Slow space

In the heartwarming documentary, Won’t You Be My Neighbor?, we learn that young Mister Fred McFeely Rogers (1928-2003) was sometimes “quarantined in bed” due to childhood diseases, including asthma and scarlet fever.  While homebound, he created his own make-believe neighborhood – the foundation for his fearless public TV show, Mister Rogers’ Neighborhood (1968-2001), an alternative to the prevailing slapstick cartoons and his form of evangelism ("love your neighbor as yourself") after he trained and ordained as a Presbyterian minister.  We also learn about Mister Rogers’ quiet power of “slow space”—the value of silence for reflection and “time to explore the deeper levels of who we are, and who we can become.” 

“…the space and time to be liked exactly as you are feels like the most precious gift imaginable. The tranquil rhythms of Won’t You Be My Neighbor? remind us how simple the job of being a good friend, a good parent, or a good citizen can be: You offer up your heart, your patience, and your silence, and make some room for whatever your neighbor might bring.” –- Heather Havrilesky, “Why Did We Ever Leave Mister Rogers’ Neighborhood?” New York Magazine (May 28, 2018) 

When older adults reside in age-segregated facilities, their world of connections can get smaller… especially as peers die.  It’s hard for residents to share slow space with staff who are too busy checking off their daily tasks.  Moving into assisted living/skilled nursing facilities really means joining a disability community, as one 80-year-old resident told me that she felt she had “aged ten years” because she was surrounded by so many residents with multiple impairments, navigating the traffic jams of walkers/wheelchairs and especially discouraged by a resident she befriended only to miss her due to her friend’s frequent hospital stays.  Residents also complain that their children are “too selfish, self-absorbed, and busy with their own lives” to contact them.  Isolation and loneliness can compound due to stigma of ageism and ableism, as I have encountered people outside of facilities who “do not wish to go there” when I extend invitations to visit facilities.

I’ve been indulging in slow space …in life review with older adults, while incorporating Mister Rogers’ kindness, openness ("feelings are mention-able and manage-able") and unconditional positive regard (“Those who try to make you feel less than you are is the greatest evil” and “No person in the whole world is just like you, and I like you just the way you are”) … much needed, given longer and more complex lives.  I also love the company of fellow introverts and models of civility and humility, PBS TV personality Fred Rogers and Supreme Court Justice Ruth Bader Ginsburg, who are subjects of my two favorite films this year, Won’t You Be My Neighbor? (95 minutes) and RBG (98 minutes, plus DVD extras).  I admire RBG's gender equality advocacy and Olmstead decision; wish her complete recovery from lung surgery, as 85-year-old RBG expects to serve at least 5 more years on the Supreme Court!

Last month, I managed to be a shut-in for a week to avoid outside air pollution from the deadly Camp Fire (160 miles northwest of San Francisco).  Even after the rains washed out the smokey air, my allergies were severe enough that one facility resident told me that my sniffling made her “nervous” and then suggested that I get a nose operation, like she did, to clear my nasal passages.  Like Rudolph the Red-Nosed Reindeer, I did not get a nose job! Instead, I ended up taking antihistamines (children’s dosage) for the first time in my life …

One side effect of taking antihistamines is drowsiness, which is safer experienced as a shut-in, especially avoiding traffic during winter holiday season.  Also perfect for winter with longer periods of darkness, I welcomed slowing down and sleep, particularly sleeping on the side, which may be necessary to clean the brain of toxins.  Researchers are studying the theory that sleep is necessary to clean the brain of toxins, as this failure may lead to build-up of damaged proteins in the brain that are associated with loss of brain cells in conditions such as Alzheimer’s and Parkinson’s diseases.  

Anyway, as a sleepy shut-in, I stayed wide awake watching Miri Navasky’s Frontline documentary, Living Old: The Modern Realities of Aging in America (2006), featuring the old-old (age 85+), our fastest growing segment of the population, who often have chronic conditions that require long-term care—60% of people who live past 85 will go into a nursing home, and if they stay past 6 months, they may never leave.  Documentary was made 12 years ago, but relevant take-aways:

·     “When you're young, you want to live forever, ...but many people don't want to live forever when they're old,” said William Coch, MD, family practitioner in a rural New York community with a large older adult population.

·    “Someone with three or more daughters or daughters-in-law has a better-than-even chance of not ending up in a nursing home or institution,” according to Leon Kass, MD, Chair of President’s Council on Bioethics which issued the landmark report, Taking Care: Ethical Caregiving in Our Aging Society (September 2005). 

·     David Muller, MD, co-founder of Mount Sinai’s Visiting Doctors, made a house call to retired physician Henry Janowitz, a widower with two daughters who live too far away to be involved in his daily care, so he spends $150,000 a year (over $187,000 adjusted for inflation in 2018) for 24-hour help to remain at home! (Incidentally, as Chief of Gastroenterology at Mount Sinai, Dr. Janowitz trained over 100 gastroenterologists, so he was able to boast that he could get sick in any major town in the U.S., as long as it is a digestive problem, and be treated by one of his students!) 

To age in place when you require long-term care, you need social capital (ready, willing and able family members nearby) and/or financial capital (to pay the cost of care). Then when you move to assisted living or skilled nursing facility, it still pays to have social capital for monitoring care (get chummy with your local long-term care ombudsman!) and providing companionship. 

Filmmaker Miri Navasky dedicated the documentary to her grandmother, Estelle Strongin (1911-2006), who was featured as a 94-year-old stockbroker, working every day until she died of heart failure three months after filming.  May her memory be a blessing.

On a cheerier note, I volunteered at the 26^th annual Kung Pao Kosher Comedy (KPKC), which sold-out all 6 shows (370 seats each) during its 3-night run at New Asia Restaurant.  (Mixed feelings about City of San Francisco’s plan to convert Chinatown’s largest banquet hall into affordable housing.)  KPKC founder Lisa Geduldig and Volunteer Coordinator Dana Miller started the show with raffle drawings.  

Set American-Chinese menu featured 6 courses (on rectangular table for volunteers v. round tables for ticketed guests): Lisa G’s Intergalactically-Famous Kosher (blessed by very reform rabbi) Walnut Prawns, Kung Pao Chicken, Grandma Lillie’s Braised Tofu and Broccoli in Garlic Sauce, Mixed Vegetable Chow Mein a la Boca Raton, Barbra Streisand’s Famous Green Beans in Hoisin Sauce, Arline Geduldig’s World-Renowned Sweet & Sour Rock Cod Filet) plus Steamed White Rice and Fortune Cookies with Yiddish proverbs.  Volunteering at KPKC has been my tradition since 2015 when Legal Assistance to the Elderly was a beneficiary, as ticket sales cover Charity + Chinese Food + Comedy!

Lisa talked about starting KPKC at age 31 with a sold-out dinner show at 6 pm, next year she added cocktail show at 9:30 pm, but now shows start an hour earlier so the late show is now 8:30 pm.  Noticed Lisa’s trademark gray streak of hair framing her face now blends in with the rest of her graying hair, so not sure about status of her film project, Is That Natural or Did You Dye It?  Seque into Lisa’s more amusing observations about the aging experience:

·     forgetting so she has breadcrumbs all over her home to help find her way

·     finding herself eligible for senior discounts when she turned age 55, though Ross Dress for Less prematurely applied 10% senior discount when she was only 54.5 years old

·     thinking it was Take Your Daughter to Work Day when she went in for a medical procedure to see someone who could be her daughter treating her

·     finally pot is legal, but instead of getting high, she uses it to treat back pain (according to The New York Times’ Older Americans are flocking to medical marijuana, 33 states and the District of Columbia have legalized medical marijuana, along with 10 states that also have legalized recreational use)

Lisa’s 33-minute documentary, Esther and Me (2010), about her friendship with octogenerian Esther Weintraub, former model and stand-up/sit-down comic resident at Jewish Home of San Francisco, is now available for viewing online at http://www.cultureunplugged.com/storyteller/Lisa_Geduldig#/myFilms

Joseph Nguyen was born to a Vietnamese father and a Jewish mother who set-up a one-stop shop where they filed nails and taxes! He wondered why people are proud just because they are born with a race or place—“like, instead of being proud to be Korean, it would be more impressive born a turtle and then you become Korean.”

When Carol Leifer took the stage, she announced her age 62 to applause.  She compared her old-timey name like Carol to today’s popular names like Hannah, Zelda and Sophie—“sounding like an entry list to Ellis Island all over.”  Then she told how she got into trouble with another old-timey name like Richard, which is nicknamed “Dick,” but someone accused her of calling him “a dick.”  She thought WikiLeaks was the name of a new pad.  Carol does not workout because her philosophy is no pain, no pain. 

Carol is author of When You Lie About Your Age, the Terrorists Win (2010), which is best read in her Long Island accent.  The title of her book comes from realizing that lying about her age was a no-go if she couldn’t share her greatest memory to date happened when she saw the Beatles in a live concert at Shea Stadium in the summer of 1966; invariably, people would ask, “How old are you?”  In “Shea Stadium and Its Effect on the Aging Process,” Carol reasoned, “when you deny your age, you deny yourself … be who you are—memories and all.”  She gloats over the realization that aging is the great equalizer (or “old age is the revenge of the ugly ones”), so pretty girls who relied on their looks are “seriously having a hard time now… When you don’t turn heads anymore and yours still just bobbles? Kinda sucks, when you made sure to hit all those beauty appointments, but never once stopped at a library. Geez, having a conversation is hard!”

Well, I never relied on my looks and libraries are my favorite hangout! I love the San Francisco Main Library's current exhibit, Visual Poetry: A Lyrical Twist.  While I missed the opening event last month while homebound, SF Public Library recorded the event, which included readings by 85-year-old poet Jack Hirschman: “One day I’m gonna give up writing and just paint! … I’m gonna give up sitting and just breathe! I’m gonna give up breathing and just die! I’m gonna give up dying and just love! I’m gonna give up loving and just write!"  

Reimagine End of Life

Reimagine End of Life (EOL) https://www.letsreimagine.org/ was a weeklong event that “envisions a world in which we are all able to reflect on why we’re here, prepare for a time when we won’t be, and live fully right up until the end.”

Conference founder Brad Wolfe said inspiration to create Reimagine event came from his grandparents’ experience of surviving Auschwitz: “What is so precious about life that, in the face of death, we are inspired to fight for more time?” Partnering with the San Francisco Palliative Care Workgroup, Reimagine offered 150 events that looked at EOL from perspectives of healthcare + social services, arts + entertainment, design + innovation, culture + spirituality.

Psychedelics and Death: New Science, New Understandings was a conversation between Temple Emanu-El Rabbi Sydney Mintz (who said Judaism does death well) and Richard Miller, PhD, clinical psychologist and author of Psychedelic Medicine: The Healing Powers of LSD, MDMA, Psilocybin, and Ayahuasca (2017).  Richard said psychedelics help at EOL to remove cultural fear from death experience; he talked about LSD opening the mind to realization that the world is one breathing organism, all beings are connected, death is sleep without dreaming; his tombstone would state date of birth to blank date of death because “who’s to say”? 

End of Life Project: A Theatrical Exploration of Death, Dying and Suffering was sold-out at Castro Theatre, filled to over 900 people. 

Dramatic readings of scenes from Sophocles’ Philoctetes and The Women of Trachis by David Strathairn, Frances McDormand and Marjolaine Goldsmith.  In both plays, there was a lot of screaming at the audience by actors portraying patients suffering in pain. 

Community Conversation moderated by Bryan Doerries, founder of Theater of War, and featured panelists Eric Poche (Zen Hospice Project), Anne Germanacos (writer and “amateur student of death”), Steve Weitz (JFCS Palliative Care volunteer) and Bonnie Lasky (caregiver for her dying husband).  What kind of EOL experience do we want?

One audience member talked about a dying loved one “covered up with meds” such that the person was no longer there, not awake when death happened.  Is it worse to hear dying people scream in pain or be complicit to silence when dying people can no longer express themselves?

At the end of each Reimagine event, participants received a box of cards inviting us to:

1.   Remember: (fill-in-name) who inspires me to (fill-in-blank).  Included were cards with photos of public figures and their quotes:  “Try to be a rainbow in someone’s cloud” by Maya Angelou (writer and first African-American female cable car conductor), “You gotta give room for people to experiment” by Mayor Ed Lee (who was also an organ donor),  and “You need music, I don’t know why” by Jerry Garcia (Grateful Dead guitarist). 

2.   Prepare: (fill-in-name) is a person I can imagine talking to about helping me carry out my end of life wishes.  Speak up about the things that are important to you (advance health care directive), help family and friends be your advocate (durable medical power of attorney), and for what you want to leave behind (will, after gifting).

3.   Wonder: (fill-in-blank) when I think about end of life. Questions to ponder:  where would you have your last meal? What would it be? Where do you want your remains to go after you die? If you could leave one piece of advice for the next generation, what would it be? What would you do differently if you knew that this was your last day? Year? Who would you spend time with? What would be important to say? Do you think life would be better if we could live forever?  

At Yom HaShoah (Holocaust Remembrance Day on April 11) event, Gloria Hollander Lyon spoke about surviving seven concentration camps during the Holocaust and engaging in Tikkun Olam (repairing or healing the world) by bearing witness and speaking out against prejudice, discrimination and threats to civil liberties.  Six candles (representing 6 million Jews killed) were lit by Holocaust survivors, followed by music (“Eli Eli” sung by Jan Peerce and “Avinu Malkeinu” sung by Barbra Streisand) before a screening of Gloria’s documentary, “When I Was 14: A Survivor Remembers."  For the past 40 years, Gloria has dedicated herself to teaching the lessons of the Holocaust and published her memoir, Mommy, What’s That Number on Your Arm? A-6374. (I attended Gloria’s book release reception nearly 18 months ago, and now it was a privilege to work with her in organizing this moving remembrance program.)

At JCCSF’s 12^th Annual JCCSF Art of Aging Gracefully Resource Fair, Donald Abrams, MD, integrative oncologist at UCSF repeated Cannabis as Medicine presentation, including its use during end of life. 

“Cannabis — also known as marijuana — increases the desire for food, makes foods smell better and taste richer, decreases pain and relaxes and elevates a person’s mood. Subsequent studies have confirmed these effects, in addition to cannabis’ effectiveness in reducing nausea and vomiting.

Patients at the end of their lives can have problems with appetite, nausea, pain, anxiety and sadness…

I see cannabis as an extraordinarily safe drug to be given if needed at the end of life.” –John Morley, MD, “Senior Focus: Should marijuana be legalized for end of life care?” St. Louis Post-Dispatch (Oct. 10, 2013)  

In her new book, Natural Causes: An Epidemic of Wellness, the Certainty of Dying, and Killing Ourselves to Live Longer (2018), 76-year-old Barbara Ehrenreich (a cancer survivor) writes that she’s given up on preventative care after realizing that she’s “old enough to die” (sounding almost like Ezekiel Emanuel’s “Why I Hope to Die at 75,” article published in The Atlantic almost four years ago):

“Once I realized I was old enough to die, I decided that I was also old enough not to incur any more suffering, annoyance, or boredom in the pursuit of a longer life. I eat well, meaning I choose foods that taste good and that will stave off hunger for as long as possible, like protein, fiber, and fats. I exercise—not because it will make me live longer but because it feels good when I do. As for medical care: I will seek help for an urgent problem, but I am no longer interested in looking for problems that remain undetectable to me. Ideally, the determination of when one is old enough to die should be a personal decision, based on a judgment of the likely benefits, if any, of medical care and—just as important at a certain age—how we choose to spend the time that remains to us.”—Barbara Ehrenreich, “Why I’m Giving Up on Preventative Care: How Contemporary American Medicine is Testing Us to Death,” Literary Hub (April 9, 2018) 

A recent Stanford University study, published in the Journal of Palliative Medicine, suggests an EOL approach to facilitate better “preference-sensitive” care and informed decision-making is for patients to share their bucket lists with physicians who can discuss the impact (if any) of their medical treatments on their life goals.  Researchers hope their findings will promote more intimate discussions that focus on what patients want to make the most out of life, rather than over-reliance on advance directives that focus on death (though patients should still complete/update their advance directives).  According to VJ Periyakoil, study author and director at Stanford Palliative Care Education and Training Program, regret is the most common emotion seen in patients when they are dying.  She also noted that participants who said religion/spirituality was important were the most likely to have a bucket list, which suggests that faith allows “the ability to imagine something is a proxy for a level of hope even in the face of little evidence.”

Money magazine reported, “A Growing Cult of Millennials Is Obsessed With Early Retirement. This 72-Year-Old is Their Unlikely Inspiration” (April 17, 2018), referring to Vicki Robin, co-author of Your Money, or Your Life (YMoYL). (When I read YMoYL originally published in 1992, it inspired me to maintain my simplified lifestyle and reject consumerism because money=life energy; YMoYL has been revised to emphasize financial interdependence, such as a community building to share resources and support.)  Apparently, millennials are focused on “Financial Independence, Retire Early (FIRE) with more emphasis on the goal of FI than what to do for the rest of their retirement lives before they die?! When older adults retire at age 70, the “biggest challenge is to make your life as meaningful as it was when you were working,” according to Dr. David B. Reuben, Chief of Geriatrics Medicine at UCLA.  Towards the end of life, we may think even more about making a contribution to society based on Erik Erikson's theory. 

Live from Age-Friendly San Francisco

Livestreaming has the potential to make the world more accessible, especially for homebound people.  Starting with the Great American Solar Eclipse last summer, I’ve organized a few livestreaming watch parties in an older adult residential community.  Last month’s Power to Change symposium included closed captioning and the ability to ask real-time questions.  Then earlier this month, I organized a watch party of Supreme Court Justice Ruth Bader Ginsburg (author of 1999 Olmstead decision) being interviewed by Forward editor Jane Eisler, with ASL interpreter and questions submitted by viewers in advance. Each livestream came with technical audio-visual difficulties, along with complaints from mainly oldest-old (age 85+) residents who preferred face-to-face interactions than virtual learning.

As a lifelong learner and old soul myself, I reach out to local experts who can speak live from age-friendly San Francisco on a variety of topics that engage mature adults.   

Nostalgia for comfort food

Rachel Gross, Professor of American Jewish Studies at SFSU, presented a talk on Referendum on the Deli Menu: American Jewish Nostalgia and the Deli Revival about adapting traditional American Jewish comfort foods for the 21^st century, with an emphasis on sustainability and local sourcing.

Medical cannabis 

Donald Abrams, MD, Professor of Clinical Medicine at UCSF, presented a timely talk on Medical Cannabis. With the growing number of states legalizing cannabis for medical or recreational purposes, cannabis use among older Americans has increased significantly, despite a lack of biomedical, clinical, and public health research.  Cannabis remains illegal under federal law.  Because the Drug Enforcement Administration (DEA) has listed cannabis as a Schedule 1 drug (“high potential for abuse” and “no currently accepted medical use”) and has designated National Institute on Drug Abuse (NIDA)—part of National Institutes of Health (NIH)—as the sole source of cannabis for scientists, NIDA will not fund cannabis studies on its health benefits but only harm.  Yet, with funding from NIH, Dr. Abrams has conducted pioneering research on the safety and pain relief properties of cannabis for patients with AIDS and cancer.

Dr. Abrams suggested that cannabis-induced euphoria is not such a bad thing: “Is it really an ‘adverse experience,’ particularly in a terminal patient? Is a single treatment that increases appetite, decreases nausea and vomiting, relieves pain and improves sleep and mood, a potentially useful tool in oncology and palliative medicine?”  

During Dennis Peron Memorial Tour in Castro District (aka LGBT mecca), Green Guide Tours founder Stuart Watts showed a photo of himself with Castro resident Peron aka “Father of Medical Marijuana” who died last month at age 71. Peron advocated for medical cannabis, which helped his partner ill with AIDS ease pain and nausea. 

“Brownie Mary” Rathbun (1921-1999) met Peron at Café Flore in 1974.  Brownie Mary was an IHOP waitress, with a grandmotherly visage, who earned extra money baking and selling cannabis-laced brownies from her home.  Her customers were mostly gay men with AIDS, who found that cannabis helped them with wasting syndrome.  Later people donated cannabis to Brownie Mary, who then began baking more brownies and distributing them free to sick people.  She was arrested several times for possession of cannabis brownies.  Brownie Mary also volunteered at SF General Hospital’s AIDS ward, where Dr. Abrams worked as physician and became inspired to conduct the first study about the effects of cannabinoids in people with HIV. 

Thanks to the efforts of Peron and Brownie Mary, San Francisco passed Prop P, the nation’s first medical cannabis bill in 1991.  In the following year, they opened the San Francisco Cannabis Buyers Club, the first medical cannabis dispensary in the U.S.  In 1996, California became the first state to legalize medical cannabis with voter-approved Proposition 215. According to Peron, “Every cannabis user is a medical patient whether they know it or not.” 

Effective January 1, 2018, Proposition 64 (passed in 2016) allows licensed medical cannabis dispensaries in California to open their doors to recreational customers age 21+ who can purchase a limited amount (1 ounce) of cannabis without a current physician’s recommendation or medical marijuana identification card (MMIC, which can cost up to $100).  MMIC holders must be age 18+, may purchase higher quantities of cannabis, and do not have to pay sales and use taxes on their cannabis purchases. 

Social insurance

At Home With Growing Older hosted a forum on Social Security, Medicare and the Campaign against Entitlements, presented by Justice in Aging Executive Director Kevin Prindiville and UCSF Sociology Professor Emerita Carroll Estes, at SF Public Library.

Lifelong mothering

At Reinhardt Alumnae House, Mills College President Elizabeth Hillman and former College President Jan Holmgren hosted It Never Ends: Mothering Middle-Aged Daughters (2017) book reading and discussion with authors, Sandra Butler (age 79) and Nan Fink Gefen (76), who explored older women’s reflections on motherhood when daughters are in their 40s and 50s. 

Reverse Aging? 

Sutter Health Institute for Health and Healing hosted The Science of Healthy Aging with 51-year-old Sara Gottfried, MD, at Sherith Israel.  As one of the first 350 to register for this free event, I received a free copy of Gottfried’s book Younger: A Breakthrough Program to Reset Your Genes, Reverse Aging, and Turn Back the Clock 10 Years (2017).  As an old soul who aspires to greater maturity, I was almost repelled by the title of this anti-aging book and its overemphasis on a youthful physical appearance rather than health.

Creative Aging 

At Contemporary Jewish Museum, met up with SFSU Gerontology Professor and Program Chair Darlene Yee-Melichar to attend Creating A New Old San Francisco, a one-day “deep dive into contemporary aging” by Creative Aging International (CAI).  She stands between journalist Paul Kleyman and fellow Gerontology Professor Emiko Takagi.

Event included resource table and networking opportunities.  Connected with Caitlin Morgan of Institute on Aging and Hope Levy of City College of San Francisco’s Older Adults Program.

Dominic Campbell, CAI co-founder and Global Brain Health Institute (GBHI) Fellow, described this mini-fest of contemporary aging about conversation, connections and “joining the complex story in the middle.”

Session 1 Overview – Issues in Contemporary Aging: “Why? Everyone attending brings expertise. To avoid telling people what they already know while articulating what makes contemporary aging unique, we asked these speakers to share knowledge from their experience, so we might begin to think together.”

San Francisco Bay Area speakers seated from right to left in photo above, and presented in the following order:

•     Carroll Estes, PhD, of UCSF and Nicholas DiCarlo discussed concepts from their upcoming An Encyclopedia of Contemporary Aging (expected to be published by Routledge in late 2018/early 2019): inequality, power, resistance, abjection, trauma, destruction of the commons, right to self-development, intergenerational, interdependence, austerity, gentrification, watch-bitch v. watchdog.

•     Susan Hoffman, Director of Osher Lifelong Learning Institute (OLLI) at UC Berkeley, spoke about Radical Aging: BELIEF that we can all self-actualize, KNOW that there are obstacles and limitations, WISDOM and experience to expand possibilities; our roles (pioneers & activists; researchers & translators; poets & philosophers; inventors & designers; educators; artists & amateurs); 25% of OLLI members are age 80+, calling OLLI the “4^th Age Salon.”  She highlighted influences through the decades (1960s: Marian Diamond’s brain plasticity research, Free Speech activism, White House Conference on Aging; 1970s: gerontology programs, Gray Panthers, The Center for Independent Living, American Society on Aging, On Lok, California Arts Council; 1980s: Age Wave, SeniorNet, Genome Research Institute, Association for Cultural Equity; 1990s: Encore, Multimedia Gulch, UCSF Memory & Aging, Walter Bortz’s Dare to be 100, Xerox PARC; 2000s: Osher Lifelong Learning Institute, Stanford Center on Longevity, Village Movement, IDEO, Elizabeth Blackburn’s telomeres research; 2010s: Age-Friendly Cities, Aging 2.0, GBHI Fellows).  She said we need to transcend divisive generation labels because we are all perennials!

•     Gretchen Addi, Consultant and Designer-in-Residence at Aging 2.0, on Technology and Business – Insider Awareness: recalled Jetsons family in 1962 living in the future—"what we take for granted today was the science fiction of the previous generation”; mentioned superpowers, like IDEO colleague Barbara Beskind who is seeking to design glasses and earbud for facial recognition as adaptive technology for her macular degeneration; new technology can improve lives of people as we age; called for shift to design with (not for) older adults, about people (not age group), interdependence (not independence); keep older adults mobile, engaged, healthy, connected; accessibility to avoid risks of exclusion and isolation if not tech savvy, privacy and security concerns. 

•     Bruce Miller, MD, Director of UCSF Memory and Aging Center, on Challenges of Dementia: epidemic of age-related cognitive impairment, most costly health problem in U.S. that especially impacts poor; 70% preventable risk factors (cardiovascular disease, high cholesterol, lack of exercise, loneliness, isolation, depression, head trauma), 30% neurodegeneration by aggregate bad proteins.

Session 2 The San Franciscan View – Innovations at Home: “Why? Aging shrinks geography, all successes are, ultimately, local. Great innovations are happening. This celebration of SF projects already ‘creating a new old’ shares some of the innovation in this city.”  Choice of two breakout sessions:

Room 1 – Caring Systems – how we live where we live: “Cultures of caring community being nurtured in SF.”  This session was chaired by Tim Carpenter, founder of EngAGE, a 20-year-old nonprofit that builds and operates affordable senior and multigenerational apartment communities as “vibrant centers of learning, wellness, and creativity.” 

·     Jerry Brown, CEO of Bethany Center Senior Housing, talked about his affordable housing site’s collaboration with partners (OnLok PACE, IHSS, IOA, Openhouse, etc.) to provide a continuum of care to diverse elders representing 37 countries and 8 languages. Housed at Bethany Center and modeled after Mather LifeWays, Ruth’s Table is a multigenerational community center that provides art and wellness programs, integrating senior residents with visitors of all ages from the surrounding community. 

·     Kate Hoepke, Executive Director of San Francisco Village (SFV), talked about social networks diminishing as we get older and face marginalization; in response, the village grassroots movement began 12 years ago to create intentional communities that are intergenerational to dignify aging.  She noted the greatest barrier is reluctance to ask for help, yet one needs to ask to get help.

·     Karyn Skultety, Executive Director of Openhouse, introduced her organization as the 1^st LGBT-welcoming affordable senior housing, serving over 2,300 people not living in housing last year, and a resource for cultural humility training.

·     Rachel Lovett of Thriving in Place (advocacy for IHSS) and Re:Imagine (end-of-life exploration event on April 16-22, 2018).

Room 2 – Dignity and Empathy in Place: “Dignity and empathy as drivers of creativity, generations of innovation,” chaired by Rachel Main of Alzheimer’s Association.  (Photo only, attended session in Room 1 instead.)

·     Jessica McCracken – Ruth’s Table http://www.ruthstable.org/

·     Doniece Sandoval – LavaMae https://lavamae.org/

·     Jenn Chan – Senior Shower Project https://www.seniorshowerproject.com/

·     Cathy Davis – Bayview Senior Services https://bhpmss.org

·     Adam Waskow – Memory Dog http://www.memorydog.org/team

Vegetarian box lunch prepared on-site by Wise Sons Jewish Deli 

JCCSF Adult Programs Manager Shiva Schulz and Hope Levy

Session 3A – Creative Practice as Strategy – Examples from national and international understanding of creative practice leading change.

·     Anne Basting, Professor of Theater at University of Wisconsin-Milwaukee, and Founder, CEO of TimeSlips Creative Storytelling, asked us to text someone: "what gives you a feeling of awe?" She mentioned 3 sources of awe: nature, art and spirituality.  We can facilitate awe through creative engagement: Yes, and (inviting and affirming choices through play/improv); Beautiful Questions (open shared path of discovery); Proof of Listening (radical affirmation of choices); Rigor/Value (frame in context with social capital); Connect (individual and communal purpose)

·       Arti Prashar, Artistic Director/CEO of Spare Tyre in London, promotes collaborative participatory art with hard-to-reach people (age 60+, people with dementia/learning disabilities, women who have experienced violence).  This can be done using gardens as non-verbal theater that engages in the present moment, invites in space of senses, adjusts to slower pace, elicits play and imagination.

·       Dominic Campbell, co-founder of CAI and director of Bealtaine Festival in Ireland, the world’s first (1996) nationwide arts festival celebrating creativity and aging.  He talked about Celebration as Strategy, and the need for fun festivals, with elements of individual choice (because life is about risk), empathy exchange, disruption (stereotype-smashing creative arts day club, Meet Me at the Albany) and connection.

In The Vintage Years: Finding Your Inner Artist (Writer, Musician, Artist) After Sixty (2013), author and retired SF Bay Area clinical psychologist Francine Toder, PhD, notes that later life is an exceptionally good time to study art because our mature brain has improved judgment, focus of attention, patterning, and bilaterality. Nearing age 70 as she approached retirement, she took up playing the cello and practices daily. 

Hope Levy and Darlene Yee-Melichar, holding Legacy Film Festival on Aging (LFFoA) program, meet-up with LFFoA Director Sheila Malkind.

Dance and Tai Chi with Greacian Goeke, Director of Impromptu No Tutu, and her Bay Area dance ensemble express themselves in improvisational movement outside CJM, after emergency alarm triggered temporary evacuation.

Session 3B - Creative Practice as Strategy - Evolving Innovation: Where, how and why.

·     Anne Basting of Timeslips talked about transforming long-term care with the collaboration of nursing home residents through The Penelope Project: An Arts-Based Odyssey to Change Eldercare (2016)  

·     Kate de Medeiros of Miami University co-authored with Basting The Gerontologist article, "'Shall I Compare Thee to a Dose of Donepezil?': Cultural Arts Interventions in Dementia Care Research" about the challenges of measuring interventions in dementia care based on subjective experience.

Variety Pack! a capella community choir from Oakland, with Artistic Director Lauren Carley.

Session 4 – Sustained Systemic Innovation: Planned sustained change session chaired by William Cleveland from Center for the Study of Art and Community (Bainbridge Island, WA), which builds arts partnerships.

·       Maura O’Malley and Ed Friedman, founders of Lifetime Arts in New York, provide technical assistance to support arts programming for older adults based on Gene Cohen’s creative aging research focused on mastery and social engagement.  Lifetime Arts is also a leader in library-based creative aging programs, partnering with American Library Association. 

·       Kelly Dearman, Chair of Aging & Disability Friendly Task Force in San Francisco, presented on the implementation of San Francisco’s Age and Disability Friendly Plan

·       Gavin Barlow and Annabel Turpin of Meet Me in Albany & Future Arts Centres in UK

·       Tim Carpenter – EngAGE 

Bay Area monologuist and GBHI Fellow Josh Kornbluth performed a piece from “Brain Improvs” based on his experiences with people with dementia, a disease characterized by loss of empathy.  His idea is to start a revolution through storytelling, which mirrors what people have gone through so distance is broken down for a “worldwide peaceful revolution of peaceful empathy.”  His show at The Marsh has been extended through the end of this year. 

Session 5 - Tools for Change: Moving towards deeper strategy.

·       Penelope Douglas of Culture Bank in San Francisco talked about how art helps us see the poor as communities with assets of value and opportunity for investment.

·       William Cleveland, Director at Center for the Study of Art and Community in Washington State, talked about Arts Based Community Development (ABCD) ecosystem to advance dignity, health, productivity

·       Teresa Bonner, Director of Aroha Philanthropies in Minneapolis, shared website of resources at https://www.vitalityarts.org/ to champion participatory arts education programs for older adults.  

Session 6 - What Next? A question to start and end with. When you determine the kind of old you want to be, you shape the world you want to grow older in. What’s your next step? Sharing thoughts from the room gathered over this one day – nurture and heal, inspire and mobilize, educate and inform, build and improve.

Community Music Choir Solera Singers of Mission Neighborhood Center sing songs in Spanish from Latin America.