Dignity + R-E-S-P-E-C-T

“Dignity is our inherent value and worth as human beings; everyone is born with it. Respect, on the other hand, is earned through one’s actions…

This shared desire for dignity transcends all of our differences, putting our common human identity above all else...The glue that holds all of our relationships together is the mutual recognition of the desire to be seen, heard, listened to, and treated fairly; to be recognized, understood, and to feel safe in the world.”

--Donna Hicks Ph.D., founder of Declare Dignity and author of Dignity: Its Essential Role in Resolving Conflict

Because of my current work focused on home visits to mostly homebound seniors, I miss a lot of community meetings during working hours, and thus sometimes feel as isolated and invisible like my clients.  Outside of working hours, I make efforts to stay connected with advocates from Community Living Campaign, Gray Panthers, Older Women’s League (OWL) and Senior & Disability Action (SDA).  And I share information with clients to empower them to make themselves heard because “all lives matter,” including homebound older adults!  

Though it might be challenging for clients to show up at City Hall for the July 19 rally before the Board of Supervisors’ vote on The Dignity Fund to place it on the November 2016 ballot, perhaps clients can send representatives to speak on their behalf about removing barriers that keep them as shut-ins, like funding for:

·         escort services (beyond medical appointments, like affordable outings for people with dementia)

·         elevator repairs in SROs

·         stair lifts in buildings without elevators

·         power wheelchairs/scooters for seniors tethered to oxygen tanks

·         neighborhood and pedestrian safety 

·         taxis willing to serve residents in Bayview-Hunters Point (aka “the San Francisco America pretends does not exist” according to James Baldwin in his 1963 Take this Hammer documentary)

·         treatments for urinary incontinence, etc.

Legal Assistance to the Elderly = Power to the Elderly! 

The Dignity Fund includes provision for protecting the rights of seniors to remain living in their homes: legal services focused on eviction/homelessness prevention.  For example, a court ruling in April allowed 99-year-old Iris Canada to remain in her San Francisco home if she pays over $100K in legal fees to her landlord or else agrees to a condo conversion; two months later, her landlord is attempting to evict her again though she needs more time—and likely legal counsel—to understand condo conversion documents. 

 

Marilyn French-Speller, at her retirement party from Meals On Wheels of San Francisco (MOWSF; see Marilyn in video at 2:15), gets R-E-S-P-E-C-T and honorable mention for at least three reasons: 1) her influence in inspiring me to pursue MA in Gerontology from SFSU, as she did, 2) her example of having a sustainable career spanning 30+ years working in non-profits while residing in San Francisco, and 3) her decision to leave San Francisco (one of the most expensive cities) to be closer to her family in St. Louis (more affordable) as she embarks on her next stage in life, got me thinking about where I want to be “aging in place.” (Would I want to retire in Honolulu, which is more expensive than San Francisco, just to be closer to family?) 

Studying gerontology

When I met Marilyn five years ago during a stint at MOWSF’s Social Work Department, while I was an intern at Department of Aging and Adult Services, I was deciding whether to pursue graduate studies in gerontology or public health.  Marilyn’s passionate advocacy, manner of treating everyone with dignity and infectious laugh just won me over.  I didn’t consider social work because gerontology was already part of the School of Social Work at SFSU, and I was more intentional about studying aging.

At API Social Work Council’s Panel: Preparing You for a Career in Social Work, it was refreshing to see that the only male panelist represented gerontology! Chris Lum, MSW medical outpatient social worker with the Veterans Administration (VA), didn’t intend to work with older adults but now works mostly with veterans age 50+.  His experience included work in a homeless shelter and community mental health when he applied twice with the VA until he got hired. 

Social work representation was absent among the five awardees (which included one male!) of this year’s PG&E Legacy Employee Resource Group (ERG) Scholarship, intended to award students who “support Senior communities.”  At its “Reaching for Tomorrow” Awards Ceremony, I was the only recipient to attend in-person to give another big shout out to PG&E Legacy ERG for extending its scholarship eligibility to persons pursuing continuing education (not just degreed programs), and not limiting applicants to long-term care administration (as is the case with nearly all scholarships offered at SFSU Gerontology Program; last fall, I was surprised to learn that my donation check intended for SFSU Professor Brian de Vries’ retirement gift actually went to Frank P. Broz Long-Term Care Administration Program Fund at SFSU.) 

“Surviving” in non-profit work/pay

When people learn that I work at a non-profit agency serving seniors, they often remark, “wow, you must have a lot of dedication,” and then remind me, “non-profits don’t pay anything like comparable positions in government” and ask, “how do you manage to survive, especially living in San Francisco?” Oh, hand to mouth, one day at a time . . . like my mostly homebound clients on limited income, thanks for your concern.

But for the grace of my landlord who allows me to continue living in my rent-controlled apartment, I am managing financially to work at a non-profit and reside in San Francisco (the most expensive rental market in the nation where the median monthly rent for a one-bedroom is $3,590; and landlords have been reported to raise rents more than fourfold in units not subject to rent control).  During my stint in affordable senior housing, female residents who were retired social workers expressed the irony of how they found themselves income-qualified to live in the same housing as their clients who had mental illnesses, substance abuse and/or were formerly homeless--with all the drama of adapting to community living.  Would I have a similar fate (and loss of professional boundaries)?

All women panelists from the non-profit sector at this month’s OWL meeting focused on Women & Money offered some survival strategies:

• Lori Nairne, RN at Kaiser Permanente, talked about the feminization of poverty and campaign of Global Women’s Strike for recognition and payment for all caregiving work by investing in caring, not killing (military). 
• Lea Salem, Director of Finance at Northern California Community Loan Fund, spoke on investing conscientiously in socially responsible loans that support non-profits and social enterprises.
• Rebecca Paul, attorney at Jewish Family and Children’s Services, discussed fiduciary services (power of attorney for finances, conservatorship, trustee, administrator of estate, representative payee).

I contemplated my first foray into non-profit employment was probably many years ago at a bank's personal trust department administering probate, conservatorship and other fiduciary accounts for high net worth individuals. As a result of the bank's real estate loan losses, the bank was unprofitable and laid-off one-third of the department. A few months after I was laid-off (and already employed elsewhere), I was invited to return to my old position due to deaths that generated more probate work.  I decided then that it was too morbid to have a career profiting off people dying. 

Where to age in place

As we age, we grow more different from one another so there’s a diversity of opinion as to where we wish to age in place, so long as there is R-E-S-P-E-C-T for elders and their differences.  

Architect Susanne Stadler of At Home With Growing Older hosted Redefining Mobility to Ensure Social Inclusion at IDEO’s San Francisco office.  In her introduction to the salon’s theme, she noted that allowing people to “age in place” only works if they can continue to participate in public life.  She challenged us to brainstorm what qualities of public spaces invite all? 

IDEO’s own Gretchen Addi moderated the interdisciplinary and intergenerational panel of designers/planners and expert users to explore: What does it take for an older adult with mobility, vision, hearing or cognitive impairments to participate in life outside the home?

• Richard Weiner, transportation designer at Nelson Nygaard, shared strategies for improving senior mobility: work with transit agencies to educate ineligible applicants; work with DMVs when people lose licenses to educate about range of options; develop win-win cost sharing arrangements; identify subset of seniors who are not benefiting from ADA—lobby for customized services.
• Dan Gillette, research specialist/product designer at CITRIS, UC Berkeley, talked about co-design and transforming car-centric culture in favor of navigating a human path through community connections (neighborhood, condo) and transportation (shuttle bus stops, BART elevator signage, trip planning apps).
• Jarmin Yeh, a doctoral sociology student at UCSF, talked about redefining mobility to ensure social inclusion instead of mainstreaming.
• Dr. June Fisher and Barbara Beskind, UCSF professor and IDEO designer respectively who are both expert users, talked about their positive experiences riding CalTrain because of the courteous conductors.

Barbara Beskind’s suggestion, at last year’s Aging and Technology conference, for an app to translate language to facilitate communication with non-native English language caregivers is now reality with the launch of Ladon, a platform to crowdsource interpreters to promote language access.

Ladon was designed by Anh-Thu Ho, a UC Berkeley student who provided Vietnamese interpretation services through Volunteer Health Interpreters Organization (VHIO), for residents at my Oakland senior housing site, which was like Tower of Babel.  It was awesome to have VHIO provide simultaneous interpretations to facilitate language access for community building among residents who were monolingual in six languages other than English, while contributing to an intergenerational experience!  

Pedestrian safety

Essential to aging/living in place is avoiding premature death.  WalkScore ranked San Francisco as the 2nd most walkable city because most errands can be accomplished by foot; however, pedestrians can risk their lives sharing public space with vehicles.  Though San Francisco adopted Vision Zero in 2014, with the ambitious goal to eliminate all traffic deaths by 2024, pedestrian deaths have not declined.  

Lurilla Harris with ubiquitous eyeglasses and cap, dressed in yellow sweater, while seated in back center of table during SDA Leadership Training more than three years ago 

86-year-old Lurilla Harris would have been amused by earlier reports of her untimely death describing her as a woman in her 50s, but not by the circumstances of her death by a Paratransit driver who drove over her body after dropping her off late to this month’s SDA meeting.  I miss her tremendously as we often showed up at the same gatherings where our minds could be stimulated, and she would greet me, “We can’t go on meeting like this—people will gossip about us!”  I believe Lurilla’s death was preventable. 

Took an afternoon of personal leave from work to attend Safe Streets for Seniors and People with Disabilities Town Hall Meeting with a focus on pedestrian safety, at George W. Davis Senior Center in Bayview, where I have at least one homebound client residing in the new senior housing that opened this month.  In my work visiting homebound seniors in the predominantly residential southeastern part of the City (Bayview-Hunters Point, Excelsior, Ingleside, Portola and Visitacion Valley), I am required to drive a vehicle and assumed the lack of pedestrians was due to the lack of commercial corridors and public transit options (perhaps related to area’s reputation for crime and poverty?)… but perhaps residents are staying home to avoid vehicle traffic for safety reasons?  At the end of home visits, my clients often repeat, "God bless you! God bless you!" Yes, I drive safely...

SDA’s Pi Ra (who facilitated Transit Justice advocacy training two years ago in the pedestrian and commercial-rich Mission District) and Lighthouse for the Blind’s Beth Berenson hosted this meeting with Bayview seniors, who presented pedestrian safety concerns and recommendations.  Their concerns included:

• Vehicles encroaching into crosswalk on red traffic light
• Vehicles not yielding to pedestrians when making a left or right turn
• Not enough pedestrian crossing time
• Vehicle speed
• Vehicles running red/yellow light
• Poor maintenance of streets and sidewalks
• Street refuge islands too narrow

SF Municipal Transportation Agency Board member Cristina Rubke and Transportation Planner Anh Nguyen were present to hear recommendations of Bayview seniors:

• For enforcement: greater presence of SF Police Department’s Traffic Company; more periodic enforcement of all modes of travel; pedestrian crosswalk stings
• For engineering: corner bulb outs; widen refuge islands; lengthen crossing times by lengthening traffic cycle; installing advance pedestrian crossing; better maintenance of sidewalk & street facilities
• For education: traffic & pedestrian lights; better distribution of videos 

Recommendations favored co-existence rather than banning vehicles (like Golden Gate Park’s car-free Sundays—similar to Sunday Streets, or Twin Peaks Boulevard pilot program banning vehicles so pedestrians and cyclists can enjoy panoramic views).

Cultural humility

MOWSF Social Work Director Robin Meese-Cruz introduced Rochelle Towers, who presented LGBT Cultural Humility Training, and Openhouse Program Director Michelle Alcedo.  Rochelle talked about the unique conditions of LGBT seniors: more likely to be childless, single, living alone; higher rates of poverty, suicide ideation and PTSD due to a legacy of past discrimination.  The idea of cultural humility is to avoid making assumptions that may perpetuate stereotypes and discrimination, in favor of an ongoing process of engaging (by asking, actively listening to) people who experts of their own lives.  She shared the following best practices to create an inclusive, respectful and safe environment for LGBT seniors:

• explicit nondiscrimination policy in intake materials that includes sexual orientation & gender identity; LGBT-friendly language, images, resources, programming, staff & leadership
• allow individuals to identify themselves across the spectrum (e.g., transgender, in addition to binary male or female) & ask how they wish to be addressed in their chosen language
• maintain privacy & confidentiality

Cultural diversity

In honor of the 110th Anniversary of Japantown in San Francisco's Western Addition, Kokoro Assisted Living for Seniors hosted an Open House.

Kokoro Executive Director Kirk Miyake gave tour of studio that rents for $2,178-$5,959 per month, depending on level of care needed to assist with activities of daily living; monthly fee includes resident services (Japanese & Western meals, care staff, housekeeping, recreational activities, etc.). Studio resembled SRO unit with private bath, mini-refrigerator and microwave. 

Inside former synagogue’s Ohabai Shalome Temple is dining room with sushi bar and performance by koto player Tamie Koyooenga.  Kokoro offers a Japanese cultural setting to its 61 residents, which include five Chinese, one White and the remainder are Japanese.

Eat a rainbow of colors! Sushi prepared by Kokoro Chef Taka Nagamine.

Legacy: film + scholarship

Legacy (noun)

1: a gift by will especially of money or other personal property

2: something transmitted by or received from an ancestor or predecessor or from the past <the legacy of the ancient philosophers>

http://www.merriam-webster.com/dictionary/legacy

Legacy film festival:  Silver tsunami on silver screen

As a gerontology geek, my favorite films are about aging: the 7 Up series, whose subjects are now 56 Up, and Before Sunrise/Before Sunset/Before Midnight series. 

With its August 2012 issue, The Gerontologist journal launched its “On Film and Digital Media Section,” showcasing releases focused on aging and instantly became a favorite.  In San Francisco, it’s easy to catch popular features like Amour, Hope Springs, The Best Exotic Marigold Hotel, and Trouble with the Curve.  But it seems more challenging to access film shorts or documentaries about aging, especially ones made outside the U.S.  

 

Fortunately, Sheila Malkind, who has worked in the aging field for over 40 years, organized the Legacy Film Festival on Aging, now in its third year, at SFSU’s Coppola Theatre! Though on summer break after completing my spring semester finals just two weeks earlier, I returned to campus to volunteer (including taking event photos posted here).  The film fest was a wonderful opportunity to connect with like-minded folks about issues surrounding aging during refreshment breaks following each screening’s Q&A session.   

SF Commission on Aging President Edna James (also SFSU MA Gerontology alumna) and NEXT Village Executive Director Jacqueline Zimmer Jones at Opening Night!  Edna teaches weekly health classes at I.T. Bookman Community Center through Nia/Ujima Wellness Nursing Center, sponsored by OMI (Oceanview-Merced Heights-Ingleside) Community Action Organization, which aims to reduce health disparities (specifically in hypertension/stroke, heart disease, diabetes and obesity) among African-Americans in the OMI Community, and to empower people to take ownership of their personal and community health by promoting health literacy. 

Opening Night’s Housing Choices as We Age featured three documentaries.  Silver Age looked at aging in India, Japan (intergenerational “senior homes” that allow family and friends to live together, with “volunteers” subsidized by the government) and Tunisia (caring for one’s parents obligatory since 1994 law, and state cares for old without family).  Being Old and Active (Oud Actief) looked at the Dutch system where one is “free to choose how to grow old” – with its walk-in daycare centers and communal living based on common culture and language for its immigrant elders.  Academy Award nominee for best documentary Kings Point followed a group of seniors who had run away from the “danger and cold winters” of New York in the 1970s to move to Florida’s Kings Point retirement resort; who knew that they’d live so long and miss their children/grandchildren, and how fear of loss might lead to self-preservation so “no one gets close” (“I buried one wife, I don’t want to bury another”).   

Q&A with Legacy Executive Director Sheila Malkind (moderator), Kings Point director Sari Gilman, SF Village Director Kate Hoepke, Netherlands consul Thijs Boekhoff, and Living Well Assisted Living at Home President/CEO Doris Bersing.

As we consider where and how we wish to age, I wondered about the outsourcing of aging, like Sonny’s description of The Best Exotic Marigold Hotel:  “a home for the elderly so wonderful they will refuse to die.”  Doris noted there is no “one size fits all” and a foreign environment would not work, pointing out the recent NY Times article about depression linked to isolation and Alzheimer's disease (http://newoldage.blogs.nytimes.com/2013/05/01/does-depression-contribute-to-dementia/), so moving to Florida without friends and roots would not work if one does not “belong” to a community.

Sari said her father called watching her Kings Point film “relentlessly anxiety-producing,” noting that Americans value independence more by choice, as it’s a badge of pride not to live with parents, who likewise never want to make children take care of them, so there’s a tug to be self-reliant and need other people – how about being interdependent?

After Opening Night, I was hooked.  As a nature lover, I didn’t think I could spend my weekend daytime hours inside a dark theater but the film-watching and ensuing discussions were so enlightening! Some highlights from this year’s 25 thought-provoking films and lively Q&A after each screening:

Slomo filmmaker Josh Izenberg’s father attended medical school with John Kitchin, a neurologist who developed prosopagnosia (face blindness), which prompted him to quit his job (at age 55) to “do what you want now” – living in the Zone (“I am”) while skating slow-motion on Pacific Beach boardwalk!

After a screening of Grasping the Bird’s Tail, about adapting tai chi to one’s physical limitations, we joined SFSU instructor Patrick Ryan for tai chi, which is about connection so we are not alone in the world. 

Kaziah, The Goat Woman filmmaker Kathleen Dolan is developing her documentary into a feature film of this goat rancher who survived polygamy and has painted portraits of over 1,000 fallen soldiers as gifts to their families.  

Gardening friend Pia and classmate Liz enjoy refreshments during break. 

Legacy board member Amy Hittner and classmate Koko at ticket table outside Coppola Theatre.

Sheila introduces The Sum Total of Our Memory director Barbara Klutinis and geriatric social worker Edith Kaplan.  When Barbara’s husband was diagnosed with Alzheimer’s, they joined a support group with three married couples who are featured in this documentary.  Barbara plans to expand her documentary to include experts who can explain the disease and behaviors. 

When it comes to aging, I prefer documentaries as few dramas seem to get the aging process right . . . (like I also have a tendency to critique cooking shows when I see food safety violations like not wearing hair restraints while preparing food).  I suppose I should mention the other Academy Award nominee for best action short, Henry, which Edith found too melodramatic and not medically accurate.  The film began from Henry’s perspective, referring to his wife Maria in the present tense – until we later learn that she died a year ago.  His character seemed so sweet and romantic, unlike the “women mourn, men replace” pattern.  It’s refreshing to see a man actually pine over a relationship loss, especially with the flashbacks showing the couple’s early years. At one point, Henry asks, “Have I been a good man?” which I thought was like the sum total of one’s life.  But I didn’t agree with the film’s ending quote about “the worst thing about old age is an old man losing his memory.”  Instead, after living a full and long life, I would expect that people would need to be more selective about what they choose to remember.  It’s like Botany of Desire’s marijuana chapter—it’s not so great to actually remember everything, like pain or post-traumatic stress disorder, so some memory loss might be beneficial for our survival.  Forgetting the past keeps us in the present so it's almost zen-like? But I’m already looking forward to the future, like the 4^th annual Legacy Film Festival on Aging next year!

Legacy scholarship: Shout out to PG&E employees!

Talk about films, I had my Academy Award winner Sally Field (now 66 years old) “You like me, you really like me!” moment when PG&E Legacy Employee Resource Group notified me that I was a recipient of its scholarship awarded to “individuals who support senior citizens in the communities we serve.”  Since then, I have not looked at my utility bill the same way again J.

The scholarship announcement stated “one or more deserving working adults or students will receive a scholarship of $1,000 to $2,000.”  My scholarship award was actually a larger amount to cover my final year of graduate gerontology studies at SFSU, which really exceeded my expectations! According to Scholarship Committee Chair Alva Svoboda, there were 48 applicants for 11 awardees – 10 females and 1 male, similar ratio at SFSU gerontology program.

Wow, I was so impressed by the generosity of financial support plus the lovely celebratory banquet, where I brought along my two extraordinary RD mentors--Lisa Yamashiro, Nutrition Program Coordinator at City College of San Francisco, and Linda Lau, Nutritionist at Department of Aging and Adult Services--who wrote letters of recommendation and remain truly inspiring role models of professionalism, expertise, collaborative spirit, kindness, compassion and cultural sensitivity, to make our City an amazingly inclusive place for everyone to age in community with nourishing food! 

The Scholarship Awards Ceremony, "Common Passion, Diverse Focus," combined Legacy with NuEnergy Employee Resource Groups (pictured above are Patrick Tan of NuEnergy and Susan Randall-Nelson of Legacy) for a total of 15 scholarship recipients.  The ceremony began with a safety message – “duck, cover, hold” in the event of an earthquake, followed by a show of hands who were CPR-trained.  My mentors and I shared a table with two CPR-trained PG&E employees, including recently retired Beth who explained that employees were involved in scholarship fundraising (including bake sales!) throughout the year because supporting students committed to working with seniors is in their best interests as they'll all be seniors soon!

We were told to limit acceptance speeches to one minute, so I managed to thank Alva (pictured above) and Legacy Scholarship Committee, my guests Linda and Lisa for their inspiring mentorship in senior nutrition and health promotion, and my family who modeled intergenerational living where seniors really rocked!  

In the morning prior to the scholarship banquet, I was at UCSF Neurosciences to get my brain scan as part of the non-depressed group study (mentioned in my April posting).  Above are views of my brain top and left brain—looking quite happy in anticipation of the evening’s event meeting wonderful PG&E Legacy Scholarship Committee members (thanks Alva, Marlene, Susan, Karla, etc.!), my totally inspiring mentors (thanks Linda and Lisa!) and new colleagues (hello Fairley from Openhouse and Isabel from California Pan-Ethnic Health Network)!