AGING TODAY
v
Covering advances in
research, practice and
policy nationwide.
www.agingtoday.org
Vol. xxxii, No. 2 The Bimonthly Newspaper of the American Society on Aging March–April 2011
Elders and the Perils of Long-Term Care ty. Many transgender elders report that
they would rather forego care alto-
gether than live in such a facility.
By Daniel Redman it, “A secret fear of all transgender peo- Transgender Aging Network, executive
To avoid dealing with bullying by
ple, surgical or not, is to grow old and director Loree Cook-Daniels says,
other residents, and because transgen-
Phyllis Frye is a long-time lawyer be psychologically abused, day after “People reported that they would rather
der elders are different, some facilities
and a judge in Houston. She is also a day, by the staff of a nursing home.” kill themselves than enter a nursing
will segregate them. An ombudsman
prominent transgender activist. To Transgender elders are afraid staff home and be at the mercy of staff. official reports that in one California
transition from male to female—her members will refuse to let them live That’s how afraid some people are at
true gender identity—she underwent consistent with their gender identity, the thought of being unable to defend
several medical procedures and takes deny them appropriate medical care themselves from transphobic health- ‘People reported that
estrogen. In Phyllis’s life, she chooses (such as hormone therapy), violate care providers.”
where and how she lives without fear. their privacy and leave them vulnerable they would rather kill
Looking to her future, she is adamant
she would not feel safe living in a
to harassment and mistreatment.
These fears are widely prevalent in
Erasing Identity
themselves than enter a
Nursing home staff members have
nursing home. the community. In a study published in enormous power to ignore—and thus nursing home and be at
Transgender elders are afraid of 2010 in the Journal of GLBT Family erase—a transgender elder’s identity.
long-term-care facilities. As Frye puts Studies, and conducted by FORGE/ For transgender elders, one of their
the mercy of staff.’
worst fears is being placed in a facility
that tries to force them to live in their
A Vibrant New Look for Aging Today original sex. By using the wrong pro-
nursing home, a transgender resident
was “prevented from eating with other
ASA is pleased to announce that the pages of Aging Today will soon have a nouns or names, a staff member essen- residents, talking with them or being
new look! Beginning with the May−June 2011 issue, you’ll see a major trans- tially negates a lifetime of struggle. involved in social and recreational ac-
formation to a brighter, bolder, more vibrant design. We’ll still bring you the Transgender elders also fear staff tivities with other residents.” Nursing
same timely, useful and engaging stories by experts in the field of aging—but will refuse to provide them with hor- home officials also employ this tactic
with the added touch of eye-catching four-color photography and graphics. The mone therapy, force them to wear the against lesbian, gay and bisexual el-
new Aging Today will debut at the 2011 Aging in America Conference and will other gender’s clothing or prevent ders. Jane Gross of The New York Times
arrive in your mailbox in early May. them from using appropriate rest-
rooms or showers. Facility staff may l continued on page 4 l
2 Aging Today March–April 2011
Aging at UCLA’s School of Public Affairs. Diana Lam is a graduate research assis- 94105-2938; by fax to (415) 974-0300;
tant at UCLA’s School of Public Affairs. or by e-mail to ahood@asaging.org.
March–April 2011 Aging Today 3
FORUM
Assisted Living and Medicaid:
Exploring the Unanswered Questions
By Eric Carlson based if it provides single-occupancy
units with a lockable front door.
Increasingly, state Medicaid pro- Also, in 2009 the CMS requested
grams are offering to cover personal public input on the interpretation of the
and healthcare services provided by term community-based, and it is ex-
assisted living facilities. But it’s a pected to announce a broad policy on
new model, which means many poli- this issue during 2011. The NSCLC
cy questions remain unanswered, pos- and its partners in the Assisted Living
ing challenges for states, providers Consumer Alliance (www.assistedliv
and beneficiaries. ingconsumers.org) support an interpre-
In order to better understand these tation similar to the policy applied in
unanswered questions, the National MFP programs.
Senior Citizens Law Center (NSCLC) Quality of care is another important
conducted a study of states that cover issue. When the Medicaid program
assisted living services through a Med- covers nursing home services, the nurs-
icaid Home and Community-Based Ser- ing home must comply with compre-
vices (HCBS) waiver. (The study was hensive quality standards set by the
funded through a grant from The Com- federal Nursing Home Reform Law. In
Photo: iStock Photo/MirekP
&OLFN&RQQHFWDQG/HDUQ
and may be devastated if staff or resi- Advancement Project, 30% of trans-
dents disclose that information. Others gender people put off or avoid seeking
want to live openly, but may be pre- medical care for this reason.
vented from doing so.
Hopeful Signs
Turned Away at the Door While all of this is cause for alarm,
Sometimes, because of discrimina- there is cause for hope. Thirteen states,
tory attitudes, nursing home officials the District of Columbia and more than
Ǥ will bar a transgender elder from their 100 cities have transgender-inclusive
ǣ facility. In late 2007, an older transgen- nondiscrimination laws. Where those
der woman who was homeless contact- laws include public accommodations
͕͗Ȅ ǣ ed Chicago’s Center on Halsted—a provisions, they can be used to bring
community center serving the lesbian, lawsuits against nursing homes discrim-
gay, bisexual and transgender commu- inating against transgender people.
͙Ȅ
nity. She needed emergency brain sur- To change the climate of California
ǣ
gery, but doctors refused to operate on nursing homes, in 2008 the legislature
her unless she had somewhere to go af- passed a law mandating that the state
terward. She had already contacted Department of Public Health design
͕͕ȄǦ
three nursing homes, but they had all and institute an LGBT-inclusive train-
turned her down. ing program for certified nurse assis-
͕͝Ȅǯƪ
“It was really blatant refusal,” says tants and other personnel. Advocates in
Serena Worthington, former director at the District of Columbia are currently
Services & Advocacy for GLBT Elders working toward passing a similar law.
͝Ȅǣ
͚͔ (SAGE) in Chicago. Worthington A nursing home in Chicago conducted
worked with the center’s Volunteer focus groups and is currently working
Transgender Community Liaison, and toward developing a policy that will
͕͕Ȅ
ǣ
together they found a long-term-care ensure that transgender elders receive
facility that would take her. When Wor- proper respect and care.
͕͛ȄǦ
thington shares this story with people These efforts are in their infancy,
who don’t work with LGBT elders, she and much more must be done. But with
͕͜Ȅ
Ǧ says, “They cannot believe it hap- more robust cultural competency train-
pened.” But when she tells those who ings, vigorous litigation against dis-
work with LGBT elders, she says that criminatory facilities, increased activ-
͖͙Ȅ
“each of them has a similar story. Un- ism both inside and outside nursing
ǣ
fortunately, people are refused medical homes, and more widespread nondis-
services and housing and treated badly crimination laws across the country, we
all too often.” can hope for a time when no elder will
͕͚ȄȀ
Even medical providers can be un- fear the inside of a nursing home. v
welcoming—or worse. According to Daniel Redman is an attorney in the
Injustice at Every Turn, a study re- Elder Law Project of the National
ǤǤȀ leased in February 2011 by the Nation- Center for Lesbian Rights, San Fran-
al Center for Transgender Equality and cisco, Calif.
March–April 2011 Aging Today 5
to help individuals invest in life’s next stage. Why not allow people to stop and start
their Social Security payments as circumstances change?
Develop a comprehensive Encore Bill. Let us help people in the new stage to
develop their human capital, transition into new roles and cope with the financial
challenges by creating policy measures to ease the transition.
—Marc Freedman Marc Freedman
6 Aging Today March–April 2011
www.CampaignForBetterCare.org
The Campaign for Better Care is led by the National Partnership for Women & Families, Community Catalyst,
and the National Health Law Program and funded by The Atlantic Philanthropies.
March–April 2011 Aging Today 7
IN FOCUS
articles are from speakers at the April We’ve seen amazing technological
28 Mature Women’s Summit at the age, and are the leaders in bringing our
and political evolution across the past
2011 Aging in America Conference (for country out of the recession. In devel-
century, but the single most powerful
more information visit www.agingcon oping nations, 90% of women who
economic change has not been caused
ference.org), as well as from experts in earn income reinvest it in families and
by technology or the rise of developing
communities—by sending kids to
the areas of finance, workplace issues nations. It has been created by women.
Maddy Dychtwald school or buying clean water and elec-
and caregiving. A hundred years ago, the world
tricity for their communities—com-
looked very different. Cars and tele-
phones were scarce, television not in- pared with only 30% to 70% of men.
MetLife Foundation
To learn more about MindAlert Program,
visit www.asaging.org/mindalert
Brought to you through a generous grant from MetLife Foundation
12 Aging Today March–April 2011
Home Instead Senior Care® has teamed up with the Mark your calendar so you don’t miss
American Society on Aging (ASA) to present a series of these great webinars:
web seminars that address pertinent caregiving issues.This
family caregiver support webinar series features a variety of February 9, 2011:
topics that will help caregivers navigate the many issues that How to Select an
A
In-Home t t
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August 17, 2011:
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All webinars in the series will be presented by will help you in
Dr. Amy D’Aprix, Executive Director of
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Each of the webinars will be recorded and available for
Each webinar is an hour in length and provides one viewing for up to 60 days after the live presentation.
continuing education unit of credit. Pre-registration is required to attend the live webinars.
Register by going to
asaging.org/webseminars
For information about Home Instead Senior Care, call
877.335.8877
asaging.org homeinstead.com
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March–April 2011 Aging Today 13
mature women who are bright, engaged, scorning or ignoring them. Mentoring
passionate and wise. programs are an important step but, as
with any kind of prejudice, permanent
change begins on an individual basis,
‘Wise women are ideal person to person.
role models for the Writing Coming Home to Yourself has
been an eye-opening experience for me.
younger generation.’ Being a somebody simply means being broad vision. We all have such women In interviewing the 18 women in the
who I am and living that way. Being a in our lives, but most of them go un- book, I saw firsthand how women from
somebody is being myself.” noticed and unheralded. My 67-year- ages 55 to 77 years live with purpose,
Take Edie Elkan, who gave up the These are just a few of the thousands old yoga teacher, Sonia Nelson, is a
love of her life—playing the harp—at of older women from across America wise woman in my life. Although l continued on page 15 l
age 22 for financial reasons and who want to share their wisdom and
yearned for it for 28 years. Today at experience, if only our society would The following is excerpted from Coming Home to Yourself: Eighteen Wise
age 66, she runs Bedside Harp, which give them the respect and appreciation Women Reflect on Their Journeys by Patricia Gottlieb Shapiro (Santa Fe, N.M.:
brings harp therapy to patients in hos- they deserve. 2010 Gaon Books). Reprinted with the permission of Gaon Books.
pitals in Pennsylvania and New Jersey. Elaine Pinkerton, age 68, was adopted at age five after spending her early
The Longevity Paradox
Her words of wisdom: “It’s never too years in abusive foster care. She finished graduate school, survived two mar-
late to follow your dreams. Allow your- Since January 1, 2011, more than riages, raised two sons, wrote four books and ran nine marathons, but she never
self to go after the things you long for 10,000 baby boomers daily have felt good enough. Here she describes the turning point that led her to acknowl-
or you’ll die never having done them.” reached the age of 65. That occurrence edge herself as a strong, wise woman.
Valerie Ramsey loved raising her six will continue for the next 19 years, and
result in more women living longer, My years with my adoptive parents were happy: I felt wanted…and they were
children and when they left home, she
proud of me. My parents wanted me to think of them as my “real” parents. I was
forged a career in the corporate world. healthier lives than the previous gener-
painfully self-conscious, because I felt I had to wear a mask, so I could be the
Today she is an author, public speaker ation. At age 65, we women are no lon-
“real” daughter. Of course, everything was so much better in my “new” life, but
and runway model. She said, “At sev- ger in mid-life and yet we don’t con-
the burning questions festered and took on a life of their own. I was just not
enty years of age, I’m comfortable with sider ourselves elderly either. This age
okay; otherwise how could my mother have given me away?
who I’ve become. I’m doing the things group is in a phase of adult develop-
that most fulfill my passion: inspiring ment without a name or an identity. When I was 11, I received a five-year diary with a red plastic cover and a lock
other women to continue to grow, to That’s the rub and the opportunity— and key for Christmas. That diary became my best friend. I wrote down every-
expand their horizons and to reinvent that there is no template for this stage thing, but mostly, I poured out my heart about my shameful secret. And I wrote
themselves as they move through tran- in our lives. Our parents died at young- every day in diary after diary, through my teen years and college, while I was a
sitions, especially aging.” er ages and viewed their lives as “over” wife and mother, and even later, as a grandmother….
Then there’s Victoria Zackheim, age once they retired. Not so today. Many Four years ago, after my second husband died, I felt lost. I decided to read my
65, who wanted to be “somebody” her of us are still working. If we’re not diaries…. Going through the journals, my feelings about myself began to shift.
whole life—somebody famous or some- working, we’re engaged in meaningful Reading my diaries was transformational for me: having more information made
body who would make her parents volunteer work or in pursuing a pas- me realize, in retrospect, how my life really was and how hard I tried…. I gained
proud. In 2008, after a traumatic fall sion. We still have a lot of energy and a new respect for myself. I had to reach back and symbolically put my arms
down the stairs in her San Francisco loft, years of life experience to share. around myself.
she realized, “After six decades, I finally Wise women are ideal role models I didn’t know what was in those diaries until I went back and read them. I
understand that being a somebody is not for the younger generation. They bring knew I was looking for a thread—about the adopted me. But now there’s another
the opposite of being a nobody. It has a sense of historical continuity, sea- me that’s wiser, richer, and better.
nothing to do with being famous…. soned judgment, encouragement and a
Tips on Transitioning
years old with substantial retirement wealth of talent, knowledge and expe-
savings before the downturn, 40% are rience. The options are endless: some
planning to work longer, delaying re- women may pursue politics, mentor- Here are few tips on transitioning to new roles:
tirement by four or more years. AARP ing, an encore career or become advo-
• Review your work experience and identify aspects of work you expect to miss
finds that 88% of those ages 46 to 53, cates. Others may teach, mentor, create
or actually do miss. You might want an experience that addresses a similar
and 87% of those ages 54 to 64, will new movements and organizations, and
need or value.
work during their retirement years. participate in the arts. Whether found
Assuming that retirement is still via- in work or volunteerism, these new • Speak to friends and colleagues who have made a good transition. Ask how
ble for a large number of women, de- roles and identities discovered in life’s they did it and what lessons they have learned.
mography may be a powerful guide to next chapter must satisfy these women • Ask yourself if you want to return to work, have an encore career, become an
anticipating what’s next. Forty million who have a track record of accomplish- entrepreneur or get involved in something very different from your primary
baby boomers are women, and more ments and success. v work. Explore a wide range of possibilities.
than one-third of them work in man- Helen Dennis is owner and found- • Be able to articulate your interests as well as the gifts you bring to an organiza-
agement and other professional capaci- er of Aging, Employment and Retire- tion or employer. Try your hand at creating your own position or unique role.
ties. About 10 million are likely to ment Specialists, Redondo Beach,
work in occupations that provide re- Calif., and is the chair of ASA’s Busi- • Explore some women’s organizations and movements that focus on the transi-
wards beyond money. ness Forum on Aging. She is the co- tion such as the Transition Network, WomanSage and Project Renewment™.
As many of these 10 million women author of Project Renewment (New —Helen Dennis
move from success to exploring post- York: Scribner, 2008). Dennis and
14 Aging Today March–April 2011
ASA is pleased to present a FREE MindAlert Speakers Bureau web seminar series delving into the nation’s most innovative brain fitness programs.
When I Grow Up I Want To Be a Student: The Art and Science of An Intergenerational Computing Model to Empower Older Adults
Lifelong Learning Programs May 5, 2011 Presenters: Jean F. Coppola,Ph.D., May 26, 2011
Presenter: Ruth Flexman, Ph.D. Barbara A. Thomas, RN, MA, MS, FNP,
Lin J. Drury, PhD, RN and Sharon Stahl Wexler, PhD, RN, BC
Research documents that lifelong learning contributes to the quality and length of life.
Learn how effective programs offer opportunities for older adults to expand knowledge, Computer technology enhances the quality of life and empowers older adults, and when
develop new interests and connect with old and new friends. Examples from the Osher coupled with intergenerational “teachers” energizes seniors for healthy aging in place.
Lifelong Learning Institute at the University of Delaware in Wilmington (2100 members per Participants in this webinar will obtain best practice insights and lessons learned to repli-
semester), Lewes (450 members), the new Dover program (130 members the first semes- cate a low-budget intergenerational computing program in their own agencies.
ter) and other programs will be used to illustrate how course content, marketing, adminis-
tration, and volunteer contributions support a successful online learning venture. My Turn—An Educational Program for Adults 60 Years and Older
Memory Training’s Influence on Cognitive Aging and Functional Ability Presenter: Beverly Collier, MBA June 9, 2011
The “My Turn” program is an educational program at Kingsborough Community College
Presenter: Graham McDougall, Ph.D. May 19, 2011 for adults over 60 years of age. Students attend the college and take tuition-free courses
As individuals age, many have decreased confidence in their memory, or memory self- for credit. This web seminar will provide an overview of the program, including its history,
efficacy, which is directly related to their everyday memory performance. This web seminar enrollment and registration, and special features.
will focus on one efficacy-based memory training program, SeniorWISE, and its longitudinal
outcomes on a triethnic sample. The Buddy ProgramTM—Pairing First Year Medical Students and Persons
with Early Stage Alzheimer’s June 30, 2011
Presenter: Darby Morhardt, MSW, LCSW
The goal of The Buddy Program is to provide a mutually enriching experience for medical
students and people with early stage dementia by strengthening the knowledge and sensi-
tivity of future physicians regarding issues of aging and dementia while offering a mentor-
ship opportunity to a person with dementia. This seminar will describe the development
and step-by-step organization of the program, share outcomes and lessons learned, and
MetLife Foundation how the The Buddy Program is currently being replicated at other medical schools.
All Seminars begin at 10 AM Pacific Time. Visit www.asaging.org/webseminars/metlife_mindalert_series.cfm for full details on how to access these free web seminars.
March–April 2011 Aging Today 15
ASA Update
the cause of supporting and serving el- when you know that a Every such meeting can inspire hard- The Winter 2010−11 issue of Gen-
ders is strong and whole-hearted. When- er work on your cause. And then there erations, which covered 21st century
ever I pick up the phone to garner sup- new idea or innovation are the advantages of “virtual” meet- workforce challenges and opportuni-
ties, was also an eye-opener to the
port for ASA’s mission, programs and
projects, or to discuss new ideas and
can potentially save a ings. ASA also builds collaboration and
community through weekly online plethora of needs that will face us in
plans with someone who already has a human life—these are learning gatherings—our web seminars. the near future as America’s aging pop-
full plate, I’m usually welcomed with On March 10 we offered a practical ulation increases. And in the Spring,
enthusiasm and heart. powerful motivators. and pragmatic seminar on “Sibling Generations will highlight the com-
Wars and Parent Care.” Led by Fran- plexities of healthcare reform and how
Getting the Word Out
hanced the quality of life for older cine Russo, author of They’re Your Par- the legislation can affect the ability of
Our ASA members, a dedicated adults, when you know innovation ents, Too! How Siblings Can Survive older adults in our country to age with
community of professionals, are deter- can potentially save a human life, it’s Their Parents’ Aging Without Driving dignity and a good quality of life.
mined to get the word out about where a powerful motivator. Each Other Crazy, clinical social
worker Steve Barlam and geriatric care ASA Members: Our Guiding Light
manager Rona Bartelstone, the session But before you see the Spring Gen-
taught participants how to become more erations in your mailbox, you’ll see the
sensitive to complex family dynamics, May–June 2011 issue of Aging Today.
REGISTER NOW!
and provided potential interventions to With that issue—and with all of our is-
help adult children reach resolutions. sues to come—you’ll see evidence of
In May we’ll offer a web session on the expert guidance and commitment
the inspirational “Art and Science of from our members who have stepped