Sunday, July 31, 2016

Shut-ins

In contrast to my mostly homebound senior clients, I’m usually out and about so I’ve often considered taking a 30-day challenge to live like a shut-in so I could experience life like my clients.  As an introvert, I am inspired by shut-in clients who engage in creative arts like writing and publishing poetry, painting and selling artworks online, composing and performing music, etc.     
The Shut-Ins perform at fundraiser for Legal Assistance to the Elderly (LAE).  
LAE staff attorneys – Judy Hitchcock (elder abuse prevention; also Spanish bilingual), Christine Lau (public benefits; also Cantonese bilingual), Tom Drohan (housing; also bass player with The Shut-Ins) – have been with LAE for about 25 years each!  Paralegal Christy Nieves brought age diversity (and Spanish bilingual skills) after Bessie (who joined LAE in 1980 shortly after its founding) retired last year.  
Volunteer receptionist Tom Tallman (sandwiched between friend Richard and LAE Director Howard Levy, in photo above) has been with LAE for more than 25 years! 
Howard presented long-time LAE volunteer paralegal Sandra Fenix (Portuguese bilingual) with Volunteer Award. 
Howard announced his retirement by year-end after 28 years as LAE’s Executive Director.  Howard’s legacy is his role in fostering employee and volunteer retention (aging in workplace!), which seems remarkable for a non-profit serving older adults in San Francisco.  (Staff retention also helped by union membership in National Organization of Legal Services Workers.) 
LAE Board (not bored) member and journalist Tim Redmond noted that 14% of eviction defense cases in San Francisco are represented by LAE, winning each case to promote aging in place!  Woo-hoo! 
Get up and dance to music of The Shut-Ins!


Mental health 
Department of Aging & Adult Services (DAAS) Education Coordinator Rick Appleby introduced presenters at DAAS Community Training on Mental Health in Older Adults.  None of the presenters were psychiatrists, but it was refreshing to hear two geriatricians take a holistic (mind+body) approach rather than focus only on internal medicine diseases of older adults

Pei Chen, MD, UCSF Division of Geriatrics, presented on Depression, Suicide and Loneliness.  The risk factors for late on-set depression and loneliness seemed to describe my shut-in clients:
  • Female
  • Social isolation or low contact with friends or low quality relationships
  • Widowed, divorced, separated marital status
  • Lower socioeconomic class
  • Comorbid medical conditions or worsening physical health
Dr. Chen shared screening tools for depression (PHQ-9), suicidality (P4), and loneliness (De Jong Gierveld 6-item).  Her recommendations: ask about mood/loneliness, be present and encourage interactions, connect with community resources.

While my shut-in clients seem receptive to contacting Friendship Line or friendly visitor programs, they are sometimes reluctant to seek services of mental health professionals due to stigma. 
Anna Chodos, MD, UCSF Division of Geriatrics, presented on Substance Abuse, a cohort issue with higher lifetime prevalence among baby boomers age 60-64. She also noted that 25% of older adults use psycho-active prescription drugs with potential for misuse/abuse:
  • Opiates: morphine, oxycodone, methadone; 40-50% older adults in chronic pain
  • Benzodiazepine: lorazepam, diazepam, etc.; avoid in older adults as these may cause decreased attention, memory, cognitive function, motor coordination lead to increased risk of falls/car crashes
  • Medical marijuana: controversial (risk/benefit not clear); used for neuropathy, glaucoma, pain, anxiety
Screening for substance use disorders include TWEAK for alcohol use, and DAST-10 for other substance use.

Tobacco is the most common substance used by my clients.  As much as I want to support aging in place, there have been days when I’d come home smelling like an ashtray after home visits with clients who smoked like chimneys, and I’d think I’d be better off in a non-smoking institution like a nursing home!

Sonya Maeck, LCSW, Clinical Administrator and Program Director at Jewish Home, discussed her facility’s 12-bed acute geriatric psychiatry hospital that exclusively serves older adults who require short-term treatment (average 18-day stay) for psychiatric conditions like anxiety, depression, suicidal thoughts, etc.  Its staff has specialized training in the unique medical and psychiatric needs of older adults to evaluate physical conditions (e.g., infection) that can be underlying factors in mental disorders; after successful treatment, the goal is for the senior to return home.

Encourage interaction

My work with shut-ins is rewarding with opportunities to make a difference and the mutual appreciation for home visits.  While I wish I had more time with clients, I have a fairly tight schedule of 5 to 6 home visits per day plus travel time.  I often politely redirect clients who use questions to seque into long stories.  (See The Onion video report, Census Visits Providing Shut-Ins Once-A-Decade Chance For Human Interaction,” featuring 87-year-old Helen DeAngelis who gives tips for trapping a census worker in your home for as long as possible.) 

For example, when I asked one client about her mobility, she replied that she used a cane to ambulate, and then she proceeded to recount her delightful story about getting the carpet in her studio apartment shampooed, which required her to leave home for 6 hours, so she took this opportunity to explore her neighborhood, which included visiting library to get a library card, then went to the movie theatre, etc.  Being out and about improved her disposition.

One way to reduce isolation of shut-ins is to fix broken doorbells, especially those who live in houses with outer gates preceding front doors so visitors need to ring doorbell or telephone: ding-dong-ding, how else can Jehovah’s Witnesses go door-to-door and reach isolated seniors who might welcome free home Bible studies?

Advance care planning 
San Francisco Village and Institute on Aging (IOA) hosted Talk to Me: Conversations that Matter about advance care planning and end-of-life options. IOA’s Patrick Arbore was a no-show due to illness, so SF Village Executive Director Kate Hoepke assumed role as moderator, opening up discussion by asking panelists what are the results of having these conversations?

  • Sarah Hooper, Executive Director of the UCSF/UC Hastings Consortium on Law, Science & Health Policy, talked about how the process of documenting one’s legacy (in the form of advance health care directives, power of attorney for finance, wills, etc.) is empowering because law students care to ask and listen to clients about their goals and wishes, which are given the force of law—yet emphasizing the conversations are more important than the forms.
  • Eric Widera, Clinician-Educator at UCSF Geriatrics, said “ditto” adding though it’s hard to predict future situations, conversations focus on what are important values—some people are known to appoint their bartender, who is someone they trust, they can have conversation and who is available to serve.
  • Stefanie Elkins, California Medical Outreach Manager at Compassion & Choices, discussed California End of Life Option Act, which became effective June 9, 2016, authorizing medical aid in dying.
Because I have shut-in clients who cycle in and out of hospice care, I wonder about California End of Life Option Act applying to terminally ill adults with a “prognosis of six months or less to live” when it is difficult to predict when someone will die

Thursday, June 30, 2016

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.


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:
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.

Monday, May 30, 2016

Older Americans Month: Blaze a Trail

“Older Americans have unique knowledge and a breadth of insights that are tremendous assets to our country -- and our seniors are eager to impart the wisdom learned from their experiences….Aging affects us all, and I am dedicated to empowering more of today's seniors and future seniors.”

This year’s OAM theme: “Blaze a Trail emphasizes the ways older adults are reinventing themselves through new work and new passions, engaging their communities, and blazing a trail of positive impact on the lives of people of all ages.”  The OAM website included tip sheets for Civic Engagement, Reinvention, Securing Your Finances, and Wellness.

Civic Engagement:  Getting Involved

Leaders from California Alliance of Retired Americans (CARA) and Community Living Campaign (CLC) volunteer their unique experiences to make a difference in the community by presenting a 2-hour Empowered Elder Workshop at this month’s Older Women’s League (OWL) meeting.
 
Hene Kelly, retired public school teacher and former CPR instructor whose nephew is an EMT, presented on Vial of Life: a kit to store medication information for access by emergency personnel.  
Sandra Mack, another retired teacher, presented 4 key lessons on Hospital Stay: 1) use personal support network, including patient advocate and someone who can care for your responsibilities like pets, 2) money – know insurance coverage, 3) arrange for visitors and/or bring pictures of family/friends – humanize yourself to receive better treatment from hospital staff, and 4) engage with discharge planner – exercise your right to a safe discharge, including appeal an early discharge by calling 1–877–588-1123 if necessary.  To get full benefits of Medicare after hospitalization, make sure to ask each day if you’re inpatient (formally admitted to hospital) versus outpatient (observation status).   
Gray Panthers advocate Michael Lyon presented on Advance Health Care Directives for durable power of attorney and health care.  He reminded us that these forms can be amended when our definition of an “acceptable quality of life” changes with medical expectations and situations. 
Hene is one of the Inspiring Women for Democratic County Central Committee!  
Legacy Film Festival on Aging Director Sheila Malkind with Pia.  Sheila’s 6th annual Festival on September 16-18, 2016 is an opportunity to further civic engagement with each film screening followed by Q&A forum to discuss aging issues.

Reinvention:  Follow Your Passion, Use Your Skills

AARP “Real Possibilities” hosted a 3-hour LifeReimagined Checkup: a personal guidance system to help people navigate life transitions and pursue new opportunities in work, well-being and relationships. 

  • Ice breaker question: If you had an opportunity to travel to a different time and place, when and where would it be?  My answer: Back to the time of Adam and Eve in the Garden of Eden J!
  • Purposeful Life = Gifts (what you’re good at) + Passions (what you love) + Impacts (who you want to benefit) + Values (what motivates you) + Possibilities (what you want to be, feel & have)
The following 6 practices of Life Reimagined made me think appreciatively of my ERISA recruiter Jeff, who was always checking up on me to stay relevant (and not to be shy about changing jobs to gain advantages like expanding KSA and access to professional networks):
  1. Reflectpresent situation is opportunityà take inventory of where you are, people you care about, your work & purpose
  2. Connect:  don’t have to go it aloneà engage people to mentor, support & listen to you
  3. Explore:  approach future with openness & curiosityà discover & bring new possibilities into your life
  4. Choose:  commit to making a changeàweigh options & decide on your new direction
  5. Repack:  accept necessary tradeoffsàdecide what you need to reach your goal, what you can do without
  6. Act:  you can do ità take 1st step & adapt as you go
As an island girl inspired to be a do-gooder from weekly Bible study and seeking opportunities to leave the rock, I thought becoming a traveling missionary would be my life’s purpose.  However, as a child of Chinese immigrants, I could choose from 5 acceptable career fields: medicine, engineering, finance, law and academia.  Been there, done that! Now I suppose it’s surprising that I chose an encore career in social services since I am more an introverted ideas (ITNJ personality) than extroverted touchy-feely, social butterfly type of person.  But organizations need employees who reflect the diversity of their clients, including those near the end-of-life (i.e., older adults) – always an opportunity for more introversion/introspection and appreciation. 

Throughout my life, my passion for reading, mostly nonfiction, has been constant and so engrossing that I sometimes forget about eating (another lifelong passion).  
As a bookworm, I had a blast indulging at Oakland Book Festival, a celebration of what makes us human – our ability for reflection, storytelling, sharing ideas! This year’s theme was Labor, and I was able to meet many talented and inspiring writers!
Mary Roach on her latest book, Grunt: The Curious Science of Humans at War, about how science is trying to make soldiers immune to panic, exhaustion and trauma.  If I am to make a living pursuing my passion for books, including exploring topics that pique my curiosity, I will need to be more disciplined to find time …
My passion for social justice led to me attend “Justice for the Young” panel: Elaine Brown talked about the Black Panthers starting their own Liberation School because they were against desegregation, which they perceived as inferior mis-education at the time because teachers had no relationship based on life experience shared with black students.  I continue to have mixed feelings about segregation based on race, gender, age, etc. to counter –isms, especially since I loved to sing-along to USA for Africa’s “We Are the Worldduring my formative years:

(Tina Turner) We are all a part of God's great big family …
(Michael Jackson) We are the world, we are the children
We are the ones who make a brighter day
So let’s start giving …
(Cyndi Lauper) Let us realize that a change can only come
(Kim Carnes) When we stand together as one …

“The Uncanniness of Altruism” panel gave me more food for thought about my own career choices, including my latest desire to advocate for older adults’ right to live independently in their homes for as long as safely possible.  San Francisco Magazine editor Gary Kamiya moderated this thought-provoking discussion based on Larissa MacFarquhar’s  Strangers Drowning: Impossible Idealism, Drastic Choices, and the Overpowering Urge to Help (2015).  I identified with social worker Julia Wise, one subject of extreme altruism profiled in this book.  Julia’s utilitarian dilemma:  is the greater good served by taking a higher-paying (corporate) job to make monetary contributions, or taking a lower-paying (non-profit) job to make direct labor contributions, for worthy causes?  While working in the corporate sector, I attempted to do both—maximizing tax-deductible contributions by making donations to non-governmental organizations (e.g., Foundation for Sustainable Development and Global Service Corps) to personally volunteer overseas using paid time-off from work.
“Undervalued, Invisible: Domestic & Emotional Labor” featured panel of Bay Area women:  Katie Quan, UC Berkeley labor specialist; Ruth Rosen, author of The World Split Open: How the Modern Women’s Movement Changed America (2006); Arlie Hochschild, author of The Second Shift: Working Families and the Revolution at Home (2012); and moderator Deidre English, former editor of Mother Jones magazine.  This discussion focused on childcare (last month, San Francisco passed Paid Parental Leave for Bonding with New Child Ordinance), rather than eldercare, which needs more attention like San Francisco Supervisor Eric Mar’s Support at Home to subsidize home care for seniors and persons with disabilities (PWD) who do not qualify for IHSS yet do not have enough income to pay for private home care.  Eric also introduced Dignity Fund, a proposal to amend the City Charter to authorize setting aside 2% of future property taxes to stabilize funding services for seniors and PWD.

At AgeSong’s University campus, passionate Julia Wolfson presented From the Inside Out: Changing the Culture of Care about the shift from the medical model (fix problem patient) to an empowerment model (learn what’s important to the person). She said using the power of love-based curiosity, we find out what makes one come alive from inside out, even from someone who does not use words to communicate.

Securing Your Finances: Plan Wisely, Watch Closely

At Chinatown Night Out, I drew more Blaze a Trail inspiration from 41 Ross Alley’s 3650 exhibit featuring Mr. Zhao, who immigrated 10 years ago from China at age 66 with his American Dream to “make a decent living” in San Francisco, which necessitated hard work including his steadfast determination to acquire English fluency. 
Instead of learning the phonetic English alphabet, Mr. Zhao denoted the pronunciations of English words with Chinese characters in his hometown dialect—transcribing over 2,000 words on cardboards plastered on the walls and ceilings of his Chinatown SRO.  He studied ESL at City College, earned his driver’s license, found work in a white-owned store, became a U.S. citizen within 5 years, collected recyclables, etc.  Then, 3650 days after his immigration, mission accomplished: Mr. Zhao earned enough to enable a “return home in silken robes” to visit his 90-year-old mother in China
                                   
Wellness:  Be Wise, Be Well

OAM tip sheet for Blaze a Trail to Wellness reminds us:  “Activity is important, but nutrition is equally vital.”  Krab cake in dill sauce with herbed rice and country veggies, courtesy of Meals on Wheels of San Francisco!