Do you know your status?

Over three decades have passed since we first heard of HIV/AIDS. The first reported case in the US was in 1981, when The New York Times reported an outbreak of a rare form of cancer among gay men in New York City. This “cancer” was identified as Kaposi's Sarcoma, a disease that later became known as HIV/AIDS. Since 1981, researchers have made a lot of progress in learning about the virus. We now know how it is transmitted, how to get tested, and how to stay safe. Still, there are too many new infections occurring every year.

How Many? Who and Where?

According to UNAIDS, an estimated 1.2 million people now live with HIV/AIDS in the United States. About 20% of those infected (240,000 people) are unaware of their HIV status. These people may unknowingly spread the infection while missing early treatment for the virus.

In the US, an estimated 50,000 persons are infected annually. While most new infections occur in urban areas, the entire country is affected. Nearly 107,000 New Yorkers are living with HIV, while thousands more don't know they are infected.

UNAIDS and the Center of Disease Control and Prevention (CDC) have identified high-risk groups. Men who have sex with men accounted for 61% of new infections in 2009. Intravenous drug users accounted for 9%, and heterosexuals accounted for 27%. In 2009, 73% of the new HIV cases occurred in males. Previously, infections occurred in individuals between the ages of 13 – 29, but now middle-aged adults and seniors are becoming infected in greater numbers. About 17% of newly diagnosed HIV/AIDS cases in the USA are found in people over the age of 50, according to the 2009 CDC report. About one-third of all people living with HIV/AIDS in the USA are 50 years of age or older. This number is expected to increase by one-half by 2015. Everyone is at risk for HIV, not only high risk groups.

Why don’t people get tested?

If you are sexually active and you know that you had intercourse or oral sex without using protection, you should get tested. Not only does HIV/AIDS affect your health, but it is also your responsibility to make sure you don't spread the virus further. Many people are afraid of being tested for HIV; however, HIV testing must become more widespread. We have to bring it out in the open and decrease the stigma associated with it. We need to change our attitudes about HIV and make it easier to be tested.

How testing works

Ways of being tested are constantly improving and taking an HIV test is becoming easier. Blood samples are the most common diagnostic test used to identify HIV/AIDS. Recently, tests were developed in which a mouth swab may be used to identify the infection. Some tests require more than a week to provide results; meanwhile, others can give you a preliminary answer about your infection status in less than an hour.

You can get tested in many different settings. A physician may administer a test during your normal checkup. There are also Local STD Testing Sites all around the US (STD ALERT). This is easy way to get tested: you don't need an appointment and you don't need to see a doctor. STD Alert can give you the results within 24 – 48 hours. Check out the website for prices and centers:

http://www.stdalert.com/

Now you can use a new product called EZ – TRUST. This is a test you can take at home. The kit comes with everything you need to be able to find out your HIV status.

http://www.1mintest.com/how-to-use-hiv-test.php

Staying HIV Negative

Many people misunderstand how HIV is transmitted. You can become infected if you are having unprotected sex with someone who has HIV. The virus can be in an infected person's blood, semen or vaginal secretion. You can also get the virus if you share a needle and syringe with someone who is HIV positive while injecting drugs. Babies born to women with HIV can also become HIV positive during pregnancy, birth, or breast feeding.

You cannot get HIV by working with or being around someone who is HIV positive. The virus is not transmitted through sweat, saliva, tears, clothes, drinking fountains, toilet seats, or phones. Neither does it spread through insect bites or from donating blood.

To avoid getting infected it is important to protect yourself while having sex. Latex condoms offers the best protection against HIV and other sexually transmitted diseases. If you use drugs, never use needles that another person has already used. Find out if there is a needle exchange program near you.

HIV Positive, now what?

If you are diagnosed with HIV, it is up to you to make the decision to share that information with others. In some states you are legally required to reveal your status to certain people. For more information, please visit the American Liberties Union's State Criminal Statutes on HIV Transmission:

http://www.aclu.org/lgbt-rights_hiv-aids/state-criminal-statutes-hiv-transmission

It is very important that you talk with your current and past sexual partners about your HIV status. If you have shared needles with others while using drugs, you need to inform them as well. You don't have to tell them yourself; the health department in your area can notify your sexual or needle-sharing partners.

Finding out you are HIV positive can be difficult to handle. Throughout my year at Global Action on Aging, I have spoken to a lot of people who are living with HIV. When my friend, Antonio Munoz, found out the news about his status, he says that “everything stopped.” He “felt that the consequences of his past had caught up with him”. My other friend, Ed Shaw, took the news “as a death sentence; he never though in his wildest dreams that he would live passed the age of 48.” Today, he has lived with the infection for more than two decades.

However, affected people find that sharing one’s status with those you trust can be very helpful. It is very important that you reveal your status to your healthcare provider to make sure that you get the best care possible. If you need further support and help, there are several resources available to you. Gay Men's Health Crisis is a great organization that works with people who are HIV positive. Please visit their website at:

http://www.gmhc.org/

Sanna Klemetti 

s.klemetti@globalaging.org

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 5^th floor, where her friend Pearlie’s room is located. When it stopped on the 4^th 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 5^th 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 5^th 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

Second Session of the United Nations Open-Ended Working Group on Ageing (August 2011)

During my three-month internship at GAA, I had the chance to observe some discussions during the Second Session of the United Nations Open-Ended Working Group on Ageing (OEWG) that was held August 1-4, 2011. The meeting focused on the situation of older persons in a world where longevity and ageism are new features. More, the gathered Member State delegations, experts, and NGOs, were considering whether to proceed further toward a Convention on the Human Rights of Older Persons. In short, is such a binding UN document needed ?

After the opening session, human rights experts explored “Violence and abuse against Older Persons” and “Age and Social Exclusion of Older Persons.” At the Plenary, discussions focused on “Identification of existing gaps at the international level and measures to address them, a topic which concluded the session.

What were my reactions, you might ask. I was a bit surprised by the ambiance in the conference room: very calm and quiet; no applause; no unrest or noisy demonstrators from any part of the room. It gave me the impression that nothing important was going on there and that the people just talked when they had to; this was of course false. I think that all the people in the room were highly involved in older persons’ issue in the world, even those who oppose a Convention or other instrument focused on the Human Rights of Older Persons.

Also, some Member States were very mobilized on the issue. The main speakers who supported a human rights document during the entire week seem to have come from Latin America along with Central America and the Caribbean countries. Unfortunately I did not see many African delegates and noticed few Asian delegations, with the exception of India and China.

I think that these four days succeeded in exploring many different issues faced by older persons in the whole world. Hopefully, a general conclusion has been drawn: the need to discuss today the rights of older persons. Why? First, the world is now starting to face an increasing ageing population, so issues on pensions, dependence and good health are much more visible. Second, the rights of older persons -even though known and recognized by an international and national framework- are not well respected both in emerging and developed countries. Everyone agreed that the UN and citizens everywhere need more research and more data about older persons’ abuses in order to target the biggest issues.

In contrast to the Member States, NGOs argued, in general, for a Convention.

Delegations did not change their positions between the first and the last day of this second session. The countries of MERCOSUR (Brazil, Uruguay, Paraguay, and Argentina), Chile and other Central American Countries strongly argued for a Convention that would provide a fundamental text to insure the respect and implementation of the Rights of Older Persons. For example, Chile argued that a study made by the Advisory Committee of Chile showed that:

- 25% of the population thinks that ageing is being dependent

- A lot of Chileans have negative ideas on ageing

- Some old persons prefer to stay at home, keeping isolated, as they think they are useless to society or even a burden.

According to Chile, the solution is an international process promoting intergenerational awareness. The European Union, China, Japan, US, Russia and New Zealand took the position that the existing non-binding framework protects the Rights of Older Persons and is, in their opinion, sufficient. They all pointed the need to implement the 2002 Madrid International Plan of Action on Ageing and to wait for its UN review in 2012.
However, the great majority of the delegates, NGOs and panelists supported the OEWG and encouraged its continuation. Many seemed to suggest that “Ageing” should be one of the priorities both at national and international level. Also some delegates, such as Switzerland and Canada, and NGOs asked for a Special Rapporteur on the Ageing issue.

The panelists’ presentations varied in quality. I found some really interesting; others more like an advertisement for the group they represented.
I had the chance to hear two great presentations on the situation of older persons in Africa, in different sessions: one about Ghana, the other about Tanzania. Both were really instructive showing problems older Africans face and how their countries try -or not- to solve them. Teresa Minja represented the Tanzania Social Protection Network talked about the shocking cases of persecution older women for “witchcraft” in Africa and, in particular, in her country. Due to traditional beliefs and a confused and unfair inheritance law, older women are sometimes accused of witchcraft and victims of different forms of discrimination (from exclusion and isolation to lynching and killing) as a method to take land “rights” away from widows. Ellen Borkei-Doku Aryeetey represented the University of Ghana tried to evoke all the problems faced by older persons in Africa: income insecurity, competition between young and old persons for scarce resources, lack of interest on the older persons issue in Africa and more.
Himanshu Rath, from the Indian NGO Agewell International, was really interesting as he gave us data and testimonies on the issues older Indians have to face: illiteracy, abuse from family members, in particular, the daughter-in-law, no resources, circumstances that force elders to remain invisible, a gender gap that renders many old women powerless and poverty-stricken. He pointed to these quotations: “Loneliness and the feeling of being unwanted is the most terrible poverty” (Mother Teresa) and “It is good to swim in the waters of tradition, but to sink in them is suicide” (Gandhi). Finally, he urged consideration for a UN Convention to assure the rights of older persons.
Oldrich Stanek, from the Czech organization, Zigo 90, that works with the European Union, gave a clear presentation during the “Age and Social Exclusion of Older Persons” session. He underlined that there were three types of exclusion older persons face: social, financial and from the labor market. He gave proposals to thwart this situation and presented two reports he had made to a member of power in the Czech Republic and European Union and as a guide of civil dialogue.
On the session on “Violence and Abuse against Older Persons,” the first two presentations had no direct link with the subject. Indeed, Claudio Grossman, from the Committee against Torture, just wondered about the need for another Convention while citizens already have the Human Rights Declaration with all the fundamental rights. Then, the presentation by Keren Fitzpatrick, an Asia Pacific Forum member, gave a general overview all the institutions and jurisdictions the Forum embraces.

Finally, during the last session, Marie Keirle, a delegate from France, synthesized the work and presentations of this week. She clearly identified nine issues on older persons:

- Need to discuss older persons’ issue now as the world is facing longevity and ageism; and many governments do not consider it an important in their states’ agendas;

- Existing discriminations (age and gender, economic situation, health, rural/urban) and their consequences on employment, access to health, public services Stigmatization and stereotypes, such as witchcraft;

- Poverty and financial abuse;

- Maltreatment from family members and employees in nursing homes;

- Physical and mental health, with focus on Alzheimer’s that has to be a priority issue according to member states, NGOs and panelists;

- Social exclusion;

- Education (illiteracy…);

- Equality before the law.

She also pointed, and I share her approach, what we need now:

- A partnership approach;

- Reliable data;

- A public debate and a political will on the subject,

- An intergenerational solidarity;

- A better access to services including health care;

- A work on the image the society has of older persons.

-Fanny Duval, Sciences Po Rennes, f.duval@globalaging.org-

Faith-Based Action to Achieve Universal Access

“Faith- Based Action to Achieve Universal Access- Confronting the Impact of Funding Cutbacks and Advocating for the Special Needs of Mothers and Children Living with HIV” (June 8, 2011)

This side event, held in conjunction with the UN High Level Meeting on HIV/AIDS, focused on Catholic Church- sponsored programs with regard to the impact of funding cutbacks and flat-lining children and women living with or affected by HIV. Panelists included a number of experts in the field. Dr Paul De Lay of UNAIDS described how 10 years ago everyone thought that there was a limitless supply of money, until two years ago when they faced a flat-line. He described the 4 milestones of the faith-based organizations’ (FBOs) AIDS programs, which are bridging the health sector with ministries and the private sector, meaningfully engaging those mostly affected, debating the issue of gender inequality, and openly discussing sexuality. Becky Johnson of CHAN discussed the outcomes of a report done on developing countries; as of end of 2010, 6.6 million people are on anti retroviral treatment (ART) with 9 million still left without medications. Organizations are facing flat-lining and budget cuts because there is no commitment for funding. She praised FBOs for providing up to 70% of health services in African rural areas and providing ARTs to over 90,000 people. Reverend Vitillo of Caritas mentioned some obstacles to universal access including a lack of access to fixed-dose medicine combinations and late or no diagnoses for pregnant women. He also stressed the need to address multiple infections, not only HIV. Moreover, Sr. Alison Munro of South African Catholic Bishop’s Conference highlighted the unsustainability of treatment costs, the fear of stigmas and thus non-disclosure, and the insufficient health personnel in some public sectors, such as South Africa.

Dalia Sayess from Global Action on Aging

2011 UN High Level Meeting on AIDS

During the 2011 UN High Level Meeting on AIDS, I had the opportunity to attend two side events. This year, the Meeting focused on universal access to treatment. Although older persons attended both meetings, older people were not specifically mentioned. I had assumed that with the talk of universal access, all people infected by HIV/AIDS would be taken into account and that the topics and information would apply to older persons as well.

On June 7, I attended a meeting organized by Médecins Sans Frontières and the African Union. The topic of this event was “HIV Treatment: Reducing deaths, illness, and HIV infections while keeping costs down.” Some numbers came up frequently: 6.5 million people currently get antiretroviral therapy (ART); nevertheless, 9 million other people living with HIV/AIDS have not access to ART. The panelists underscored the need to provide treatment to these people. First, treatment saves lives. People with AIDS live longer and in better health than they would without treatment. Second - and this may be the most important means to stop or at least control the epidemic- is that having HIV positive people under treatment reduces transmission and can help stop the spread of the epidemic. But once you say that, another striking number is mentioned. Between 2011 and 2020, indeed, 12.2 million new people are expected to be infected. So the question comes up about how to treat all infected persons. Who will pay for the drugs? How can poor people afford drugs that are still expensive? Two panelists mentioned the role of government. For instance, the South African government recently decided to put all people living with HIV on treatment. Brazil, since its 1996 law has defined health as a right, now provides medication to everyone who needs it.
But the major challenge concerns the price of drugs. While pharmaceutical industries benefit from patents, the most effective way to decrease drugs’ prices is generic drugs competition. Unfortunately, this competition is challenged by developed countries that want to assure conformity with the TRIPS (agreement in the World Trade Organization on intellectual properties). So is there were we stand? Expensive drugs because of patent protections and actual funding cuts in AIDS programs since 2009? What should have precedence? Health or Profits?

I attended a second session on June 8 titled, “Faith-based Action to Achieve Universal Access.” Here the panelist described funding cutbacks, but the emphasis was more on mothers and children living with HIV. In some African countries faith based organizations provide support of up to 70% of the HIV positive population. For them, budget cuts mean more difficulty to access drugs, scarce nutritional support, and no access to ART for new patients. As traditional funding decreases, it is necessary to develop new ideas for revenue resources, such as the Air ticket tax implemented by UNITAID. Panelists also mentioned the need to develop better combinations of drugs, especially for children. But this idea can be extended to adults and older people as simpler and fixed-dose drug combinations help decrease the prices. In addition, a lower price will likely increase the demand as more countries and/or organizations can afford to purchase the drugs. Increased demand is likely to attract more pharmaceutical industries competing and eventually lowering prices.

To conclude, I would like to say that according to what I heard, universal access can be achieved. Dr. Bernhard Schwartlender, a UNAIDS worker said this was financially and technically possible. Of course, funding at the level of $22 billion annually by 2015 is needed too. I tend to agree with Dr. Bernhard Schwartlender: “[Fighting AIDS] is not a question of paying now or later; it’s a question of paying now or forever”. So what are we waiting for?

- Aude Feltz

Demographic Changes Challenges Sweden

After attending the first session of the UN’s Open-Ended Working Group on ageing I wanted to take a closer look Sweden. The reason why is not just because it’s where I’m from, but also because I have experience working with what we in Sweden call Home Help. This program, Home Help, is a part of the public health sector. It makes it possible for older people to keep living in their own homes and receive the individual help they might need-, such as cleaning, cooking, shopping, or to accompany the older person to the dentist or doctor. As I worked in this job, I learned how older people live Sweden.

Sweden has a fairly small population of about 9.3 million people. Around 19 percent are aged 65 or older; few other countries have such a large proportion of elders in the population. Sweden has one of the world’s longest life expectancies and one of the lowest birth rates. As the 1940’s baby boomers age, these numbers are expected to grow faster and in greater numbers than ever before. Up until now, Sweden has been able to manage and provide well for its older citizens. For instance, in 1982 the Social Services Act stated that all individuals have the right to public services at all stages of life. Everyone who needed help with his or her daily life had the right to claim assistance if they were unable to meet their needs in any other way. The Swedish welfare policy provides an “old age pension.” Everyone who has reached the age of 65 years, regardless of income, gets a certain amount of a state allowance. Now, the current demographic developments are challenging this policy.

Mats Thorslund, Professor in Social Gerontology, at Karolinska Institutet, a medical university in Stockholm, has researched the trends in the living conditions and health of the older population. Thorslund’s studies outline some of the biggest problems Sweden faces as the number of older persons increases. He argues that the government is failing to look at the numbers in a realistic way. As the aged increase in the population, the government does not have sufficient programs available for those who need care. People with dementia are always a first priority. But if the existing facilities are filled, there will be no spots left for the rest. This implies that the Swedish communes will need to hire more people to work in this field. The government needs to set priorities A rarely mentioned problem is the low wages in the health care field as well as the need for workers who have sufficient at the salary in this field is low and the job requires physical strength. Women dominate this field and often end the career with a worn out body.

Thorslund also found that there are visible gender and class differences. Social status and class correlate with health and functional capacity. This is more visible among men than women. When facing dependency, the majority of old men receive care from spouses, while old women rely on relatives or public care. Men have higher odds of receiving care. A 2002 study showed that elders’ health has worsened. This information contradicts data from other parts of the world. How can this can be possible? What does this indicate? Could it have something to do with the fact that a lot of the Swedish older people live by themselves?

During my job with Home Help, I discovered that older people who lived by themselves often felt lonely; my visit was the highlight of their day. Some of them had families who would come and visit, some of them did not. I always felt sad that I was on a tight schedule and could only offer limited time to them. Because I worked in the countryside, I noticed that the resident felt more isolated; there was a lot of space in between the houses and most of them were very limited as to how much they could move outside their own homes. Although Sweden has social programs and events for older persons, I noticed that the government cuts the older persons’ programs first; this is where it hits hard.

Thorslund and his research team have finished a number of research studies but the results have not been used in the best way possible. Need no longer determines policy; rather it’s the economy. Some theorists suggest that the needs of the increasing number of very old Swedes will change the government’s model of the welfare state. No longer, they say, will Sweden provide its older citizens with care and support on equal terms. In 1970 Sweden reached its highest level of service and care for the old. If Swedes want to stay in this position, it will have to examine where the national resources are going—to the wealthiest? To the best connected to the government? Banks? Industrial profits? A Monarchy? Other? Older citizens have been aging for more than 60 years and more will come. Swedish citizens will have to decide where they want their taxes to go. This challenge faces not only for Sweden, but many nations.

Sanna Klemetti

s.klemetti@globalaging.org

CSW 2011: Advocating for Older Women and Widows

The Fifty-fifth Session of the UN Commission on the Status of Women:
Gender, Education, Science and Technology, and Employment"

Education Never Ends": Advocating for Older Women and Widows

New York, NY: “We are addressing women’s needs. You are never too old to learn. Education never ends. We are bringing something valuable to women in their twilight years,” explained Liz Morgan, President of Soroptimist of Great Britain, during her closing statements at a February 22, 2011 UN CSW panel focusing on life course approaches to formal and non-formal education.

Soroptimist has three projects that focus on meeting the needs and strengthening the human rights of women aged 60 and up. Morgan’s programs incorporate both formal and non-formal education to “keep their brains active.” Traditional education targets younger people, creating an ageist education system that does not recognize the health benefits of learning. While many women served by Soroptimist may indeed be too old for a lecture setting, the informal education that comes with learning from each other and the community improves their well-being and mental health.

Morgan spoke specifically of their program in Nigeria where widows suffer a terrible plight. Widows do not inherit the property when husbands die; children are often dispossessed and widows may be subjected to ritual cleansing. Speakers said that this ritual involves dehumanizing acts such as walking naked, having their heads scraped of hair, observing regular wailing hours, and sleeping on a bare floor.

Many advocates are pressing for changes in such cultural rituals and policies because they violate human rights.

Soroptimist is working to empower older women through a “Fashion Center” that is training 100 widows and their children to sew. On International Women’s Day, the club arrived with food supplies, made a feast, and organized motivational talks for the women. Vocational skills and training provisions were free.

How will governments address these issues? Can the 2010 CEDAW General Recommendation on the Human Rights of Older Women be used to encourage change in such rituals?

Rebecca R. Richman

The UN Commission for Social Development 49th Session by Aude Feltz

As a Global Action on Aging intern, I had the opportunity to attend one of the meetings of the Commission for Social Development that had the theme of poverty eradication. I was very interested in the High Level Panel Discussion on this topic because the speakers presented so much information. I especially liked to learn about concrete policies such as those that the Chinese government put into place to fight against poverty. Of course, panelists shared much general information and informed us that by 2015, close to 50 million people will remain poor.

Though we must know the data to become aware and to develop new policies, I felt a little disappointed that most information was very general. As one panelist remarked, “History proves that to eradicate poverty you must not only concentrate on the poor but you need to focus on the whole society”; yet the figures and policy examples deal only with the poor. Furthermore, poverty affects children, young adults and older people in different ways. Each group requires different solutions. But discussions lead us to think that poor people are a single population. For example, I heard no mention of older people while they represent one of the most vulnerable populations affected by poverty and thus special policies are needed to target them. Even in side events focusing on older people like the one organized by AARP, I noticed that the issue of older people having difficulties to get micro-credit was only raised because one person in the audience raised the question. I would have expected the panelist to treat this issue with some depth.

Finally, because I attended one discussion of the Commission and also two side events, I was reminded that unfortunately time is the key component to initiate and make changes. While experts pointed to the urgency to take concrete actions, a Convention on older Persons’ Rights will require significant time to address the issue, to mobilize a critical mass, and to push forward to draft a convention, a process that will likely take five or more years.

Awareness of Elder Abuse, a Growing but Hidden in Asian Communities

Elder abuse can happen by family members
Elder Abuse occurs when someone 60 or older is mistreated. Elder abuse includes emotional, mental and physical abuse, financial exploitation, neglect, and abandonment. Abusers of older people are both women and men and may be family members, friends, or ‘trusted people.’ Family elder abuse affects as many as 2 million seniors in the United States, as well as up to 5 million seniors who are subjected to financial exploitation, according to the National Center on Elder Abuse (NCEA), a program of the U.S. Administration on Aging.

To investigate the elder abuse situation of Asian communities in New York City, GAA Research Associate Nuri Han met with Peter Cheng, Executive Director of Indochina Sino-American Community Center (ISACC). Located in Manhattan’s Chinatown, ISACC has assisted Chinese, Vietnamese, Cambodian, Laotian, Burmese, Philipino, and Malaysian immigrants and refugees integrate into mainstream society by providing programs, services and activities since 1990.

Only one elder abuse program
Two years ago, Cheng recognized elder abuse when one elder client asked the organization’s staff to help him fill out an application for government housing. Cheng knew that the elderly man had purchased a co-op apartment. Cheng, curious why he needed government housing, asked. The elderly man said that he worked hard and purchased the co-op apartment in his son’s name. However, his son did not want to live with him so he was evicted.
Cheng surveyed other clients and found that this man’s situation was not unique. In response, Cheng launched the Chinese Americans Restoring Elders (CARE) Project, the first and only elder abuse prevention program in New York City’s Chinese community. The CARE Project raises awareness of elder abuse and assists older people in need by providing linguistically and culturally appropriate education materials. Unfortunately, due to the lack of funding, only one case worker can be solely devoted to this project.

Growing but hidden
Reflecting the rapid growth of Chinese elders in New York City, the population of Chinese seniors 60 or older is 93,000 persons and will more than double in 10 years. This will be the fastest growth rate among all ethnic groups in New York, according to the City Council. However, nobody knows how many elder abuse cases there are in New York’s Asian community. Even in the majority community, the picture of senior abuse is vague. According to NCEA, the most recent studies show that only one out of six such cases is reported to authorities. For Asian American families, the strong influence of traditional culture brings additional challenges to prevention and protection. Generally Asians believe that respecting older persons is important in Asian culture and thinks that the tradition is well maintained. The concept of elder abuse is easily ignored or unknown. Many Asian American elderly victims tend to hide the abuse or even protect the family member abuser because of shame and fear. A New York State ongoing study finds elder abuse is underreported, only 1 out of 24 cases. According to Cheng, many Asian older people hold an immigration status sponsored by their adult children. They do not speak much English and have few other relatives or friends they can consult. This makes them more vulnerable than seniors in the majority community.

How to solve?
Cheng believes that educating the community to be aware of elder abuse issue is significant to prevent elder abuse and protect older people. Cheng suggested three ways:
Community outreach to educate and raise awareness about elder abuse
Psychological counseling
Legal enforcement and political assistance
Advocacy to government

Elder Justice Act
A little known part of the health care reform law enacted in 2010 is the Elder Justice Act and the Patient Safety and Abuse Prevention Act. For the first time, the law will provide funds to coordinate national research and other efforts to combat elder abuse and exploitation by improving data collection and dissemination and distributing information about best practices to local authorities.
For more information, visit these websites: National Center on Elder Abuse, and the Elder Justice Coalition.

How I Acquired a new Superpower at Global Action on Aging By Marium Abdul Sattar

From the first day I came to Global Action on Aging in April, I knew that I would be offering my services to help older persons by researching issues concerning them and advocating for their rights. What came as a surprise to me is that Global Action on Aging also helps the younger generations: the interns. The various research topics assigned to us, and the experiences we shared has enabled GAA to change our perspectives.

Finding articles on pensions and elder rights for the global aging website is one of my responsibilities. On my first day, not knowing what pensions were or how they worked presented a challenge for me. I soon realized that pensions support people in their old age when they no longer have a steady income and is often provided by an employer or insurer. Yet, that is just the icing on the cake since there are several more sources of pensions such as the state and unions. While preparing a report on pensions I learned that Germany was one of the first countries to pioneer this practice. In fact, Otto Von Bismarck suggested this idea as early as the 19th century in hopes that it would encourage Germans to work harder and create a stronger national economy.

Spending time at GAA gave me a certain superpower; it enabled me to see life from the perspective of an older person. After reading vast amounts of material about issues affecting older persons, I was able to learn about some of their primary concerns. I learned that society has the potential to be much friendlier to older persons, and that the word ‘elderly’ is a blanket term which categorizes people. For example, although it is used to describe a range of ages, it puts those aged 60 and above into a category despite the fact that it refers to a huge population; one which is ever-growing as the baby boomer generation begins to retire.

One of my most daunting experiences during my time at GAA occurred when I was near our office and I met an old woman who seemed lost. She also seemed to be tired from standing in the summer heat, and was unable to locate her home. When I asked her how I could help her she became more agitated and upset. I realized that I was not prepared for handling the situation at all! In hindsight, I learned that in this situation, it is best to seek out a police officer and inform him or her of the senior citizen who needs help to locate their place of residence. So I feel that we all have the potential to help our elders, as long as we know how to help them.

Another topic which I have researched is ‘Elder Rights’ which monitors some of the rights that older people enjoy but also, unfortunately, describes the infringements on their rights. At this time, I came across several articles that identify the point when a person needs some form of assisted care. One author indicated that immobility experienced during old age causes some people to lose weight due to their inability to even pick up heavy groceries or travel to the supermarket – something most people take for granted. I realize that this is the difficult side of aging, however, society usually only focuses on this bleak side of aging.

For example, did you know that by volunteering with older persons, you are more than likely to have a rewarding experience? Some have even termed it the ‘volunteer’s high.’ During my time at GAA, I have certainly learned to become more aware of my surroundings and older persons which might need help. On my way crossing a large intersection the other day, I noticed an old gentleman using a walker who was having trouble crossing the road in time before the traffic light changed from red to green. I saw through his eyes, and a seemingly normal road suddenly became a rocky path full of hazards. The gentleman said to me: “It feels like each of these potholes is out to get me.” Those who are shy don’t even need to speak to the older person crossing the street, but just accompany or be aware of them to make sure they are able to manage it.

By becoming more empathetic to the needs of older people, and seeing through their eyes, both old and young can benefit from these experiences. The younger generation can learn from the experience of older persons. We need to know how to help older persons and channel our superpower of empathy rather than sympathy.