Sustenance

Food has the power to connect and engage people, and build community.  This is evidenced by programs that center around food, such as home-delivered meals, adult day programs and senior congregate meals—enticing older adults with sustenance and access to social services that support healthy aging in community.  During my graduate gerontology studies, I worked at On Lok, Inc.’s 30^th Street Senior Center location, which provides all three programs across the continuum of care in its 3-story building:

·       1^st floor kitchen, where Valley Services (same contractor used by Meals on Wheels San Francisco) prepare meals for home deliveries and six community dining sites 

·       1^st floor dining room for 30^th Street Senior Center participants, who have access to 3^rd floor’s activities, health and wellness, social services, computer lab, hair salon and snack bar

·       2^nd floor dining room for On Lok’s Program of All-Inclusive Care for the Elderly (PACE) participants, who have access to activities, health and social services, and roundtrip transportation

·       3^rd floor garden, which grows edible plants harvested for monthly Garden Market. The garden has views of the adjoining Pritikin Mansion estate, which is up for sale ($12.5 million price from September 2017 dropped to $5.5 million). 

Earlier this month, I returned to 30^th Street Center to join the celebration of its new campaign, “Mission Nutrition.”  “Mission” campaign name is double entendre, referencing 30^th Street Senior Center’s location in the Mission neighborhood, attracting mostly Latinx participants, though other sources place it in more upscale Noe Valley and Glen Park.  

30^th Street Senior Center management team’s Director Valorie Villela and On Lok, Inc. CEO Grace Li welcomed guests, including San Francisco Mayor London Breed. 

Informal meet and greet before official program began.  Of course, there was food (passed around in trays by Oakland catering staff) and hosted bar. 

On Lok 30^th Street Senior Center Chair Joseph Barbaccia, MD, provided an overview of 30^th Street Senior Center--San Francisco’s largest multi-purpose senior center connecting 6,700 older adults annually to each other and a wide range of services to support their health, well-being and independence.  The Center is the lead agency for the City’s evidence-based health promotion programs (including Always Active^SM, Healthier Living-Chronic Disease Self-Management Program, and Diabetes Education Empowerment Program).  All social services (Aging and Disability Resource Center, Case Management) are offered in bilingual English/Spanish format.

Hadley Hall provided a brief history of 30^th Street Senior Center, which will celebrate its 40^th anniversary next year!  As Director of San Francisco Home Health Service, Hadley initiated acquisition of the 30^th Street building for $1 and $750,000 mortgage in 1979.  He also obtained grants from Haas family and San Francisco Department of Aging and Adult Services’ Office on Aging (OOA) to convert the 3-story former psychiatric hospital into a vibrant senior center offering activities and meal programs.  Hadley introduced Valorie, who was hired as the Center's Nutritionist in 1979. 

As the Center's Director, Valorie talked about Mission Nutrition program goals to help older adults maintain proper health with hot, nutritious meals. Last year, Mission Nutrition served over 88,870 meals in community dining sites, and delivered another 130,000 meals to more than 360 homebound older adults. 

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

30th Street Center's garden beds with colorful wall mural  

Monthly Garden Market sells herbs, greens, fruits and flowers 

Way back in Fall 2011 (before I began this blog), I volunteered at 30^th Street Senior Center as Project SHINE (Students Helping in the Naturalization of Elders) coach.  In addition to reviewing English and U.S. history for the citizenship exam, we rehearsed singing “You Are My Sunshine” in English and Spanish for an intergenerational program with K-8 students at Synergy School, a teachers’ cooperative in the Mission District.  With City College of San Francisco ESL instructor Elizabeth Silver interpreting in sign language, Center participants provided entertainment after Synergy School's teachers, parents and students provided lunch per Thanksgiving myth.   

Synergy School's mural with wisdom by Chief Seattle: “Humankind is but a thread within the web of life.  All things are bound together.  Whatever we do to the web, we do to ourselves.” #RakeAmericaGreatAgain  

With my allergies triggered by the worst air quality worldwide after the devastating Camp Fire, I became a shut-in for a week.  (Wish I had attended Gerontological Society of America's Annual Scientific Meeting in Boston instead!)  Homebound, I forgot about the outside world as I enjoyed cheap and nourishing Depression Cooking (mostly pasta with beans or vegetable) inspired by Youtube celebrity chef Clara Cannucciari (1914-2013), nonagenarian author of Clara’s Kitchen: Wisdom, Memories, and Recipes from the Great Depression (2009).  According to Clara, people bought chapters rather than whole books “back then” (p. 170).  I was grateful to savor all six chapters in this 194-page book, co-authored with her grandson Christopher who filmed her Youtube series. 

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

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

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

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

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

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

Mmm, good!

Out and about

According to Traditional Chinese Medicine and permaculture principles, one should live in harmony with the natural cycles of the environment.  Spring is the time for growth, renewal and regeneration.  Following winter’s hibernation stage, it’s now time to get out of bed, stretch and move!

Afia Walking Tree and soul line dancing at Black Health & Healing Summit at SFSU

Transit Justice

One challenge of aging is the loss of mobility due to chronic conditions, loss of a driver’s license, safety or cost of transportation.  Older adults and persons with disabilities may feel stuck in their homes unless they have access to safe and affordable transportation options.  This month I joined Senior & Disability University for Transit Justice (Transito Justo) advocacy training at Valencia Gardens, which was attended mostly by seniors from nearby Centro Latino de San Francisco Community Center so information presented was bilingual English-Spanish, thanks to Flor who provided Spanish translation. 

Senior & Disability Action's Pi Ra (aka PiRaTransit when he worked for Paratransit Services) noted that San Francisco is changing, especially who the City is taking care of in the areas of transportation and housing.  These issues are related because private commuter shuttles that take tech workers living in the City to work in Silicon Valley clog Muni stops and drive up the price of nearby housing.  Long-time residents, mostly seniors, have experienced a high rate of evictions and rent increases, with the majority taking place within two blocks of the Apple/Google/Yahoo shuttle stops.  San Francisco is becoming expensive.  Pi asked, “If you can’t afford to ride the bus, you walk and get hit by a car—where’s the justice?”  Free Muni for seniors and adults with disabilities campaign would be modeled after Free Muni for Youth program providing bus passes for low- to moderate-income students. 

Community organizer from POWER inspired us with 5 strategies that worked for Free Muni for Youth campaign: 1) build base by organizing at and on bus and schools, 2) build coalition, 3) develop champion (Supervisor David Campos dedicated staff person), 4) build strong case with fact sheets, personal stories about problem, and 5) build pressure against the target at public events to get media attention.  He explained strategy to start small and gain something, so they started with youth who have no money of their own.  Free Muni for Youth pilot program that began last year will be permanent.

Oops, I arrived too late for April 15 SF MTA (Municipal Transportation Agency) HEARING ON FREE MUNI FOR SENIORS AND PEOPLE WITH DISABILITIES at City Hall, and ended up drawn to SEIU Local 1021 demonstration outside City Hall over economic inequality.  Nurses, caregivers and 911 dispatchers protested unsafe staffing levels.  Without enough nursing staff, dementia patients risk being tied in restraints to prevent falls or wandering. 

City workers seek fair pay to live in the communities they serve, and enough staffing to keep San Franciscans safe and healthy.  They say ending the tax break for Twitter and other tech companies in the mid-Market area would reduce the City’s deficit and free up funds for staffing and pay.

Though I missed the MTA hearing, I learned that the hearing room was packed and the MTA Board decided to revisit funding Free Muni for Seniors and Disabled in January.

Walk SF Executive Director Nicole Schneider and District 6 legislative aide Sunny Angula provided an overview of City and community responsibilities (SF MTA, SF County Transportation Authority, SF Police Department, SF Board of Supervisors, Walk SF, California Walks, Pedestrian Safety Advisory Committee, etc.); engineering, enforcement and education for pedestrian safety; Vision Zero plan to eliminate traffic deaths within a decade, which includes Walk First initiative to improve safety at 170 high-collision corridors in the City.  Top causes of collisions are speeding, red light running, not yielding to pedestrians in crosswalk, unsafe turning, and not coming to a complete stop at stop signs.  As of this month, 7 pedestrians have been killed in vehicle collisions in San Francisco; last year’s record was 21 pedestrians killed.  To add insult to injury, Bay Area drivers who kill pedestrians rarely face punishment.

Pi talked about lobbying strategies: letter writing, phone calling, public speaking (at hearings, rallies/demonstrations, community meetings), media (press conference, press release), petition, events, and visiting public official (do prep work—know issue, elected official, role-play presentation; and follow-up after presentation).

Buck Institute: Science of Aging

Aging is a complex process influenced by biological and psychosocial factors.  I advocate for behavioral justice, or empowering individuals with access to resources in their environment to support healthy behaviors and reduce health disparities.  This month, the Brookings Institute released its study showing that life expectancy gap between the rich and poor is growing in America, with life expectancy gaining most among the rich who live longer.  Millions of dollars have gone to San Francisco Bay Area institutions for research to “stop the aging process” and potentially increase healthspan, but I wonder if everyone will benefit or just the well-to-do who can afford cutting edge treatment?   

Gerontologist Hope Levy and I carpooled with my SFSU classmate Gabriela to visit Buck Institute for Research on Aging, which offers free, docent-led tours to the public on Thursday mornings.  Established in 1999 in Novato (30 miles north of San Francisco), Buck Institute’s mission is to extend healthspan through interdisciplinary research and education, focusing on age-related diseases like Alzheimer’s and Parkinson’s.  Its reception wall reads: 

I want to extend help towards the problems of the aged.--Beryl Hamilton Buck

 

We viewed Scientist as Artist exhibit in semi-circle shaped atrium with fruitless olive trees in planters.  Hope (at left) examines Chubby Angry Fat Cells, by Regina Brunauer, PhD, who researches the regenerative potential of adult stem cells from mice by staining fat tissue in red dye and cell nuclei in purple dye.  Gabriela (at right) stands in front of Astronomy of a Cell, by Shona Mookerjee, PhD, who studies insulin-secreting cells. 

The atrium skylight resembles I.M. Pei’s steel and glass pyramid at the Louvre. 

Architect I.M. Pei designed 5 structures, but only 3 have been built to date for 550 capacity.  Buck campus sits atop a rock foundation sturdy for scientific instruments, and surrounding land in deer-friendly natural state. 

At Buck Learning Center, stem cell researcher Julie Mangada, PhD, talked about how models like fruit flies, yeast, worm, mice and water bears have genes similar to humans.  She mainly works with school kids, who are often surprised to meet a female scientist who’s also “darn cute” versus the stereotypical nerd.  

Buck staff kept referring to our gerontology group as the “UCSF group” so we had to repeatedly correct them that we’re from SFSU Gerontology Program! 

When adults ask Julie about the latest scientific cures for diseases, she explains that science is more about making connections and building information as illustrated in this poster, Systems Biology of Human Aging, from http://legendarypharma.com/chartbg.html.

Art of Aging Gracefully:  Heart Advice

This month’s JCCSF’s Art of Aging Gracefully featured speakers who were all women with topics on Sexual Health and Aging Woman, How to NOT Have a Heart Attack, Sleep in a Society that Never Sleeps, and Evidence-Based Look at Popular Dietary Supplements.  

Anne Thorson, MD from UCSF Center for Prevention of Heart and Vascular Disease, pointed to chart showing prevalence of high blood pressure in adults increases with age:  more than half of adults age 55 and older have high blood pressure.  Ideal cardiovascular health factors are:

• Total cholesterol < 200 mg/dL
• Blood pressure < 120/<80 mm Hg, untreated
• Fasting blood sugar < 100 mg/dL, untreated
• Body mass index < 25 kg/m2
• Abstinence from smoking (never or quit > 12 months)
• Physical activity at goal
• DASH (Dietary Approach to Stop Hypertension)-like diet (or Mediterranean diet)

Dr. Thorson noted that ideal patients are rare—less than 5%--in most clinical practices.  I am the 5%!

On Lok:  Experience Matters in Senior Care

 

Joined Hope Levy’s Encore Adventures for field trip to On Lok Lifeways Rose Center, with On Lok shuttle service arranged by Daniel Frias-Vidal so we could experience what it’s like to be an adult day healthcare client for a day. 

Our group participated in Fit & Fun exercise led by a recreational therapist.  We also toured the physical therapy room, medical clinic (on-site optometrist, doctor, dentist, podiatrist, etc.), swimming pool with jet massage, laundry room, kitchen (“largest woks outside of Chinatown”), SRO housing and garden.  To respect client privacy, I was not allowed to take photos showing client faces, which was challenging so not many photos taken.  

We enjoyed Asian lunch of almond jelly, white rice, baked chicken, bok choy, tea and cranberry juice.  Though federal nutrition standards provide for at least half whole grains, older adults may have a harder time digesting brown rice (chewed by the mouthful 200 times by Macrobiotic practitioners) and heavy metals (arsenic, cadmium, mercury) tend to accumulate in bran and husk, which are polished off in processing white rice. After lunch, there was a slide presentation on Italy, which I missed because I had to leave for another appointment.

LGBT Aging

Sigma Phi Omega, our gerontology honor society, hosted LGBT Aging talks by graduate Loren Meissner and Professor Brian de Vries. 

Loren presented his study on HIV and Aging 

Professor Brian presented on LGBT Aging Challenges and Strengths, discussing stigma and discrimination, minority stress, strength and resilience (positive marginality). When Professor Brian talked about LGBT seniors asking “who will care for me?” in the absence of a spouse or children, I thought this was universal to never-married, childless seniors —a growing demographic, especially since personal finances (including maintaining rent-controlled housing) may be a factor in the decision to remain single.  As an introvert, I know I don’t want care in an institution so I looked at John Lam, On Lok Enrollment and Outreach Specialist, and said out loud, “On Lok will care for me!”  if I can afford its private pay rate of $5,400 per month, or impoverish myself by remaining in school while working part-time at a non-profit to qualify for Medi-Cal?

SFSU Graduate Showcase 

As part of our culminating experience, 25 classmates and I participated in SFSU Graduate Showcase presenting posters summarizing our research papers.  My subject, Chronic Disease Self-Management Program (CDSMP) and Behavioral Justice, was based on applying a systems approach to my work organizing CDSMP workshops. My 123-word abstract:

As an intervention to provide older adults with the tools to remain independent and “age in place,” the U.S. Administration on Aging funded the nationwide delivery of the evidence-based Chronic Disease Self-Management Program (CDSMP).  CDSMP is based on self-efficacy theory, which assumes people have individual responsibility and control over how they manage their health.  Behavior and the environment have a greater impact on health than genetics and medical care, yet low-income persons may not have access to resources in their environment to engage in health-promoting behaviors.  This paper explores the need to connect low-income participants in CDSMP with access to community resources to support their weekly action plans, based on a behavioral justice model for health promotion, aimed at potentially reducing health disparities.

My text-rich poster and I stood at the edge next to Gerontology, Engineering and Public Health so I could easily slip away to visit other posters.  I believe the permaculture principle, “Use edges and value the marginal: The interface between things is where the most interesting events take place.  These are often the most valuable, diverse and productive elements in the system.” I was commonly asked, “What is gerontology?” and I thought how the gerontology poster topics made aging seem like a host of problems: chronic disease self-management & behavioral justice (from yours truly), dementia, crisis of type 2 diabetes, elder abuse, problem gambling, medication adherence with major depressive disorder, reducing antipsychotic drugs in nursing home residents, sex in long-term care, etc.  Then I remembered the philosophy of permaculture: “The problem is the solution.”  I love systems thinking J!

 

Smiling classmates Maryann and Brittany stand beside Professor Anabel Pelham, who served as second reader for 9 classmates, generously volunteering her time this spring semester when she’s on sabbatical as part of her 5-year phased retirement under Faculty Early Retirement Plan.  Professor Brian took a break from grading our posters when he saw Edna James, SFSU gerontology alumna and Commission on Aging President.

In my paper, I acknowledge Edna who first told me about adapting CDSMP for cultural relevancy; Kay Strawder and Sheila James of San Francisco Office on Women’s Health for hosting Women’s Health Leadership Institute training last summer that led to my partnering with Aging & Disability Resource Center (Lolita Kintanar) for my Community Action Project; San Francisco Department of Aging & Adult Services and Administration for Community Living (ACL) for funding this invaluable work. I was happy that Edna and my ACL internship mentors came to Showcase!  

ACL Aging Services Program Specialist Anna Cwirko-Godycki and Legacy Film Festival on Aging Executive Director Sheila Malkind. 

SFSU Professor Darlene Yee chats with my ACL internship preceptor Darrick Lam. 

Gerontology dining table: note two men in our graduating class of 2014! 

Professor Brian is a raffle winner!

Careers in Aging 

Careers in Aging Week (CIAW) is an annual event that takes place the first full week in April on college campuses to promote careers in aging.  Though I missed this month’s event at SFSU due to my internship, I happily returned to University of San Francisco’s event which took place in the late afternoon so I could attend after work.  Two years ago after I attended USF’s CIAW event, which featured SFSU gerontology alumna Edie Yau, Director of Diversity and Inclusion at Alzheimer’s Association in Northern California, I applied to SFSU gerontology program and the rest is history.  This month I brought our SFSU gerontology program brochures to USF for interested attendees.  Wow, the room was packed, much credit to USF Professor Chris Thompson who offered extra credit to his kinesiology students for attending!