Older Americans Month: Connect, Create, Contribute

This year’s Older Americans Month theme, Connect, Create, Contribute, encourages older adults and their communities to:

Older adults are empowered and communities are stronger as we connect, create and contribute to make a world in which we all want to grow older!

Joined over 1,200 advocates, mostly from Northern California, for the first-ever Disability & Aging Capitol Action (DACA) Day, co-hosted by California Alliance for Retired Americans (CARA) and Disability Action Coalition (DAC)! CARA arranged for free roundtrip bus transportation between San Francisco and Sacramento, plus brown bag lunch.

After a comfy, nearly two-hour ride on our chartered bus, our San Francisco group arrived at sunny Sacramento’s Cesar Chavez Park. 

FOB (Fresh Off Bus) photo opportunity with Senior & Disability Action (SDA) and My Diversability banners.

At check-in, we signed up to join 40 legislative teams (each team meeting 1 Senator and 2 Assembly members) and picked up our commemorative DACA Day/Unity with Diversity buttons as our lunch tokens.  CARA Director Jodi Reid said that sign-ups for San Francisco Assembly members Phil Ting (also Budget Chair and legislative sponsor of DACA Day) and David Chiu were already full, so I signed on to join team facilitated by Jessica Lehman, SDA Executive Director.  Since the legislature was in session, we ended up meeting staff rather than legislators.

Visited Resource Fair vendors like California Department of Aging, which gave out bottled water.

CARA's Nan Brasmer and DAC's Goldie T. House welcomed the crowds to educational rally. Representing close to 1 million people through 275 affiliated organizations, CARA is California’s largest, grassroots senior advocacy organization working to improve the quality of life of older adults and their families.  DAC represents people with disabilities and allies in California to protect and advance our civil rights, self-determination, and life opportunities by educating, communicating, and advocating—culminating in this 15^th anniversary of Disability Capitol Action Day!

Hip hop performance by Very Special Arts The Mini Monsterz from Luther Burbank High School!

Kendra DeAnna sang “I can’t hear you on the right side, can you switch to the left, I can’t help it, together we can make a change…”

81-year-old Pauline Brooks of CARA talked about working in fashion industry for 65 years until she retired with help from moving in with her daughter and son-in-law in Oakland, reminding us that not everyone has a family safety net so it is important to support DACA Day platform:  SB 512 Long-Term Services and Supports Options, and AB 1434 Increase SSI/SSP Base Grant and Reinstate COLA. 

Special education teacher sang about universal healthcare.

After our march from Cesar Chavez Park to steps of Capitol building, SDA team (Pi, Ligia, Jessica, Betty, Theresa, Tony, Sam Alicia, C.W.) are all smiles.

During lunch, our team of six met to discuss our upcoming legislative visit.  Jessica served as facilitator (introduced CARA, DAC, team members) and nailer (make sure questions answered); I served as note taker and packet presenter; and storytellers covered bills.  At minimum, we covered these two priority bills:

·       Californians have a unique opportunity to pass legislation that would begin to chart a path to provide long-term supports and services (LTSS) to all Californians, beginning with a feasibility study and assessment.  We must pass SB 512 and pave the way for providing LTSS for all! (We ask $1 million to conduct an actuarial study to determine the cost of providing additional options for LTSS: how many people will need these services, what they will cost, and how California may pay for them.)

·       It is time for California to increase the State portion of SSI/SSP so that we can move seniors and people with disabilities out of poverty.  Last year, we increased the state COLA slightly and made CalFresh available to SSI recipients.  Now we are urging passage of AB 1434 in order to restore recession-era cuts to SSI/SSP, bring payments to at least 100% of 2019 poverty level, and reinstate the annual COLA.  (To make this happen, we ask $1 billion.  Note:  More than $11 billion has been taken from 1.3 million SSI/SSP recipients who have had to live at sub-poverty level for the past decade after Governor Schwarzenegger made cuts to balance the state budget in 2008.) 

Team members also chose to present on following DAC policy platform bills: 

·       AB 715 Increase Medi-Cal Aged and Disabled Program Income Level to 138% of Federal Poverty Level ($1,396/month for individuals, and $1,892/month for couples).

·       SB 338 Senior and Disability Justice Act to strengthen law enforcement response to abuse of elders and adults with disabilities, with training and detailed policies and procedures based on model San Diego County Elder and Dependent Adult Abuse Blueprint.

·       SB 10 Establish state certification process for peer providers of mental health services and require Department of Health Care Services to submit Medicaid State Plan Amendment to add peer support specialist services as reimbursable Medi-Cal benefit.

After more than 30 minutes of waiting in line to enter State Capitol building, passing security check, and then waiting for an available elevator… we met with Israel Landa, Legislative Director for Assembly member Monique Limon (Democrat, 37^th Assembly District representing Santa Barbara and Ventura counties).  Though we could not get commitments from this office, we picked up cool blue tote bags with yellow letters reading, “Everything is Better #con LIMON!” 

Squeezed into reception area to meet with Gianna Rogers, aide to Assembly member Jordan Cunningham (Republican, 35^th Assembly District representing San Luis Obispo and portions of Santa Barbara counties).  He said he would deliver our messages to Cunningham, who authored legislation to increase access to health care and strengthen public safety.

Assembly member Cunningham’s father showed up during our visit!

Nora Lynn, Legislative Director for Senator Hannah-Beth Jackson (Democrat, 19^th Senate District, representing Santa Barbara and western Ventura counties), made our day when she (they) said Senator was committed to supporting our priority bills! She (they) wore DACA Day button and posed with our team of happy campers.  (As Chair of the Senate Judiciary Committee, Senator Jackson introduced gender-neutral language.) 

During the March to State Capitol building, chants included “Seniors and Disabled, need a seat at the table” and “Our homes, not nursing homes!” 

“Live in your home, not a nursing home” is the motto of Center for Elders’ Independence (CEI), which celebrated grand opening of its Downtown Oakland Day Center, sharing this historic 1922 building with administrative offices upstairs.  Modeled after San Francisco's On Lok, CEI is a Program of All-Inclusive Care for the Elderly (PACE) organization that supports East Bay seniors age 55+ with multiple health challenges to live safely at home.

CEI CEO Linda Trowbridge thanked regulators who allowed CEI to separate the day center from PACE clinic about 5 miles away.  The former dark, dance club was renovated to this bright space that features a lounge area that opens into an activity center, 1,200 square foot fitness gym staffed with physical and occupational therapists for individual therapy and group exercise, computer lab, “tranquility room” for participants who want peace and quiet, outdoor courtyard with shaded seating and landscaping, etc.

Hors d’oeuvres at open demonstration kitchen, designed for participants to make their own snacks with dietitians during activity time.

Participant performs Korean dance to live piano.

Ribbon-cutting.

San Francisco Supervisors introduced a November ballot measure, Mental Health SF, which would build a new Mental Health Service Center to facilitate universal mental health care for anyone to access psychiatrists and other providers of mental health/substance use treatment, and establish a new Office of Coordinated Care to bring the City’s mental health systems under one network.  This initiative would be funded by a surcharge on local companies whose CEOs make more than 100 times the median income of their workers. 

Given the history of stigmatizing and institutionalizing people with mental illness, many older adults do not actively seek out stand-alone mental health care services and thus are underserved. For many older adults, primary care remains the entry point so I would prefer to see integrated behavioral health clinics to meet people where they are.  Further, as noted in Dr. Marc Agronin’s Therapy with Older Clients: Key Strategies for Success (2010), common medical conditions can impact mental illness; for example, joint pain and immobility of arthritis can lead to social isolation, insomnia, increased anxiety over falling; steroids used to treat rheumatoid arthritis can lead to confusion, anxiety, and depression.  Therefore, treat the whole person=mind+body!

Psychological First-Aid for Neighborhood Emergency Response Team with Elizabeth McMahon, PhD, who provided these tips to mentally prepare for an emergency to reduce stress and trauma reactions:

·       Adapt interactions based on diversity in community: Observe (cues), Ask (what is appropriate), Respect (differences)

·       In stressful situations: Stop (take “4 for Calm” belly breaths), Slow (for moment), Think (about situation—our role, what’s needed, possible reasons for someone’s actions/emotions, what’s best action available), Act (in most calm, caring and competent way you can).

·       If stress reactions begin to impact judgment/interactions: say “Time to Take Five” (cue to step away and practice self-care: eat, hydrate, do “4 for Calm”)

·       During emergency, connect with others: Set Tone Nonverbally (calm, caring, competent) and Verbally (soothing tone, lower pitch, adjust volume as needed, slower pace, short and simple phrasing); See the Need, Say the Need (“You can’t find your pet. You’re worried. You want your pet found”); Get a “Yes” (agreement to cooperate; e.g., “I’m here to help.  Are you willing to let me?”)

·       Assess needs (medical, practical, social, psychological) and know what resources are available

·       Direct: state simply what to do and why (“I need you to stay here because someone is coming to help you”)

·       Self-care after disaster: allow time to deal with reactions, use stress management tools, maintain social connections-talk with others who understand, create positive environment, limit media viewing, write about what learned from experience; always get support for suicidal thoughts, substance overuse, or violent activities

Historical trauma: As part of Asian Pacific Heritage Month and this year’s 70^th anniversary of China’s Communist Revolution, Helen Zia discussed her new book, Last Boat Out of Shanghai: The Epic Story of the Chinese Who Fled Mao’s Revolution, with journalist Sherry Hu at SF Main Library.  Helen’s latest book was 12 years in the making, involving interviews with over 100 people, after her mother in her 70s finally shared her story of abandonment by her parents and exodus from Shanghai. Helen explained that her book is the only one in the English language about the exodus from Shanghai because people who survive trauma are not willing to share their experience right away, and many of her interviewees were talking to Helen, a stranger, for the first time sharing their whole stories.  Helen advised to keep asking because at some point people might be ready to tell their story, like her own mother who finally “felt strong enough” and then sensed a release of shame in the process.  Helen believes the World War II generation have post-traumatic stress syndrome.  
During her book tour, Helen said the Chinese government would not allow distribution of her book, but e-book available online; in Shanghai, Helen’s talk title was changed to “Four Young Shanghai People Leave and Go to America.” 

At Civic Center Plaza, Lest We Forget Holocaust Remembrance Project, by German-Italian photographer and filmmaker Luigi Toscano, included huge portrait of Gloria Lyon, who survived seven concentration camps, was rescued by the Swedish Red Cross and immigrated to the United States in 1947.  SF resident Gloria has shared her World War II experience in documentary, book, and Yom HaShoah service.  

Being older

Gerontologist Hope Levy presented Age as an Asset in Your Job Search workshop, at SF Main Library.  Lots of techies, who face job discrimination at younger ages, in attendance.  Workers age 40+ are protected under Age Discrimination in Employment Act (ADEA), and Congress is considering additional protection under proposed Protecting Older Workers Against Discrimination Act (POWADA).  
Hope’s presentation balanced the seriousness of challenging age discrimination in employment with moments of comic relief in cartoons by Randy Glasbergen.  My favorites:

·       Reality Check – hiring manager to job applicant: “We’re looking for someone with the wisdom of a 50-year-old, the experience of a 40-year-old, the drive of a 30-year-old, and the payscale of a 20-year-old.”

·       Advantages of Hiring Older Workers: “Don’t think of me as a 54-year-old job applicant.  Think of it as getting two 27-year-olds for the price of one!”

Take-aways:

·       Value your age and experience, which you’ve earned so emphasize your talents and abilities

·       Upgrade your skills strategically and identify resources that can help you do that

·       Target employers who will value your skills and experience

Employers who serve older adults generally value older workers.  Hope shared her experience when she was a 40-something being interviewed as to whether she might be able to relate to older adults age 55+ served at City College of San Francisco’s Older Adults Program.  Yes, she was qualified and hired! 

Sarah Cooper, former tech employee and author of How to be Successful Without Hurting Men’s Feelings: Non-threatening Leadership Strategies for Women (2018), advised that older job applicants avoid falling into the “trap of being proud of their age” like sharing information that might date them, if they want to avoid ageism. 

In conjunction with Chinese Historical Society of America (CHSA) exhibit, Towards Equality: California’s Chinese American Women, CHSA’s Acting Executive Director Jane Chin moderated Pioneering Leaders: Discussion Panel with Chinese American Women featuring Jaclyn Locke (biotech researcher since earning her bioengineering Ph.D. two years ago), Felicia Lowe (award-winning documentary filmmaker; former TV producer/director/writer/first female Asian news reporter at KGO-TV, and Miss Congeniality in 1965 Miss Chinatown USA Pageant), Lauren Marshman (2nd generation high school counselor for past 15 years) and Helen Zia (award-winning book author, investigative reporter and community organizer--“which is now a path to the White House”; former Executive Editor of Ms. Magazine, autoworker, construction worker earning hourly $10 versus $1.30 minimum wage at the time, Tufts medical school dropout, graduate of Princeton’s first co-educational class).  

In Amy Tan’s The Joy Luck Club tradition, Felicia and Helen were inspired to document the lives of their Chinese mothers whose immigration stories were secret until later life.  For the past 40 years, Felicia has shared the story of her family’s immigration to the United States in documentaries—China, Land of My Father (1979), Carved in Silence (1988), and then Chinese Couplets (2015) about her mother’s experience as a “paper daughter” during the Chinese Exclusion Act era.  Helen’s latest book, Last Boat Out of Shanghai: The Epic Story of the Chinese Who Fled Mao’s Revolution (2019), includes the story about her mother who was abandoned by her poor parents because she was a girl at age 6—unknown to Helen until she was in her 50s and her mother was in her 70s living in a retirement community.  They also talked about their choice of media – Felicia’s films and Helen’s books – from a desire for “shelf life.” 

Anna Wong of the SF Guzheng Musical Society played the guzheng, a traditional Chinese plucked string instrument.  Anna immigrated from Hong Kong in 1962 when she was 11 years old, thanks to Kennedy’s Emergency Immigration Act of 1962 that allowed 5,000 Chinese refugees to enter the United States. She lived and worked in sweatshops in San Francisco’s Chinatown through her early teens, and then put herself through school and became a clinical psychologist.

At 12^th annual Art of Aging Gracefully at JCCSF, licensed acupuncturist Esther Gokhale and her daughter Monisha White presented No More Aches and Pains: For You, Your Family, and Your Community.  It’s not too late to reclaim our primal posture, challenging assumptions about aging means falling, rounding, shrinking, etc.

Based on her studies of populations with very little muscle and joint pain, our ancestors and how we moved as toddlers, Esther discovered how we are meant to stand, sit, bend and move using our natural J-shaped spines. 

Wendy Zachary, MD, introduced Acute Care for the Elderly (ACE) Unit at California Pacific Medical Center’s Mission Bernal Campus. 

Open since last August, ACE is a specialized unit for older adults age 70+ focused on preventing functional decline and improving patient experience.  ACE units have resulted in shorter length of stay, reduced 30-day readmissions, reduced costs, increased patient satisfaction, and increased retention of functional capacity. ACE team consists of geriatric trained healthcare professionals: medical doctor, NICHE-trained nurses and certified nursing assistants, social worker, case manager, physical therapist (PT), occupational therapist (OT), speech therapist, activities therapist, registered dietitian, pharmacist, etc.  This interdisciplinary team reports daily using SPICES (Sleep, Problem eating, Incontinence, Confusion, Evidence of falls, Skin breakdown) tool. 

Sara Cohen, RN, AGCNS-BC, talked about community partners that included On Lok, Inc. 30th Street Senior Center’s Health Promotion!  Volunteers trained in HELP (Hospital Elder Life Program) also contribute to improved outcomes by providing core interventions: daily visitors, frequent orientation, cognitively therapeutic exercises, personal feeding, early and frequent mobilization, non-pharmacologic sleep protocol, review of medications, and assessment of cognitive status.

One of 34 private rooms in ACE unit.  Sleep promotion policy means no wake times 12 am to 6 am, unless absolutely necessary for vitals/meds/labs. (Like Medicare for All, let's have Sleep Promotion for All!) Tour included visits to gym for PT/OT and activity room for shared meals and activities.  During their stay, patients have access to supplies, such as iPad with interpreter services, pocket talkers, hearing aid batteries, tilt-in space wheelchairs, reading glasses, large print newspaper subscriptions, essential oils, etc. 

Tax dollars at work:  Surveyors announced their annual Medicare/Medicaid inspection in this poster at skilled nursing facility.

SF Main Librarian Janet Tom organized How Different Faith Traditions View Death, as part of Death and Dying series.