America is growing older.

According to gerontologist David Hahklotubbe, an age specialist, one out of every eight Americans were over 65 years of age in 1997. He said that number will swell to one out of five by 2030.

Preparing for the demographic shift, the School of Social Work hosted a conference on aging at Jack Adams Hall in the Cesar Chavez Student Center last week. A rapt audience of 250, mostly social work graduate students and adult protective service workers, attended.

They heard a forum of social work experts discuss critical issues of aging, including common chronic illnesses, depression and suicide among older adults, and elder abuse.

Susana Konishi is a gerontology graduate student who also works at On Lok Senior Health Services. The conference caught her attention, she said, because she is interested in healthy aging.

She said exercise is the key to good health in old age, and she wants to educate elderly people on how to best benefit from exercise programs tailored to individual needs. She also emphasized the importance of maintaining independence to elderly people.

“Independence is staying in the community,” said Konishi. “They need to stay in their own homes and be able to carry on their lives as they always have.”

Dr. Dina Redman, a professor at the School of Social Work, thanked the audience for ignoring a downpour to attend the conference and introduced social work graduate students Jacqui Lichstein and

Stephne Lencioni, who both organized the event.

Lencioni said American society marginalizes the elderly. She noted that the national perspective often means a fear of growing old, and pointed to the popularity of ‘Botox’ (Botulism) injections to eliminate wrinkles as a symptom of youth worship.

“Old age is not respected,” said Lencioni. “You end up at the time of life when you should be celebrating what you have become, but instead society tells you you’re not valuable anymore.”

SF State graduate Hahklotubbe now runs Choctaw House, a six-bed care facility in Napa that treats elderly people who suffer from dementia. Hahklotubbe told the conference audience that dementia was not a disease, but a classification of many types of memory impairment that can cause a patient to lose touch with reality.

He added that half of all persons over the age of 80 suffer some form of dementia. Hahklotubbe noted that the first line of treatment is not with drugs, but with social and behavior modification through activities and re-direction.

“I’m hoping the message of the conference is, if you start contemplating the process of aging for a loved one, then by osmosis that person will have the tools for (themselves) to navigate the complications of aging,” said Hahklotubbe.

Hahklotubbe cautioned that discrimination against the aged is rampant in the United States and that many people have the misconception that retirees live a life of ease at the expense of the employed.
He noted that the average cost of an assisted living care facility is $6,000 per month.

“If I were to retire now, I could not afford to live in my facility,” said Hahklotubbe. “My wife and I purchased land in Ireland because of the nationalized health care there. My retirement plan is to live outside of the U.S.”

Dr. Patrick Arbore, a psychologist, and Mary Twomey, a social work graduate student, both of the San Francisco Institute of Aging, discussed senior suicide and elder abuse. Arbore, who runs the suicide prevention hotline at the institute, said it should more aptly be called depression prevention, keeping elders from going into a suicidal crisis.

Arbore called depression an undeniable characteristic of elderly suicide. Men commit suicide four times more often than women, he said, but women suffer depression at a rate of four times more than men.

Many elders don’t know how to cope with this torment, Arbore said, so they hide their grief through substance abuse, most commonly alcohol. Arbore added that older people who have been drinking for decades are adept at inducing family and friends into denying that there is a problem.

"Alcoholics avoid the company of those who don’t drink to excess and it is vital to keep open the lines of communication,” Arbore said. “Even as they try to push family away, they are most in need of intimacy but feel ashamed of their behavior.”

He then alerted the conference to the issue of depressed elders who own firearms. He cautioned that firearms are the most commonly used means of suicide.

"Firearms don't offer any chance to intervene," said Arbore. "The most important question (for social
workers) to ask is not, 'Do you drink?' (It is), 'Do you own a firearm?' You've got to be direct, even with somebody (who is) 77 years old."

Twomey explained that 90 percent of elder abuse is perpetrated by family members. It is most often done by adult children suffering substance abuse or mental illness, or a financially dependent child.

She called elder abuse a crime that social workers cannot shy away from investigating and confronting.

"Some elder abusers are likable people, but simply unsuited to be caregivers for the aged," said Twomey.

SF State gerontology professor Cathy Cress closed out the conference on an upbeat note. She stressed the need to re-engage elders into the social atmosphere of everyday life by establishing formal and informal support systems through church, garden clubs or even attending baseball games.

She cautioned students that even at age 20, they have to plan the future.

"It's important for young people to bite the bullet and plan for the last 50 years," said Cress. "The fastest growing population in the U.S. is 85 and over.

“Is the government going to save for you? Social Security is a limited amount of money. You need to know how to fund the last half of your life - and have fun."