Aging in place: home and community

The ability to live in our own home and community is a prerequisite to aging in place.  Yet lack of affordability and accessibility are challenges to staying in home and community as long as one can in the later years. 

Home-less

This month Flyaway Productions presented Multiple Mary and Invisible Jane, a 30-minute aerial dance performance about the struggles of older homeless women.  As part of a trilogy about urban poverty, this work was based on local investigative journalist Rose Aguilar’s article, “Old, Female and Homeless,” published in The Nation last year.  Set against an 80-foot wall of the YMCA in San Francisco’s Tenderloin District, dancers are suspended by rope around their waist, with no safety net below.  They are strong but vulnerable in this environment and circumstance as we learn the oral histories of the older homeless women whom they represent. 

Sleeping in chairs: “You couldn’t lie down, you had to sit up.”

 

Carrying your stuff: “It’s so hard to push pride aside to tell someone I was homeless . . . but people notice it.” 

Living on the streets is dangerous, with homeless women experiencing high rates of physical, sexual and emotional violence.  A recent UCSF study found much of the violence on homeless and unstably housed women was inflicted by acquaintances and strangers.  In this context, researchers found that social isolation protected them from experiencing violence. 

Multiple Mary (Poppins) umbrellas represent shelter.  The increase in homeless older women is related to the rising cost of living and evictions.

 

After the performance, Flyaway Productions Artistic Director Jo Kreiter and dancers touch ground for Q & A session.  Their goal is to give light and inspire compassion to the plight of the growing numbers of older women living on the streets of San Francisco.  

Single Room Occupancy (SRO)

Chinese Historical Society of America (CHSA)’s exhibit, “Living in Chinatown: SRO,” featured artist Frank Wong’s miniature diorama and a life-size version of a Chinatown Single-Room Occupancy (SRO), and a panel discussion on affordable housing.

This Frank Wong miniature was inspired by a SRO containing all the possessions of a bachelor resident of the International Hotel at the edge of Chinatown.  SRO housing, originally intended for low-income, immigrant workers, are typically rooms measuring 8 by 10 feet with a communal bathroom down the hall.  San Francisco has over 500 SRO buildings with more than 19,000 units located mainly in the Tenderloin, Chinatown, Mission and SoMa districts.  About 8,000 seniors and persons with disabilities live in San Francisco SROs, which are regarded as important housing stock to support their independence to age in place.  In addition, more than 450 families live in SROs, most built right after the 1906 earthquake and intended for bachelor living.  Many seniors move in with families living in Chinatown SROs. 

Life-size SRO contains bed, sink, and rice cooker.  A 2010 survey found that more than half of SROs in San Francisco had no access to a kitchen in the building.  In SROs, crowded conditions mean 40 people sharing a kitchen, toilet fights, and electrical problems.

Tenants in SROs are being evicted to create vacancies for tourist rentals, so it was disturbing to hear District Supervisor David Chiu talk about investing in SROs and legalizing “in-law units as variations of SROs” to address affordable housing crisis because he has introduced legislation to legalize and regulate short-term rentals through online social networking platforms like Airbnb, which has the effect of removing SRO units intended for lower-income residents, while flagrantly violating existing leases, local rent control laws and prohibitions against converting residential units in buildings with four or more units to tourist or transient use, and failing to pay the City’s 14% transient occupancy or hotel tax.  Further, these laws have not been enforced, including the failure to collect an estimated $25 million in back hotel taxes. 

CHSA hosted a timely affordable housing discussion with CHSA Executive Director and former San Francisco Planning Commission President Sue Lee, Chinatown Community Development Center (CCDC) Executive Director Norman Fong, and San Francisco Planning Commission President and CCDC Community Planning Manager Cindy Wu.  Cindy talked about families crammed into SROs for affordability with an average stay of 7 to 10 years until they have saved enough to move to Visitacion Valley or Excelsior. 

SRO residents work as peer organizers through Chinese Progressive Association to improve living conditions in SROs.  The recent college graduate said last year's Ellis Act eviction of Lee family (elderly couple with disabled adult daughter) from their low-rent apartment of 34 years empowered her to fight for “just and fair living.” While some people consider SROs as transitional housing, they are permanent housing for others and thus worth taking action to improve habitability.

Affordable housing initiatives

Last month, California Housing Partnership Corporation released its report, How San Francisco County’s Housing Market is Failing to Meet the Needs of Low-Income Families.  It found more than 50% of extremely low-income households are elderly or disabled, and San Francisco is short about 40,845 housing units affordable to the poorest, which means a third of household income; in response, the Mayor’s Office of Housing said it was committed to supplying 10,000 units at below market rate, or just a third of the 30,000 housing units that the Mayor has promised to build or rehabilitate by 2020.

At the top of San Francisco Planning and Urban Research (SPUR)’s 8 Ways to Make San Francisco Affordable Again is protect the existing rent controlled housing stock.  San Francisco is about two-thirds renters and has about 172,000 units of rent controlled housing.  As housing prices go up, owners have an incentive to Ellis Act evict tenants (often seniors and persons with disabilities) and get out of the landlord business so they can sell. About 60% of Ellis Act evictions in 2013 were issued by property owners who had owned for less than one year.

Eviction Free San Francisco (EFSF), a direct action group for housing justice, has organized public protests against the displacement of long-time San Franciscan seniors by serial evictors.  This rally and press conference outside San Francisco Superior Courthouse took place before the hearing that quashed the attempted Ellis Act eviction of seniors Patricia Kerman and Tom Rapp based on improper service of their eviction notice by their landlord Kaushik Dattani, who has used Ellis Act on 24 households in the Mission District.  

Demonstrators carried signs, “ELLIS ACT IS ELDER ABUSE” and “STOP EVICTING SENIORS.”  Earlier this month, the Ellis Act eviction of 63-year-old teacher Benito Santiago was rescinded after protests by anti-eviction activists.

Senior and Disability Action (SDA), winner of this year’s n4a Aging Innovations Award for advocacy, kept busy advocating for affordable housing.   

At SDA’s July meeting on Housing, longtime community activist Calvin Welch and Housing Rights Committee Community Organizer Fred Sherburn-Zimmer discussed housing balance and anti-speculation tax legislation. 

Angelica Cabande, Organizing Director of SOMCAN (South Of Market Community Action Network) presented Healthy SoMa (South of Market) about the impact of the 1990s dot-com resulting in gentrification and displacement of mostly seniors, veterans, homeless, low-income residents and Filipino community.  Now this second tech boom is impacting not just SoMa and Mission Districts but the entire City of San Francisco.  Between 2012 and 2013, evictions went up by 115%! Angelica discussed the need for Housing Balance between market rate and affordable housing, with public participation, in order to increase the City’s accountability for meeting its housing goals.

 

SDA University Organizer Pi Ra and Housing Organizer Tony Robles provided advocacy training on Protect Affordable Housing: Stop the Flipping Speculators at the International Hotel Manilatown Center. Tony’s uncle Al Robles was a poet-activist involved in the almost decade-long fight against eviction of the original I-Hotel Manilatown tenants to preserve low-income housing and their community. 

Fred talked about support for anti-speculation tax (Proposition G), which is an additional transfer tax on certain multi-unit residential properties that are sold within 5 years of purchase:  up to 24% then scaling down to 14% on the fifth year.  

Calvin explained that San Francisco has a shortage of land available to build housing:  of its 46.7 square miles, 23 square miles is developable (not beach, parks) and only 13 square miles zoned for housing.  He also provided a history of San Francisco development, blaming today’s housing crisis on ill-conceived land use policies for the past 30 years that favored office buildings over housing, assuming workers would live in suburbs. But most people want to live in San Francisco, including tech workers in Silicon Valley.  In fact, San Francisco’s population has grown to an all-time high of 837,442 in 2013.  To address affordable housing, he favors policies designed to control housing costs and conversions, and investment in public and subsidized housing.  

April Veneracion was former SOMCAN Director before becoming District 6 Supervisor Jane Kim’s legislative aide to focus on land use and redevelopment.  April worked on the initial Housing Balance proposal that included mandated conditional use approval for developments if construction of units fall below the 30% below-market-rate unit threshold.  However, the Mayor’s Office believed this would slow development so the "compromise" measure resulted in a housing policy statement (Proposition K) that sets a goal of providing 33% below-market-rate units and annually reporting on the cumulative ratio between below-market-rate and market-rate housing.

Building home and community through design

 

The 2014 Architecture and the City festival theme, Home: My San Francisco, included panel discussions about affordable housing beyond shelter and our relationship with the built environment.

At the San Francisco Chapter office of American Institute of Architects (AIA), Home Matters convened a panel for a conversation about The Future of Affordable Housing: How Do We Create Affordable Housing Beyond Just Shelter? Panelists included Russell Krummow of Opportunity Nation, Susan Neufeld of non-profit BRIDGE Housing, architect Lisa Gelfand, and neuroscientist Pireeni Sundaralingam.  Defining home as beyond shelter, it provides a sense of place and relationships to feel connected and engaged as part of a community.  Designing home with a view of the individual as part of an ecosystem provides opportunities for interaction with the natural environment (daylight, fresh air, healthy materials, spaciousness) and access to resources like transportation and social capital to enhance emotional well-being and health benefits.

Mapping the home: The roles of subjective and objective in the design process panel of architects and UCSF neurologist Zachary Miller repeated theme of our brains responding to the built environment, nature as healing and creating spaces that feel good to reduce stress.  However, hospitals (nursing homes) may not be healing environments when the wrong science causes problems like sick building syndrome, with sealed windows intended for infection control, but trapping indoor air pollution that is worse than outdoor pollution from operable windows that allow natural ventilation.

Community engagement

Aging in place is about growing old in one’s own home, as opposed to nursing home placement, and facilitating this process by making home safety modifications.  However, this focus makes aging in place limited to physical and safety needs.

Aging in community is a more holistic approach that considers our need for connection.  San Francisco’s compactness, relative walkability and extensive public transit system facilitate connections with others face-to-face. 

Because loneliness is independently associated with functional decline and risk of nursing home placement that jeopardizes aging in place, it’s important to identify loneliness and interventions.  Patrick Arbore, Director and Founder of Center for Elderly Suicide Prevention and Grief Related Services at Institute on Aging, presented a talk about loneliness in gerontologist Hope Levy’s Staying Engaged for a Lifetime, offered through City College of San Francisco at our Main Library. 

According to the U.S. Census Bureau, the number of Americans living alone in 2010 was 29 million – a 30% increase since 1980.  However, Dr. Arbore mentioned that introverts, like himself, prefer solitude so we should not assume that living alone means loneliness.  Instead, loneliness is a feeling of longing and emptiness that is caused by the lack of emotional attachment and/or social ties – and thus a subjective experience. Loneliness expert Louise Hawkley proposed loneliness has three dimensions: isolation, connectedness and belongingness.  Ageism contributes to feelings of being invisible and ignored.

Loneliness interventions include:

• ask about loneliness
• spend time with the person, in silence or in conversation
• assist the person in keeping contact with people important to them
• explore the nature of loneliness with the person
• develop community support for the person 

Practice Oprah’s Just Say Hello! Dr. Arbore urged us to be more welcoming and less suspicious in our fear-based culture:

• connect with people
• be as present as possible with people who are lonely
• empathize with people’s losses and suffering
• EASE our way to social connection: 

Extend yourself to others

Action plan

Selection – solution is quality, not quantity, of relationships

Expect the best – we have more control over our thoughts than we think

San Francisco’s diversity offers many opportunities to find community and dialogue. This year's Legacy Film Festival on Aging (LFFOA) and Aging While Black events took place on the same weekend, yet I couldn't be at two places at the same time so . . .

I didn't buy an all-fest pass to this month’s 4^th annual LFFOA, but I attended Friday's Opening Night and Sunday's afternoon screening. With its mission to inspire, educate (including CEUs for MFTs and LCSWs) and entertain intergenerational audiences about the issues surrounding aging, LFFOA builds community.  Opening Night featured Three Perspectives on Aging:  Burn the Clock (UK drama short about septuagenarians who smoke, drink and have sex), Beauty Before Age (documentary about fear of aging in gay male community that values youth/beauty; one older interviewee mentioned that he used physical attractiveness to compensate for his emptiness because he was really seeking validation and connection) and Fabulous Fashionistas (UK documentary about 6 women, whose average age is 80 who show us that style and attitude is not just clothes but knowing what you want like “live in color, don’t wear beige—it might kill you,” being comfortable in “faithful clogs—Crocs,” and making the most of whatever time is left including self-care and being interested).  

Afterwards, LFFOA Executive Director Sheila Malkind moderated a Q &A with Beauty Before Age director Johnny Symons and Dazie Rustin Grego, 19-year-old who said “life is over after age 26” in 1997 documentary.  Now a 37-year-old performance artist, Dazie said he is more thoughtful, less about “look-ism, pretty doll image” and he was just telling his truth at age 19 though this offended some people.  

LFFOA’s Opening Night was also a celebration of Sheila turning age 76! In her interview with KALW’s Your Call host Rose Aguilar about What does it mean to be an elder today, Sheila said she wishes women would stop worrying about aging and stating their age because we should be proud to get to that stage and do wonderful things.  Sheila is a fabulous fashionista herself by embracing aging -- “no botox, plastic surgery” plus no hair dye! 

Sunday afternoon screening of Forget Me Not (Vergiss Mein Nicht), a documentary by German filmmaker David Sieveking about the home care of his mother who had Alzheimer’s disease, showed his use of music, travel, and reading his mother’s diaries (revealing his professor father’s infidelity, which reminded me of the drama Away From Her) to maintain personal connection.  At times, his mother simply wants to retreat in response to attempts to engage her in activities—scenes that resonated with me because I can relate to just wanting down time at home.  After all, home should be a place of retreat—a break from the programmed activities of an institution like a senior center, assisted living, nursing home, cruise ship, etc.  

In Wendy Lustbader’s It All Depends on What You Mean by Home, her study of elders who did not feel at home after moving to continuing care retirement communities (CCRC) to receive supportive services, she found that discontented elders sought: 1) access to dignity, privacy and choice inherent in normal life (versus reminders to “keep busy” through a program of activities like staying at a perpetual resort), 2) the capacity to form significant relationships (versus age segregation that leaves one disconnected from the outside world), and 3) the means to contribute to other people’s lives (reciprocity versus being served all the time).

Community Living Campaign (CLC) uses the power of relationships to build connections of support that we need to age in community.  CLC’s Aging While Black Forum returned to Pilgrim Community Church (panel) and IT Bookman Center (reception).  IT Bookman Director Jackie Wright is seated with panelists Dr. Raymond Tompkins (Aging in a Toxic Environment), Lorenzo Dill (Aging as an African American Veteran) and Anne Warren (Aging with Bills and Legislation).

 

Senior Assembly Member E. Anne Warren represents Older Californians in San Francisco County at California Senior Legislature (CSL).  During CSL's 2013-2014 Session, Legislative Committee Chair Warren introduced Assembly Proposal 43 for a tax credit under personal income tax law for family members providing long-term care.

Pilgrim Community Church Pastor Harold Pierre recognized CLC Community Connector Deloris McGee for founding annual Aging While Black Forum and her community connecting work to support healthy aging in place.  Deloris is retiring and leaving San Francisco to return to her hometown in Mississippi.  I'll always be grateful to Deloris for her inspiration and letting me tag along to learn first-hand about her grassroots community organizing work for my public health classes.  San Francisco will not be the same without Deloris, but she has left a tremendous legacy with her achievements in helping us to age in community by founding OMI Food Network, Breast Cancer Support Group, Fog Walkers, Aging While Black Forum, etc.  

Mindfulness

In this age of 140-character tweets, my biggest academic adjustment over the past year has been to adopt the “SF State of Mind,” which seems to emphasize brevity, or KISS (Keep It Simple Sweetie, as one gentle professor reminded my class): course assignments were typically 2’ x 3’ posters; research papers ranging from 5 to 8 pages (like executive summaries); and oral presentations allowed only 2 to 5 minutes on average, and 10 minutes maximum.  

For an introvert like myself, who prefers gray matter – complexity versus black/white simplicity, deep discussions versus chit-chat or sound bites, I had to constantly remind myself to be less intense and think like a blogger instead. . . Now in my second (and, I hope, final) year in graduate school, I felt rewarded upon learning that my culminating experience assignment would be 30 pages! 

Outside SFSU, I use this blogspot for freely wandering and wondering -- without paying attention to length and time restrictions :-)

Senior & Disability Action: Putting the "D" in SDA! Mind your manners

SDA staff use popular education in this skit to cover what to do and what not to do in interactions with persons with disabilities.

Moderator Donna held up a STOP sign to de-brief after each scenario of Jessica (in wheelchair) and Tony (standing as her companion) when they encounter Sarah and James at a meeting.

• Don’t treat a person in a wheelchair as though she's not able to speak for herself 
• DO speak directly to the person in a wheelchair, on the same eye level if possible
• Don’t assume low expectations of a person in a wheelchair by making over-the-top comments like “wow, it’s so inspiring how you actually got up and left the house to come here,” as if doing everyday activities is exceptional
• DO remember the person is not a disability
• Don’t be patronizing or pity a person in a wheelchair by offering to “pray so you can be a whole person”
• DO treat all persons with respect and dignity

More at http://geronature.blogspot.com/2012/09/october-is-disability-awareness-month.html

Aging While Black Forum

Deloris McGee and Marie Jobling of Community Living Campaign organized their second annual Aging While Black Forum at I.T. Bookman Community Center.  OMI Community Connector Deloris initiated last year’s Forum in response to her community’s request for a culturally sensitive program in the OMI community because blacks are “sicker, poorer, and have more issues to deal with when born into a pre-existing condition of racism and discrimination.” 

Highlight was hearing from Dorsey Nunn, Executive Director of Legal Services for Prisoners with Children (LSPC), who didn’t find humor in a previous speaker’s “joke" about sending seniors to prisons where they can get their basic needs met including video monitoring and guards.  Some audience members actually laughed at this "joke," which made me uncomfortable to think that the invisibility of persons in institutions like prisons and nursing homes might lead to insensitivity and ignorance about true conditions.

Formerly incarcerated as a 19-year-old, now 61-year-old Nunn said that depicting prison as a luxury vacation is like characterizing slavery as good for jobs – the reality is no freedom in prison and slavery.  He invited us to celebrate LSPC’s 35^th anniversary next month with Michelle Alexander, author of The New Jim Crow: Mass Incarceration in the Age of Colorblindness, which presents evidence that more Blacks are enslaved behind bars today than were enslaved on plantations in 1850, a decade before the Civil War began and the Emancipation Proclamation was signed.

Nunn also talked about the realities of aging in prison, like a 70-year-old struggling to climb to the top of a bunk bed, defecating on himself, not being able to defend against younger prisoners who play loud hip-hop, falling inside a cell with no one to check on him, etc.  Read LSPC’s report, Dignity Denied: The Price of Imprisoning Older Women in California, by Heidi Strupp and Donna Willmott (note: same Donna as the SDA moderator above).  Consistent with the program’s theme of community building, Nunn also brought attention to the recent prisoners' hunger strike to protest solitaryconfinement.  

On Lok Lifeways Sustainable Long-Term Care: Matter Over Mind?  

Mind matters! Raised in the holistic (mind-body connection) practice of Traditional Chinese Medicine (TCM), I find the Cartesian mind-body split puzzling.  I also find puzzling the notion of emotions being either “positive” (encouraged) or “negative” (discouraged).  According to the Nei Jing (Chinese medical text), the seven emotions—joy, anger, sadness, grief, pensiveness, fear and fright—all appear in healthy individuals, and cannot be separated from the physical.  In TCM, moderation and balance are key, so emotions are acknowledged and expressed appropriately; but when an emotion is either excessive or suppressed, then this disharmony results in compromised health. 

On Lok Lifeways CEO Bob Edmondson welcomes 300+ conference attendees

When I received this year's invitation to the 6^th annual On Lok Sustainable Long-Term Care Conference focused on “the latest developments and innovations in meeting the mental health needs of older adults,” I was intrigued by the “Matter Over Mind?” theme, but somewhat disappointed that this emphasis on the “latest” meant there was no presenter representing the “traditional” Chinese medicine perspective.  (Nonetheless, I registered for the conference—just as I did last year because I couldn’t resist the student discount rate!) 

After all, the holistic Chinese perspective influenced On Lok to pioneer the model of coordinated care for older adults with chronic care needs in community settings, rather than institutions, in San Francisco’s Chinatown over 40 years ago.  Based on traditional Chinese “it takes a village” and preventive health services model, On Lok (which means “peaceful, happy abode” in Cantonese) provides high-quality, culturally appropriate one-stop shopping:  medical and social supportive services, like nursing and physical, occupational and recreational therapies; meals; nutritional counseling; social work; home health and personal care; prescription drugs; respite care, etc.  On Lok’s model was so cost-effective while reducing nursing home admissions for participants that it was replicated under a new name, Program of All-Inclusive Care for the Elderly (PACE), in 1987 and then made a permanently recognized provider type under the Medicare and Medicaid programs in 1997.  (In 2006, On Lok renamed its PACE program to On Lok Lifeways.)  

AgeSong CEO/Founder Nader Shabahangi's conference moderator role was rather limited to introducing presenters and fielding questions from the audience.  I thought he would be an interesting presenter himself – especially as I was interested in learning more about AgeSong’s new partnership with University Mound Ladies Home.

Pop psychiatrist Daniel Amen on Preventing Alzheimer's Disease - Former X-ray technician Dr. Amen said the important question is: how do you know what’s going on in the brain unless you look?  He uses single-photon emission computed tomography (SPECT), a form of nuclear imaging test that measures blood flow to the brain.  His belief is that the brain does not deteriorate, but behavior can accelerate or deteriorate the brain, so we have a choice how fast the brain ages and can reverse brain damage.  But often we do not care because we can’t see.  Dr. Amen said we need to start by knowing the health of our brain, as revealed by SPECT scan, and losing belly fat because “the obesity epidemic is the biggest brain drain.”  The rest of his presentation was common-sense advice to reduce risk factors (avoid anything that hurts brain, engage in regular brain-healthy habits).  Yet, Dr. Amen remains controversial due to his use of SPECT to diagnose individuals, and the lack of peer-reviewed studies of his work. 

The next two speakers provided an interesting counterpoint with their emphasis on peer-reviewed research.  Psychotherapies are about as effective as medications in reducing symptoms of clinical depression or anxiety disorders, but without meds’ side effects. 

UCSF clinical psychologist Patricia Arean, on Behavioral Interventions for Late Life Depression, Anxiety and Chronic Illness Management, talked about the evidence-based research to support psychotherapy for older adults: cognitive behavioral therapy, interpersonal therapy, and problem-solving.

On Lok Lifeways Chief Medical Officer Jay Luxenberg on Drugs and Other Therapies for Mental Illness in the Frail Elderly: What is the Evidence?

Next up was a more touchy-feely presenter, Khatera Aslami, who is President of the Board of Directors at Copeland Center for Wellness and Recovery, on Wellness and Recovery Action Plan (WRAP) and Eldercare.  WRAP is a strengths-based approach founded on the principles of hope, personal responsibility, education, self-advocacy and support.  WRAP includes wellness tools, daily maintenance, action plans for triggers/early warning signs/when things are breaking down, crisis planning and post-crisis planning.  Aslami didn’t really address eldercare, other than to briefly mention that Alzheimer’s might prevent new learning to make good decisions about lifestyle, relationships, health care, leisure, etc., and isolated older adults might find it more challenging to have at least five key supporters to call upon when needed.  But her presentation was a good WRAP review as last year I took an introductory class on this recovery model at City College of San Francisco, where I continue to take coursework in its Community Mental Health Worker program. 

Engineer Joseph Choi founded TheraBaby, life-sized baby dolls that serve as companions for seniors living with dementia.  His own mother, who had late-stage Alzheimer’s disease, had dramatically improved her quality of life after bonding with the first TheraBaby, which also sparked social interaction among other residents.  In July 2012, Choi launched TheraBaby as a social good project by finding sponsors to adopt TheraBaby into senior care organizations in the Bay Area and Hawaii.  At this time, TheraBaby appears with blue eyes only, though Choi says he would consider different looks as his project grows.

Brain-friendly Mediterranean lunch of salmon on bed of greens: what's good for the heart is good for the brain

Psychiatrist Roberto Mezzina on An Open Door/No Restraint System of Care for Recovery and Citizenship in Trieste, Italy, reported that Trieste was able to dramatically reduce hospitalization/institutionalization with community services to promote aging in place, even when more than 27% of the population is over age 65! 

Stanford research psychologist Philippe Goldin on Science and Practice of Mindfulness Meditation, began a meditation exercise when I excused myself to head over to my late afternoon gerontology research class at SFSU.   

I also missed the last presentation on Harnessing Neuroplasticity of the Older Brain to Enhance Cognition, by UCSF neuroscientist Adam Gazzaley.  However, I’d read about Gazzaley’s study suggesting that older adults can improve cognition by playing video games, which are fast-paced and unpredictable, adaptable in difficulty, and challenging to working memory, attention and processing speed.  Sure, this might be one of the “latest developments and innovations,” but I prefer to engage my brain from traditional social interactions in the real world rather than games in the virtual world.  The former is intrinsically rewarding, while the latter is just a means to an end—much like how I prefer getting my nutrition from traditional whole foods, rather than supplements or fortified foods.

Brain Fitness

Psychologist Charles Vella presented Aging, Dementia and Brain Health in gerontologist Hope Levy's popular Brain Fitness series at the Main Library through City College of San Francisco's Older Adults Program.  Here are Dr. Vella’s Ten Commandments for Brain Fitness:

1.     Thou shall exercise daily.

2.     Thou shall minimize risk factors for cerebrovascular disease (hypertension, hyperlipidemia, diabetes, overweight, smoking)

3.     Thou shall eat Mediterranean diet.

4.     Thou shall choose thy parents wisely.

5.     Thou shall maintain intellectual engagement throughout life.

6.     Thou shall cultivate and sustain friendships and good company.

7.     Thou shall obtain restful sleep.

8.     Thou shall enjoy only one drink of alcohol.

9.     Thou shall manage stress effectively.

10.Thou shall not text or use cell phone while driving.

Mindful Eating 

Neuropsychologist Nancy Hoffman on Food and Mood: How the Food You Eat Affects the Way You Feel, at Life Planning Network meeting, hosted by Lee Abel, at AgeSong's rooftop garden.  Hoffman based her talk on nutritionist Elizabeth Somer’s book, Food and Mood, focusing on food sources of neurotransmitters like mood-enhancing dopamine (meat, milk, eggs, fish, beans, tofu), calming serotonin (tryptophan with complex carbs), pain-killing endorphins (high protein, daily exercise) and acetycholine for memory/new learning/attention (egg yolk, wheat germ, soy, cauliflower, chicken).  It was very similar to Marin County psychotherapist Julia Ross’ The Mood Cure, which I read while studying holistic nutrition.

Moving Meditation 

I get my qi flowing during Da Yan Qi Gong class at Botanical Garden inside Golden Gate Park.