism was the
only way the position could be paid above union scale. Higher pay without
overtime and union benefits?! What happens to worker solidarity?! Another
nonprofit agency required staff to work alternate days between windowless basement
office and home, understandably for physical distancing during pandemic, but without
providing agency computers for this remote work so staff use their personal home computers for agency business—raising HIPAA privacy issues?!
Time to “tell it like it is” with call for independent audit of case management system in NPIC.
Great
Resignation/Rethink/Discontent
According to authors/executive coaches Russ Hill and Jared Jones, “The Great Resignation is being fueled by a workforce that will no longer tolerate a bad boss, a toxic culture, a company without purpose, or a lack of development.”
The Great Resignation has been called the Great Rethink of self in relation to workplace culture—a desire for workplace spirituality that integrates employee well-being/quality of life, a sense of “real purpose and meaning in their work beyond paychecks and task performance,” and a sense of interconnectedness/community.
“The
pandemic changed the way people work and how they view work. Many are
reflecting on what a quality job feels like, and nearly half are willing to
quit to find one. Reversing the tide in an organization requires managers who
care, who engage, and who give workers a sense of purpose, inspiration and
motivation to perform. Such managers give people reason to stay.
In other words, reversing the Great Resignation requires fixing the Great Discontent -- and managers are the key.”—Vipula Gandhi & Jennifer Robison, “The 'Great Resignation' Is Really the 'Great Discontent',” Gallup (July 22, 2021)
Yet workplace spirituality can
be lacking in social work environments, especially given the disconnect between
social workers who believe clients’ spirituality can improve mental health yet
these same social workers aren’t even discussing spirituality with clients. If social workers can’t address
spirituality with clients, can they address spirituality in their workplace? Integrating
spirituality often leads to improved holistic health because it reduces
self-centeredness while it creates a sense of belonging to a larger community
when one contributes value to the greater common good, potentially reducing
feeling of other-ness.
According to MIT researchers, “toxic corporate culture” (i.e., failure to promote DEI; workers feeling disrespected; and unethical behavior) is driving the Great Resignation, and ten times more important than compensation. BBC reported toxic work culture also exists in remote work: “Most toxic work cultures originate with poor management, whose bad habits can be contagious.”
No surprise. While researching effective ways to integrate gerontology into MSW
curriculum to promote preparedness to work with older adults, related inquiry
why people don’t want to work in places that serve older adults? It’s the toxic
culture, which includes ageism. Great Resignation is like #MeToo
movement against toxic work culture.
Return to
community that values aging
During pandemic, people who returned to multigenerational living gained benefits of age diversity: opportunity to experience value of generational caregiving and perhaps to become a “better” person by living interdependence and searching for commonalities before differences.
“Spending
more time with elderly loved ones may also emerge as something people
cherish post-COVID, and the reality of not knowing what we have until we lose
it could very well translate into more time spent with family and friends.
The people who moved out of the cities could find a new lifestyle and prefer the sound of nature in their backyard over the honking of heavy traffic. The adults who moved in with their parents due to the virus may feel closer to them than ever before and see them through an entirely different lens of appreciation. Without the obstacles of the pandemic and quarantine, people may not have discovered such personal changes.”—Jared Glasser, “We All Quit—Sorry for the Inconvenience,” HR Daily Advisor (Aug. 4, 2021)
Gerontologist
Tracey Gendron wrote about halcyon days when people were more holistic, living
and working on the family farm that brought all ages together and older people
were valued.
“After
the Industrial Revolution, … places where we were working and living became
separate. That was truly a turning point when it comes to attitudes about
aging. You started to see the families change in shape and form. So that was
one factor in the workplace. We started to value more productivity. And you
started to see some sentiments that older workers were doing things the old way
and that they couldn't keep up with the new way of doing things.
At the same time, we also started to socially construct childhood to more of how it looks today. Instead of having children work on the farms as they used to do as active contributors, childhood became this protected period of time for children to develop and be nurtured and grow. Caring for children became something that was expected, that came with great rewards and great challenges. But a byproduct was that we started to see caring for elders as something different, more of a burden. We started to institutionalize, to create these nursing facilities that would house older people.”—Tracey Gendron, Ph.D., director of Virginia Center on Aging and author of Ageism Unmasked:Exploring Age Bias and How to End It (2022).
Self-help books
by men of AARP age
In From Strength to Strength: Finding Success, Happiness and Deep Purpose in the Second Half of
Life (2022), social scientist Arthur C. Brooks
(age 57) shared research on human happiness:
·
Happiness
tends to decline throughout young adulthood and middle age, bottoming out
at about age 50, and then heads back up again into one’s mid-60s. Then, older
people split like two roads diverged in a wood: one group getting much happier
(“happy-well” enjoyed good physical/mental health and high life satisfaction),
and other group getting much unhappier (“sad-sick” who were below average in
physical/mental health and life satisfaction).
· Arthur noted at least seven self-care cumulative advantages are under our control to
plan for later life happy-wellness: no smoking, avoid “problem” drinking,
“healthy” body weight, physical movement, emotional resilience (practice coping
via spiritual practice, therapy), “lifelong, purposive learning,” and cultivate
“stable, long-term” relationships.
·
Arthur’s
model speaks to Anglo-American ideal of rugged individualism, almost like
opportunity to achieve “successful aging” through one’s own efforts.
“Aging in place is the dream plan for a lot of us, but for our families it can be more of a nightmare. I will make the appropriate arrangements for my care, and not just hope it all works out.”—Steven Petrow, “I Won’t Burden My Family with Taking Care of Me,” Stupid Things I Won’t Do When I Get Old: A highly judgmental , unapologetically honest accounting of all the things our elders are doing wrong (2021)
After
his 50th birthday, civilist Steven began compiling a list of “things
I won’t do when I get old,” mostly based on the experiences of his parents (who
used profanity, which is used in his book). For example, Steven writes how his
parents’ insistence on “aging in place” became a burden on him and his two
siblings who took turns being on-call for their parents while providing money
management, hiring/firing health aides… After his parents died, and after his
60th birthday, with no partner and no kids, elder orphan/solo ager Steven
decided to think about “an aging plan for just me.” He seemed to limit this
plan to asking friends about “senior living” and toured continuing care and
cohousing communities (caution: read “They took a chance on collaborative living. They lost everything,” NY Times, Feb. 13, 2022) before mailing his deposit for the
former (though he didn’t complete tour to skilled nursing facility). Steven
makes this decision, though transitioning to higher level of senior living
might make it more difficult to avoid “things I won’t do when I get old” like:
·
“I
Won’t Limit Myself to Friends My Own Age” (p. 36): senior living is
age-segregated for residents.
·
“I
Won’t Be Ordering the Early Bird Special” (p. 172): facilities schedule
mealtimes while sun is still out, which can be beneficial for eating patterns
in sync with our natural circadian rhythm.
· “I Won’t Turn My House into a Sweat Lodge” (p. 177): facilities are required to maintain temperature range of 71- 81 F, often at high end in practice.
In “I Won’t Postpone for Tomorrow What Matters to Me Today” (p. 216), Steven used DeathClock.com to find out his personal day of death – age 73, which was within range provided by his oncologist, and then at age 56 he decided to quit his job as salaried editor to write. Yet, Steven may outlive this prediction (and possibly live out more years in senior living). When I entered data for my parents (who are happily aging in place!) on DeathClock.com, the message was “I am sorry, but your time has expired. Have a nice day!”
Wonder if I should introduce myself as gerontologist to engage Steven to consider “aging in place” options? Wonder if Steven’s response due to internalized ageism (passive recipient deferring to industry “expert” v. older person as expert of own life) or lack of imagination to mobilize for change (ask what you hope/want, if you know what you hope/want)?
This morbid idea of checking oneself into a LTC facility to avoid becoming a burden or “nightmare” for family caregivers reminded me of The Manor, last Halloween’s horror film featuring protagonist (played by septuagenarian Barbara Hershey) who moves into a nursing home after suffering a stroke on her 70th birthday…and resident nightmare begins with evil gaslighting! When asked, "What do you think it is about nursing homes and assisted living facilities that make them a perfect setting for a horror story?" The Manor's writer/director responded:
"You
have vulnerable people whose abilities are starting to decline, whose own minds
they sometimes have trouble trusting. And they’re stuck in a place where communication
is difficult, where even people who mean well have trouble hearing and
understanding and figuring out how to help. And where, for your own good,
you’re locked inside... So your world gets smaller and smaller and very often
if your symptoms manifest as [fear], you will be locked in the very place that
you’re scared of.
The experience of not knowing how to communicate must be incredibly isolating…So there’s a lot of elements that thematically were very rich. And also in a horror movie we always try to justify: Why can’t she call for help? Why is her cellphone not working? Why is she not running away from this place? And all of this is kind of answered by, Well, she’s in a nursing home, there are rules [in place that limit outside contact]."-- Jenny Desborough interview with Axelle Carolyn, “'The Manor': Amazon Horror Movie's 'Provocative' Ending Explained By Cast and Director,” LA Times (Oct. 15, 2021)
Recent headlines about family caregiving costs sound horror-scary:
“People Over 80 Are Still Taking Care of Their Parents and Partners” even when parents live in a continuing care community (Wall Street
Journal, Feb. 9, 2022)
“Caring for Older Relatives Is So Expensive That Even AARP’s Expert Filed for Bankruptcy: Unexpected costs can accumulate over time and overwhelm even most experienced of nation’s 53 million family caregivers” (Wall Street Journal, Feb. 20, 2022)
“What
caring for an aging parent could cost you” (NerdWallet, Feb. 20, 2022)
Imagine: how a LTC “facility” can transform into a “community?” Make the culture change you want to see in LTC!
“When I talk with people who are getting into the field, I always recommend that they choose their employer very, very carefully…Look for the innovators, the learning organizations that are pushing back against the status quo. The ones with healthy cultures that promote the potential and value of the people who live and work in their communities. Culture is everything and healthy cultures lead to personal and organizational success.”—Jill Vitale-Aussem, “Disrupting the Status Quo of Senior Living,” Mindshift (Aug. 20, 2019)
In need of Pep talk, I turned to reading Disrupting the Status Quo of Senior Living: A Mindshift (2019) by Jill Vitale-Aussem, who shared her 20+ years of senior living employment (plus admitting herself as a resident to experience what it’s like, similar to being a refugee after a hurricane, trading freedom/self-determination for protection/care) and how she came to reframe her facility to “community.” Introduced to Dr. Bill Thomas’ Eden Alternative and after confronting her internalized ageism, Jill led her facility to culture change shift from traditional senior living framework of segregation (ageism, ableism), paternalism (regressing into dependency, focusing on self), institutional mindsets (diagnosing/medicating/mind-numbing people who exhibit “normal” human response/”acting out” to loss of power/purpose) to an “inclusive culture of possibilities and purpose, where people continue to grow and flourish” (p. 6). Rather than view residents as mere recipients of services, encourage community organizing by empowering residents to organize on their behalf – like disability movement’s mantra, “nothing about us, without us!”
Jill discussed four components of building
community in senior living:
1. Fulfillment of needs: might be sole focus of traditional
senior living to provide basic needs and functional assistance with activities
of daily living for residents
2. Membership & belonging: intentional creation of “us”
community (reciprocal relationships) including everyone who works (staff) and
lives (residents), e.g., purposely inviting to sit at mealtimes people with
different cognitive and physical abilities to foster culture of acceptance and
inclusion
3. Influence: put real power into people, be
transparent about problem and own things together as community of citizens, ask
for participation and accountability in problem resolution; e.g., stop “doing
for” customer service and empower citizen residents to start pet committee –
“when we promote (bi-directional) influence and encourage experience and
knowledge to play out in community decision-making, we achieve better outcomes”
(p. 78).
4. Shared emotional connection: encourage real relationships where community members experience meaningful interactions and emotional risk with each other. Here, Jill ditched the disempowering “escape” from real life/everything done for guest hospitality model and Disney “happiest place on earth” model (role-play using customer service scripts, full of joy and cheer) in favor of Real World like normalizing death by embracing community-driven rituals and opportunity to mourn.
Jill saw the light in keeping it real, so one/we can be our self/selves in community: “When we sanitize life and try to hide everything that might feel uncomfortable, we devalue the people who live and work in our organization and create unhealthy environments. When we are open and embrace the bad and the good in life, we build community as people come together to work through the hard times” (p. 83).
Wise words like those spoken a century ago by the kind and old Skin Horse, who explained “Real” is “a thing that happens to you. When a child loves you for a long, long time, not just to play with, but REALLY loves you, then you become Real.”
'Sometimes,' said the Skin Horse, for he was always truthful.
'When you are Real you don't mind being hurt.'
'Does it happen all at once, like being wound up,' he asked, 'or bit by bit?'
'It doesn't happen all at once,' said the Skin Horse. 'You become. It takes a
long time. That's why it doesn't happen often to people who break easily, or
have sharp edges, or who have to be carefully kept. Generally, by the time you
are Real, most of your hair has been loved off, and your eyes drop out and you
get loose in the joints and very shabby. But these things don't matter at all,
because once you are Real you can't be ugly, except to people who don't
understand.”
― Margery Williams, The Velveteen Rabbit
(1922)
Love the sense of community and shopping locally at farmers markets, even ones overrun by tourists at SF Ferry Plaza Farmers Market, which hosted SF General Hospital Foundation’s Hearts in SF.
Michele Bell’s Chinatown Live heart sculpture has fortune cookies with solidarity mantras like “Respect your Elders,” “Look out for each other,” “Help your community,” etc.
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