Thursday, March 22, 2012

A Nursing Home Tour with Chiquita Smith

Last Thursday, we visited two nursing homes in Brooklyn with Chiquita Smith. Chiquita Smith is 88 years old but that number does not quite capture the vigor with which she lives. Moreover, she lost her vision a number of years ago as a complication of diabetes. Despite the obvious, these circumstances do not limit Chiquita Smith in her work defending the rights of nursing home patients. As Global Action on Aging interns, we serve as an extension of her vision. We fill in the details that she herself cannot paint alone. Also on this trip were two others: Fabiola Church, a Certified Nursing Assistant/Chiquita’s home aide and Pastor Caesar who, with a characteristic smile, drives the group to these on-site visits.

It was our first time visiting a nursing home in the United States. Though we’ve written about the subject countless times in the GAA newsletter, the experience of it first hand was quite different. There were few moments where Chiquita would confidently say how it is not enough to hear or read of the experience but it is equally if not more important to see it for ourselves. And for Louise and I that day was our special opportunity. We did not know what to expect but of course we had some of our own preconceived notions.

We first stopped at Cobble Hill Health Center, where Chiquita had already brought GAA’s blog intern Sanna a year ago. The Cobble Hill Health Center is a non-profit facility that houses almost 400 patients. From the outside, the imposing 5-floor brownstone building looks very well-maintained: visitors are greeted by flowers and the entrance is only a short walk away from the sidewalk. The first floor reminded us of a small village and we noted the effort to make the place feel homey. The little gift shop and the spacious restaurant-like dining room decorated with chandeliers and wall paintings almost made us forget we were in a nursing home. Though the presence of a hand sanitizer station did remind us of where we really were.

Chiquita told us we would be visiting her friends in both nursing homes, and we took a fairly clean elevator to the 5th floor, where her friend Pearlie’s room is located. When it stopped on the 4th floor to let an old woman out, we were all struck by a powerful and unpleasant smell of urine that unfortunately followed us to the upper floor.

We were taken to the family room by one of the nurses to wait for Pearlie, and therefore had time to look around the place. We acknowledged the presence of many posters concerning nutrition: what to eat, what foods should be avoided, the importance of exercising, and the consequences of diet on aging. Also, a sheet of paper was there to inform residents and visitors of the week’s activities, including reading, a fitness class and different religious services. Another displayed the week’s menu. Most of the residents were sitting in the recreational room. It was nice to see the involvement of the residents with real-life activities as they do lead to strengthening of coping skills and self-esteem. However, what was saddening was the array of elders in the hallway. Some residents were without any attention; one man was reclined in a mobile bed as he blankly stared down the corridor. Others were more active; one woman walked in her socks somewhat oblivious to what was happening around her.

Knowing that Fabiola is also a part-time Certified Nurse Assistant in the Bronx, we asked what her thoughts were of the Cobble Hill Center. She replied that people walking around shoeless was not necessarily neglect, but sometimes just a practical way of dealing with patients who either lose their belongings or simply feel more comfortable this way. Regarding the man in his bed, she stated that someone was probably cleaning his room, but admitted that he shouldn’t have just been left in the corridor and nurses should have made sure his privacy is respected. Her main point of conflict was the odor. A nursing home that does not clean after its patients or the linens and beds will carry the smell of body and urine odor. And this was evident as that smell permeated the halls and the very room we were sitting in together.

Pearlie then joined us in the room and we got to ask her questions about her life in the nursing home. She told us she has been at Cobble Hill for 2 years and really enjoys the staff’s devotion to residents, the racial mix and the diversity of activities. She said, however, that she didn’t always feel like that. She didn’t want to be put in an “old folks’ home” when her daughter first mentioned moving, mostly because she feels she can still do a lot by herself, but recognized that with time, being helped with daily tasks did feel like a relief. Chiquita was very keen on knowing whether residents could vote, and made sure her friend understood that it is their right to be able to do so. Pearlie reassured her by explaining the residence has purchased voting machines for residents and that the staff encourages them to do so.

Pearlie and Chiquita at Cobble Hill Health Center

As we were leaving the 5th floor, a white female Alzheimer’s patient approached us and began to converse with us freely. She was not aware of the reality of the situation unfortunately. She was very calm and we followed suit as we walked into the elevator. The last glimpse we had was of her pointing and speaking to the elevator doors. We felt a little taken aback by the situation because we were under the impression that dementia patients would be on a different floor altogether with more aggressive care. She, however, was not really being supervised.

We said goodbye to Pearlie and headed to our second destination: the New York Congregational Nursing Center, also located in Brooklyn but closer to Chiquita’s home. There, we parked in the gated parking lot which is guarded by security, making it a lot safer and easier to take residents in. The setting was even more impressive: we entered the block-long building and discovered a huge fish tank, a cage in which happy-looking birds were tweeting and a little corner in which bowls indicated the presence of cats. Pets are always known to bring inner calm to their owners so the addition of animal and plant life definitely created a Zen-like feeling inside the nursing home. The hallways were airy and there were absolutely no strange odors of urine. The difference was a bit stark compared to Cobble Hill, in our opinion.

We sat on the 5th floor to wait for Chiquita’s friend Minnie to finish her lunch. As we waited we observed our surroundings. The rooms were larger and brighter. The linens there had a calming pastel color (compared to the dark and aging drapery and sheets of Cobble Hill). Overall, this nursing facility had less of an institution feel. We enjoyed comfortable chairs and acknowledged that the visitors’ bathroom was clean. Two residents we watching TV next to us- one with a glass of juice coming from the automatic fountain in his hand, the other one wearing a blanket on her lap. At one point, one of the residents was shaking a small bell to get the attention of staff. After some noisemaking of the bell and her shouts, Fabiola decided to notify the working staff. She went to the office to get a nurse, and told us that just as every other nursing home this one was also dreadfully under-staffed. Minnie soon came in her wheelchair. We could not approximate her age but she was definitely mentally alert. She held onto Chiquita’s hands as the two talked in the few moments they had. We also noticed other residents expressing silent curiosity as to why we were there. One woman sat in her wheelchair, a blanket on her lap, and with inquisitive eyes positioned towards us. It was endearing and at the same time, upsetting. We did not know her story.

Comparing the two places, the first one wasn’t as welcoming and clean, and the smell was really repulsive. Fabiola assured us that this inconvenience can be easily avoided if the staff is cautious, which made us feel as though the staff wasn’t trying very hard. The second one reminded Louise of her grandmother’s nursing home in France, which is a private facility hosting people suffering from Alzheimer’s disease but at a very high cost. Chiquita mentioned what we already knew as we left the building- the second place, owned by a church, is also much more expensive than the first one.

As a Bengali-American, the concept of old age homes is somewhat new to Naoreen. Traditionally, the structure of the Bengali family includes elders. However, with modernization and an ambitious generation, values are being discarded as are the elders, regrettably. It is unfortunate that those who have contributed their entire lives for the progress and well-being of their children are now being left under the care of strangers. Despite this being a foreign concept, Naoreen does understand that there may be situations outside of our control that require complex care and rehabilitation. And we sincerely hope that this is truly the reason for the elders that we met last Thursday.

By Louise Riondel and Naoreen Chowdhury

Thursday, March 8, 2012

Older Women Rights, Voices, Actions

Aparna Mehrotra, at the podium
Rosemary Lane and Susanne Paul

March 2, 2012

Chaired by:

Susanne Paul, President Global Action on Aging

Sponsored by:

Baha’i International Community, EURAG, Global Alliance

Supported by:

Women’s Alliance for a Democratic Iraq, Widows Rights International, National Alliance of Women’s Organizations


The seminar on “Older Women: Rights, Voices, Action” provided an opportunity to discuss and explore about the situation of older women in the world today, efforts to secure the human rights of older persons. The panel also highlighted the voices of rural older women as they are the major food providers in world’s rural areas. A broad range of people participated in the event from different civil society organizations. The Chair, Susanne Paul opened the panel and welcomed all who attended and encouraged the exchange of ideas among participants.


The keynote speaker, Ms. Aparna Mehrora from UN Women, addressed the issues of aging, gender and the global lack of data on older women. It was followed by Rosemary Lanes speech on the progress of the UN Open-Ended Working Group on Ageing. Elizabeth Kharono explained the new plan of action for the right of women to land and social protection in Uganda. Elizabeth Sclater brought out the framework of the contributions of rural women to the CEDAW document. Unfortunately, Pakishan Zangan could not attend the event who was supposed to talk about the experience of older women in Iraq. Every speech was followed by a short Q&A session.

Ms. Aparna Mehrotra: Senior Advisor on Coordination and Focal Point for Women in the UN System, Division for Coordination, UN Women

Ms. Mehrotra spoke out about the issues of ageing and gender. She confirmed that the aim of the UN research was to consider the progress that has been made over the past decade in implementing the Madrid Plan of Action on Aging. She also stressed the fact that gender perspective is not being effectively taken into account in ageing policies.

In 1994, the statistics for the campaign “Violence against Women” covered only women aged 49 or younger. This is an important data that should be highlighted. The lack of data helps to underline the need to include older people and ageing in our policies. . She pointed out the importance of supporting member states to improve the data collection and analysis in order to unleash the potential of older women. She finalized her speech by hoping that the World’s Older Persons Report would mark a step where older women are no more seen as jeopardy but as a perfect union.

Rosemary Lane: Senior Social Affairs Officer, UN Focal Point Ageing

Ms. Rosemary Lane addressed the progress of the UN Open-Ended Working Group on Aging. It’s noteworthy that two of the regions (Africa and Asia) were almost completely absent at the discussions of the OEWG meetings. She quickly went over the monitoring process of the Madrid International Plan of Action on Ageing at the global level, particularly during the second review and appraisal period which is to come at the end of 2012. She amplified the importance of including older persons’ issues in the existing human rights mechanisms as well as national policies and programs. Ms. Lane encouraged developing national data collection on older people and supporting older persons’ organizations to attend the OEWG session in August 2012.

Elizabeth Kharono: Baha’i International Community Delegate, Uganda

Elizabeth Kharono emphasized the prominence of access to land and social protection for women in Uganda. Women continue to face multiple threats of discrimination in Uganda. She underlined the significant role of rural women in Uganda in providing food for the whole family. She believed that the women‘s lands rights and rights to social protection would strengthen the national protection regime. It would also provide them with a decent life as well as their families and communities.

Elizabeth Sclater: General Secretary, Older Women’s Network, Europe/EURAG Representative

Elizabeth Sclater distributed the Secretary General’s report on the Human Rights of Older Persons report. She said that the UK older women are considerably poorer than older men, and the oldest are the poorest. On average, a woman’s income in retirement is only 57% of that of men. The rural older women in the UK are facing more financial hardship than urban older women. The living costs in rural area are much higher than urban area for older people. Older women have contributed to UK CEDAW by including the protection of the rights of older women.

by Sanaa Smaoui,

Friday, March 2, 2012

HIV – A Disease of Poverty?

Last week I attended a meeting at the UN. This side event for the Fifteenth Session of the Commission for Social Development focused on “Poverty as a contributing factor to and consequence of HIV infection”. The meeting examined how poverty and HIV intersect in the USA, India and on the African continent. Here is a summary:

* Felix Jones from VIVAT International described HIV and poverty in India. He explained how HIV can be devastating for a family who might already have economical struggles. For example, the infected parent will lose his/herjob; the family will lose their income and they will be pushed into poverty. The children will have to quit school and start working to help the family’s finances. Wives will engage in prostitution to produce income which means the disease will be spread further. Daughters will marry earlier than usual. Because the family can’t afford medications, the parents die young and leave the grandparents to care fo their grandchildren.

* Eric Sawyer from UNAIDS demonstrated the strong link between poverty and AIDS in both Africa and US. He explained that heterosexuals that live below the poverty line in the US are five times more likely to get infected with HIV compared to the rest of the nation’s heterosexual population, regardless ethnicity and culture. Having a person with HIV in the family pushes that family into greater poverty. If you barely can afford to feed your family, it is impossible to afford medical aid.

* Professor Beatrice J. Krauss studied new HIV infections in inner city of New York. She studied different areas and found that the Lower East Side has the highest rate of new HIV infections in the US, with 2 percent of all the new infections, that she attributes to the history of the neighborhood as a center of sex and drug trafficking. It also hosts housing projects for low-income persons.

Panelists, such as Eric Sawyer said “sex is everywhere, but you can't talk about it.” He believes that the US has become more conservative than it was earlier. In the 80's condom commercials appeared on TV, but today such information is not allowed on day time television. Consequently, he is not surprised that the US has the highest teen pregnancy in the western world.

Michael Sidibé, UNAIDS Executive Director, called on the African governments to invest in AIDS programs in the countries across the region. Today, foreign donors pay for African AIDS program that serve over 4 million Africans citizens who are depending on it. He said that Africa must stop depending on external resources, especially when it comes to HIV responses. He believes an African agency could provide its own medications and should do so. France suggested that African nations should start taxing their alcohol, cigarettes and cell phones to support such expenditures.

There is another link between poverty and new HIV infections. In India, the USA and Africa, poverty and hunger are increasing. Some 26 percent of the world’s population lives on less than $1.25 per day. One can argue that HIV does not discriminate, but it is becoming a disease for the impoverished. The Universal Declaration on Human Rights guarantees to protect the rights of all members of the human family. It states that “Everyone is entitled to all the rights and freedoms set forth in this Declaration, without distinction of any kind, such as race, color, sex, language, religion, political or other opinion, national or social origin, property, birth or other status. ”Social origin often means one’s class in society. Are poor people protected by the Universal Declaration on Human Rights?

This side event focused only on the younger population. Seniors and older adults were only described as care givers for their grandchildren due to their parents dying from the virus. In earlier articles I have mentioned that seniors are being pushed into poverty with high medical bills and a depressed national economy. (In the meantime, the US stock market has hit the high level it held in 2008). Because many older adults and seniors are also getting infected, we must examine the link between poverty and new HIV infections among elders.

Sanna Klemetti