A day with Chiquita Smith

An Activist for Nursing Home Seniors

GAA interns Nuri Han and Scott Kelly had the pleasure of speaking with a GAA supporter, Chiquita Smith. This Brooklyn activist defends the rights of nursing home residents. Every month Chiquita makes personal visits to several of the 26 nursing homes in her borough. After talking with any residents she knows and getting a sense of the place, she calls the Board of Health or the nursing home director to make sure her concerns about residents’ care are heard. This inspiring work is made even more impressive by the fact that Chiquita is 87 and blind.

“It’s personal”

Over the years Chiquita became interested in elder rights through visits to her family members and friends in nursing homes. “It is personal,” she says about her decision to check up on possible abuses by these institutions that housed her friends and family. Of a more general concern is what she calls the “shifting of seniors”—the trend to move seniors from their apartment or house to an institution, such as a nursing home. She wonders whether older persons living in nursing homes feel comfortable in such unfamiliar surroundings and whether they face abuse or neglect in the institutions.

Chiquita makes it a point to visit a nursing home if one of her friends or relatives has recently moved there. She’s even visited nursing homes as distant as Washington, DC, or Philadelphia.

“Are these people being treated like human beings?”

Whenever Chiquita visits a nursing home, one major question guides her; “Are these people treated like human beings?” To assure that they are, she first engages the residents, asking whether they are properly dressed, not wearing mismatched or dirty clothes. She touches the residents’ hands and talks with them. They always smile at her. They all have stories to tell and they enjoy speaking with other people. She also asks if weekly schedules for the dining hall and for recreational activities are posted. Some nursing homes might only let their residents go outside on rare occasions, left instead sitting and idle inside—a lonely, monotonous existence. Some nursing homes even allow outside businesses, such as a “dollar store,” to come in to offer a selection of items for the residents to buy.

Chiquita checks possible institutional abuses by the nursing home. She said that some nursing home residents with larger pensions are taken advantage of by family and nursing home administrators. Recently, she has focused on how the nursing home may ignore residents’ right to vote in elections. She asks whether they had easy access to a ballot; almost none did. Chiquita believes no one is too old to vote. She contends that the nursing home must facilitate the voting process for its residents. She also tries to talk with the nurses and, if possible, the administrators to make sure they know someone is watching. If the situation is bad, she will call the Board of Health, or make another surprise visit to check up. At her local church she shares her observations with her senior group called “The Golden Circle.” It’s essential for her to share her findings with as many people, through as many channels, as possible.

“Day of Visitation”

Chiquita wants everyone to know that even a little gesture, like a card or phone call, makes a difference for the residents, who may rarely hear from family or friends. She proposes a “Day of Visitation” for those who are interested in these issues. Simply go visit the residents, talk with them, and touch their hands—you’ll be surprised by how appreciative the residents will be! She advises visitors to send cards to the residents after you visit!

On the institutional level, she hopes every nursing home will create a specific “Friends and Family Day” to encourage monthly visits. She suggests people contact their elected officials so he or she will understand the process and politics better. Too often these officials are unaware of the situation at nursing homes.

“Go and visit!”

If you’re interested in learning more about nursing homes, Chiquita suggests calling the Board of Health to get the official list of nursing homes. Then, go visit! Ask for literature on the place and about its policies. Ask questions about how it works, talk with the residents. What are they doing? Where are they? How do they look? It’s not so much a matter of asking the right questions; it’s about letting the administration know that someone is watching so they become more aware and alert to these issues. And, of course, it’s about providing companionship to those who are often neglected. Lastly, Chiquita suggests publicizing what people observe or learn, through Global Action on Aging, your religious institution or any other means you may have.

Inform yourself, engage yourself! Be active like Chiquita! She has been at it for years now and has no plan to stop!

Why are older persons not addressed in the Millennium Development Goals?

During the recent celebration of the 20th International Day of Older Persons in New York, Bridget Sleap, a rights policy adviser at HelpAge International, addressed why the Millennium Development goals did not deal adequately with gender equality and discrimination. According to Bridget, governments are not required to reach the most marginalized people and end discrimination against women, making such discrimination "invisible." Often poverty reduction programs ignore the most marginalized population- older women.

Not only do elderly women comprise 60% of the work force in those countries, but they contribute to poverty reduction by spending the small pensions that they have on food. They are more likely to care for families, especially because the gender gap widens with age. In South Africa, for example, 88% of older people caring for their grandchildren were women. If women are such an integral part of promoting and developing their communities, why are they not protected by the MDGs?

Bridget focused on this question and suggested a number of actions that could be taken to strengthen and empower older women. Non-contributory pensions and a minimum level of social protection are needed as a first step. She suggested that the UNWomen Unit take a life course approach and pay greater attention to ageing. Also, CEDAW should include older women as well. Many older women face discrimination, but their hardships are much less frequently addressed. Last but not least, Bridget stated that governments need to enter a discussion about a human rights convention for older persons’ rights. Older women do a lot to uphold their communities. They need to be heard, empowered, and given the tools to do more.

“Grandmother to Grandmother: New York to Tanzania”

In celebration of the 20th Anniversary of the United Nations International Day of Older Persons, AARP and the Fordham University Ravazzin Center on Aging hosted a Film Screening: “Grandmother to Grandmother: New York to Tanzania.”

The film documentary features the lives of grandmothers raising orphaned grandchildren in New York City and also in Tanzania. While seemingly worlds apart, these grandmothers came together in Tanzania and realizeed that their challenges and experiences were very much the same. The film highlights aging as a gendered experience, and the cultural life course trends that converge to create additional vulnerabilities in the lives of older women.

Globally, grandparents are increasingly raising their orphaned grandchildren. Parents are dying due to HIV/AIDs, drugs and violence. Grandmothers, already one of the most vulnerable group in terms of poverty, are relied upon to take care for children without adequate means.

One panelist stated that this global issue is gaining recognition across the world. In New York City, in particular, some low-income housing is designated for grandparents raising grandchildren on $10,000/year or below. The facility provides evening programs, counseling and building security. Grandmothers attend support group meetings that help them adjust to their new task as a primary caregiver and also to express their concerns with a supportive audience. One woman said, “I realize there are others just like me and I don’t have to be ashamed that my child wasn’t able to raise his child”.

A panel of experts on this global trend from New York and Tanzania also spoke. Rimas J. Jasin, Executive Director of Presbyterian Senior Services, discussed New York City’s attempts to alleviate poverty among grandparents raising grandchildren in some of the city’s most at-risk neighborhoods.

While discussing the slow evolution of social change and the changes necessary to strengthen the human rights of older persons, Modest J. Mero, Minister Plenipotentiary at the Permanent Mission of the United Republic of Tanzania to the United Nations said that “Development is a gradual process.”

Alzheimer’s Disease in Belize by Christy Kessens

During the summer of 2008 I had the opportunity to volunteer with the National Council on Ageing (NCA) in Belize, Central America. My time there consisted of developing educational brochures regarding Alzheimer’s disease (AD) and participating in an educational radio program that focused on older adult issues. Throughout the following year I maintained a relationship with the NCA and discovered that the Alzheimer’s disease information I had developed was welcomed with an overwhelming response. For the first time family members were learning the cause behind the unusual behaviors and personality changes experienced by their loved ones.

Aware of the positive impact additional Alzheimer’s disease education could have on those living in Belize, I chose to complete my Master’s degree program by interning with the National Council on Ageing. Between August 31 and October 9, 2009 I had the opportunity to participate in community outreach and interview family members who provide care for someone with Alzheimer’s disease.

Using the resources provided by the NCA, I was able to interview several family caregivers while in Belize. They consisted of husbands, wives, adult children, granddaughters, grandsons, sons-in law, and daughters-in-law. They expressed feelings of guilt, helplessness, anger, and frustration. Most were eager to share their feelings and experiences while others refused to acknowledge that their loved one had a memory problem. Regardless of their situation, it was apparent that all of them were facing the challenges of caregiving and doing the best they could given their current situation.

The stigma associated with Alzheimer’s disease is very prevalent in Belize. The shame attached to this disease keeps family members from feeling comfortable talking openly about the challenges they are experiencing. It often leaves them feeling frustrated and alone. Through public television programs and local radio stations, we were able to provide caregivers the opportunity to learn about what they are going through, offered tools needed to help them provide appropriate cares for their family member, and hopefully helped them understand that they are not alone.

The purpose of this internship was to develop a support group that would provide assistance to family caregivers who support a loved one with Alzheimer’s disease. After interviewing family members, visiting care facilities, and working on public awareness programs, it became apparent that the lack of available respite care services and the stigma attached to AD would hinder the development of a support group at this time. Instead it was determined that a workshop geared towards community advocates would have a greater impact on improving the lives of Alzheimer’s disease caregivers.

The 21 guests who attended the workshop included community nurses, psychiatric nurses, nursing professors from the local college, senior advocates, as well as a social worker and police officer. Over the course of the day participants learned about the impact Alzheimer’s disease has on the brain, took part in fun learning activities, and worked in small groups. We discussed behaviors experienced by AD patients and how to best support families who are struggling with these stressful situations. The group remained focused and open to learning, shared their own personal stories, and discussed ways to use the information gained when working with caregivers.

With the participants’ desire to learn and positive feedback received after the workshop, I believe the Educational Workshop for Community Advocates was successful and will ultimately benefit family caregivers. Working with the National Council on Ageing, I hope to return to Belize in 2011 to conduct additional workshops, allowing caregivers and community advocates the opportunity to continue learning about this debilitating disease.