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Spring 2010

The “New” VillageCare
(212) 337-5600
We’ve been breaking down the barriers among our programs so that you – our
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
For example, we used to treat our services for older adults and those for persons liv-
ing with HIV/AIDS quite separately. We no longer make that distinction, seeing our
“new” organization as serving everyone in all our settings regardless of their diagno-
sis. We no longer divide our care between AIDS services and senior care, but instead
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.
S P R I N G 2 0 1 0 | V O L U M E 4 , N U M B E R 1
In the News 2
Using Robots to Serve Older Adults at Home; HIV/AIDS
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.
Nobody Said It Would Get Easier
A Lifetime Commitment
Health Center For Every Season
A Burden and a Blessing
A Lot More Than A Hot Meal
2 Vi l l ageCare TODAY | Wi nt er 2010
In the News
Newswise — Robots that lend a very
human-like helping hand to healthy
seniors with limited mobility may be on
the horizon.
“We want to help elderly people com-
municate with robots, to tell them what
they need, and to perform physical activi-
ties,” said Miloš Žefran, associate pro-
fessor of electrical and computer engi-
neering at the University of Illinois at
Žefran is lead investigator in a three-
year undertaking to develop software that
would allow older adults to communicate
with robots that can respond to a wide
range of verbal language, non-verbal ges-
tures and touch. The effort is being
financed by a grant of nearly $1 million
from the National Science Foundation.
“If we can help people remain inde-
pendent and continue living in their own
homes, that will improve their health
outlook while relieving the burden on
family members and health care provid-
ers,” Žefran said.
Žefran’s expertise is in robotics and
computerized sense of touch while other
team members specialize in computer
vision and pattern recognition, natural
language processing, and nursing care
for the elderly.
Communication software in the robot
will allow it to comprehend speech altered
by impairments and to learn and adapt to
such speech. By combining techniques
from natural language processing and
touch, the robot will understand and cor-
rectly respond to various forms of human
touch. It will also know how to respond to
the user safely when performing everyday
chores such as cooking or making a bed.
The research team will program and
test a robot and devise refinements as the
project progresses.
“The human-robot interface is really a
long-standing, open problem that won’t
be solved in three years,” Žefran says.
“But we’ll have a working prototype by
then, and we’ll know what additional
research needs to be done.”
Žefran added that this research could
also find widespread use in delivery of
institutionally based health care, where
routine tasks now done by nurses could
be handled by robots. “If robots can
alleviate some of the burden nurses
face, they then could spend more time
where they’re really needed — provid-
ing the human contact that a robot can’t
Using Robots to Serve Older Adults at Home
VillageCare TODAY | Spring 2010
HIV/AIDS Message
For Thousands
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.
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
wo professors from the
International University of
Health and Welfare in Tokyo,
visited the VillageCare Health Center
in Chelsea recently to examine how
nurse practitioners function in
health care settings in the United
States. This was the second time
in a year that professors from the
university visited the clinic setting
to learn about nurse practitioners.
They learned of the center through a
Hunter University graduate student.
A nurse practitioner program started
up in Japan since the first visit, fol-
lowing the same curriculum of the
programs in the U.S. The two most
recent visitors gave a $200 dona-
tion to the Village Center for Care
Fund, which supports VillageCare’s
programs. In the photo, from
left, are: Michelle Samuels ANP,
VillageCare employee health manag-
er; Miho Suzuki, RN, Hunter College
grad student; Mineko Niino, RN;
Hisayo Maeda, nurse midwife, and
VillageCare Health Center Director
Nicolas Rosetti.
Newswise — Why are some men,
both HIV-positive and negative, still
engaging in risky activities with male
Dr. Trevor Hart, director of the HIV
Prevention Lab at Ryerson University in
Canada, is conducting a comprehensive
study to find out the answer to this per-
plexing and alarming question.
In a four-year study called the Sexual
Health and Attitudes Research Project
(SHARP), the psychology professor
is examining the connection between
social anxiety and its effect on men who
have unprotected sex with other men.
“Higher social anxiety is associated
with risky behavior, but we’re not sure
why,” Dr. Hart, the study’s principal
investigator, said. “One of our hypothe-
ses is that social anxiety carries over into
sexual encounters, making it difficult
for some men to take necessary precau-
tions against HIV if they think it will be
perceived negatively by their partner.”
Dr. Hart and his research team have
interviewed 300 men from the Greater
Toronto Area to better understand the
link and develop practical solutions.
The SHARP study, which is funded
by the Canadian Institutes of Health
Research, is one of several research proj-
ects being conducted at Dr. Hart’s lab.
“Preventing HIV transmission is
the mission of our lab,” Dr. Hart said.
“Ultimately, we want to know how we
can help people.”
Dr. Hart recently presented some of
his research findings to-date at confer-
ences in New York City and Toronto.
The findings from Dr. Hart’s SHARP
study are expected to be published with-
in the next two years.
Researcher Explores Link Between Social
Anxiety and Risky Behaviour Among
Same-Sex Partners
4 Vi l l ageCare TODAY | Wi nt er 2010
Newswise — Highly active antiretroviral
therapy has increased the longevity and
quality of life for people living with human
immunodeficiency virus. But it requires
strict adherence in taking the medicine,
something that is extremely difficult for
many individuals to do.
Two new University of Washington stud-
ies illustrate just how hard it is to make
sure people take their HIV medication. One
study looked at the effects of drinking alco-
hol on adherence and showed the risk for
non-adherence was double among drink-
ers compared to abstainers. The second
study evaluated interventions using peers,
electronic pagers or both, and showed that
these tools promoted no lasting improve-
ments in adherence rates.
“HIV is unique in the adherence levels
needed to be effective,” said Jane Simoni, a
University of Washington psychology pro-
fessor who specializes in studying adher-
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
going to work for HIV medications and will
lead to resistance to the drugs. Taking drugs
for HIV is a lifetime commitment; you are
married to the pills,” she said.
The alcohol paper analyzed data from
40 previous studies involving more than
25,000 people and established that drink-
ing does have a consistent effect on adher-
ence across studies.
“Drinking quantity, more than frequency
of drinking, is associated with non-adher-
ence,” said Christian Hendershot, a post-
doctoral researcher at the University of New
Mexico who was lead author of the alcohol
study. “In general, people who drank alco-
hol had nearly twice the risk of non-adher-
ence. But the risk of non-adherence went
up as the level of drinking went up,” he
said. “At problem levels of drinking we see a
higher probability of non-adherence.”
However, Hendershot cautioned that
these finding don’t necessarily hold for all
people on HIV medication who drink.
“Alcohol may have a causal effect, but
there also may be other factors affecting
both alcohol and adherence that partly
explain the association. We need to treat
people individually.”
For the peer-pager study, researchers
recruited 224 patients being treated at
a Seattle clinic. Patients were randomly
assigned to one of four treatment groups —
peer, pager, combined peer-pager and treat-
ment as usual — for three months.
Patients with peer support attended
twice-monthly meetings with other partici-
pants and trained HIV-positive peers who
provided medication-related social support.
Peers also called participants weekly to pro-
vide more one-on-one feedback. Participants
in the pager group were asked to carry a
customized device when they were awake.
The two-way pagers came with messages
that were timed to each participant’s daily
medication schedule.
The pagers also sent educational, humor-
ous and adherence assessment text mes-
sages. Participants in all four groups also
received the usual care at the clinic including
an educational program that provided infor-
mation about the medication and adherence
in a series of three meetings with a pharma-
cist, nutritionist and case manager.
The participants “self-reported” on their
adherence two weeks after the study began
and again at three, six and nine months.
An electronic pill cap and bottle also was
used to monitor medication taking. Every
three months they also had blood drawn to
measure the levels of HIV and white blood
cells in their system. For this study, adher-
ence was defined as taking medication 100
percent of the time over the past seven
days. The typical patient on the highly active
antiretroviral therapy takes one or two pills
once or twice a day.
Simoni said patients who had peer sup-
port initially showed some increased adher-
ence levels, but this didn’t persist once the
support ended. The pagers did not success-
fully promote adherence at any point.
“We can change adherence a little, but it
disappears when the intervention is taken
away,” Simoni said. “Even though you are
capable of doing something that doesn’t
mean you are motivated to do it all the time.
Just ask anyone, ‘Did you exercise yester-
day?’ ‘Floss your teeth?’ ‘Avoid sweets?’
“Add to this the complication that a
person has to take these meds every day for
a life-threatening disease. There is a lot of
emotional baggage surrounding the disease
and the pills, and the medications have
severe side effects.”
So what is needed to promote better
“We looked for less intensive solutions.
But they didn’t work,” Simoni said. “What
we need are very individualized compre-
hensive programs. And to sustain adher-
ence, the intervention must be as dynamic
as the changes in people’s lives.”
The studies also have broader societal
implications and Simoni believes adherence
will be a major problem in the years ahead
as the nation’s aging baby-boom population
takes its medications to stay healthy.
The studies, published in the Journal of
Acquired Immune Deficiency Syndromes,
were funded by the National Institute
on Alcohol Abuse and Alcoholism, the
National Institute of Mental Health and the
UW Center for AIDS Research. Co-authors
of the papers are David Huh, Cynthia
Pearson, Michele Andrasik and Dr. Peter
Dunbar of the UW; Susan Stoner of Talaria,
Inc; David Pantalone of Suffolk University;
Pamela Frick, formerly of the UW-affiliated
Haborview Medical Center UW, and Dr.
Thomas Hooton of the University of
Taking Medicine for HIV Is A Hard Pill
To Swallow for Many People
Taking drugs for HIV is a lifetime commitment;
you are married to the pills.

VillageCare TODAY | Spring 2010
en Stewart,
who directs
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.
NYAHSA annually
gives the award to an
individual demon-
strating outstanding
accomplishments in
the long-term care
Stewart’s dedica-
tion to helping those
in need has has often
been the springboard
for new initiatives by
VillageCare. A few years ago, he created and spearheaded an effort
to find ways to help “low-threshold” persons living with HIV/AIDS.
This undertaking ultimately led to the affiliation of VillageCare with
The Momentum Project, expanding capacity to help those who are
difficult to serve and need extra help.
NYAHSA, in presenting the award, said that with his combination of
creativity, determination and compassion and his strong commitment
to those in need, Stewart has inspired his staff and others. He offers
constant encouragement to others that they can make a difference.
Honoring a
VillageCare Hero
he international organization Aid for AIDS
honored VillageCare’s Daphne Rivera with
its 2009 “My Hero” Award, which is given
annually for outstanding activism.
Rivera, who works in VillageCare’s Community
Case Management program, received the award at
the Aid for AIDS gala held at the Puck Building in
New York City on December 1.
In announcing the award, Aid for AIDS said
Rivera was being honored “for her outstanding
activism on behalf of people living with HIV and
AIDS in New York City.”
The awards program from the event stated: “As
a woman, mother, and person living with HIV, Ms.
Rivera has fought passionately against the pandem-
ic. For 11 years, she has advocated on behalf of the
Latino and African American community, ensur-
ing that their voices are heard. More than 7,000
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
his work on behalf of people living with HIV and
AIDS on the public policy level, and actor Mark
Consuelos for his efforts to create awareness about
Earlier in 2009, Rivera was recognized by
VillageCare for her efforts to improve the quality of
life of persons living with HIV/AIDS. She received
the Nicholas A. Rango Award at the St. Patrick’s
Day fundraiser sponsored by VillageCare board
member Rev. James J. Gardiner.
Helene Gayle, M.D.
President & CEO
(Cooperative for Assistance
and Relief Everywhere)
“In this country, about
30 percent of new
[HIV] infections are
occurring among women.
Compare that to 10 or
15 years ago when eight
to ten percent of our
infections were among
NYAHSA’s “Professional
of the Year” Helps
Those in
Ken Stewart, center, accepted NYAHSA’s “Professional
of the Year” Award at a special luncheon held by the
statewide organization in Saratoga Springs. With
Stewart are Village Care President and CEO Emma
DeVito and Carl Young, former NYAHSA president.
Village I hope that the new year brings an
end to these wars that we’ve grown accus-
tomed to. I also hope that the new year brings
me good fortune in maintaining my current
level of health, and be able to con-
tinue with the activities that I am
engaged in now. I volunteer in
the community and find that
extremely satisfying. I hope
that I will be able to con-
tinue my volunteer work
through the new year
and beyond.
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
have friends help me along the way and take me
into their homes, but I am hoping that I will not
have to rely on them much longer and be able to
have a place of my own. The housing situation
for seniors has been a mess for quite some time,
and I hope that the coming year will bring
some resolution to that. As a fitness
instructor for seniors, my other
hope is that more seniors recognize
the need to stay fit, and take advan-
tage of the many resources that are
available to them to ensure that.
Greenwich Village On a broad
scale, my hope is for peace to be
brought around the world and here
in the U.S. For myself, I hope to
gain more flexibility with what
I can do in my life. I currently
have many issues that tie me
down to this city, but I would
love the opportunity to be able
to travel abroad, and do exciting
things that I have always wanted to
do. I hope that my health
maintains a good level
so that I can be able
to do these things
as well.
PHIL SAUERS, West Village As an activ-
ist and strong supporter for environmental
health, my hope for the new year is to see
national focus sway from war to protecting
our environment, in particular our waters. We
take water for granted, but as the years go on,
our water supply is becoming more and more
polluted and contaminated. We need water
to live and prosper, and
I urge the world to
take notice of this
serious, yet
quiet prob-
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.
8 Vi l l ageCare TODAY | Wi nt er 2010
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, 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
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
By Bonnie Rosenstock
83-year-olds Harvey and Phillis Wolf Metzler met on They were married within a year.
10 Vi l l ageCare TODAY | Wi nt er 2010
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
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.”
VillageCare TODAY | Spring 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
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
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.
12 Vi l l ageCare TODAY | Spri ng 2010
uch has been written about Lucy Cecere. To the friends of VillageCare, the stories are
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
By Jess Espinosa
A Lifetime
Lucy Cecere sees
a need — such as
“saving” Village
Nursing Home — she
throws herself into the fray
14 Vi l l ageCare TODAY | Wi nt er 2010
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
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
of fun with the horses,” she recalls.
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
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
Above: The young Lucy Cecere. Below: The building where
Something Special is located is a landmark.
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
the shop a shelf holds framed photos of Lucy and Lenny with
their famous friends. And all year round, Christmas or not, a
clock plays Adeste Fidelis every hour on the hour.
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
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.”
Above: Something Special is a favorite neighborhood hangout
for many, including the friendly crossing guard for the nearby
St. Anthony School. Below: Lucy Cecere collects signature for
the landmark designation of South Village.
16 Vi l l ageCare TODAY | Wi nt er 2010
By Bonnie Rosenstock
A Health Center
For Every
Chelsea Center Serves
Every Condition, Every Age
VillageCare TODAY | Spring 2010
hile the nation debates the future of the ailing health
care system, each day ordinary people are dealing
with the stressful, time-consuming task of finding
the right doctors for what ails them. Fortunately, VillageCare’s
Health Center is just what the doctor ordered.
The three-year-old medical center at 121A West 20th Street
in the heart of Chelsea brings primary care physicians, nurse
practitioners, dentists and podiatry services all together under
one wellness roof.
Nicholas Rossetti, the center’s director, said the primary care
facility offers a full array of services in a setting that “provides
coordinated care integrated across all elements of the complex
health care system.”
Rossetti says that the Health Center sees the patient-cen-
tered “medical home” model of primary care, something the
medical community envisions being implemented throughout
care settings, as the ideal in terms of getting high-quality care
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-
tomer service.”
Dr. Lawrence Hitzeman, the center’s medical director, points
out that the center’s intimate nature is an important plus. “We
are not a big bureaucracy,” he said. “The patients get to know
everybody, and the staff works well together, which makes the
clients comfortable. They feel happier here.”
The Health Center’s clientele is varied.
Dr. Hitzeman specializes in internal medicine. He sees a
number of patients who are HIV positive, and in his practice he
stresses the importance of preventive health care to keep people
from having to go to the hospital. “We want them to save their
immune systems instead of waiting until they get very sick
before they seek treatment, often too late. The idea is to keep
them healthy, so they don’t have to utilize hospital services.”
One of his colleagues, Dr. Veeraf Sanjana, is a general inter-
nist, board certified in infectious diseases.
For Dr. Sanjana what makes the center unique is that the
121A West 20th Street, between Sixth and Seventh Avenues
Telephone: 212.337.9290
Hours of Operation:
Monday and Thursday, 9 a.m. to 6 p.m.
Tuesday 8 a.m. to 6 p.m. º Wednesday, 9 a.m. to 7 p.m.
Friday 9 a.m. to 5 p.m.
Saturdays (twice monthly) 9 a.m. to 4 p.m.
18 Vi l l ageCare TODAY | Wi nt er 2010
staff provides individualized services to a
group of patients that often don’t get that
kind of attention in a hospital or a city
clinic. “Underprivileged patients who often
have Medicaid or ADAP [state AIDS Drug
Assistance Program insurance] don’t get
to see private doctors in the community
because most doctors don’t accept these
insurances,” he said.
The VillageCare Health Center also
accepts most major commercial insur-
ances as well as
Medicare. There
is a sliding scale
for those with-
out insurance.
“People come
here because at
a hospital or
city clinic they
have imper-
sonal service in
general, at least
that’s what the
patients report,”
said Dr. Sanjana. “They are very happy to
get a private doctor that takes Medicaid.”
He also sees people with mental health
issues, routine medical problems, like high
blood pressure and diabetes, and people
referred by their employers for routine
medical check-ups.
Given that
23.7 million
Americans, or
7.8 percent of
the population,
suffers from
diabetes — 5.7
million of them
undi a gnos e d
— it’s notewor-
thy that another
of the Center’s
primary physi-
cians, Dr. Jean-Louis Salinas, also special-
izes in diabetes. Other specialists include
a psychiatric nurse practitioner, who does
psychological evaluations and prescribes
medication as needed; a psychologist for
counseling, and a women’s health nurse
practitioner, Niru Somasundaram. She
provides routine pelvic exams, pap smears,
STD testing, breast exams, birth control
counseling, menopause counseling and
gynecological referrals for more serious
“Patients come here because of the
amount of time I have to spend with
them,” she said. “All the providers are very
thorough and conscientious. And it’s great
to be able to walk over to them and have a
VillageCare Health Center also has
onsite facilities for venipuncture and blood
workup, urine and sputum collecting; out-
side laboratories do the results. The Health
Center’s dental services opened last sum-
mer, and Rossetti says the addition was
well received by patients. “It’s been a big
hit,” he said.
“The patients are satisfied with the den-
tists,” he said. “Hopefully it will attract
people for other services as well.”
The center has been attracting more
and more clients since it opened its doors.
“The advantage is we provide high-quality
under a comprehensive umbrella of ser-
vices,” Gerrido said.
Because the Health Center is part of
VillageCare’s wide array of services, “we are
in an excellent position to provide the pri-
mary care needs of the community,” said
Rossetti, reciting the list of the organiza-
tion’s community and residential services.
Those services include home care, adult
day health centers, short-stay rehabilita-
tion, skilled nursing care and assisted liv-
ing, among others.
The VillageCare Health Center has a full
complement of doctors, dentists, nurses
and other professional health care staff,
enabling the facility to offer patients a com-
plete range of primary care, care for chron-
ic and ongoing conditions and preventive
services. The Center also offers supportive
services such as nutrition, mental health
services and social work, with a collabora-
tive team that coordinates care.
The Center offers the availability of
same-day appointments. Dental care is
provided in a warm, friendly environment
with the highest standards of dentistry and
exceptional consumer care.
You can learn more about the services for
VillageCare and the Health Center by visiting
VillageCare TODAY | Spring 2010
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 ageCare TODAY | Spri ng 2010
n the last day in November, ducking out of a
cold evening rain on a dark Second Avenue,
a visitor walks through the glass-and-bronze
doors beneath the majestic stained glassed arches of
Middle Collegiate Church. Once inside the dimly lit
nave, he follows the rope line along the wooden pews
that leads him to a large meeting room behind the
It’s a Monday, and the meeting room is filled with the
soft echoes of about a hundred people, mostly men, as
they chat with each other. Some sit at the four long rows
of tables, some roam the room greeting old friends. At
the near end of the room is a small stage (there will be
music later), covered with plastic grocery bags filled with
food. At the far end is a kitchen and table set up buffet-
style. Five or six young women, volunteers from the
Leadership and Public Service High School, wait to serve
the food being prepared by the chefs behind them.
Peter LaMarca greets the visitor with a gentle two-
handed handshake, offering coffee and soup. The main
meal will be served in about 10 minutes at 5:30. LaMarca
is a volunteer for the Momentum Project, which has
been feeding poor and homeless persons living with
HIV/AIDS for 25 years.
Every day except Sunday, people coping with the
disease can visit one Momentum’s 10 sites in four
boroughs for a hot meal and a take-home pantry bag of
canned goods and fresh produce.
And though the food is the central focus of
Momentum, Jan Zimmerman, the program’s adminis-
trator, says the meals are only the entry point into their
clients’ lives.
“We start with food as a basic need for anyone to
survive,” she said. “Though clients don’t have to do any-
thing but come in and eat — there’s no other structure
or requirement — we use the meals to engage people
in better self-care to survive, thrive and grow, to live the
best possible lives they can live.”
She says HIV treatment is challenging even for the
most stable individual, requiring several pills a day,
every day, for the rest of life. Miss doses of HIV-specific
medication and its effectiveness can be compromised.
On top of the HIV medications many clients also take
pills for the full range of other conditions that exist,
both due to HIV disease and due to people living longer:
diabetes, heart disease, high blood pressure, antidepres-
sants. But for individuals whose lives are not stable —
the people Momentum tries to reach — the challenges
to treatment are much more daunting.
“About 80 to 90 percent of our clients struggle with
mental illness or substance abuse issues,” Zimmerman
said. “The medical community says HIV is a chronic
22 Vi l l ageCare TODAY | Wi nt er 2010
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
VillageCare TODAY | Spring 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, and to
24 Vi l l ageCare TODAY | Spri ng 2010 VillageCare TODAY | Spring 2010

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,
By Bonnie Rosenstock
A Burden and a Blessing
Taking Care of a Loved One at Home Is
Both Challenging and Rewarding
26 Vi l l ageCare TODAY | Wi nt er 2010
one called
has delineated about 30 “symptoms
of caregiver burnout.” They include:
powerlessness, hopelessness, emotional
exhaustion, inability to handle more
than one problem or crises, isolation,
despair, feeling trapped, apathy, crying,
easily angered or annoyed, change in
eating and sleeping habits, headaches,
anxiety, impatience, resentment, harmful
behavior to care recipient and escapist
behaviors, such as sex, drinking, drugs
or shopping binges to escape negative
Caregiving for those with Alzheimer’s
is particularly stressful and one of the
hardest situations for individuals to deal
with, explained Lisa Bohmart, social work
supervisor at VillageCare’s Adult Day
Center at 644 Greenwich Street. “There
are a lot of emotional feelings because
the person is there, but not really there.
There is also denial about them really
being sick or more capable of doing
things than they actually are because of
the moments of clarity. It can be really
Nancy Seigel, social worker at Village
Nursing Home said that for a spouse,
companionship is gone. “Seeing your
loved one, a person who knows every-
thing about you and now just looks at
you, it takes a toll,” she said.
As Alice watches her father’s short-
term memory slip away, she feels a
sense of disequilibrium. “He can be
forgetful and ignore me; on the other
hand, he will remember such details that
it’s disconcerting as well. I never know
what’s going to happen next,” she said.
Moreover, she is learning how to sift out
his moods, to determine whether they
are a result of physical discomfort from
his other illnesses or drug interactions,
“instead of the terror of Alzheimer’s,”
she said.
Competing demands often wreak
havoc on the caregiver’s own state of
mind. This is common for an adult child
taking care of both a parent as well as
their own children. Another example is
the competition between the demands of
a job and those of caring for a loved one.
Barbara often has to take days or half
days off from her job as a word processor
in a law firm to accompany her mother to
medical appointments.
She also faces the additional responsi-
bility of dealing with caregivers she has
hired to assist her – “whether training
them or contacting the agency to replace
them if it’s not working,” Barbara said.
“When I get a call at work that my
mom is uncooperative with an aide, I
have to deal with it within earshot of my
colleagues. I have to intercede with a doc-
tor when some medication or protocol is
not working out. I have to get necessary
paperwork to Village so they can comply
with New York State regulations. The list
goes on. Even when I am not with my
mother, I am about my mother,” Barbara
said. As a result of all the pressures, she
says she suffers from chronic depression
but is not currently on medication or in
For a period of time Alice didn’t work
at all because of “all the systems to work
out,” she related. “My stress level was
high dealing with the issues of day care,
medications, Medicaid, food stamps and
any other services we could apply for.
Now for the first time in two years, I am
Bohmart recommends that caregivers
ask for help.
“They think they can do it all. Getting
home care and taking advantage of ser-
vices such as an adult day health care are
important, she said. Alice agrees, relat-
ing that because she must work to pay
her rent, her father’s rent and mounting
bills, she did not have the time or energy
to engage and entertain him. “One per-
son can’t do physical therapy, walks, sing-
a-longs, art classes or cooking classes,”
she said.
Alice is thankful that she found
VillageCare’s Adult Day Health Center
where her father has been going five
days a week since April. On weekends, he
goes to a center in Riverdale and through
a grant, for two days a month he goes
to a Chinese center near the Brooklyn
“My dad is very social, so he loves it,”
she said. “He gets to meet people, talk to
them, nobody is down on him because of
VillageCare TODAY | Spring 2010
n recognition of National Family Caregivers Month this
past November, the Women’s City Club of New York
sponsored a panel discussion entitled “Who Cares for
Caregivers?” on the challenges of caregiving, its inordinate
impact on women and policy solutions that would ensure that
caregivers are also cared for.
The three guest speakers are not only experts on these
issues, but also have personal experience as primary caregiv-
- Suzanno Mintz, co-loundoi ol tho advocacy giouµ,
National Family Caregivers Association (NFCA), is a recog-
nized national spokesperson for family caregivers and has tes-
tified before Congress. Her husband has had multiple sclerosis
since 1974.
- Bostsolling authoi Gail Shoohy is µoihaµs lost known loi
her seminal Passages. Her new book about the caregiving cri-
sis, Passages in Caregiving – Turning Chaos into Confidence,
will be out April 20. Video interviews with families across
the country who have found creative ways to take on the chal-
lenges of caregiving are at Sheehy’s
husband, Clay Felker, New York magazine’s founding editor,
died last year at the age of 82 after battling cancer for seven-
teen years.
- Caiol Lovino diiocts tho Fanilios & Hoalth Caio Pioioct loi
the United Hospital Fund, which focuses on developing part-
nerships between health care professionals and family caregiv-
ers, especially during transitions in health care settings. Her
husband is a paraplegic as a result of an automobile accident.
In 1900, the average person lived to age 47. Now, thanks to
modern medicine, it is 77. Therefore, this is the first genera-
tion that has had to deal with the issues of chronic care and
lingering diseases.
“It is so hard because we are starting from scratch and the
systems are not set up to deal with family caregiving,” said
Mintz. She stated that Medicare is primarily aimed at short-
term acute care for people in their sixties, but people are living
into their nineties. In fact, over-85 is the fastest growing seg-
ment of the population. She asserted that Medicare monies are
not being spent properly, and new services and new ways to
look at the health delivery system are needed. NFCA has com-
piled a comprehensive summary of bills pending in Congress
related to family caregiving in such categories as respite, tax,
social security/Medicare/Medicaid enhancements, family leave
and health care reform. The organization has also published a
statement on Principles, Plans and Policy Recommendations,
available at
Sheehy added that the average caregiver is a 46-year-old
woman with a job, who spends at least 26 hours a week in
caregiving responsibilities, averaging four and a half years in
the role, with needs escalating. “Forty-four million Americans
are affected, that is, one in four families. It’s a job that nobody
applies for and everybody is unprepared for,” Sheehy said.
She recommends hiring an independent geriatric care man-
ager, if one can afford it, because there are “ “traumatic jolts.”
These include transitioning from one care setting to another –
for example, from home to hospital, from hospital to rehabili-
tation, as well as various other facilities along the way. Sheehy
said that a geriatric care specialist understands the system and
works with the caregiver to sort out the sometimes nightmar-
ish medical bureaucracy involved in the patient’s care. Poor
people have this service available, but the middle class is left
out in the cold. Sheehy suggests that geriatric care manage-
ment, a growing industry, be covered under Medicare.
Levine stated that family caregiving is a national problem,
but at the same time, we should look locally for solutions. She
pointed out that New York is the only state that doesn’t allow
families to make end-of-life decisions unless you are a family
proxy. Additionally, there are two bills languishing in the State
Assembly (but passed in the Senate), Levine pointed out. They
are the Family Health Care Decisions Act and the Paid Family
Leave Act. California has passed a leave act similar to the one
proposed for New York, but Levine pointed out that people
seem reluctant to use it for fear of losing their jobs.
However, one bright light is the Collaborative Design
Group, a forty- to fifty-team collaborative composed of six
teams from New York – hospitals, nursing homes and home
care agencies - that will work together to improve patient man-
agement, scheduled to start this year.
“Caregiving is a lifespan issue,” stated Levine, “ranging
from parents caring for their children with special needs, all
the way to end of life. Palliative care is good chronic illness
These are some websites for further help on caregiver
-New York State Respite Coalition,
-New York City Family Caregiver Coalition, www.cscs-ny.
-For New York City resources:
-For New York City programs run by the Department for the
Aging (DFTA), call 311, or
-New York State Senator Liz Krueger’s Resource Guide for
Seniors, 2009-20010 edition, downloadable at www.lizkrueger.
By Bonnie Rosenstock
Caring for
The Caregivers
28 Vi l l ageCare TODAY | Wi nt er 2010
his condition and there are counselors to
guide him. Before, he wouldn’t even get
out of bed.”
Bohmart has helped Alice coordinate
other ancillary services, such as medical
supplies and medications, van trans-
portation and an escort to some doc-
tors’ appointments, for example. This
helps free up Alice for her freelance
work assignments. The help was indis-
pensable in Alice’s navigation through
the dizzying maze of documentation for
Medicaid, allowing her father to qualify
for a home aide twenty-three hours a
Caregivers may also find themselves
doing unfamiliar, time-consuming tasks
that the other person did for years. In
Alice’s case, she does double duty by
shopping, cleaning and cooking for her-
self and her father, which includes pre-
paring his special diabetic meals a few
days in advance.
Mike says his wife used to maintain
the household, do the shopping and
manage the finances. Aides now take
care of his wife, but he must look after
himself. “The IRS just audited me, so
apparently, I’m not doing such a good job
with the taxes,” he said with a laugh.
Most of the clients at the VillageCare
day center have Medicaid. “Medicare
doesn’t pay for home care except after a
hospital stay if there is some need, and
it’s temporary,” explained Bohmart.
Unfortunately, many people fall in
between the cracks. They don’t qualify
for Medicaid but don’t have enough
money either. “It would be great if
Medicare paid for adult day centers, but
it doesn’t,” Bohmart said.
Approximately 44 million Americans
currently provide caregiving to family
members or friends. If this level of
caregiving were replaced by paid caregiv-
ers, the cost would exceed $300 billion
annually, according to a report by the
National alliance for Caregiving and the
AARP in 2004.
According to statistics published in
last October’s AARP Bulletin, caregivers
“provide care worth about $25 billion a
year in New York, and it delays or post-
pones costly nursing home care.” That
translates to over 2 million family mem-
bers statewide who provide these vital
services. New York State provides only
$2 million for respite and social adult day
services, which includes training volun-
teers who come in so a family member
can run errands or go to appointments,
the article added.
Additionally, some medications, sup-
plies, special pads for the bed and dis-
posable underclothes are not covered by
Medicaid or insurance companies and
pull on the resources of the caregiver.
Luckily for Barbara, her father provided
for her mother very well, so rent, ser-
vices and a private aide are taken care
of. However, even with the addition of
Medicare and an AARP supplemental
plan, she still spends her own money
on Fresh Direct for groceries, bottled
water and a constant supply of dispos-
able clothing because of her mother’s
Caregiving for those diagnosed with
HIV/AIDS presents a more complex set
of issues. While the stigma attached to
those living with the disease has lessened
in recent times, “it’s a special caregiver
who stays with the individual even though
the person has moved to an AIDS skilled
nursing facility, such as VillageCare’s
Rivington House,” said “Diane.”
She said, “It’s terribly stressful. Many
of the residents are abandoned, either
because of their drug use that pushes
people away, or are shunned because of
their AIDS diagnosis.”
Because a number of those living with
HIV have histories of drug and alcohol
abuse, the relationship between caregiver
and patient might be tenuous. Some
have been able to kick their habits, but
others have not. “On top of taking care
of someone who is sick, how do you take
care of someone who is using?” Diane
asked. “The HIV sufferer might shun the
person who helps because the addiction
is more powerful than friendship or fam-
ily. The caregiver suffers the indignity of
someone caring more about the addic-
tion than human relationships.”
Having a social network is crucial
for caregivers, whether it is other family
members, friends or a support group.
However, because of all the time they
spend with the ailing individual, friend-
ships and social contacts may fall by the
wayside. On the other hand, people who
are uncomfortable in the face of illness
might walk away.
“It’s amazing how many people don’t
want to talk to you once they know you
have problems,” Mike observed.
Mike said that, against his better judg-
ment because he is not a “joiner,” he
started attending a support group at
Village Nursing Home with Nancy Seigel
about a year ago. He and the other male
in the group are not otherwise involved
with the facility. Through this, Mike says
he realizes that others have problems as
severe as his. “I have learned to help the
other people, and it is good to talk out
my problems,” he says.
Support groups help people struggle
to cope, said Bohmart. Most of the
older clients at VillageCare’s adult day
program live with their caregivers. “A
support group is a good respite for care-
givers. It gives them a break for a few
hours. I tell them they have to take care
of themselves before they take care of
anybody else, and they should do things
they like to do,” she said.
Ironically, even the support groups
face competing needs. At the time of her
interview for this story, Bohmart said she
didn’t have any support groups active at
the day center. “People don’t want to
commit. They are tired from working all
day. Even though it is good for them, it’s
another burden,” she said.
VillageCare TODAY | Spring 2010
Sometimes primary caregivers lose
sight of their own health and everyday
needs. Although Mike has wonderful
aides, he can’t bear to be apart from his
wife. “I used to go to the gym three times
a week. I know I have to get out of the
house, do my exercises or go to a movie
once in a while,” he admitted, although
these are things he no longer does, or
doesn’t do often.
“Fatigue leads to physical illness, which
can lead to depression,” said Diane.
One website http://www.strengthfor- recommends that caregivers
take a break for “personal renewal.” As
the website puts it: “Take an afternoon;
even all day. Enjoy it by yourself or with
a friend. Do something self-indulgent.
Take a walk in the park; go to a movie;
find a relaxing area. Read a deliciously
naughty novel. Take a nap if you weren’t
able to get your 7-8 hours of sleep the
night before.”
Alice attended some support groups
a few years back for children with par-
ents who have Alzheimer’s, sponsored
by the New York City chapter of the
Alzheimer’s Association, where she got
invaluable legal, medical and financial
advice and emotional support. She has
ongoing access to a counselor at the
association whom she can email with
any questions. “I might go to a support
group again, but it’s hard to fit it in. I try
to go to the gym as often as I can because
I certainly need it. If I am not healthy, it
will be more problematic. For the time
being, the situation is somewhat stable,”
she said.
Barbara and Alice also search for
information online at primary caregiving
sites. Barbara would like to participate in
a support group, but she concedes that
she is “in an in-between space.” She is a
primary caregiver, but her mother does
not live with her. Most support groups
are for people who have parents in their
“I almost feel embarrassed to intrude.
While it feels like 24-7, it isn’t. I have
a psychological need for one but can’t
compare my lot with someone who has
no staff aid. It’s a grey zone, which isn’t
addressed,” she said. In addition, she has
no children, so she is not the sandwich
generation, caught between children and
parents. “But more support needs to be
in place on all levels,” she asserted.
Today, the issue of caregiving is becom-
ing increasingly urgent, particularly to
aging Baby Boomers, who are both the
caregivers and the cared for. Because of
the miracles of modern medicine, people
are living well into their eighties and
nineties, which is putting stress on all
In 2006, people 65 years and older
numbered 37.3 million, which represent-
ed 12.4 percent of the U.S. population, or
about one in eight Americans. By 2030,
there will be about 71.5 million older
people, about 20 percent of the popu-
lation, reports the Administration on
Aging (AOA). This indicates that more
programs, particularly those that are gov-
ernment-financed, along with access to
other services will be in great need.
Carol Levine, director of the United
Hospital Fund’s Families and Health
Project was quoted in the October 2009
AARP bulletin as saying, “It’s difficult to
find services because they’re scattered,
they’re under different agencies [with]
different eligibility standards. It’s not a
consistent program and it’s hard for fam-
ily caregivers to put this all together.”
Taking care of a loved one can prove
to be a burden or a blessing, depending
on the caregiver’s access to adequate
resources. As Alice put it, “I’m glad to
have an opportunity to convey both the
horror that’s been part of my experience
and the happiness in finding there are
help options in New York City that I can
get for my dad. It’s been a great lesson
The Challenges of Aging for an Older Population
n the year 2030, the youngest members
of the Baby Boomer generation will hit
65, making up nearly a quarter of the
country’s population, according to the U.S.
Census Bureau. If current older Americans
are a precursor of what is to come, they will
experience health challenges such as dia-
betes, dementia, depression and functional
disability in record numbers.
But their huge presence may also open
up specialized emergency rooms and criti-
cal care units, encourage more research
into the mysteries of the aging body and
place a focus on specialized geriatric and
end-of-life care.
Researchers and clinicians in the
Division of Geriatric and Palliative Medicine
at the University of Texas Medical School at
Houston, have listed ten of the most com-
mon challenges that we all face as we grow
the U.S. Department of Agriculture, the
body loses one percent of muscle mass a
year beginning at age 45, which can result
in sarcopenia as skeletal muscle is eventu-
ally replaced with fat and the body becomes
Some research has linked protein defi-
ciency with sarcopenia. For every week
spent in the hospital, it takes an aging
body a month to recover muscle strength
with daily rehabilitation, says geriatrician
Liliana Andrade, M.D., assistant professor
of internal medicine at the UT Medical
School at Houston. Exercise, including
resistance and strength training, is abso-
lutely essential for retaining muscle mass
and strength.
“For balance, Tai Chi is good,” she said.
“We also encourage patients to rent ‘sit and
be fit’ videos that use hand and leg weights.”
A study published recently in Diabetes
Care, a journal of the American Diabetes
Association, found that older adults, espe-
cially women with Type 2 diabetes had a
higher rate of skeletal muscle loss.
DEPRESSION. Considered by some to
be as prevalent as the common cold among
older adults, depression can be the result of
major life changes, including retirement,
losing loved ones and loss of mobility and
independence. It can show up differently
in older people, says geriatrician Nasiya
Ahmed, M.D., assistant professor of inter-
nal medicine at the UT Medical School.
“There’s not as much of a tendency toward
tearfulness or feelings of hopelessness,”
she said. “Instead they have vague somatic
complaints, increased pain, not sleeping or
eating well or general apathy.”
DISEASE. Chronic diseases associated
with the aging process that can take a toll
as one ages include high blood pressure,
stroke, cardiovascular disease, osteoporo-
sis, chronic obstructive pulmonary dis-
ease, hypothyroidism, constipation, incon-
tinence and arthritis. Preventive measures
taken early, such as quitting smoking,
eating healthy food and exercising, are all
important steps toward a better quality of
life. “Even quitting smoking at age 60 is
better than not quitting at all,” Andrade
POLYPHARMACY. A term geriatri-
cians are using for the number of prescrip-
tion and over-the-counter medications that
elderly people are taking in alarming num-
bers is polypharmacy. “People go to five
different doctors and none of the others
know what is going on,” Dr. Ahmed said.
In some cases, seniors who wind up
in the hospital may be prescribed a differ-
ent medication for an existing condition
such as high blood pressure because the
hospital doesn’t stock the particular one
they’ve been taking in the past. The patient
returns home with a new prescription
from the hospital physician and continues
taking the other medication as well, which
can be deadly.
“I’ve had patients come in who are tak-
ing 20 different medications,” Dr. Andrade
said. “A lot of them also take vitamins and
herbal supplements that they don’t need
and that can interfere with medications.”
The solution, they say, is to have a written
record of all prescriptions, supplements
and vitamins that they can bring to their
appointments and have a family practi-
tioner or geriatrician who can be the lead
physician in managing their care.
FALLS. Low blood pressure, which can
be a result of poorly managed hypertension
or dehydration, can lead to dizziness. That
dizziness, combined with a decreased abil-
ity of the vascular system to compensate for
changes in position such as standing up, is
the largest cause of falls, clinicians say.
“So many patients have told me that
they take blood pressure medication when
they feel like it’s high instead of taking it
as it is prescribed,” Dr. Ahmed said. “I ask
them how they know it’s high and they
give vague signs such as their nose tingles
or their tremor worsening.” Taking medi-
cations for sleep can also be dangerous.
“Some take Benadryl to help them sleep
and as people get older, that’s not such a
good thing because it causes confusion
and they can fall because they’re sleepy,”
Andrade said.
problems, including self-neglect, will con-
tinue to afflict older adults, said Carmel B.
Dyer, M.D., professor and director of the
geriatric and palliative medicine division
at the UT Medical School and co-author
of the book, “Elder Abuse Detection and
Intervention.” Education programs are
needed now to train physicians to recog-
nize the signs of abuse and neglect.
In 20 years, 25 percent
of the Amercians will
be over 65, putting huge
demands on health care
and social services.
30 Vi l l ageCare TODAY | Spri ng 2010 VillageCare TODAY | Spring 2010
The Long Goodbye
Turning the Caregiving Experience into a Partnership
n 1998, I lost my father to his ten-year journey with
Alzheimer’s disease. Before his passing, I had heard
Alzheimer’s called “the long goodbye.” I know no better
description of the experience. With every change – losing his way
home, no longer knowing my name, losing his ability to speak,
and then, to walk – I watched the father I knew slip away. Each
day, each moment, there was only something more to lose.
As Dad’s caregiver, I centered my attention on doing the title
justice. It was all about me giving to him. I so strongly identi-
fied with being a caregiver that I hadn’t really taken in the ways
that he gave to me in return.
One particular morning with Dad showed me that gifts
of care come in the most unexpected packages. I found him
wild-eyed and rowdy, chanting nonsensical syllables. No longer
using words, this was Dad’s new language of choice.
Unable to walk anymore, he writhed on his bed while he
sang. Overwhelmed at first, I began to envy him as I watched
him dance between the worlds. I no longer saw him as the
victim of a debilitating disease, but rather, as an inspired mes-
senger. He was entirely in the moment – full of unfettered
playfulness and joy. How long had it been since I’d stopped
to celebrate a moment so exuberantly? So I joined in and
chanted with him, delighting in the sweetest connection I had
ever shared with him. We were no longer caregiver and care
receiver; we had become care partners.
What I gained was this: when care receivers experience that
they have something to offer, and caregivers recognize the many
gifts they gain, amazing shifts occur in the care dynamic.
Focusing on reciprocity naturally shifts the energy away
from disabilities to abilities and enables us to build on what
works right now, because it implies that everyone has some-
thing to give. Care partnership implies a balance of care – an
acknowledgement that opportunities to give as well as receive
are abundant and experienced by everyone involved in the care
As we welcome the largest aging population ever, we need
creative grassroots solutions for enhancing quality of life for
older Americans and their care partners.
The most effective approaches will be those that include
shifting cultural perspectives about aging and how we value
what our elders have to offer. Being deeply known and having
the opportunity to give as well as receive are vital antidotes to
the loneliness, helplessness and boredom that impact the lives
of so many frail elders.
Laura Beck is an Ithaca, N.Y., resident and project director of
Eden at Home, an initiative of the Eden Alternative, an interna-
tional non-profit committed to improving quality of life for elders
and their care partners. To learn more about Eden at Home or the
Eden Alternative, go to
nerable elderly people can easily become
victims of family members or caregivers.
“We see cases where grown children have
moved back in with them and are depend-
ing on them financially. They use their
resources, borrow the car, rely on them to
baby sit, and it upsets the senior’s ability
to function,” Dr. Ahmed said. “I had one
patient in her early eighties whose leg
had just been amputated and she was still
babysitting her 11- and 12-year-old grand-
children, who were taunting her.”
DEMENTIA. Alzheimer’s disease is the
most common form of dementia, a gradual
decline in a person’s mental functioning,
and is the fifth leading cause of death
for Americans over age 65, according to
the National Center for Health Statistics.
The Alzheimer’s Association reports that
Alzheimer’s disease and dementia triple
health care costs for people over 65. But edu-
cation about dementia and possible treat-
ments including medications is lacking.
“There are now more medications that
are helpful. They can’t cure it, but they can
help,” Dr. Andrade said. “Unfortunately, a
lot of people are in denial. I had a 78-year-
old patient who I knew was suffering from
dementia because of the way he was man-
aging his medications and health. But his
son got upset when I started talking about
it and they left the room.”
boomers age, many will also be taking care
of their own aging parents. That brings
caregiver burden, which can lead to a
higher risk for depression and other stress-
related illnesses. Dr. Ahmed says caregivers
should solicit health resources, such as day
care for seniors, to help them shoulder the
stress. They should take advantage of sup-
port groups and ask social workers regu-
larly about available community resources.
Special units for acute care for the elderly
can help make hospitalizations less stress-
ful for the patient and family.
DEATH AND DYING. Individuals need
to decide how they want to live out the end
of their lives and how they want to die.
Cultural and religious beliefs will impact
these decisions and physicians will need
to be sensitive to that, Dr. Ahmed says.
As patients age, the physician begins to
play a larger role in a patient’s life and
strong physician-patient relationships will
be important in determining a patient’s
wishes. People should make those wishes
known to family members and caregivers
and put them in writing.
By Laura Beck
Being Polite. It’s Just That Simple.
hat’s happened to common
decency, respect, courtesy and
treating others with dignity?
You know what I’m talking about.
What got me thinking about this? Well,
a cartoonist, believe it or not. Stephan
Pastis, who is the creator of Pearls Before
Swine, which isn’t necessarily the most
dignified of comic strips itself. But it’s
not the strip that got me on this line of
Pastis and nine of his fellow daily comic
strip colleagues this past November went
on a USO mission to the Middle East, and
he wrote about the trip a few times in his
blog, which I was reading one day.
He made the following comment in
one entry about the men and women in
uniform that he’d met during his travels
through Kuwait and Iraq: “They were sin-
cere and direct and respectful to a degree
I have never experienced in my day-to-day
life here.”
I thought how right he is. The people I
come across in the military treat civilians
with a great deal of respect. It’s always “sir”
or “ma’am” when they address a civilian.
These are people who are extremely proud
of what they have chosen to do – stand
between us and “them” and, if necessary,
lay down their lives. (Pastis put it this way:
“If something were to have posed a threat
to any of us while we were there, I had no
doubt they would have protected us before
they protected themselves.”)
If anything, their choice to serve their
country ought to give them a sense of
superiority. But to the contrary, they are,
almost to a man and woman, humble.
So this got me thinking about the rest
of us.
Can we be more rude, impolite and
unkind? Tell me about it.
I can start, of course, with some of
those ranters on talk radio – hosts and
callers alike – or with a certain member
of Congress who calls out the President –
“You lie!” – from the floor during the State
of the Union.
OK – I don’t want to stumble into the
realm of political correctness or trample
on freedom of speech. After all, a friend
of mine, who was then press secretary to
New York’s governor, once remarked that,
“The New York Post is the price we pay
for freedom of the press.” Although some
might say today it’s Fox News.
Yet, having said that, we’re at a pivotal
point where the whole idea of respect for
others seems fast on the wane.
I went on the Internet armed with
Google and searched terms such as
“respect,” “dignity” and “courtesy” to see
what, if anything, others were saying.
I wish I could say there is a lot of
moaning and gnashing of teeth over this
issue, but there isn’t. I’m almost like the
proverbial voice crying in the wilderness.
But there are a few.
Take this blogger who calls himself
“lendingtreeinc.” He said he’s a mortgage
broker and he looked back fondly to the
days when he developed “business rela-
tionships and even friendships based on
a foundation of courtesy and respect.” But
now all he sees is “a new level of disre-
spect and lack of courtesy” that he has a
difficult time dealing with.
Another blogger named Medina was
dismayed about a conversation she’d had
(via Twitter, of course) about youth not
respecting their elders. She related two
separate accounts – one on the West
Coast, the other on the East – of youths
putting their feet up on bus seats while
older adults stood “wobbling on old knees
on the bus trying to hang on to cane and
Her blog post engendered a lot of
discussion about children and how they
are being raised today and how they are
impolite and out of control. I thought,
even if there’s some truth to that, what
about the adults?
Medina’s take on adult behavior came
through her relating a story about how
she had to help an older woman through a
thick crowd at the ballet who never would
have gotten to her seat otherwise because
“most people were so wrapped up in what
they wanted to do at that moment, they
were oblivious to her.”
Have we become that self-centered and
that self-absorbed?
I hope not. This might seem contradic-
tory to everything else that’s been said
here, but every single day I meet polite
and kind strangers. Every day. Without
Yet I do believe there is a sort of mob
rule of impoliteness out there.
There isn’t a single societal problem,
for example, that someone’s solution to it
isn’t met with disdain or ridicule.
There’s a way to fix this, of course. We
simply need to change the way we treat
each other. We should be more like those
men and women in uniform. Be polite.
Another blogger – Helen/H1202 – I
came across put it this way: “Manners
are a way to show respect for the human-
ity of someone else. You don’t need to
know them or like them. Just honor their
To switch subjects a bit, Medina’s blog
post was entitled “Elder Respect.” That in
turn got me thinking about the ongoing
worries about the future of Social Security
and Medicare, and even the recent health
care debate.
I recently saw a reference in Business
Week to a silent movie by D.W. Griffith
called, “What Shall We Do with Our Old?”
It was made in 1911, long before social
reformers achieved Social Security in 1935
and way long before 1964’s Medicare act.
The short film is about an elderly car-
penter with an ailing wife who loses his
job to a younger worker, and they quickly
use up their scant savings.
If you’ve got an Internet connection,
and chances are you do, you can find
Griffith’s film on YouTube and watch it.
But I think you already know it doesn’t
turn out well.
Enough said.
32 Vi l l ageCare TODAY | Spri ng 2010 VillageCare TODAY | Spring 2010
34 NEW HORIZONS | Wi nt er 2010
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