Spring 2010

TOD
TODAY
VillageCareToday The “New” VillageCare
EDITOR-IN-CHIEF
BY EMMA DEVITO, PRESIDENT AND CEO
LOUIS J. GANIM

MANAGING EDITOR THE MAGAZINE YOU HOLD IN YOUR HANDS IS PART OF A TRANSFOR-
BRETT C VERMILYEA
MATION THAT HAS BEEN TAKING PLACE AT VILLAGECARE OVER THE
——————
PAST YEAR.
PUBLISHED BY
VILLAGECARE
We’ve been breaking down the barriers among our programs so that you – our
154 CHRISTOPHER STREET
NEW YORK, NEW YORK 10014 patients, clients, families, friends and donors – can see us not just as an array of many
services for the community, but as a single entity committed to your better health and
CHAIRMAN
well-being.
DAVID H. SIDWELL
For example, we used to treat our services for older adults and those for persons liv-
PRESIDENT & CEO ing with HIV/AIDS quite separately. We no longer make that distinction, seeing our
EMMA DEVITO
“new” organization as serving everyone in all our settings regardless of their diagno-
WWW.VILLAGECARE.ORG sis. We no longer divide our care between AIDS services and senior care, but instead
(212) 337-5600
arrange what we have to offer in a more logical breakdown as either community care
or residential care.
You’ll note too that we have a new logo, and we’ve shortened our brand to reflect what
most people know us as: VillageCare.
We’ve renamed this magazine too, because where the former New Horizons focused
primarily on information and news about matters of interest to seniors, VillageCare
Today focuses on what matters to all those whom we serve. The people we serve, by the
way, reached more than 13,000 in number in 2009.
We are still the same caring and responsive organization that so many of you have
come to know, whether you’ve been with us for many years, or just recently came into
our family.
But, VillageCare offers so much, to so many people with so many different needs,
that we thought it was time that we put it all together for you.
In the coming months and years, we at VillageCare will continue our deep commit-
ment to the communities we serve. This coming fall, for example, we will be unveiling
our newest offering, VillageCare’s state-of-the-art Rehabilitation and Nursing Center.
It’s something to look forward to.
 SPRING 2010 | VOLUME 4, NUMBER 1

F E AT U R E S
8 Nobody Said It Would Get Easier
BY BONNIE ROSENSTOCK

AS WE AGE, DATING RULES DON’T GET ANY LESS COMPLICATED

12 A Lifetime Commitment
BY JESS ESPINOSA

LUCY CECERE JUMPS INTO THE FIGHT AND MAKES AN IMPACT

16 Health Center For Every Season

BY BONNIE ROSENSTOCK

CHELSEA CENTER SERVES EVERY CONDITION, EVERY AGE

20 A Lot More Than A Hot Meal

BY BRETT C VERMILYEA

MOMENTUM PROJECT’S MISSION IS FELLOWSHIP AND SUPPORT

24 A Burden and a Blessing

BY BONNIE ROSENSTOCK

HOME CARE CAN BE BOTH CHALLENGING AND REWARDING

In the News 2
Using Robots to Serve Older Adults at Home; HIV/AIDS
D E PA RT M E N T S
Message For Thousands; Researcher Explores Link Between
Social Anxiety and Risky Behaviour Among Same-Sex Partners;
Health Center Is A Global Model; Taking Medicine for HIV Is
A Hard Pill To Swallow for Many People; The Professional of
the Year Helps Those in Need; Honoring a VillageCare Hero

Senior Perspective 7
What are your hopes for 2010 and beyond?

Opinion 30
The Challenges of Aging for an Older Population; The
Long Goodbye

The Last Word 32

Being Polite. It’s Just That Simple.
 In the News

Using Robots to Serve Older Adults at Home

Newswise — Robots that lend a very pendent and continue living in their own chores such as cooking or making a bed.
human-like helping hand to healthy homes, that will improve their health The research team will program and
seniors with limited mobility may be on outlook while relieving the burden on test a robot and devise refinements as the
the horizon. family members and health care provid- project progresses.
“We want to help elderly people com- ers,” Žefran said. “The human-robot interface is really a
municate with robots, to tell them what Žefran’s expertise is in robotics and long-standing, open problem that won’t
they need, and to perform physical activi- computerized sense of touch while other be solved in three years,” Žefran says.
ties,” said Miloš Žefran, associate pro- team members specialize in computer “But we’ll have a working prototype by
fessor of electrical and computer engi- vision and pattern recognition, natural then, and we’ll know what additional
neering at the University of Illinois at language processing, and nursing care research needs to be done.”
Chicago. for the elderly. Žefran added that this research could
Žefran is lead investigator in a three- Communication software in the robot also find widespread use in delivery of
year undertaking to develop software that will allow it to comprehend speech altered institutionally based health care, where
would allow older adults to communicate by impairments and to learn and adapt to routine tasks now done by nurses could
with robots that can respond to a wide such speech. By combining techniques be handled by robots. “If robots can
range of verbal language, non-verbal ges- from natural language processing and alleviate some of the burden nurses
tures and touch. The effort is being touch, the robot will understand and cor- face, they then could spend more time
financed by a grant of nearly $1 million rectly respond to various forms of human where they’re really needed — provid-
from the National Science Foundation. touch. It will also know how to respond to ing the human contact that a robot can’t
“If we can help people remain inde- the user safely when performing everyday replace.”

2 VillageCare TODAY
Vi l l a g e Ca r e T O DAY || Spring
Wi nt er 2010
2010
 HIV/AIDS Message
For Thousands

F
or the two-month period leading
up to this past World AIDS Day,
VillageCare sponsored a 15-second
video spot promoting HIV testing and
treatment on the CBS super screen on
42nd Street, seen by thousands of New
Yorkers and tourists daily.
The video message urges people to
“Get Tested. Get Treated. Stay With It.”
That’s the theme of VillageCare’s “No
New Infections” prevention campaign,
which sees testing and treatment as the
foundation of AIDS prevention.
The message ran once each hour
every day throughout October and
November, ending on World AIDS
Day, Dec. 1. The video can be seen on
VillageCare’s website (www.villagecare.
org).
Viewers of the message were urged to
contact VillageCare’s Health Center on
20th Street in Chelsea, where HIV test-
ing is available.

Health Center Is
A Global Model

T
wo professors from the
International University of Researcher Explores Link Between Social
Health and Welfare in Tokyo, Anxiety and Risky Behaviour Among
visited the VillageCare Health Center
in Chelsea recently to examine how Same-Sex Partners
nurse practitioners function in
Newswise — Why are some men, for some men to take necessary precau-
health care settings in the United
both HIV-positive and negative, still tions against HIV if they think it will be
States. This was the second time
engaging in risky activities with male perceived negatively by their partner.”
in a year that professors from the
partners? Dr. Hart and his research team have
university visited the clinic setting
Dr. Trevor Hart, director of the HIV interviewed 300 men from the Greater
to learn about nurse practitioners.
Prevention Lab at Ryerson University in Toronto Area to better understand the
They learned of the center through a
Canada, is conducting a comprehensive link and develop practical solutions.
Hunter University graduate student.
study to find out the answer to this per- The SHARP study, which is funded
A nurse practitioner program started
plexing and alarming question. by the Canadian Institutes of Health
up in Japan since the first visit, fol-
In a four-year study called the Sexual Research, is one of several research proj-
lowing the same curriculum of the
Health and Attitudes Research Project ects being conducted at Dr. Hart’s lab.
programs in the U.S. The two most
(SHARP), the psychology professor “Preventing HIV transmission is
recent visitors gave a $200 dona-
is examining the connection between the mission of our lab,” Dr. Hart said.
tion to the Village Center for Care
social anxiety and its effect on men who “Ultimately, we want to know how we
Fund, which supports VillageCare’s
have unprotected sex with other men. can help people.”
programs. In the photo, from
“Higher social anxiety is associated Dr. Hart recently presented some of
left, are: Michelle Samuels ANP,
with risky behavior, but we’re not sure his research findings to-date at confer-
VillageCare employee health manag-
why,” Dr. Hart, the study’s principal ences in New York City and Toronto.
er; Miho Suzuki, RN, Hunter College
investigator, said. “One of our hypothe- The findings from Dr. Hart’s SHARP
grad student; Mineko Niino, RN;
ses is that social anxiety carries over into study are expected to be published with-
Hisayo Maeda, nurse midwife, and
sexual encounters, making it difficult in the next two years.
VillageCare Health Center Director
Nicolas Rosetti.
3
Taking Medicine for HIV Is A Hard Pill
To Swallow for Many People
Newswise — Highly active antiretroviral both alcohol and adherence that partly ence levels, but this didn’t persist once the
therapy has increased the longevity and explain the association. We need to treat support ended. The pagers did not success-
quality of life for people living with human people individually.” fully promote adherence at any point.
immunodeficiency virus. But it requires For the peer-pager study, researchers “We can change adherence a little, but it
strict adherence in taking the medicine, recruited 224 patients being treated at disappears when the intervention is taken
something that is extremely difficult for a Seattle clinic. Patients were randomly away,” Simoni said. “Even though you are
many individuals to do. assigned to one of four treatment groups — capable of doing something that doesn’t
Two new University of Washington stud- peer, pager, combined peer-pager and treat- mean you are motivated to do it all the time.
ies illustrate just how hard it is to make ment as usual — for three months. Just ask anyone, ‘Did you exercise yester-
sure people take their HIV medication. One Patients with peer support attended day?’ ‘Floss your teeth?’ ‘Avoid sweets?’
study looked at the effects of drinking alco- twice-monthly meetings with other partici- “Add to this the complication that a
hol on adherence and showed the risk for pants and trained HIV-positive peers who person has to take these meds every day for
non-adherence was double among drink- provided medication-related social support. a life-threatening disease. There is a lot of
ers compared to abstainers. The second Peers also called participants weekly to pro- emotional baggage surrounding the disease
study evaluated interventions using peers, vide more one-on-one feedback. Participants and the pills, and the medications have
electronic pagers or both, and showed that in the pager group were asked to carry a severe side effects.”
these tools promoted no lasting improve- customized device when they were awake. So what is needed to promote better
ments in adherence rates.

“
“HIV is unique in the adherence levels
needed to be effective,” said Jane Simoni, a
University of Washington psychology pro- Taking drugs for HIV is a lifetime commitment;

”
fessor who specializes in studying adher- you are married to the pills.
ence. She is a co-author of the alcohol study
and lead author of the other. “Typical adher-
ence for people taking medication is 50 per-
cent. But 50 or 60 percent adherence isn’t The two-way pagers came with messages adherence?
going to work for HIV medications and will that were timed to each participant’s daily “We looked for less intensive solutions.
lead to resistance to the drugs. Taking drugs medication schedule. But they didn’t work,” Simoni said. “What
for HIV is a lifetime commitment; you are The pagers also sent educational, humor- we need are very individualized compre-
married to the pills,” she said. ous and adherence assessment text mes- hensive programs. And to sustain adher-
The alcohol paper analyzed data from sages. Participants in all four groups also ence, the intervention must be as dynamic
40 previous studies involving more than received the usual care at the clinic including as the changes in people’s lives.”
25,000 people and established that drink- an educational program that provided infor- The studies also have broader societal
ing does have a consistent effect on adher- mation about the medication and adherence implications and Simoni believes adherence
ence across studies. in a series of three meetings with a pharma- will be a major problem in the years ahead
“Drinking quantity, more than frequency cist, nutritionist and case manager. as the nation’s aging baby-boom population
of drinking, is associated with non-adher- The participants “self-reported” on their takes its medications to stay healthy.
ence,” said Christian Hendershot, a post- adherence two weeks after the study began The studies, published in the Journal of
doctoral researcher at the University of New and again at three, six and nine months. Acquired Immune Deficiency Syndromes,
Mexico who was lead author of the alcohol An electronic pill cap and bottle also was were funded by the National Institute
study. “In general, people who drank alco- used to monitor medication taking. Every on Alcohol Abuse and Alcoholism, the
hol had nearly twice the risk of non-adher- three months they also had blood drawn to National Institute of Mental Health and the
ence. But the risk of non-adherence went measure the levels of HIV and white blood UW Center for AIDS Research. Co-authors
up as the level of drinking went up,” he cells in their system. For this study, adher- of the papers are David Huh, Cynthia
said. “At problem levels of drinking we see a ence was defined as taking medication 100 Pearson, Michele Andrasik and Dr. Peter
higher probability of non-adherence.” percent of the time over the past seven Dunbar of the UW; Susan Stoner of Talaria,
However, Hendershot cautioned that days. The typical patient on the highly active Inc; David Pantalone of Suffolk University;
these finding don’t necessarily hold for all antiretroviral therapy takes one or two pills Pamela Frick, formerly of the UW-affiliated
people on HIV medication who drink. once or twice a day. Haborview Medical Center UW, and Dr.
“Alcohol may have a causal effect, but Simoni said patients who had peer sup- Thomas Hooton of the University of
there also may be other factors affecting port initially showed some increased adher- Miami.

4 VillageCare TODAY
Vi l l a g e Ca r e T O DAY || Spring
Wi nt er 2010
2010
 NYAHSA’s “Professional
of the Year” Helps
Those in
Need

K
en Stewart,
who directs
VillageCare’s
Community Case
Management pro-
gram, has received
the “Professional
of the Year” award
from the New York
Association of
Homes and Services
for the Aging.
Honoring a NYAHSA annually
VillageCare Hero gives the award to an
individual demon-
strating outstanding

T
he international organization Aid for AIDS
honored VillageCare’s Daphne Rivera with accomplishments in
its 2009 “My Hero” Award, which is given the long-term care
annually for outstanding activism. field. Ken Stewart, center, accepted NYAHSA’s “Professional
Stewart’s dedica- of the Year” Award at a special luncheon held by the
Rivera, who works in VillageCare’s Community
tion to helping those statewide organization in Saratoga Springs. With
Case Management program, received the award at Stewart are Village Care President and CEO Emma
the Aid for AIDS gala held at the Puck Building in in need has has often
DeVito and Carl Young, former NYAHSA president.
New York City on December 1. been the springboard
In announcing the award, Aid for AIDS said for new initiatives by
Rivera was being honored “for her outstanding VillageCare. A few years ago, he created and spearheaded an effort
activism on behalf of people living with HIV and to find ways to help “low-threshold” persons living with HIV/AIDS.
AIDS in New York City.” This undertaking ultimately led to the affiliation of VillageCare with
The awards program from the event stated: “As The Momentum Project, expanding capacity to help those who are
a woman, mother, and person living with HIV, Ms. difficult to serve and need extra help.
Rivera has fought passionately against the pandem- NYAHSA, in presenting the award, said that with his combination of
ic. For 11 years, she has advocated on behalf of the creativity, determination and compassion and his strong commitment
Latino and African American community, ensur- to those in need, Stewart has inspired his staff and others. He offers
ing that their voices are heard. More than 7,000 constant encouragement to others that they can make a difference.
people effected by HIV can testify to her work,
not only as a vocal activist working to improve the
quality of care available for her peers, but also as an
advisor and educator for her community. Daphne
is truly a hero in the fight against HIV and AIDS
and we are proud to honor her accomplishments.”
Rivera was honored alongside Dr. Julio Frenk,
dean of the Harvard School of Public Health, for
Quotable “In this country, about
his work on behalf of people living with HIV and 30 percent of new
AIDS on the public policy level, and actor Mark [HIV] infections are
Consuelos for his efforts to create awareness about
HIV and AIDS. occurring among women.
Earlier in 2009, Rivera was recognized by Compare that to 10 or
VillageCare for her efforts to improve the quality of
life of persons living with HIV/AIDS. She received Helene Gayle, M.D.
15 years ago when eight
the Nicholas A. Rango Award at the St. Patrick’s President & CEO to ten percent of our
Day fundraiser sponsored by VillageCare board CARE
(Cooperative for Assistance
infections were among
member Rev. James J. Gardiner.
and Relief Everywhere) women.”
5
 S E N I O R PERSPECTIVE

What are your hopes for

2010 and beyond?
LINDA SMITH, Greenwich Village My hope
is to finally get an apartment through the NYC
Housing program. I have been fortunate to PHIL SAUERS, West Village As an activ-
have friends help me along the way and take me ist and strong supporter for environmental
into their homes, but I am hoping that I will not health, my hope for the new year is to see
have to rely on them much longer and be able to national focus sway from war to protecting
have a place of my own. The housing situation our environment, in particular our waters. We
for seniors has been a mess for quite some time, take water for granted, but as the years go on,
and I hope that the coming year will bring our water supply is becoming more and more
some resolution to that. As a fitness polluted and contaminated. We need water
instructor for seniors, my other to live and prosper, and
hope is that more seniors recognize I urge the world to
the need to stay fit, and take advan- take notice of this
tage of the many resources that are serious, yet
available to them to ensure that. quiet prob-
lem.

VICTORIA PETRILAK, Greenwich Village My

hope is to be able to continue as I am and enjoy
life to the fullest. I have many hobbies, and I
always like to try new things. I have been fortu-
nate to stay healthy to be able to do these things.
For our country, I hope things can improve. We’re
not really in a good place right now, and I hope that
the situation can take a turn for the better. I think the
administration is trying to tackle too many things at
one time, and I hope that they realize that there is
no quick fix to this problem. For our younger
population, I hope that the employment situ-
ation gets better. There are too many good
people out of jobs right now.

ANNABELLE GREENBERG,
Greenwich Village On a broad
scale, my hope is for peace to be
MARYANN DURINSKI, Greenwich brought around the world and here
Village I hope that the new year brings an in the U.S. For myself, I hope to
end to these wars that we’ve grown accus- gain more flexibility with what
tomed to. I also hope that the new year brings I can do in my life. I currently
me good fortune in maintaining my current have many issues that tie me
level of health, and be able to con- down to this city, but I would
tinue with the activities that I am love the opportunity to be able
engaged in now. I volunteer in to travel abroad, and do exciting
the community and find that things that I have always wanted to
extremely satisfying. I hope do. I hope that my health
that I will be able to con- maintains a good level
tinue my volunteer work so that I can be able
through the new year to do these things
and beyond. as well. 7
 Nobody Ever Said
It Would Get Easier
The Rules for Dating May Change As
We get Older, but They Don’t Get Any
Less Complicated

T
he media and public are enthralled with heartwarming stories about people finding love and
romance in later life. Who could not help but fall for the story about the 83-year-old couple
that met online and got married, reported on the front page of The Villager, Manhattan’s
downtown newspaper.
Harvey Meltzer met his wife, Phyllis Wolf, on Match.com, and their vigorous e-mail conversations
quickly turned to hour-long phone conversations.
“I told her I walked with a cane,” Harvey said. “Which hand do you hold the cane?” she asked.
“The left,” he answered. “That’s good, I hold my cane in the right hand,” she said.
Within the year the couple had a wedding and the guests included their grandchildren.
The public also takes delight in tales of high school and college sweethearts rekindling
old flames after a separation of decades and other marriages. It loves the kind of story
related to me by Anna, a retired illustrator, about a friend of hers who just got mar-
ried at 82. “They met at a swimming pool. Very few of us at our age look good in
bathing suits,” she joked. “But it was love at first sight. She said it’s the best
marriage she’s had, and it’s her third.”
Are they the exceptions to the rule? Does finding love in the silvery light
of December defy the odds? To start off, when I broached the subject of
senior dating to people in their sixties, there was an immediate refuta-
tion of the word “senior,” which for most of them connotes old, or
decrepit, or past one’s prime. If fifty is the new forty, and sixty is the

8 Vi l l a g e Ca r e T O DAY | Wi nt er 2010
 PHOTO BY TEQUILA MINSKY

By Bonnie Rosenstock

83-year-olds Harvey and Phillis Wolf Metzler met on

Match.com. They were married within a year.

9
new fifty, then people squinting at the second half century do not
consider themselves in the senior category despite AARP harp-
ing. The first real depressing sign that you might be huffing over
the hill is not that white hair or new wrinkle that wasn’t there the
day before, but AARP mailers that begin filling up your mailbox
starting before you are even 50 and increasing in frequency and
urgency with each passing birthday.
But as one very youthful-looking woman quipped, “I haven’t
been a senior since I graduated from college.” Larry, retired, in
his mid-sixties, eschewed the word senior for himself, but then
went on to say that he prefers dating women in their forties
“who aren’t seniors.” Baby Boomers, being born after 1945, lie
just south of 64, and as everyone knows, there is no way in hell
they are ever going to be seniors. Ever. In fact, when I contacted
organizers of dances and meet-ups for those above the age of
forty, they declined to be interviewed about senior dating, saying
they felt uncomfortable discussing the issue and didn’t like the
terminology.
Once over the senior designation hurdle, those who
agreed to tell all (on condition of anonymity) were forthcoming
and frank. At one extreme was a thrice-married foreign-born
woman in her early seventies, who thought it was disgusting and
ridiculous to date at this stage of the game. “They want to act like
teenagers,” she sneered. “They need to grow up and get over it
and live their own lives.”
At the other extreme was a 66-year-old, self-described “hot
woman,” who currently balances two boyfriends (they know
about each other), and is open to any others that might come her
way. “I will have sex until I die,” she declared. As a writer who
does readings and performance work, she said men come up to
her and come on to her all the time. “I have never had conven-
tional goals,” said the twice-married “hottie.” “There is pressure
on women to shrink and shrivel up when they get older. It’s so
sad. I tell them to wear sexy dresses, show cleavage, go out and
have a good time,” she asserted.
Despite the growing role of Internet senior dating sites and
chat rooms in connecting folks, the majority of people said they
met through mutual friends or mutual interests. Cindy was
66 and just retired when she met James, then 82, at a political
club they both belonged to. Before that, she had accepted that
she wasn’t going to meet anyone, or, if she did, the relationship
wasn’t going to go anywhere, and she was leery of online dating.
After overcoming her initial reticence due to difference in age,
they became inseparable. “We were activity partners and had
common values and mutual respect. There was hugging and
affection,” she said. They were together for five years before he
died in 2009.
Janet, a retired nurse in her mid-to-late-sixties and divorced
for many years, told me that almost everyone she knows who is
dating met through a mutual friend, but due to set habits, the
relationships don’t seem to last that long, “no matter how nice
the individuals are.” She went on, “It might be that those of us
who have been independent many years find it difficult to adapt
to the kind of cooperative lifestyle relationships demand. Too, if
one has not shared space with another in many years, suddenly
having someone around all the time is not easy. I found I still
wanted to see my friends by myself, and they preferred that too,
and really didn’t want my ‘boyfriend’ hanging around so much.”

10VillageCare
Vi l la ge Ca r eTODAY
T O DAY | |Spring
Wi nt er2010
2010
After less than a year together, she broke up with her boyfriend
last spring, finding him “too needy.”
The two successful couples she knows spend a lot of time
apart. In one, her friend lives in the States and visits his
girlfriend in Israel for two or three months and then returns
home, and in the other, her friend’s boyfriend is often out of
town for days at a time visiting his family or friends who live
in another city. The one man she knows who met someone
through Internet dating has broken up with her. “Couldn’t
stand living together,” Janet said.
My 74-year-old long-married cousin in Boynton Beach,
Florida, reports a similar arrangement. She said that most dat-
ing seniors she knows go to dinner, theater, movies, take trips
together, have sex, but maintain separate residences. They usu-
ally don’t marry because of their children, or are afraid that the
other person will use up all their life savings, or they will have
to forfeit some of their social security benefits.
In New York, dating is difficult at any age. In a recent
New Yorker magazine Talk of the Town section, entitled
“Happy Hunting,” Michael Silverstein discussing his new
book, “Women Want More: How to Capture Your Share of
the World’s Largest, Fastest-Growing Market,” co-authored
with Kate Sayre, said, “Women in New York have enormous
issues with money, enormous issues with time. They are more
likely to get divorced, and they are more troubled about finding
love.”
On the positive side, Silverstein continued, “New York
women have more friends than anyone else on the planet,” and
his visit to a New York yoga center “was the friendliest, most
conversational, most open” of anywhere in the U.S.
Another one of those interviewed was Lenny, who enjoys
dating, but doesn’t like the pressure of having to shell out
big bucks for dinner. “The money aspect is tricky,” he said.
“I don’t like overpaying to impress someone.” Although he
would like to find a partner, he won’t do it online. “I have to tell
my age, show a photo. Most women under 55 say I am too old.
When I meet them face to face at dances, the initial impression
is different,” he said.
Larry, too, has a large circle of friends, both male and
female, that he hangs out with at dance clubs and at weekend
dance getaways. “There are so many distractions in New York
that people are just too busy to date,” he observed. “And hardly
anyone is marrying.” He knows about eight to ten couples who
are dating steadily, but not living together. Also, some of his
friends have aging parents in their eighties and nineties to take
care of, so they don’t have time for a full-time relationship.
Anna, divorced at 40 and now 78, has made good friends
through her ceramics class at an East Village senior center.
She commented that the great fulfillment in life is to find a
friend, “a partner to share an activity would be better,” she said,
“but I’m not looking for a relationship. I’m done attending
to everybody else’s needs. Friendships replace other forms of
intimacy.”
So, there you have it. Seniors who date and seniors who
don’t. Seniors who find love and intimacy and seniors who
find friendship and intimacy. Seniors who are pursuing their
passions and interests. With or without a partner, enjoying life
to the fullest is the ultimate self-affirming goal. !

11
12 Vi l la ge Ca r e T O DAY | S p ri ng 2010
 A Lifetime Wherever
Lucy Cecere sees
Commitment a“saving”
need — such as
Village
By Jess Espinosa
Nursing Home — she
throws herself into the fray

M
uch has been written about Lucy Cecere. To the friends of VillageCare, the stories are
familiar.
It is known that in the early 1970s, Cecere co-founded Caring Community to cater
to the needs of older adults in Greenwich Village. With her characteristic spunk and perse-
verance, she galvanized four churches to serve lunches to needy seniors when the state
refused funding on the grounds that Village residents “have money.”
Today, the Caring Community, serves 2,000 seniors at five different sites and
provides other social services such as home repairs for the homebound and arts
and crafts, language study, exercise and other activities that stimulate aging
minds and bodies.
In 1975, Cecere and concerned neighbors came to the rescue of Village
Nursing Home when the state threatened to close it. She, with an

13
 army of volunteers, collected donations door-to-door and held
bake sales and auctions to fund their fight. Garnering media
coverage and the attention of then-First Lady Roslyn Carter,
donations came in from all over the country and the world,
helping the Caring Community to take over the nursing home
and ultimately create a separate not-for-profit organization
(today’s VillageCare), which oversaw renovations in the early
1980s.
Cecere spearheaded activities that made the seniors at Village
Nursing Home feel loved and remembered — presenting them
with flowers on their birthday, preparing festive dishes to cel-
ebrate Seder with Jewish residents, putting up Christmas decora-
tions and bringing food and gifts.
The ultimate source of her drive for these remarkable accom-
plishments is her love for the city that she has called home all
her life, particularly that part called Greenwich Village, or simply
“the Village” to those in New York. Her mother once told her, “if
you like where you are living and like to stay there and keep it
nice, you have to give something.”
Cecere’s roots are firmly entrenched in the Village. She was
born on May 21 (“never mind the year!”) on Thompson Street.
She has many fond memories of the Village when life there lived
up to its name, a place with small-town, neighborly charm. She
remembers trips to the tiny neighborhood grocery store to buy
milk that turned into one-hour jaunts because there were too
many storekeepers and friends to greet and chat with on the way
home. “Everybody knew everybody!”
There were only a few pizza parlors then, but their pizza
was memorable. The corner drug store had a soda fountain that
offered a variety of refreshing treats all year round. Children
played out in the street, undistracted by television, video games
and other technological what-nots, while their parents chatted
from the stoops. In the morning, the crowing of roosters in the
chicken market across the street from her family home wakened
the neighborhood, and there was a stable nearby. “We had a lot
Above: The young Lucy Cecere. Below: The building where of fun with the horses,” she recalls.
Something Special is located is a landmark. As a young girl, she wanted to be a fashion designer. After
graduating from the Fashion Institute of Technology, she worked
in the bridal section of the old B. Altman Department Store. One
of her co-workers introduced her to a man who was fresh out
of the Army. “He was very funny, very nice,” she said, and she
went out on a date with him. On October 5, 1949, she and that
man, Lenny, married, and went to Cuba for their honeymoon.
In 2009, they celebrated their 60th wedding anniversary. Their
two children, a son who is a bankruptcy lawyer, and a daughter,
who works in the financial sector, would like to send them back
to Cuba to celebrate their milestone anniversary.
After giving up her job at B. Altman when her kids were
born, Cecere taught dressmaking to children and adults at one
of Children’s Aid Society programs. Her compassionate nature
caused her to take action when she discovered how difficult life
was for the underserved elderly population of the Village, leading
to the formation of Caring Community. The rest, as they say, is
history.
Lucy and Lenny own a landmarked building — built in 1846
— at the corner of MacDougal and Houston. The storefront run
by Lenny is called Something Special, a name inherited from one
of its former functions. That space has reinvented itself several

14 Vi l la ge Ca r e T O DAY | Wi nt er 2010
times over, from an Italian restaurant to a bakery to a card
shop. About 20 years ago, after serveral failed attempts to make
the storefront viable, a serendipitous thing happened – Lenny
rescued several mailboxes that a building super was going to
throw in the dumpster, and he came up with what turned out
to be a brilliant idea. He got himself bonded by the post office,
installed the mailboxes on one side of the shop, and turned
Something Special into what it is now – a neighborhood mail
pick-up center.
The shop cum post office, with its cluttered display of rem-
nants past has a charming appeal about it — boxes of yellowing
Christmas cards here, some wide and skinny neckties there,
an assortment of doodads, figurines and toys clutter the dusty
shelves, and old magazines and books flood the floor, some
selling for a dollar, some a bit more. The store is out of place
in the expectations of Greenwich Village. Its clientele consists
of Village characters and a sprinkling of celebrities who come
everyday to pick up their mail, catch up on the latest gossip
and see how everyone is doing. (Matthew Broderick, who grew
up in the neighborhood and lives with his wife Sarah Jessica
Parker on nearby Charles Street, is a regular.) In the back of
Above: Something Special is a favorite neighborhood hangout
the shop a shelf holds framed photos of Lucy and Lenny with for many, including the friendly crossing guard for the nearby
their famous friends. And all year round, Christmas or not, a St. Anthony School. Below: Lucy Cecere collects signature for
clock plays Adeste Fidelis every hour on the hour. the landmark designation of South Village.
As for the Village surrounding the store, it’s changing.
“It has broken my heart many times,” Cecere said. Beautiful
old buildings are knocked down and replaced by homogenous
steel-and-glass boxes without character but with rents once
unheard of in this part of the city. Now, except for a few hold-
overs like Something Special, most all the old businesses are
gone.
Recalling her mother’s words, Cecere engages in a new
battle — the protection of this neighborhood she loves. With
its cobblestone streets, hidden gardens, quaint shops, towering
ancient trees and stately brownstones, she’s determined to fend
off greedy developers interested more in profit than the neigh-
borhood’s heritage and character.
Cecere is right there with concerned Village residents,
church leaders, members of the Greenwich Village Society for
Historic Preservation and others, calling for landmark status
for the entire South Village.
Her life’s work has earned her many awards, honors and
commendations, and she was featured VillageCare’s 2009
Legends of the Village calendar. Known for bringing happiness
and caring to many people, Cecere appeared as the December
legend, a month of gift-giving, togetherness and joy.
In November 2009, Cecere received the Woman of
Distinction Award from State Senator Thomas Duane in a cer-
emony at Our Lady of Pompeii Church attended by some 100
of her fellow Villagers. She was also presented with proclama-
tions honoring her from City Council, presented by Speaker
Christine Quinn, and from Manhattan Borough President
Scott Stringer.
The Villager quoted State Assemblywoman Deborah Glick at
the event: “Lucy has always had an internal compass about what
is the right thing to do. And she does it with grace, elegance and
a strong personal commitment to those who need her help. We
are not just proud of her, we are grateful to her.” !

15
 A Health Center
For Every
Season
VillageCare’s
By Bonnie Rosenstock
Chelsea Center Serves
Every Condition, Every Age
16VillageCare
Vi l la ge Ca r eTODAY
T O DAY | |Spring
Wi nt er2010
2010
W
hile the nation debates the future of the ailing health clients comfortable. They feel happier here.”
care system, each day ordinary people are dealing The Health Center’s clientele is varied.
with the stressful, time-consuming task of finding Dr. Hitzeman specializes in internal medicine. He sees a
the right doctors for what ails them. Fortunately, VillageCare’s number of patients who are HIV positive, and in his practice he
Health Center is just what the doctor ordered. stresses the importance of preventive health care to keep people
The three-year-old medical center at 121A West 20th Street from having to go to the hospital. “We want them to save their
in the heart of Chelsea brings primary care physicians, nurse
practitioners, dentists and podiatry services all together under
one wellness roof. VILLAGECARE HEALTH CENTER
Nicholas Rossetti, the center’s director, said the primary care 121A West 20th Street, between Sixth and Seventh Avenues
facility offers a full array of services in a setting that “provides
coordinated care integrated across all elements of the complex Telephone: 212.337.9290
health care system.”
Hours of Operation:
Rossetti says that the Health Center sees the patient-cen-
Monday and Thursday, 9 a.m. to 6 p.m.
tered “medical home” model of primary care, something the
4UESDAYAMTOPMs7EDNESDAYAMTOPM
medical community envisions being implemented throughout
Friday 9 a.m. to 5 p.m.
care settings, as the ideal in terms of getting high-quality care
Saturdays (twice monthly) 9 a.m. to 4 p.m.
delivered efficiently to individuals.
“The physician includes the patient in all decisions they
are making,” he said. “It’s a real partnership. It respects the
patient’s wants, needs and preferences, adding up to real cus- immune systems instead of waiting until they get very sick
tomer service.” before they seek treatment, often too late. The idea is to keep
Dr. Lawrence Hitzeman, the center’s medical director, points them healthy, so they don’t have to utilize hospital services.”
out that the center’s intimate nature is an important plus. “We One of his colleagues, Dr. Veeraf Sanjana, is a general inter-
are not a big bureaucracy,” he said. “The patients get to know nist, board certified in infectious diseases.
everybody, and the staff works well together, which makes the For Dr. Sanjana what makes the center unique is that the

17
 staff provides individualized services to a counseling, menopause counseling and
group of patients that often don’t get that gynecological referrals for more serious
kind of attention in a hospital or a city issues.
clinic. “Underprivileged patients who often “Patients come here because of the
have Medicaid or ADAP [state AIDS Drug amount of time I have to spend with
Assistance Program insurance] don’t get them,” she said. “All the providers are very
to see private doctors in the community thorough and conscientious. And it’s great
because most doctors don’t accept these to be able to walk over to them and have a
insurances,” he said. consultation.”
The VillageCare Health Center also VillageCare Health Center also has
accepts most major commercial insur- onsite facilities for venipuncture and blood
ances as well as workup, urine and sputum collecting; out-
Medicare. There side laboratories do the results. The Health
is a sliding scale Center’s dental services opened last sum-
for those with- mer, and Rossetti says the addition was
out insurance. well received by patients. “It’s been a big
“People come hit,” he said.
here because at “The patients are satisfied with the den-
a hospital or tists,” he said. “Hopefully it will attract
city clinic they people for other services as well.”
have imper- The center has been attracting more
sonal service in and more clients since it opened its doors.
general, at least “The advantage is we provide high-quality
that’s what the under a comprehensive umbrella of ser-
patients report,” vices,” Gerrido said.
said Dr. Sanjana. “They are very happy to Because the Health Center is part of
get a private doctor that takes Medicaid.” VillageCare’s wide array of services, “we are
He also sees people with mental health in an excellent position to provide the pri-
issues, routine medical problems, like high mary care needs of the community,” said
blood pressure and diabetes, and people Rossetti, reciting the list of the organiza-
referred by their employers for routine tion’s community and residential services.
medical check-ups. Those services include home care, adult
Given that day health centers, short-stay rehabilita-
23.7 million tion, skilled nursing care and assisted liv-
Americans, or ing, among others.
7.8 percent of The VillageCare Health Center has a full
the population, complement of doctors, dentists, nurses
suffers from and other professional health care staff,
diabetes — 5.7 enabling the facility to offer patients a com-
million of them plete range of primary care, care for chron-
undiagnosed ic and ongoing conditions and preventive
— it’s notewor- services. The Center also offers supportive
thy that another services such as nutrition, mental health
of the Center’s services and social work, with a collabora-
primary physi- tive team that coordinates care.
cians, Dr. Jean-Louis Salinas, also special- The Center offers the availability of
izes in diabetes. Other specialists include same-day appointments. Dental care is
a psychiatric nurse practitioner, who does provided in a warm, friendly environment
psychological evaluations and prescribes with the highest standards of dentistry and
medication as needed; a psychologist for exceptional consumer care.
counseling, and a women’s health nurse
practitioner, Niru Somasundaram. She You can learn more about the services for
provides routine pelvic exams, pap smears, VillageCare and the Health Center by visiting
STD testing, breast exams, birth control www.villagecare.org. !

18VillageCare
Vi l la ge Ca r eTODAY
T O DAY | |Spring
Wi nt er2010
2010
19
 A Lot More Than
A Hot Meal
Now Part of VillageCare,
The Momentum Project
Carries On its Mission
Of Fellowship and Support

By Brett C Vermilyea
20 Vi l l a ge Ca r e T O DAY | S p ri ng 2010
O
n the last day in November, ducking out of a boroughs for a hot meal and a take-home pantry bag of
cold evening rain on a dark Second Avenue, canned goods and fresh produce.
a visitor walks through the glass-and-bronze And though the food is the central focus of
doors beneath the majestic stained glassed arches of Momentum, Jan Zimmerman, the program’s adminis-
Middle Collegiate Church. Once inside the dimly lit trator, says the meals are only the entry point into their
nave, he follows the rope line along the wooden pews clients’ lives.
that leads him to a large meeting room behind the “We start with food as a basic need for anyone to
altar. survive,” she said. “Though clients don’t have to do any-
It’s a Monday, and the meeting room is filled with the thing but come in and eat — there’s no other structure
soft echoes of about a hundred people, mostly men, as or requirement — we use the meals to engage people
they chat with each other. Some sit at the four long rows in better self-care to survive, thrive and grow, to live the
of tables, some roam the room greeting old friends. At best possible lives they can live.”
the near end of the room is a small stage (there will be She says HIV treatment is challenging even for the
music later), covered with plastic grocery bags filled with most stable individual, requiring several pills a day,
food. At the far end is a kitchen and table set up buffet- every day, for the rest of life. Miss doses of HIV-specific
style. Five or six young women, volunteers from the medication and its effectiveness can be compromised.
Leadership and Public Service High School, wait to serve On top of the HIV medications many clients also take
the food being prepared by the chefs behind them. pills for the full range of other conditions that exist,
Peter LaMarca greets the visitor with a gentle two- both due to HIV disease and due to people living longer:
handed handshake, offering coffee and soup. The main diabetes, heart disease, high blood pressure, antidepres-
meal will be served in about 10 minutes at 5:30. LaMarca sants. But for individuals whose lives are not stable —
is a volunteer for the Momentum Project, which has the people Momentum tries to reach — the challenges
been feeding poor and homeless persons living with to treatment are much more daunting.
HIV/AIDS for 25 years. “About 80 to 90 percent of our clients struggle with
Every day except Sunday, people coping with the mental illness or substance abuse issues,” Zimmerman
disease can visit one Momentum’s 10 sites in four said. “The medical community says HIV is a chronic

21
 disease, like cancer or asthma, and is manageable, and if you take medication you’ll be
fine. But HIV/AIDS is also a social disease. You contract it through activity like sex and
drug use. And we need a socially based programs like Momentum to address its treatment
and prevention.”
Having been a client since 1998 before becoming a volunteer who puts in four or five
hours nearly every day, LaMarca says that, while the food is great — he just finished his
meal of honey barbecue chicken, mashed sweet potatoes and buttered spinach — what’s
kept him so involved over the years is the sense of being part of a community.
“It’s great because you can come here and be social,” he said. “I’ve gotten to know a
lot of friends over the years. You can come here and talk your troubles, what you’re going
through, what new drugs are available, new treatments. Society is still ignorant of the
virus. Here, everyone is going through the same thing.”
Another long-time client, Damon Grandison, sits in the corner talking to Momentum
Director of Client Services Donnell Tillman-Basket.
“I’ve been coming to Momentum for, let’s see, 15 years? No. It’s been 17 years,”
Grandison said. “It’s about people and networking information about treatments, studies,
focus groups. It’s like a second family. You can be gone for weeks, months, years even, but
when you come back you are always welcomed like family.”
Zimmerman said this idea of a second family creates an important network of support
because, even though there’s been huge advances in understanding HIV/AIDS over the
last 20 years, there’s still a stigma.
“If you go home and tell your family you have cancer or diabetes, they put their arms
around you and say, ‘I’m so sorry what can I do for you,’” she said. “But if you go home
and tell them you have HIV, they bring out the plastic silverware and tell you not to use
toilet and not to hug your nieces or nephews. That’s why people don’t generally disclose
their status to their families.”
And because their clients don’t have many other options for care, Tillman-Basket says
Momentum tries to use the meals to dispense as much care as they can.
“We provide one-stop shopping for our clients to get help with not just their nutritional
and health needs,” she said, “but for their social needs, we want to make sure their needs
are met by removing the barriers to care.”
LaMarca said clients appreciate all the options available. “It means a lot for them, for

22VillageCare
Vi l la ge Ca r eTODAY
T O DAY | |Spring
Wi nt er2010
2010
me, to know that if you need help you get it,” he said. “If you need help finding an apart-
ment, Momentum can help. There’s social services like that. Or you can talk to a chaplain
if you’re depressed or talk about transmitting the disease.”
The services Momentum provides include nutritional counseling,
substance abuse intervention, prevention education, mental health
counseling, family services, health and adherence education, life
skills training, services for people over 50 who can require special
attention, housing and entitlements advocacy, pastoral counseling,
referrals to outside services and support groups, nursing services
and health education.
“A big challenge with our clients is that they are often disengaged
from following up with their doctors.,” Zimmerman says. “The
medical system can be not so friendly to our clients, and Momentum
engages people at the point of service of a hot meal, confronting the
barriers to treatment — when the need to connect a client to care is
especially urgent, we even escort clients to their clinics.
In 2008, Momentum joined forces with VillageCare, creating sav-
ings through combined operations and helping to ensure not only
Momentum’s survival but helping expand its services and reach.
“I was very excited,” said Zimmerman, who is also the adminis-
trator of Village Care’s two AIDS Adult Day Health Care Programs
in Chelsea and the Lower East Side. “The Day Programs provide a treatment community
which many clients can not sustain due to its requirements and structure. I saw the
value of Momentum as a critical component of our continuum of care for people living
with HIV/AIDS. For clients that I can no longer keep at the day
programs, I now have a safe, supportive, and nourishing environ-
ment that I can discharge them to. And at the same time, as our
Momentum clients heal and seek more structured support services,
referrals into her Day Programs, or VillageCare’s Case management
program are a perfect fit.” !
You can learn more about these services by going on the Internet to
www.themomentumproject.org, and to www.villagecare.org.

23
24VillageCare
Vi l la ge Ca r eTODAY
T O DAY | |Spring
S p ri ng2010
2010
A Burden and a Blessing
Taking Care of a Loved One at Home Is
Both Challenging and Rewarding
By Bonnie Rosenstock

“
A
lice” is a single 45-year-old freelance com-
mercial photographer, who looks after her
86-year-old father. They live in the same
building but not the same apartment. He is in the
moderate stages of Alzheimer’s disease – “halfway
between beginning and middle,” Alice said. Her
two older siblings live out of state and do not con-
tribute financially, so she shoulders the majority of
the caregiving responsibilities.
“Mike” is a retired writer whose wife has been
housebound for the last five years since she fell
and broke her hip. She was not a candidate for
physical therapy because she is in the latter stages
of Alzheimer’s and can’t follow instructions. As
result, she is confined to a wheelchair or her bed.
They are both 75 and “have had a love affair for
forty-seven years,” said Mike, and even though she
has round-the-clock aides, he can’t bring himself
to leave the house for very long.
“Barbara’s” mother has been a resident at The
Village at 46th and Ten, VillageCare’s assisted liv-
ing facility, since February 2006. As the unmarried
sibling of three daughters all living in New York,
Barbara is the go-to person for all questions and
issues relating to her mother’s care. Her mother,
89, has mild-to-moderate dementia, and is incon-
tinent; she is mobile with a walker although in the
last year her health has deteriorated due to a fall
in 2005, a more recent stroke and other compli-
cations. “It’s almost a typical Victorian scenario
of the unmarried youngest daughter being the
caretaker,” Barbara said. “I mostly embrace it, as I
have the most time and energy. But as my moth-
er’s condition deteriorates, it has taken a greater
toll on my stress level and my ability to live and
handle my own depression.”
No matter how many different scenarios, they
are all part of the same heartwrenching theme.
Taking care of a loved one takes an emotional,
physical and financial toll on the caregiver. Of the
myriad websites devoted to primary caregiving,

25
one called www.homecaringadvice.com forgetful and ignore me; on the other said. As a result of all the pressures, she
has delineated about 30 “symptoms hand, he will remember such details that says she suffers from chronic depression
of caregiver burnout.” They include: it’s disconcerting as well. I never know but is not currently on medication or in
powerlessness, hopelessness, emotional what’s going to happen next,” she said. therapy.
exhaustion, inability to handle more Moreover, she is learning how to sift out For a period of time Alice didn’t work
than one problem or crises, isolation, his moods, to determine whether they at all because of “all the systems to work
despair, feeling trapped, apathy, crying, are a result of physical discomfort from out,” she related. “My stress level was
easily angered or annoyed, change in his other illnesses or drug interactions, high dealing with the issues of day care,
eating and sleeping habits, headaches, “instead of the terror of Alzheimer’s,” medications, Medicaid, food stamps and
anxiety, impatience, resentment, harmful she said. any other services we could apply for.
behavior to care recipient and escapist Competing demands often wreak Now for the first time in two years, I am
behaviors, such as sex, drinking, drugs havoc on the caregiver’s own state of calmer.”
or shopping binges to escape negative mind. This is common for an adult child Bohmart recommends that caregivers
feelings. taking care of both a parent as well as ask for help.
Caregiving for those with Alzheimer’s their own children. Another example is “They think they can do it all. Getting
is particularly stressful and one of the the competition between the demands of home care and taking advantage of ser-
hardest situations for individuals to deal a job and those of caring for a loved one. vices such as an adult day health care are
with, explained Lisa Bohmart, social work Barbara often has to take days or half important, she said. Alice agrees, relat-
supervisor at VillageCare’s Adult Day days off from her job as a word processor ing that because she must work to pay
Center at 644 Greenwich Street. “There in a law firm to accompany her mother to her rent, her father’s rent and mounting
are a lot of emotional feelings because medical appointments. bills, she did not have the time or energy
the person is there, but not really there. She also faces the additional responsi- to engage and entertain him. “One per-
There is also denial about them really bility of dealing with caregivers she has son can’t do physical therapy, walks, sing-
being sick or more capable of doing hired to assist her – “whether training a-longs, art classes or cooking classes,”
things than they actually are because of them or contacting the agency to replace she said.
the moments of clarity. It can be really them if it’s not working,” Barbara said. Alice is thankful that she found
confusing.” “When I get a call at work that my VillageCare’s Adult Day Health Center
Nancy Seigel, social worker at Village mom is uncooperative with an aide, I where her father has been going five
Nursing Home said that for a spouse, have to deal with it within earshot of my days a week since April. On weekends, he
companionship is gone. “Seeing your colleagues. I have to intercede with a doc- goes to a center in Riverdale and through
loved one, a person who knows every- tor when some medication or protocol is a grant, for two days a month he goes
thing about you and now just looks at not working out. I have to get necessary to a Chinese center near the Brooklyn
you, it takes a toll,” she said. paperwork to Village so they can comply Bridge.
As Alice watches her father’s short- with New York State regulations. The list “My dad is very social, so he loves it,”
term memory slip away, she feels a goes on. Even when I am not with my she said. “He gets to meet people, talk to
sense of disequilibrium. “He can be mother, I am about my mother,” Barbara them, nobody is down on him because of

26VillageCare
Vi l la ge Ca r eTODAY
T O DAY | |Spring
Wi nt er2010
2010
 Caring for
The Caregivers By Bonnie Rosenstock

I
n recognition of National Family Caregivers Month this woman with a job, who spends at least 26 hours a week in
past November, the Women’s City Club of New York caregiving responsibilities, averaging four and a half years in
sponsored a panel discussion entitled “Who Cares for the role, with needs escalating. “Forty-four million Americans
Caregivers?” on the challenges of caregiving, its inordinate are affected, that is, one in four families. It’s a job that nobody
impact on women and policy solutions that would ensure that applies for and everybody is unprepared for,” Sheehy said.
caregivers are also cared for. She recommends hiring an independent geriatric care man-
The three guest speakers are not only experts on these ager, if one can afford it, because there are “ “traumatic jolts.”
issues, but also have personal experience as primary caregiv- These include transitioning from one care setting to another –
ers: for example, from home to hospital, from hospital to rehabili-
t
4V[BOOF
.JOU[
DPGPVOEFS
PG
UIF
BEWPDBDZ
HSPVQ
tation, as well as various other facilities along the way. Sheehy
National Family Caregivers Association (NFCA), is a recog- said that a geriatric care specialist understands the system and
nized national spokesperson for family caregivers and has tes- works with the caregiver to sort out the sometimes nightmar-
tified before Congress. Her husband has had multiple sclerosis ish medical bureaucracy involved in the patient’s care. Poor
since 1974. people have this service available, but the middle class is left
t
#FTUTFMMJOH
BVUIPS
(BJM
4IFFIZ
JT
QFSIBQT
CFTU
LOPXO
GPS
out in the cold. Sheehy suggests that geriatric care manage-
her seminal Passages. Her new book about the caregiving cri- ment, a growing industry, be covered under Medicare.
sis, Passages in Caregiving – Turning Chaos into Confidence, Levine stated that family caregiving is a national problem,
will be out April 20. Video interviews with families across but at the same time, we should look locally for solutions. She
the country who have found creative ways to take on the chal- pointed out that New York is the only state that doesn’t allow
lenges of caregiving are at www.aarp.org/gailsheehy. Sheehy’s families to make end-of-life decisions unless you are a family
husband, Clay Felker, New York magazine’s founding editor, proxy. Additionally, there are two bills languishing in the State
died last year at the age of 82 after battling cancer for seven- Assembly (but passed in the Senate), Levine pointed out. They
teen years. are the Family Health Care Decisions Act and the Paid Family
t
$BSPM
-FWJOF
EJSFDUT
UIF
'BNJMJFT

)FBMUI
$BSF
1SPKFDU
GPS
Leave Act. California has passed a leave act similar to the one
the United Hospital Fund, which focuses on developing part- proposed for New York, but Levine pointed out that people
nerships between health care professionals and family caregiv- seem reluctant to use it for fear of losing their jobs.
ers, especially during transitions in health care settings. Her However, one bright light is the Collaborative Design
husband is a paraplegic as a result of an automobile accident. Group, a forty- to fifty-team collaborative composed of six
In 1900, the average person lived to age 47. Now, thanks to teams from New York – hospitals, nursing homes and home
modern medicine, it is 77. Therefore, this is the first genera- care agencies - that will work together to improve patient man-
tion that has had to deal with the issues of chronic care and agement, scheduled to start this year.
lingering diseases. “Caregiving is a lifespan issue,” stated Levine, “ranging
“It is so hard because we are starting from scratch and the from parents caring for their children with special needs, all
systems are not set up to deal with family caregiving,” said the way to end of life. Palliative care is good chronic illness
Mintz. She stated that Medicare is primarily aimed at short- care.”
term acute care for people in their sixties, but people are living These are some websites for further help on caregiver
into their nineties. In fact, over-85 is the fastest growing seg- resources:
ment of the population. She asserted that Medicare monies are -New York State Respite Coalition, www.scrny.org
not being spent properly, and new services and new ways to -New York City Family Caregiver Coalition, www.cscs-ny.
look at the health delivery system are needed. NFCA has com- org/caregivers/index/php
piled a comprehensive summary of bills pending in Congress -www.nextstepincare.org
related to family caregiving in such categories as respite, tax, -For New York City resources: www.netofcare.org
social security/Medicare/Medicaid enhancements, family leave -For New York City programs run by the Department for the
and health care reform. The organization has also published a Aging (DFTA), call 311, or www.nyc.gov/html/dfta/html/home
statement on Principles, Plans and Policy Recommendations, -New York State Senator Liz Krueger’s Resource Guide for
available at www.thefamilycaregiver.org. Seniors, 2009-20010 edition, downloadable at www.lizkrueger.
Sheehy added that the average caregiver is a 46-year-old com !
27
his condition and there are counselors to $2 million for respite and social adult day people away, or are shunned because of
guide him. Before, he wouldn’t even get services, which includes training volun- their AIDS diagnosis.”
out of bed.” teers who come in so a family member Because a number of those living with
Bohmart has helped Alice coordinate can run errands or go to appointments, HIV have histories of drug and alcohol
other ancillary services, such as medical the article added. abuse, the relationship between caregiver
supplies and medications, van trans- Additionally, some medications, sup- and patient might be tenuous. Some
portation and an escort to some doc- plies, special pads for the bed and dis- have been able to kick their habits, but
tors’ appointments, for example. This posable underclothes are not covered by others have not. “On top of taking care
helps free up Alice for her freelance Medicaid or insurance companies and of someone who is sick, how do you take
work assignments. The help was indis- pull on the resources of the caregiver. care of someone who is using?” Diane
pensable in Alice’s navigation through Luckily for Barbara, her father provided asked. “The HIV sufferer might shun the
the dizzying maze of documentation for for her mother very well, so rent, ser- person who helps because the addiction
Medicaid, allowing her father to qualify vices and a private aide are taken care is more powerful than friendship or fam-
for a home aide twenty-three hours a of. However, even with the addition of ily. The caregiver suffers the indignity of
week. Medicare and an AARP supplemental someone caring more about the addic-
Caregivers may also find themselves plan, she still spends her own money tion than human relationships.”
doing unfamiliar, time-consuming tasks on Fresh Direct for groceries, bottled Having a social network is crucial
that the other person did for years. In water and a constant supply of dispos- for caregivers, whether it is other family
Alice’s case, she does double duty by able clothing because of her mother’s members, friends or a support group.
shopping, cleaning and cooking for her- incontinence. However, because of all the time they
self and her father, which includes pre- Caregiving for those diagnosed with spend with the ailing individual, friend-
paring his special diabetic meals a few HIV/AIDS presents a more complex set ships and social contacts may fall by the
days in advance. of issues. While the stigma attached to wayside. On the other hand, people who
Mike says his wife used to maintain those living with the disease has lessened are uncomfortable in the face of illness
the household, do the shopping and in recent times, “it’s a special caregiver might walk away.
manage the finances. Aides now take who stays with the individual even though “It’s amazing how many people don’t
care of his wife, but he must look after the person has moved to an AIDS skilled want to talk to you once they know you
himself. “The IRS just audited me, so nursing facility, such as VillageCare’s have problems,” Mike observed.
apparently, I’m not doing such a good job Rivington House,” said “Diane.” Mike said that, against his better judg-
with the taxes,” he said with a laugh. She said, “It’s terribly stressful. Many ment because he is not a “joiner,” he
Most of the clients at the VillageCare of the residents are abandoned, either started attending a support group at
day center have Medicaid. “Medicare because of their drug use that pushes Village Nursing Home with Nancy Seigel
doesn’t pay for home care except after a about a year ago. He and the other male
hospital stay if there is some need, and in the group are not otherwise involved
it’s temporary,” explained Bohmart. with the facility. Through this, Mike says
Unfortunately, many people fall in he realizes that others have problems as
between the cracks. They don’t qualify severe as his. “I have learned to help the
for Medicaid but don’t have enough other people, and it is good to talk out
money either. “It would be great if my problems,” he says.
Medicare paid for adult day centers, but Support groups help people struggle
it doesn’t,” Bohmart said. to cope, said Bohmart. Most of the
Approximately 44 million Americans older clients at VillageCare’s adult day
currently provide caregiving to family program live with their caregivers. “A
members or friends. If this level of support group is a good respite for care-
caregiving were replaced by paid caregiv- givers. It gives them a break for a few
ers, the cost would exceed $300 billion hours. I tell them they have to take care
annually, according to a report by the of themselves before they take care of
National alliance for Caregiving and the anybody else, and they should do things
AARP in 2004. they like to do,” she said.
According to statistics published in Ironically, even the support groups
last October’s AARP Bulletin, caregivers face competing needs. At the time of her
“provide care worth about $25 billion a interview for this story, Bohmart said she
year in New York, and it delays or post- didn’t have any support groups active at
pones costly nursing home care.” That the day center. “People don’t want to
translates to over 2 million family mem- commit. They are tired from working all
bers statewide who provide these vital day. Even though it is good for them, it’s
services. New York State provides only another burden,” she said.

28VillageCare
Vi l la ge Ca r eTODAY
T O DAY | |Spring
Wi nt er2010
2010
 Sometimes primary caregivers lose any questions. “I might go to a support nineties, which is putting stress on all
sight of their own health and everyday group again, but it’s hard to fit it in. I try systems.
needs. Although Mike has wonderful to go to the gym as often as I can because In 2006, people 65 years and older
aides, he can’t bear to be apart from his I certainly need it. If I am not healthy, it numbered 37.3 million, which represent-
wife. “I used to go to the gym three times will be more problematic. For the time ed 12.4 percent of the U.S. population, or
a week. I know I have to get out of the being, the situation is somewhat stable,” about one in eight Americans. By 2030,
house, do my exercises or go to a movie she said. there will be about 71.5 million older
once in a while,” he admitted, although Barbara and Alice also search for people, about 20 percent of the popu-
these are things he no longer does, or information online at primary caregiving lation, reports the Administration on
doesn’t do often. sites. Barbara would like to participate in Aging (AOA). This indicates that more
“Fatigue leads to physical illness, which a support group, but she concedes that programs, particularly those that are gov-
can lead to depression,” said Diane. she is “in an in-between space.” She is a ernment-financed, along with access to
One website http://www.strengthfor- primary caregiver, but her mother does other services will be in great need.
caring.com/ recommends that caregivers not live with her. Most support groups Carol Levine, director of the United
take a break for “personal renewal.” As are for people who have parents in their Hospital Fund’s Families and Health
the website puts it: “Take an afternoon; home. Project was quoted in the October 2009
even all day. Enjoy it by yourself or with “I almost feel embarrassed to intrude. AARP bulletin as saying, “It’s difficult to
a friend. Do something self-indulgent. While it feels like 24-7, it isn’t. I have find services because they’re scattered,
Take a walk in the park; go to a movie; a psychological need for one but can’t they’re under different agencies [with]
find a relaxing area. Read a deliciously compare my lot with someone who has different eligibility standards. It’s not a
naughty novel. Take a nap if you weren’t no staff aid. It’s a grey zone, which isn’t consistent program and it’s hard for fam-
able to get your 7-8 hours of sleep the addressed,” she said. In addition, she has ily caregivers to put this all together.”
night before.” no children, so she is not the sandwich Taking care of a loved one can prove
Alice attended some support groups generation, caught between children and to be a burden or a blessing, depending
a few years back for children with par- parents. “But more support needs to be on the caregiver’s access to adequate
ents who have Alzheimer’s, sponsored in place on all levels,” she asserted. resources. As Alice put it, “I’m glad to
by the New York City chapter of the Today, the issue of caregiving is becom- have an opportunity to convey both the
Alzheimer’s Association, where she got ing increasingly urgent, particularly to horror that’s been part of my experience
invaluable legal, medical and financial aging Baby Boomers, who are both the and the happiness in finding there are
advice and emotional support. She has caregivers and the cared for. Because of help options in New York City that I can
ongoing access to a counselor at the the miracles of modern medicine, people get for my dad. It’s been a great lesson
association whom she can email with are living well into their eighties and learned.” !

29
STANDPOINT

The Challenges of Aging for an Older Population

I In 20 years, 25 percent
n the year 2030, the youngest members major life changes, including retirement,
of the Baby Boomer generation will hit losing loved ones and loss of mobility and
65, making up nearly a quarter of the independence. It can show up differently
country’s population, according to the U.S. in older people, says geriatrician Nasiya of the Amercians will
Census Bureau. If current older Americans Ahmed, M.D., assistant professor of inter-
are a precursor of what is to come, they will nal medicine at the UT Medical School. be over 65, putting huge
experience health challenges such as dia- “There’s not as much of a tendency toward
betes, dementia, depression and functional tearfulness or feelings of hopelessness,” demands on health care
disability in record numbers. she said. “Instead they have vague somatic
But their huge presence may also open
up specialized emergency rooms and criti-
complaints, increased pain, not sleeping or
eating well or general apathy.”
and social services.
cal care units, encourage more research
into the mysteries of the aging body and DISEASE. Chronic diseases associated
place a focus on specialized geriatric and with the aging process that can take a toll
end-of-life care. as one ages include high blood pressure,
Researchers and clinicians in the stroke, cardiovascular disease, osteoporo-
Division of Geriatric and Palliative Medicine sis, chronic obstructive pulmonary dis-
at the University of Texas Medical School at ease, hypothyroidism, constipation, incon-
Houston, have listed ten of the most com- tinence and arthritis. Preventive measures tioner or geriatrician who can be the lead
mon challenges that we all face as we grow taken early, such as quitting smoking, physician in managing their care.
old. eating healthy food and exercising, are all
important steps toward a better quality of FALLS. Low blood pressure, which can
FUNCTIONAL DECLINE. According to life. “Even quitting smoking at age 60 is be a result of poorly managed hypertension
the U.S. Department of Agriculture, the better than not quitting at all,” Andrade or dehydration, can lead to dizziness. That
body loses one percent of muscle mass a says. dizziness, combined with a decreased abil-
year beginning at age 45, which can result ity of the vascular system to compensate for
in sarcopenia as skeletal muscle is eventu- POLYPHARMACY. A term geriatri- changes in position such as standing up, is
ally replaced with fat and the body becomes cians are using for the number of prescrip- the largest cause of falls, clinicians say.
weaker. tion and over-the-counter medications that “So many patients have told me that
Some research has linked protein defi- elderly people are taking in alarming num- they take blood pressure medication when
ciency with sarcopenia. For every week bers is polypharmacy. “People go to five they feel like it’s high instead of taking it
spent in the hospital, it takes an aging different doctors and none of the others as it is prescribed,” Dr. Ahmed said. “I ask
body a month to recover muscle strength know what is going on,” Dr. Ahmed said. them how they know it’s high and they
with daily rehabilitation, says geriatrician In some cases, seniors who wind up give vague signs such as their nose tingles
Liliana Andrade, M.D., assistant professor in the hospital may be prescribed a differ- or their tremor worsening.” Taking medi-
of internal medicine at the UT Medical ent medication for an existing condition cations for sleep can also be dangerous.
School at Houston. Exercise, including such as high blood pressure because the “Some take Benadryl to help them sleep
resistance and strength training, is abso- hospital doesn’t stock the particular one and as people get older, that’s not such a
lutely essential for retaining muscle mass they’ve been taking in the past. The patient good thing because it causes confusion
and strength. returns home with a new prescription and they can fall because they’re sleepy,”
“For balance, Tai Chi is good,” she said. from the hospital physician and continues Andrade said.
“We also encourage patients to rent ‘sit and taking the other medication as well, which
be fit’ videos that use hand and leg weights.” can be deadly. ABUSE AND NEGLECT. These two
A study published recently in Diabetes “I’ve had patients come in who are tak- problems, including self-neglect, will con-
Care, a journal of the American Diabetes ing 20 different medications,” Dr. Andrade tinue to afflict older adults, said Carmel B.
Association, found that older adults, espe- said. “A lot of them also take vitamins and Dyer, M.D., professor and director of the
cially women with Type 2 diabetes had a herbal supplements that they don’t need geriatric and palliative medicine division
higher rate of skeletal muscle loss. and that can interfere with medications.” at the UT Medical School and co-author
The solution, they say, is to have a written of the book, “Elder Abuse Detection and
DEPRESSION. Considered by some to record of all prescriptions, supplements Intervention.” Education programs are
be as prevalent as the common cold among and vitamins that they can bring to their needed now to train physicians to recog-
older adults, depression can be the result of appointments and have a family practi- nize the signs of abuse and neglect.

30VillageCare
Vi l la ge Ca r eTODAY
T O DAY | |Spring
S p ri ng2010
2010
 VIEWPOINT

The Long Goodbye

Turning the Caregiving Experience into a Partnership By Laura Beck

I
n 1998, I lost my father to his ten-year journey with What I gained was this: when care receivers experience that
Alzheimer’s disease. Before his passing, I had heard they have something to offer, and caregivers recognize the many
Alzheimer’s called “the long goodbye.” I know no better gifts they gain, amazing shifts occur in the care dynamic.
description of the experience. With every change – losing his way Focusing on reciprocity naturally shifts the energy away
home, no longer knowing my name, losing his ability to speak, from disabilities to abilities and enables us to build on what
and then, to walk – I watched the father I knew slip away. Each works right now, because it implies that everyone has some-
day, each moment, there was only something more to lose. thing to give. Care partnership implies a balance of care – an
As Dad’s caregiver, I centered my attention on doing the title acknowledgement that opportunities to give as well as receive
justice. It was all about me giving to him. I so strongly identi- are abundant and experienced by everyone involved in the care
fied with being a caregiver that I hadn’t really taken in the ways relationship.
that he gave to me in return. As we welcome the largest aging population ever, we need
One particular morning with Dad showed me that gifts creative grassroots solutions for enhancing quality of life for
of care come in the most unexpected packages. I found him older Americans and their care partners.
wild-eyed and rowdy, chanting nonsensical syllables. No longer The most effective approaches will be those that include
using words, this was Dad’s new language of choice. shifting cultural perspectives about aging and how we value
Unable to walk anymore, he writhed on his bed while he what our elders have to offer. Being deeply known and having
sang. Overwhelmed at first, I began to envy him as I watched the opportunity to give as well as receive are vital antidotes to
him dance between the worlds. I no longer saw him as the the loneliness, helplessness and boredom that impact the lives
victim of a debilitating disease, but rather, as an inspired mes- of so many frail elders.
senger. He was entirely in the moment – full of unfettered
playfulness and joy. How long had it been since I’d stopped Laura Beck is an Ithaca, N.Y., resident and project director of
to celebrate a moment so exuberantly? So I joined in and Eden at Home, an initiative of the Eden Alternative, an interna-
chanted with him, delighting in the sweetest connection I had tional non-profit committed to improving quality of life for elders
ever shared with him. We were no longer caregiver and care and their care partners. To learn more about Eden at Home or the
receiver; we had become care partners. Eden Alternative, go to www.edenalt.org.

FINANCIAL EXPLOITATION. Vul- Alzheimer’s disease and dementia triple care for seniors, to help them shoulder the
nerable elderly people can easily become health care costs for people over 65. But edu- stress. They should take advantage of sup-
victims of family members or caregivers. cation about dementia and possible treat- port groups and ask social workers regu-
“We see cases where grown children have ments including medications is lacking. larly about available community resources.
moved back in with them and are depend- “There are now more medications that Special units for acute care for the elderly
ing on them financially. They use their are helpful. They can’t cure it, but they can can help make hospitalizations less stress-
resources, borrow the car, rely on them to help,” Dr. Andrade said. “Unfortunately, a ful for the patient and family.
baby sit, and it upsets the senior’s ability lot of people are in denial. I had a 78-year-
to function,” Dr. Ahmed said. “I had one old patient who I knew was suffering from DEATH AND DYING. Individuals need
patient in her early eighties whose leg dementia because of the way he was man- to decide how they want to live out the end
had just been amputated and she was still aging his medications and health. But his of their lives and how they want to die.
babysitting her 11- and 12-year-old grand- son got upset when I started talking about Cultural and religious beliefs will impact
children, who were taunting her.” it and they left the room.” these decisions and physicians will need
to be sensitive to that, Dr. Ahmed says.
DEMENTIA. Alzheimer’s disease is the CAREGIVER BURNOUT. As baby As patients age, the physician begins to
most common form of dementia, a gradual boomers age, many will also be taking care play a larger role in a patient’s life and
decline in a person’s mental functioning, of their own aging parents. That brings strong physician-patient relationships will
and is the fifth leading cause of death caregiver burden, which can lead to a be important in determining a patient’s
for Americans over age 65, according to higher risk for depression and other stress- wishes. People should make those wishes
the National Center for Health Statistics. related illnesses. Dr. Ahmed says caregivers known to family members and caregivers
The Alzheimer’s Association reports that should solicit health resources, such as day and put them in writing.

31
THE L A S T WORD
BY LOUIS J. GANIM

Being Polite. It’s Just That Simple.

W
hat’s happened to common OK – I don’t want to stumble into the have gotten to her seat otherwise because
decency, respect, courtesy and realm of political correctness or trample “most people were so wrapped up in what
treating others with dignity? on freedom of speech. After all, a friend they wanted to do at that moment, they
You know what I’m talking about. of mine, who was then press secretary to were oblivious to her.”
What got me thinking about this? Well, New York’s governor, once remarked that, Have we become that self-centered and
a cartoonist, believe it or not. Stephan “The New York Post is the price we pay that self-absorbed?
Pastis, who is the creator of Pearls Before for freedom of the press.” Although some I hope not. This might seem contradic-
Swine, which isn’t necessarily the most might say today it’s Fox News. tory to everything else that’s been said
dignified of comic strips itself. But it’s Yet, having said that, we’re at a pivotal here, but every single day I meet polite
not the strip that got me on this line of point where the whole idea of respect for and kind strangers. Every day. Without
thinking. others seems fast on the wane. exception.
Pastis and nine of his fellow daily comic I went on the Internet armed with Yet I do believe there is a sort of mob
strip colleagues this past November went Google and searched terms such as rule of impoliteness out there.
on a USO mission to the Middle East, and “respect,” “dignity” and “courtesy” to see There isn’t a single societal problem,
he wrote about the trip a few times in his what, if anything, others were saying. for example, that someone’s solution to it
blog, which I was reading one day. I wish I could say there is a lot of isn’t met with disdain or ridicule.
He made the following comment in moaning and gnashing of teeth over this There’s a way to fix this, of course. We
one entry about the men and women in issue, but there isn’t. I’m almost like the simply need to change the way we treat
uniform that he’d met during his travels proverbial voice crying in the wilderness. each other. We should be more like those
through Kuwait and Iraq: “They were sin- But there are a few. men and women in uniform. Be polite.
cere and direct and respectful to a degree Take this blogger who calls himself Another blogger – Helen/H1202 – I
I have never experienced in my day-to-day “lendingtreeinc.” He said he’s a mortgage came across put it this way: “Manners
life here.” broker and he looked back fondly to the are a way to show respect for the human-
I thought how right he is. The people I days when he developed “business rela- ity of someone else. You don’t need to
come across in the military treat civilians tionships and even friendships based on know them or like them. Just honor their
with a great deal of respect. It’s always “sir” a foundation of courtesy and respect.” But humanity.”
or “ma’am” when they address a civilian. now all he sees is “a new level of disre- To switch subjects a bit, Medina’s blog
These are people who are extremely proud spect and lack of courtesy” that he has a post was entitled “Elder Respect.” That in
of what they have chosen to do – stand difficult time dealing with. turn got me thinking about the ongoing
between us and “them” and, if necessary, Another blogger named Medina was worries about the future of Social Security
lay down their lives. (Pastis put it this way: dismayed about a conversation she’d had and Medicare, and even the recent health
“If something were to have posed a threat (via Twitter, of course) about youth not care debate.
to any of us while we were there, I had no respecting their elders. She related two I recently saw a reference in Business
doubt they would have protected us before separate accounts – one on the West Week to a silent movie by D.W. Griffith
they protected themselves.”) Coast, the other on the East – of youths called, “What Shall We Do with Our Old?”
If anything, their choice to serve their putting their feet up on bus seats while It was made in 1911, long before social
country ought to give them a sense of older adults stood “wobbling on old knees reformers achieved Social Security in 1935
superiority. But to the contrary, they are, on the bus trying to hang on to cane and and way long before 1964’s Medicare act.
almost to a man and woman, humble. rail.” The short film is about an elderly car-
So this got me thinking about the rest Her blog post engendered a lot of penter with an ailing wife who loses his
of us. discussion about children and how they job to a younger worker, and they quickly
Can we be more rude, impolite and are being raised today and how they are use up their scant savings.
unkind? Tell me about it. impolite and out of control. I thought, If you’ve got an Internet connection,
I can start, of course, with some of even if there’s some truth to that, what and chances are you do, you can find
those ranters on talk radio – hosts and about the adults? Griffith’s film on YouTube and watch it.
callers alike – or with a certain member Medina’s take on adult behavior came But I think you already know it doesn’t
of Congress who calls out the President – through her relating a story about how turn out well.
“You lie!” – from the floor during the State she had to help an older woman through a Enough said.
of the Union. thick crowd at the ballet who never would

32VillageCare
Vi l la ge Ca r eTODAY
T O DAY | |Spring
S p ri ng2010
2010
VillageCare
154 Christopher Street
New York, NY 10014

34 N E W H O R I Z O NS | Wi nt er 2010