Herstory

While age segregation holds little appeal for me, I can appreciate that aging is a women’s issue and the value of an all-women’s space so that women’s voices can be truly heard.  After all, women live longer than men and thus make up the majority of older adults.  Compared with men, older women are three times more likely to be widowed or living alone, almost twice as likely to be nursing home residents, spend more years and a larger percentage of their lifetime disabled, and are nearly twice as likely to live in poverty.  Women experience higher rates of domestic violence than men, and like women who are the majority of caregivers, women in these situations report higher levels of stress, depression, and other chronic health conditions. (http://www.aoa.gov/AoARoot/Aging_Statistics/Profile/2011/2.aspx & http://www.globalaging.org/agingwatch/cedaw/cedaw.pdf)  

As one of 20 Community Health Workers selected to participate in this month’s Women’s Health Leadership Institute (WHLI), hosted by Region IX Office on Women’s Health (OWH) of the U.S. Department of Health and Human Services, I appeared to be the only participant focused on older adults’ health.  For FY 2013, OWH priorities include enhancing access to information and health care resources that promote the safety and health of older women (aged 50+) in the areas of prevention and behavioral health, abuse in older adults or caregiving.  Check out OWH's publications on Healthy Aging and A Lifetime of Good Health. (Note: California’s Office of Women’s Health was eliminated as of July 1, 2012.)

Kay A. Strawder, JD, MSW, Regional Women's Health Coordinator, welcomes our Region IX cohort.  Our facilitators, Jenifer Metz and Sali Butler, are seated in corner.  (Photo courtesy of Carmen Ferlan, MPH, MIS)

Our training emphasized a systemic or ecological approach to public health problem-solving, addressing the root causes of health disparities, to prepare for our Community Action Project.  Instead of a superficial “blame the victim” for not taking personal responsibility—like Sheryl Sandberg’s belief that men still rule the world because women lack self-confidence so they need to “lean in”—an in-depth analysis of the problem might identify systemic factors, like institutionalized sexism, lack of access to child care and flexible work arrangements; see http://www.nytimes.com/2013/08/11/magazine/the-opt-out-generation-wants-back-in.html.

We participated in several activities to understand the context of advances in women’s rights (I was surprised to learn that “Nebraska is the first state to pass a law making it illegal for a man to rape his wife,” actually took place in my lifetime, in 1976, the U.S. bicentennial year), and to analyze women’s biographies (Dolores Huerta, Oprah Winfrey, Michelle Obama) for stones (obstacles) and shovels (leadership skills used to move obstacles).  My personal choices for inspiring public figure women biographies would be Frances Perkins (U.S. Secretary of Labor during FDR administration, died at 85 years in 1965) and Vandana Shiva (60-year-old environmentalist).

During breaks, classmates led activities like hula (Wilma from Lanai, pictured above in photo courtesy of Carmen Ferlan; note, one male Jose on far left), salsa and merengue (Arletha from Oakland), creating flowers from pipe cleaners (Monissa from Saipan), body fat measurement and aerobics (Phyllis from Santa Clara).

WHLI training took place in the Federal Building, where I bumped into former colleagues at U.S. Department of Labor.  I had been one of the few female investigators, but didn’t pay much attention to this gender imbalance because I was so busy conducting field investigations and keeping current with the ever-changing benefits law (for example, check out how the recent repeal of DOMA impacts ERISA plans).  As an ERISA geek, Labor Day weekend meant celebrating the September 2, 1974 enactment of ERISA! I also paid more attention to traveling and eating, so perhaps I had succumbed to gender neutrality disorder . . .that is, until I began full-time studies in nutrition and gerontology, which are dominated by women!  Nonetheless, where the WHLI application asked, “what cultural group do you most identify with?” I responded “permaculture” instead of “woman.”

Participating in WHLI reminded me of attending “not an all-girls school without men, but an all-women’s college without boys.”  At women’s colleges, women have all the opportunities to rule, which does wonders for building confidence, breaking barriers and making herstory! Ready to break out into Helen Reddy’s “I am Woman, hear me roar!”

 

At the right place and time:  I worked as a proofreader at the College Relations Office, which gave me easy access to interview visitors like Pulitzer Prize-winning columnist Ellen Goodman.  A women’s college graduate herself, Goodman discussed how the "values gap" based on traditional roles for men (high-powered career) and women (home, family) resulted in the Superwoman myth (women can have it all, only if they do it all by themselves) as women have had more success in getting into the male world, than in changing that world.  Here I appear as an awestruck teenager in the presence of Goodman with College Relations Director Susan Shea and College President Mary Metz.  Following her retirement in 2010, Goodman founded The Conversation Project about communicating end-of-life wishes.

I pay more attention to women's leadership.  The idea for University Mound Ladies Home (UMLH) came from Mary Staples, a philanthropist and wife of the man who helped San Francisco businessman James Lick prepare his will.  Founded in 1884, with a bequest from Lick, UMLH is a nonprofit, 74-room assisted living residence for older women.  It hosted the 6-week Healthier Living-Chronic Disease Self-Management Program, attended by residents and the public, but this month’s graduates were all women :-).  I love that UMLH has management and staff trained in gerontology! Check out this interview with SFSU gerontology instructor Pat McGinnis who talks about how quality of care is compromised in the for-profit model in assisted living at http://www.pbs.org/wgbh/pages/frontline/social-issues/life-and-death-in-assisted-living/patricia-mcginnis-get-the-for-profit-model-out-of-senior-care/.  

This year marks the 50^th anniversary of the publication of The Feminine Mystique, Equal Pay Act, and March on Washington for Jobs and Freedom.  USF Diversity Scholar Visiting Professor Clarence B. Jones (pictured above) said as a 32-year-old lawyer who assisted MLK, Jr. in drafting “I Have a Dream” speech delivered at the March on August 28, 1963, he never thought he’d live to be 82 years old.  He credited Mahalia Jackson (Queen of Gospel, who was 51 years old at the time) for calling out, “Tell them about the dream, Martin!” which prompted 34-year-old MLK, Jr. to depart from reading his prepared text to describe his dreams for freedom and equality.  This dream was partly realized with the Civil Rights Act of 1964, which banned discrimination based on “race, color, religion, sex or national origin.”

Sisters Rize! video screening at Intersection for the Arts.  In August 2010, Sisters Rize! formed as a women’s group, within Central City SRO Collaborative, to create strong community bonds amongst women, learn new skills and organize actions to address problems in their neighborhoods and SROs.  Over a 12-week period, ten women used a digital flip camera to make video shorts about their lives.  

District 6 Supervisor Jane Kim (seated at left in front row) and Brenda Washington (on stage) whose “Now the Sunshine” documented her bout with cancer.  Other insightful videos were Sandy Manning's "Trying to make it in the world" (preparing breakfast in SRO), Sherrie Taylor's "Been there done that" (domestic violence), and Diane Hawkins' "Pigeons of San Francisco."  Sisters Rize! next project is to learn self-defense.  In the Tenderloin Housing Clinic’s 16 SRO hotels, men outnumber women almost four to one.  

Women lead in the aging field, like Senior & Disability Action Executive Director Jessica Lehman.    

DAAS Executive Director Anne Hinton speaks at SDA reunion in Rosa Parks Senior Center for graduates of Senior Survival School & Senior University.  SDA, DAAS and Coalition partners won a 2013 Aging Achievement Award for SRO Housing Advocacy by the National Association of Area Agencies on Aging (n4a).

Juicye arrived at SDA reunion, announcing, “Am I Bad? It’s Michael Jackson’s 55^th birthday!”    Had Jackson lived to age 55, he would be eligible for additional “senior” discounts!

Contestants from this month’s Dahlia Show 

Age-less

This month I spent two full Saturdays enrolled in a Diversity and Social Justice course on Ageism and Adultism.  Rather than compete in Oppression Olympics, these –isms are forms of age-based oppression that can result from segregation of older adults and young people who each become subordinated into “the other.”  The first Saturday (diversity education) assignment was a rhetorical triangle analysis of how the media represents youth and elders; and the second Saturday (social justice action) assignment was a paper explaining how I would intervene to stop age-based oppression.  Inspired by Martin Luther King, Jr., I have a dream that we will one day live in a world where people will not be judged by their age, but by the content of their character . . . so here’s my call to action for a healthy age-less society:

Breaking the age barrier:  This consciousness-raising course reminded me of my bargain trip to Malta just months before it joined the EU in 2004.  Merhba (hello in Malti)! Unbeknownst to me, I had joined Grand Circle Travel, which served members of AARP and continues to cater to the age 50+ set.  In Malta, entrance fees were waived for seniors, who apparently were subsidizing the cost of my tour package because the tour director often had to single me out to purchase my adult admission ticket (“I’ll pay for this one”) everywhere we went—and sometimes I got away with youth admission! As a teetotaler, I was a popular dining companion giving away my complimentary glasses of wine during lunch and dinner (night cap).  Dining table discussions centered on health concerns.  Early to bed, early to rise, my senior travel companions would remind each other to take their meds during breakfast.  One senior sent this photo of “independent, intrepid” me--our group's lone younger adult wandering up Mt. Etna, the largest volcano in Europe, during a day trip to Sicily. 

                                                                                       

Though my grandmother had dementia, she remained physically strong and energetic into her 90s.  But within weeks of my grandmother’s reluctant move into a nursing home, we noticed sudden changes in her like weight loss, lack of appetite, slower gait, uncharacteristic quietness, etc.  When we discussed our concerns with the nursing home staff, they assured us that these symptoms were “just part of normal aging so nothing to worry about.”  In my grandmother’s case, nothing was done while her condition deteriorated until she died of pneumonia.  I believe the nursing staff’s stereotyping and negative attitudes toward aging as a process of “inevitable decline” permeates American culture, which equates good health with youth, and thus fails to value health promotion among older adults.

Ageism affects how we treat older adults.  Internalized ageism affects our own behavior as we age, our will to live and even how long we live.  Based on the Cycle of Liberation, here are steps I have taken, and plan to take, to stop age-based oppression:

1.  Waking up:  The nursing home staff’s apparent ignorance of my grandmother’s true health condition (which I strongly suspect was depression, as my grandmother always said she'd rather die than live in a nursing home) and inaction (perhaps neglect) was the critical incident that caused me to really challenge assumptions about what is “normal” aging versus serious health concerns that require appropriate medical attention. 

2.  Getting ready:  My consciousness-raising included learning from gerontology courses taught by Chief Nursing Officer Dr. C at the Jewish Home (Aging Processes) and Executive Director of California Advocates for Nursing Home Reform  (Ethical and Legal Issues in Aging), which helped clarify my perspective.  After my grandmother’s experience, I simply wanted to avoid nursing homes, but Dr. C’s Aging Processes class, which included a field visit to the five-star rated Jewish Home, challenged me to see how culture change is possible to empower nursing home residents to maintain or even improve their biological, psychological and social functioning. 

I will further my gerontology studies so I can continue learning while challenging misinformation by health care providers who may not be adequately trained to understand the specific conditions of old age.  For example, weight loss through dieting is not recommended for older adults, who tend to lose muscle mass in addition to fat.  Studies suggest that being a little overweight is actually healthful in later years, with a little fat “reserve” (e.g., on hips and buttocks of pear-shaped bodies) to be used in case of illness or padding in the case of a fall.

3.  Reaching out:  Knowledge from my Aging Processes class has empowered me to speak up to challenge negative attitudes toward aging and the aged.  As I often hear laypersons stereotype conditions like hypertension and central obesity as part of the “normal” aging process, I respond by pointing to studies showing that they can be prevented through lifestyle and environmental interventions.  Successful health promotion involves sharing information about the realities of aging that can affect sensation and perception so we can recognize when and how to make adaptations and accommodations to these changes.  For example, it is liberating to acknowledge vision or hearing loss so one can take corrective actions (e.g., obtain eyeglasses or hearing aids), which help maintain a sense of balance and reduce risk for falls that could otherwise jeopardize one’s health and ability to age in community.  

Jessica and Kayi of American Red Cross’ Asian Community Preparedness with high school student volunteers visit Ageism and Adultism class to discuss their intergenerational disaster preparedness program, Youth for Chinese Elderly. 

 

4.  Building community:  Working with others of different ages toward a common purpose may decrease ageism.  For example, American Red Cross Bay Area Chapter’s Youth for Chinese Elderly program connects bilingual Chinese youth volunteers with monolingual Chinese elders to promote disaster preparedness, which fosters mutual caring between generations.

Since health status is a reflection of lifelong habits and influences or life course cumulative disadvantage, I support intergenerational health promotion and disease prevention programs—particularly as the rapid rise of childhood obesity places the current younger generation increasingly at risk for developing chronic health conditions (heart disease, diabetes) at earlier ages and even premature death, so the younger generation can learn from the experiences of older adults.  We find common ground in the universal experience of aging.  As time goes on, most of us (who survive premature death) eventually will find ourselves as older adults so everyone is a stakeholder in intergenerational health programs that increase quality of life for all ages. 

5.  Coalescing:  Through a generous grant from San Francisco Department of Aging and Adult Services, I participate in the Healthier Living Coalition with allies to promote the evidence-based Healthier Living-Chronic Disease Self-Management Program workshops that are offered to adults with chronic conditions and their caregivers, which attracts participants from age 18+.  Organizing these free workshops presents an incredible opportunity to address the intersectionality of age, disability, gender, race/ethnicity, socio-economic status, etc. to reduce health disparities in our diverse communities. 

This month’s SDA general meeting focus was on emergency preparedness for seniors and people with disabilities.  Carla Johnson from Mayor’s Office of Disability demonstrates $4,000 evacuation chair.

6.  Creating change and maintaining:  I want to improve quality of health care by creating culture change for person-centered care and gerontology training among health care providers who serve older adults.  As there is so much to do and so little time, I spread my time among different organizations involved in advocacy (Community Living Campaign, Gray Panthers, Senior and Disability Action), gerontology education (American Society on Aging, Gerontological Society of America) and health promotion for all ages (Bay Area Nutrition and Physical Activity Collaborative, Healthier Living Coalition). 

LaborFest:  age-less Medicare and intergenerational literacy

Every July I look forward to LaborFest, which celebrates its 20^th anniversary this year.  Before studying gerontology, I worked in the employee benefits field in the design, funding and administration of employer-sponsored retirement and health/welfare plans.  As my work involved consulting with employers on cost-effective ways to manage health care costs, I developed an interest in promoting health and wellness programs that emphasize self-care.    

From left: Steve Zeltzer, LaborFest founder; Charlie Andrews, healthcare writer; Brad Wiedemier, SEIU-UHW board member; and Steve Early, labor journalist. 

Today’s LaborFest program included a discussion of Healthcare, Wellness Programs and Obama’s Affordable Care Act (ACA) and Labor.  The panel discussed the impact of cuts in healthcare as a conscious program of downsizing toward privatization, especially services to the vulnerable poor and elderly: 10% cut in Medi-Cal reimbursement rates (effect is actually around 30% for nursing homes when retroactive liability included), 8% cut in In-Home Supportive Services.  They also characterized wellness programs as part of a cost-shifting trend (“if you have a health problem, you pay more”) because of the emphasis on individual responsibility over social and environmental factors, and the effect of cafeteria plans as pitting the “healthy young” against older persons with chronic conditions.  Instead of the individual mandate in “capitalist-controlled” Obamacare, they favor single-payer, Medicare for all ages.

Maestra’s DVD cover shows army of uniformed volunteer literacy teachers marching with oversized pencils symbolizing the triumph of education when the 1961 Cuban National Literacy Campaign wiped out illiteracy within one year--remarkable when one considers that almost a quarter of the Cuban nation was illiterate prior to the start of Revolution on July 26, 1953.  

In 2001, I traveled to Cuba with Global Exchange to study its universal healthcare and education systems.  So immediately following the Healthcare discussion, I stayed put in the auditorium for a screening of Catherine Murphy’s Maestra (Teacher), an empowering documentary about the 1961 Cuban National Literacy Campaign that mobilized 250,000 volunteers to teach 707,000 Cubans of all ages how to read and write (though the film doesn’t mention teaching propaganda), which meant freedom—and especially female liberation just two years after the 1959 Cuban Revolution.  Almost half of the volunteer teachers were secondary and high school students, the majority were females who left their urban homes (one forged her father’s signature on her permission slip) for the first time to teach in the countryside where they also worked alongside campesinos in the fields.  It was so beautiful to hear (actually I read the film’s English subtitles) from one teacher, who volunteered at age 7 to teach an illiterate 58-year-old man: “He never treated me like a child, nor I treated him like an old man.  We were teacher and student.”  Another volunteer mentioned that older students were proud to have their own teacher, instead of being ashamed to be taught by a young person.  In 1962, UNESCO certified Cuba as free from illiteracy. 

Maestra filmmaker Catherine and Cuban social psychologist Norma Guillard, who is featured in the documentary sharing her experience as a 15-year-old literacy volunteer in Cuba.  I found Catherine age-less, looking pretty much the same as when we were on a Global Exchange Reality Tour of a very polarized Venezuela in November 2003, during the attempted recall of President Hugo Chavez, who was implementing his Bolivarian Revolution (similar to Cuban Revolution).  Catherine grew up close to her grandmother from Havana, where Catherine studied during Cuba's Special Period in the 1990s.  

Maestra panel included college educators who discussed the privatization of community colleges like the state’s de-funding of Older Adults and lifelong education programs (SB 173) in favor of a triage-like strategic plan that focuses on training a workforce for corporate employers, instead of higher education for all. 

Catherine, Norma and Steve are all smiles.  To learn more about literacy as a social justice issue, check out Catherine's The Literacy Project. 

Old like All, My old like smile?

In the service learning component of my introductory gerontology class, I volunteered with Project SHINE (Students Helping In the Naturalization of Elders) as an ESL Citizenship Coach to 30th Street Senior Center participants from Peru, Mexico, Nicaragua, El Salvador, Colombia, China and India.  I found dictation amusing: for example, the classroom instructor would dictate, “All people want to be free” and a senior would write, “Old people one to be free,” then I would politely correct, “All, not Old” and “want, not one.”  In my reflection paper, I wrote: 

I value my SHINE experience because coaching ESL reminded me of my own roots.  My parents escaped Communist China to immigrate to Hawaii, as adult refugees with no knowledge of the English language.  English was also my second language so we were all learning English—singing along with the Carpenters, James Taylor, Simon and Garfunkel, etc.  I remember singing the opening of "The Sounds of Silence," incorrectly as, “Hello darkness, smile friend” when the lyrics are really, “Hello darkness, my old friend.”  Repeat correction:  “My old, not smile.”  I actually like both versions :-).

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)!

Free to be you and me

May is Older Americans Month  

All the lonely people, where do they all belong?

--“Eleanor Rigby” by Lennon-McCartney

At this month’s Coalition of Agencies Serving the Elderly (http://www.sfseniors.org/) meeting, UCSF geriatrician Dr. Carla Perissinotto presented “Examining Loneliness in Older Adults: Too much hype or a true medical concern?”  She found that loneliness is independently associated with functional decline, placing one at risk for nursing home admission, and increased rate of death.  

Dr. Perissinotto analyzed data in the Health and Retirement Study, which asked 1,604 older adults the following three questions to screen for loneliness:

1.     I feel left out

2.     I feel isolated

3.     I lack companionship

Participants were classified as lonely if they responded “some of the time” or “often” to any of these questions.

Loneliness is the distress that a person subjectively feels about being alone (http://psychology.uchicago.edu/people/faculty/cacioppo/jtcreprints/hc09.pdf).  Social isolation (a complete or near-complete lack of contact with society) by itself does not account for loneliness, said Dr. Perissinotto. Thus, one can be lonely without living alone.  Her research found that 62.5% of married/partnered participants felt lonely, compared to 26.7% of participants who lived alone felt lonely.  She also found the following groups reported more loneliness: women, non-white, slightly older and lower socioeconomic status.  Further, most lonely participants are not depressed.

Dr. Perissinotto believes we can make a difference by asking about loneliness (like asking about chronic disease risk factors) and offering interventions from existing community programs to help adults feel more socially connected.

Lemon trees and raised vegetable beds surround outdoor dining area at On Lok (“peaceful, happy abode” in Cantonese) Gee Center

Carp (or koi, homophone for “love” in Japanese) and lotus pond at On Lok Gee Center

Loneliness as public health crisis

In a related article published this month, “The Lethality of Loneliness” (http://www.newrepublic.com/article/113176/science-loneliness-how-isolation-can-kill-you), The New Republic science writer Judith Shulevitz notes that loneliness causes or exacerbates Alzheimer’s, obesity, diabetes, high blood pressure, heart disease, neurodegenerative diseases, and even cancer.  Researchers differ on whether loneliness is a subjective feeling that wreaks havoc on the body and brain, or a failure of social networks to take care of the lonely. 

Shulevitz reports that the lonely are outsiders: the elderly, the poor, the bullied, the different.  People who feel discriminated against are more likely to feel lonely than those who don’t, even when they don’t fall into the categories above, due to feeling rejected.  For example, psychologists discovered that closeted gay men who had to be guarded about their true identity for fear of exposure/blackmail, were more sensitive than others to the pain of rejection, increasing a fight-or-flight response system arouses stress hormones that compromise their immune system—such that closeted men infected with HIV died an average of two to three years earlier than out men.

Similarly, a common “alone-on-the-savanna moment” that could put the body in fight-or-flight mode is going off to college and having to make a whole new set of friends.  When I left home as a teenager to attend a women’s college over 2,000 miles away, I had to adapt to the intense, competitive and consciousness-raising experience of living on-campus with the typical age 17-22 group.  Since I had been privileged to grow up in a multi-generational household, I really missed the safety and mellowing “been there, done that” wisdom of older adults. 

Please Touch Community Garden was designed by artist GK Callahan with nearby LightHouse for the Blind and Visually Impaired and SF Permaculture Guild.  Here GK installed a scavenged dollhouse for a birdhouse. 

Letters spelling out "TO SEE A WORLD YOU OTHERWISE COULD NOT SEE" lean against wall behind raised vegetable beds.  May is Healthy Vision Month (http://www.nei.nih.gov/hvm/):  For healthy vision, National Eye Institute recommends eating a diet rich in green, leafy vegetables like the ones grown at Please Touch Community Garden.

Quality over quantity of relationships

Another “alone-on-the-savanna moment” could be moving to an age-segregated retirement resort in Florida, away from family and friends, which is the subject of this year’s Oscar nominated documentary, “Kings Point.”  The trailer's sound bites ("you're alone, but not alone") raise questions about loneliness: could fear underlying the belief that "a widow has to keep busy or die” interfere with intimacy? is it harder to form deep friendships later in life so we settle on acquaintances? does self-preservation contribute to loneliness? At the Legacy Film Festival on Aging’s Opening Night next Friday, join a discussion with filmmaker Sari Gilman following the screening of her “Kings Point” and two other films about Housing Choices as We Age (http://www.legacyfilmfestivalonaging.org/film-schedule.php).  

I planted these mugworts (Artemisia vulgaris) from The Free Farm last year.  Mugwort's bitter leaves can be made into a tea for use as a digestive tonic.  In Traditional Chinese Medicine, acupuncturists burn mugwort in moxibustion.

How can we address loneliness and the stigma of being “different” to allow people to be authentic instead of “passing” as someone else out of fear of rejection? How can people connect better to develop strong bonding that reinforces ties between similar groups, as well as bridging social capital among diverse groups? A cultural humility approach coupled with an introvert’s power to listen and ask follow-up questions can help with understanding to find common ground and mutual acceptance.

According to Dr. Melanie Tervalon, cultural humility involves practicing lifelong learning and critical self-reflection (awareness of potential bias), recognizing and challenging power imbalances (using person-focused interviewing and meeting people where they are to facilitate mutual respect), and accountability (readjust if necessary to remain open-minded) (http://info.kaiserpermanente.org/communitybenefit/assets/pdf/our_work/global/Cultural_Humility_article.pdf).

Cultural humility respects “voice by choice,” or giving people the space and time to speak up voluntarily—and not putting people on the spot and assuming they should respond the way one expects because one is already culturally competent.  People are complex, however much one may want to simplify by classifying individuals into “cultural” groups or stereotyping.  Only when people’s true voices are heard first, then we can begin the process of understanding and empowering people with self-determination to choose how we age or live our lives.  When we are free to be you and me, building community together, we unleash the power of age!

This bright pink seed-planting table is accessible to persons using wheelchairs

GK created this totem pole using ceramic animal figures from Santa Clara Valley Blind Center