Moving Mom & Dad — into a Village

What about moms and dads who really don’t want to move?

The problem of where to go and what to do about housing in the sometimes not-so-golden years has an assortment of solutions for those who prefer (and can afford) the retirement community or any of the multitude of assisted living communities around. But for those who are bound and determined to stay put in the old house or the long-familiar apartment? A collection of obstacles begins to accumulate.

Enter the village.

Swiftly catching on around the country, aging-in-place “villages” are designed to help  members overcome those obstacles by providing a variety of programs and services – while the members stay put. The prototype was Boston’s Beacon Hill Village, founded in 2001, which offers “groceries to Tai Chi to cultural and social activities to home care.” Others have popped up in states ranging from Colorado to New York, Florida to Nebraska, Massachussetts to Hawaii.

San Francisco Village was the second, after Avenidas in Palo Alto, to get off the drawing boards and into action in California. Although each Village differs from others, SFV illustrates many of the attractions that are drawing in the stay-put crowd. The organization began with some local grants and individual donations, and is sustained now by annual membership fees.

Sarah Goldman agreed, after a good bit of arm-twisting, to be a poster girl for SFV in upcoming stories for the neighborhood’s New Fillmore newspaper. Sarah was among the first to join the organization, and in many ways typifies the village member-enthusiast: fit, active and fiercely independent at 80, she plans to stay that way as long as humanly possible. Her first move, as a Village member, was in support of someone older still and desperately in need of help: her landlady. Goldman could see that the landlady, who also lived alone, was becoming forgetful and increasingly unkempt – the distress signals that often propel seniors into care facilities. So she began by talking the landlady into joining also. This paved the way for calling in, with the landlady’s approval, a wide-ranging group of service providers: house cleaners, organizers, financial assistance people, personal care helpers. All had been vetted by SFV. Their help has now enabled both landlady and tenant to keep right on aging in place.

Goldman also quickly started a program patterned after one she had organized when working with an assisted living community. SFV’s play-reading group was an immediate hit among those seeking socialization and intellectual stimulation. Three necessities of life — social, physical and mental fitness — added to issues such as those dealt with by the landlady, add up to the heart of the Village. Members hope that by accessing things like this while staying on familiar turf their golden years may indeed stay shiny.

This one hopes that SFV membership will help keep the contributions of this space emanating from this laptop on this Sacramento Street kitchen counter for a very long time to come.

Gay Rights, Abortion Lose – – Meanness Wins. Is this the 50s?

The New York State Senate‘s rejection of a bill that would have allowed marriage between two people who love each other — but happen to be gay — is just the most recent in a string of set-backs in the area of gay rights. Other set-backs have been occurring, or are currently looming, in women’s rights, specifically reproductive rights. One wonders about the mood of this country.

This particular one wonders if anyone else is harking back, with more than a little sadness, to the 1950s. If you weren’t around then, I can tell you it was a strange decade. Great optimism for the future — well, there’s not much of that today — while simultaneously there was terrible meanness behind the McCarthy witch hunts and the denial of women’s rights, plus a certain amount of smugness embedded into a bland, national complacency.

At ladies’ bridge parties there were small china ashtrays on each corner of the table and the conversation usually drifted toward those lovely wonder drugs emerging to give instant relief for any problem. The conversation never drifted toward back-alley abortions, unless someone had recently died and the others knew how it had happened. Those of us who had jobs — running a house, entertaining for the husband’s business, raising children; those were not considered jobs — usually had male counterparts doing the exact same thing for twice the salary. One did not complain. If one were middle class white, and involved in any sort of civil rights work, one never brought that up at the bridge table.  It was a strange decade.

Today’s New York Times story quotes senators who voted against the same-sex marriage bill as saying “the public is gripped by economic anxiety and remain(s) uneasy about changing the state’s definition of marriage.” The San Francisco Chronicle article includes a comment from sponsoring Senator Thomas Duane, “I wasn’t expecting betrayal.” I’m sure those are both accurate reports. Whatever its underlying economic, political or social fears, the public seems also to harbor a degree of meanness in discounting the rights of others.

If you substitute a measure of cynicism or hopelessness about the future for the complacency of a half-century ago, and throw in the self-righteousness of those who for religious or political reasons justify the denial of rights to their fellow citizens, it’s easy to draw parallels between this decade and that one long ago.

In the fifties the groundwork was being laid for civil rights, for women’s liberation, for Roe v Wade and the upheavals that eventually led to progress, by courageous and energetic people of all sorts. I wish I could list myself in that number; I was at the bridge table trying to pretend normalcy in a life gone amok.  Today there are others working just as hard for the rights of their fellow men and women.

I hope they can keep the faith.

Health Bill Should not Pit Women against Seniors

The health care issue is, one would think, too important for partisan games pitting one group against another. Especially when huge portions of each group are one and the same. But as Robert Pear and David M. Herszenhorn report in today’s New York Times, that seems to be happening.

In a day of desultory debate on sweeping health care legislation, senators appealed to two potent political constituencies on Tuesday, with Democrats seeking additional medical benefits for women and Republicans vowing to preserve and protect Medicare for older Americans.

The Democrats’ first amendment, offered by Senator Barbara A. Mikulski of Maryland, would require insurers to cover more screenings and preventive care for women, with no co-payments.

‘Women often forgo those critical preventive screenings because they simply cannot afford it, or their insurance company won’t pay for it unless it is mandated by state law,’ Ms. Mikulski said.

I met with my oncologist two days ago and decided to have a mammogram. It’s been two years since the last one. She and I agree that, having had breast cancer in 2006 and breezed through a mastectomy, and being fit and healthy overall, my particular situation suggests the potential benefits — catch another cancer early, gain another good decade or so of life — outweigh the risks.  This is what the whole thing is about: every woman is different, every woman should be allowed to decide, with her doctor, on screening and preventive care. The Mikulski amendment will insure that can happen, whatever one’s age and circumstances.

The first Republican proposal, offered by Senator John McCain of Arizona, would strip the bill of more than $450 billion of proposed savings in Medicare. The savings would curb the growth of Medicare payments to hospitals, nursing homes, health maintenance organizations and other providers of care.

‘The cuts are not attainable,’ Mr. McCain said. ‘And if they were, it would mean a direct curtailment and reduction in the benefits we have promised to senior citizens.’

Senators said that debate on the bill, which embodies President Obama’s top domestic priority, would last for several weeks and perhaps continue into January. A vote on Ms. Mikulski’s amendment has not been scheduled but could come Wednesday.

The health care bill would require most Americans to carry insurance. It would subsidize coverage for people with moderate incomes, expand Medicaid and create a government insurance plan, which would compete with private insurers. The House passed a similar bill last month.

Ms. Mikulski’s proposal was prompted, in part, by the recent furor over new recommendations from a federal task force that breast cancer screenings begin later for many women.

The Senate majority leader, Harry Reid, Democrat of Nevada, hailed Ms. Mikulski’s proposal, saying: ‘The decision whether or when to get a mammogram should be left up to the patient and the doctor. That decision should not be made by some bureaucrat, a member of Congress or someone they’ve never met.’

As health costs and insurance premiums rise, Mr. Reid said, ‘more women are skipping screenings for cervical and breast cancer, and doctor visits that can catch problems like postpartum depression and domestic violence.’

Votes on the Mikulski amendment will show whether Republicans “truly want to improve this bill or just want to play games, stall,” Mr. Reid said.

Ms. Mikulski said her proposal would ‘shrink or eliminate the high cost of co-payments and deductibles’ for women who receive screenings for cancer, heart disease, diabetes and other conditions.

Senator Kay Bailey Hutchison, Republican of Texas, criticized the proposal, saying it would ‘allow yet another government agency to interfere in the relationship between a woman and her doctor.’

No, Senator Hutchison, the government isn’t interfering in my relationship with my doctor, nor will it do so by insuring other women’s choices and coverage.

Republicans argued that the bill would be paid for on the backs of older Americans.

‘We are receiving incredible and overwhelming response from seniors all over America,’ Mr. McCain said. ‘They paid all their working lives into the Medicare trust fund, and now they’re in danger of having $483 billion cut out of it.’

Mr. McCain’s proposal would effectively cripple the bill, because Democrats are relying on savings in Medicare to help offset the cost of providing coverage to more than 30 million people who are now uninsured.

This senior would like to add a word to that “overwhelming response” Mr. McCain reports. I paid all my working life into Medicare (which, by the way, was not exactly a gift to America from the Republican party) and I want a decent health bill more than I want every penny of my Medicare coverage protected.

A lot of us have come to terms with the fact that the health bill we may get is a long way from the health bill we so fervently wanted. We are still hoping that something survives the attempts to sink it at any cost.

Senators Pitch to Women and Elderly on Health Bill – NYTimes.com.

White House dinner crashers? '…certainly not us!'

I am still worried about the Salahis. A few days ago it was the issue of decorum, which they do not seem to have in abundance. Today, amid protests of good manners that would never have allowed them to intrude where the uninvited fear to tread, there is concern for their grammar and syntax. For a couple who are clearly headed towards a book deal, grammar may no longer matter but discombobulated syntax can cut into book-signing audiences.

As Kathleen Hennessey and Mark Silva report in today’s Chicago Tribune,

The couple who made it past Secret Service security to hobnob with the president at a state dinner last week say “the truth will come out” about their night at the White House and insist they’re not party crashers.

The couple said in an interview on NBC‘s “Today” that they were “shocked and devastated” by accusations that they showed up uninvited and talked their way past security. They said they were cooperating with a Secret Service investigation and claimed they had evidence showing they had permission to attend the A-list affair.

An e-mail exchange with Pentagon official Michele Jones will, insist the decorous couple — certainly people who invite the TV cameras in to watch their dressings-up can’t be utterly without taste — completely exonerate them.

The Salahis wrote that they drove to the White House the night of the dinner “to just check in, in case it got approved since we didn’t know, and our name was indeed on the list!” The Secret Service has said they were not on that list and that it erred by letting them in.

“We were invited, not crashers,” Michaele Salahi said in the “Today” interview. “There isn’t anyone who would have the audacity or the poor behavior to do that. No one would do that and certainly not us.”

So far be it from this space to insinuate that they are guilty of poor behavior. But there is still room for concern about their facility with the English language:

Tareq Salahi said he and his wife have been “very candid” with the Secret Service and “have turned over documentation to them. … We’re going to definitely work with the Secret Service between Michaele and I to really shed light on this.”

Couple say they didn’t crash White House dinner — chicagotribune.com.

Menopausal Militia Mobilize for Choice

Bart Stupak is probably a nice, regular guy. It’s just that he belongs to a sub-species which cannot fully understand the need for a woman’s right to choose to have an abortion. As it turns out, a growing number of the other sub-species don’t fully understand it either. This is because that right has existed since before they were born. One person who does understand is Representative Louise Slaughter, for whom the right to choose is not just an abstract. The battle now being fought by Slaughter and others is detailed in a New York Times article by Sheryl Gay Stolberg:

In the early 1950s, a coal miner’s daughter from rural Kentucky named Louise McIntosh encountered the shadowy world of illegal abortion. A friend was pregnant, with no prospects for marriage, and Ms. McIntosh was keeper of a secret that, if spilled, could have led to family disgrace. The turmoil ended quietly in a doctor’s office, and the friend went on to marry and have four children.

Today, Louise McIntosh is Representative Louise M. Slaughter, Democrat of New York. At 80, she is co-chairwoman of the Congressional Pro-Choice Caucus — a member of what Nancy Keenan, president of Naral Pro-Choice America, calls “the menopausal militia.”

The militia was working overtime in Washington last week, plotting strategy for the coming debate over President Obama’s proposed health care overhaul. With the Senate set to take up its measure on Monday, a fight over federal funding for abortion is threatening to thwart the bill — a development that has both galvanized the abortion rights movement and forced its leaders to turn inward, raising questions about how to carry their agenda forward in a complex, 21st-century world.

Not all stories such as that of Louise McIntosh’s friend had happy endings. More of them ended in doctors offices only after botched abortions left women permanently scarred and frequently barren, although last-minute treatment led to survival. Still more of them ended in terrible pain, isolation and death. But because those stories slowly faded into abstractions, even the women who will write new ones when legal abortion is denied them have a hard time understanding how critical this fight for health and sanity is.

It has been nearly 37 years since Roe v. Wade, the landmark Supreme Court decision that established a right to abortion, and in that time, an entire generation — including Mr. Obama, who was 11 when Roe was decided — has grown up without memories like those Ms. Slaughter says are “seared into my mind.” The result is a generational divide — not because younger women are any less supportive of abortion rights than their elders, but because their frame of reference is different.

“Here is a generation that has never known a time when abortion has been illegal,” said Anna Greenberg, a Democratic pollster who studies attitudes toward abortion. “For many of them, the daily experience is: It’s legal and if you really need one you can probably figure out how to get one. So when we send out e-mail alerts saying, ‘Oh my God, write to your senator,’ it’s hard for young people to have that same sense of urgency.”

Polls over the last two decades have shown that a clear majority of Americans support the right to abortion, and there’s little evidence of a difference between those over 30 and under 30, but the vocabulary of the debate has shifted with the political culture. Ms. Keenan, who is 57, says women like her, who came of age when abortion was illegal, tend to view it in stark political terms — as a right to be defended, like freedom of speech or freedom of religion. But younger people tend to view abortion as a personal issue, and their interests are different.

The 30- to 40-somethings — “middle-school moms and dads,” Ms. Keenan calls them — are more concerned with educating their children about sex, and generally too busy to be bothered with political causes. The 25-and-under crowd, animated by activism, sees a deeper threat in climate change or banning gay marriage or the Darfur genocide than in any rollback of reproductive rights. Naral is running focus groups with these “millennials” to better learn how they think.

“The language and values, if you are older, is around the right to control your own body, reproductive freedom, sexual liberation as empowerment,” said Ms. Greenberg, the pollster. “That is a baby-boom generation way of thinking. If you look at people under 30, that is not their touchstone, it is not wrapped up around feminism and women’s rights.”

Abortion opponents are reveling in the shift and hope to capitalize. “Not only is this the post-Roe generation, I’d also call it the post-sonogram generation,” said Charmaine Yoest, president of Americans United for Life, who notes that baby’s first video now occurs in the womb, often accompanied by music. “They can take the video and do the music and send it to the grandmother. We don’t even talk anymore about the hypothesis that having an abortion is like having an appendectomy. All of this informs the political pressures on Capitol Hill.”

Well, I am the grandmother. Those videos are not the baby. They are images of an embryo in the body of a sentient human being whose life does not belong to Bart Stupak.

The women who will suffer and die if the right to choose a legal abortion is denied, though, are not women who get pretty little sonogram videos made for their grandmothers and their scrapbooks. They are the very young, the desperate, the poor. They deserve respect. They have rights.

The pressures relating to abortion had seemed, for a time, to go dormant. Mr. Obama, who campaigned on a vow to transcend “the culture wars,” even managed to win confirmation of a new Supreme Court justice, Sonia Sotomayor, without the usual Washington abortion uproar. Most of his political energy around abortion has been spent trying to forge consensus on ways to reduce unintended pregnancies.

The quiet was shattered this month, when the House — with surprising support from 64 Democrats — amended its health care bill to include language by Representative Bart Stupak, Democrat of Michigan, barring the use of federal subsidies for insurance plans that cover abortion. Lawmakers like Ms. Slaughter, who advocate for abortion rights, found themselves in the uncomfortable position of voting for the larger health bill even though the Stupak language was in it.

Proponents of the Stupak language say they are simply following existing federal law, which already bars taxpayer financing for abortions. Democratic leaders want a less restrictive provision that would require insurance companies to segregate federal money from private premiums, which could be used to purchase plans that cover abortion.

Representative Debbie Wasserman Schultz, Democrat of Florida and chief deputy whip of the House, blames what she calls the complacency of her own generation for the political climate that allowed Mr. Stupak to prevail. At 43, the mother of three children, she has taken up the abortion rights cause in Congress, as she did as a state legislator.

But if she had to round up her own friends “to go down to the courthouse steps and rally for choice,” she said, she is not certain she could. When older women have warned that reproductive rights are being eroded, she said, “basically my generation and younger have looked at them as crying wolf.”

Unfortunately, reproductive rights have already been eroded, and it’s about to get worse.

The question now is whether the Stop Stupak coalition can succeed. Ms. Wasserman Schultz sees the debate as a chance to rouse women of all generations, and Ms. Slaughter warns that if Mr. Obama signs a bill including the amendment, it will be challenged in court. She says she has worried for years about what would happen “when my generation was gone.”

At the moment, her concern has diminished. “Right now, I’ve never seen women so angry,” Ms. Slaughter said. “And the people that were angriest with me were my three daughters.”

Being a member of Ms. Slaughter’s generation myself, my concern is still pretty high. My concern is for those women who don’t have the education, access and opportunities of our own daughters and granddaughters, those women who will suffer and die if their rights are taken away. If we have to cave to the likes of Bart Stupak — and the ultra-conservatives, and the U.S. Conference of Catholic Bishops — in order to get a health bill, then so be it. But once we get a bill, the Menopausal Militia will continue to fight for those women threatened with suffering and death. Because we remember the stories, and they are terrible stories.

In Support of Abortion, It’s Personal vs. Political – NYTimes.com.

Mr. & Mrs. Salahi vs Emily Post

Tired of the party crashers who won’t disappear? Aren’t we all. But since they are now accepting bids for TV appearances or something, they are clearly going to need a lot more high-priced agents and lawyers and publicists, and the least we can do in this space is offer a few more lines of coverage to help out.

One thing seems to be missing in all this. We are obsessing about security, and celebrity status or lack thereof, and too much or too little media coverage, and the excesses of reality TV which I have to admit to never having seen. But what about decorum? Could we sit the Salahis down with Letitia Baldrige? Preferably in a small, closed room? Lock them up in there (just Mr. and Mrs. Salahi, that is) until they finish Miss Manners’ Guide to Excrutiatingly Correct Behavior, every last word?

I grew up on Emily Post myself. Extend a hand contrary to the way Emily instructed (Ms. Salahi’s casual finger-work on Vice President Biden’s chest? Good grief) and one would suffer terrible, unrelenting embarrassment.

I think these people don’t know how to spell embarrassment. And as my Emily Post Book of Etiquette-bearing mother would say, “More’s the pity.”

Recovery Act funds boost Alzheimer's research

Spotting brain changes before symptoms appear… identifying risk-factor genes… finding drugs that improve memory… these are a few goals of newly-funded Alzheimer’s research. And for millions of us, tomorrow won’t be too soon. The National Institute on Aging (NIA), part of the National Institutes of Health, is boosting these and other research areas in grants made with American Recovery and Reinvestment Funds.

Dementia is the looming fear of most of us over 50, an age group that recently inducted my son. My own mother died at 70, after a decade of strokes and the gradual fuzzing-out of a once sharp mind. My father-in-law, and his father, both suffered from “Alzheimer’s-related” illness. We are now light years beyond what we knew then, but probably another few light years away from prevention or cure. When you have witnessed close-on the devastation that dementia wreaks, any step toward those goals is very good news.

A few of the new or ongoing projects getting a boost from Recovery Act dollars were summarized several days ago by Medical News Today:

“We are delighted to announce the award of Recovery Act funds to many dedicated, hardworking scientists committed to advancing scientific discovery into Alzheimer’s disease and cognitive impairment,” said NIA Director Richard J. Hodes, M.D. “Over the next two years, the recipients will use this unprecedented boost in research funds to help reach our ultimate goal of understanding age-related cognitive decline and reducing the individual and societal burden of this devastating disease.”

More than 100 Alzheimer’s or Alzheimer’s-related research grants were awarded under the Recovery Act.

The complete list, a daunting read for the scientifically challenged, is available online at the ARRA (Recovery Act) site. Snippets of the list, paraphrased from the Medical News Today, summary, include:

$24 million to the Alzheimer’s Disease Neuroimaging Initiative to track changes in the living brain as older people transition from normal cognitive aging to amnestic mild cognitive impairment (MCI), in which individuals have a memory deficit but generally retain other cognitive abilities, and from MCI to Alzheimer’s disease.

A grant of more than $5.4 million to add 3,800 Alzheimer’s patients and an equal number of people free of the disease to a previously funded study by the Alzheimer’ Disease Genetics Consortium (ADGC), which aims to identify the additional risk factor genes for late-onset Alzheimer’s disease. These huge datasets will allow scientists also to search for genes associated with a number of traits associated with Alzheimer’s, as well as for genes related to cognitive decline.

Another study, examining cognitive decline in older African-Americans will collect and analyze the DNA of 4,140 elderly African-Americans enrolled in NIA-funded aging studies already taking place in Chicago and Indianapolis. The study will assess the associations of over 900,000 genetic markers for such issues as stroke and high blood pressure.

Another $820,000 in Recovery Act funds will advance Alzheimer’s genetics research by developing methods for identifying combinations of genes that might influence age-related risk of AD.

There are more — some looking at drugs and exercise, some studying specific populations, many (including the above) examining a multiplicity of factors in the search for answers to the puzzles of the brain.

This space will be following the progress of them all — if I don’t forget.

Recovery Funds Advance Alzheimer’s Disease Research.

Diet, exercise and Alzheimers

These paragraphs are a segue from talk of holiday festivities, over the past several days,  into the very un-festive subject of Alzheimer’s disease.

Part of the conversation at the very festive Thanksgiving dinner I was lucky to enjoy (without having cooked a single dish!) centered around food for the brain. One argument was that the good stuff for one’s neurotransmitters — egg yolks, broccoli, soy, starches — should be meticulously watched. I heard my mother’s voice in my head in response. “If you have three meals a day that look pretty on the plate,” she liked to advise, “you’re getting the proper diet.” When pressed she would explain that “pretty” equates to “color-coordinated,” i.e.: toast/bacon/scrambled eggs with parsley; or broccoli/carrots/potatoes/hamburger. I can’t remember whether our plates were 9-inch or otherwise.

Then there is the larger issue of exercise. Fitness, and occasionally brain exercise, have been contemplated several times in this space over the past few months (10/5: How’s your brain fitness today?; 9/7: The new best thing.) These theories hold that it is possible to strengthen, possibly even build anew, those neurotransmitters.

The definitive word on all this has not been written, and answers surely won’t originate with someone who barely passed Science I-II for the math/science requirement of her BA in Art. But some fascinating studies are being done, and new American Recovery and Reinvestment Funds will be going to projects that will be the focus of this space tomorrow.

Meanwhile, Alzheimer’s and various forms of dementia remain the ultimate tragedy in millions of lives, diet and brain exercise and clean living in general notwithstanding.

One of the most poignant insights into this disease you’ll be likely ever to see is currently offered by the PBS series Life (Part 2.) It follows a beautiful, articulate woman named Mary Ann Becklenberg as she confronts her own decline with incredible courage. What science may find answers for in the next few years, Mary Ann Becklenberg is exploring in real time. Schedules and clips are on the Life (Part 2) website.

Chances are, whether you’re over 50 or not, your life will be impacted by dementia. I, for one, am grateful for science and for Mary Ann Becklenberg.

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