November 2003

Bridging the Age Gap

by Mary Ellen Honsaker

Mary Ellen HonsakerOn September 6 and 7, the National Association on HIV over 50 presented a conference on “Bridging the Age Gap: Prevention, Care, and Management of HIV over Fifty.” NEAC Executive Director Bill Frampton, Board Member Scott Barnette, and I attended. Since the HIV/AIDS Committee and NEAC have targeted this growing population of HIV infections as important to our ministry within the Episcopal Church, this conference provided good information—both medical and experiential.

The conference opened with a Consumer Panel, reminding us all of the people most important to this work. The panelists ranged from a homeless drug user who is now head of an AIDS agency to an older woman “not at risk” in a small Illinois town. There followed a doctor’s look at the aging immune system, reporting on a Johns Hopkins study. He pointed out that as we age cells are still produced but that communication to those cells to fight infection is impaired.

A doctor with an AIDS practice in Provincetown spoke on gay men in this age category. Aging does increase the side effects coming from medications and the disease itself, and he has seen an increase in “safe-sex fatigue.” Use of the Internet to meet partners has complicated prevention of the spread of the virus. Age also increases the need to stay away from smoking and drinking while on medications, which is, in turn, more difficult for those with life-long habits.

A nutritionist discussing diets especially recommended a Caveman/Paleolithic Diet, with plenty of fish, fruits, and nuts. Many feel that mankind was designed to eat this kind of diet and has come away from it too far and too fast.

HIV and Women’s Issues was the last thing addressed on the first day. This demographic is growing, especially with women of color. Women are regularly diagnosed late. Because the role of family caregiver, often in poverty settings, may keep them from taking care of themselves, and then from putting medication at the top of the budget, for women more is spent on hospitalization than on drug therapy. Women are more prone to side effects from HAART, and all older people need to be aware of drug interactions.

On the second day I chose to attend a session on HIV in the Nursing Home Setting. The director of the Broadway House for Continuing Care in New Jersey emphasized that not all barriers have been broken down as yet. Broadway House serves only HIV/AIDS residents, and the care they need is more comprehensive than most care facilities. Fortunately, given care there are many that return to the community.

This was the first point at which spiritual needs were addressed. NEAC is helping Broadway House find Episcopal help to establish a “sacred space” within the facility.

A representative from an AIDS housing group spoke on the particular needs of seniors. Because often disclosure is the greatest fear, seniors may avoid use of excellent resources such as meals and grocery delivery so that neighbors won’t know. Assisted living facilities, he said, need much education, and AIDS service organizations need education on fair housing.

Maturity was seen as a positive resource of strength by the HIV and Older Women panel. Faith is an important element, but churches need to be educated on this. There is a definite need for sex education, preferably from peers, though college students speaking to seniors has been well received. The web site ww.hivwisdom.org, run by HIV Wisdom for Older Women, is very helpful. A dialogue between an actual patient and her doctor ended the session. They both encouraged women to speak up about side effects, such as dry skin, and seek alternate medications. The doctor also advocated complementary medicine, such as herbs and acupuncture. Older women in particular need to be educated on these possibilities to make living with HIV easier.

Living Positively was the last breakout session I attended. Several speakers addressed dealing with depression. Some feel that older people can adjust better to illness. AIDS-related discrimination plays a definite role in keeping older people from close relationships just when they need them most. Support groups are still often geared toward the young even if older persons seek them out. A study in progress on Puerto Rican elders and the effects of culture on older people was presented, making it clear that culture plays a major role. A social worker from Canada spoke of the need for social workers to be trained on dealing with HIV as a part of many clients’ lives.

A speaker on Prevention Education reminded us that older people do not need to be protected; they need clear information. She added that because an educator should never make assumptions about the group she is speaking to, a presentation should include as wide a variety of materials as possible. Testimonials and stories are wonderful educational tools.

The final presentation of the conference was from an HIV/AIDS specialist in Tucson. Among his main points was that HIV/AIDS is under-diagnosed; he also was concerned that too many people, for various reasons, do not go on the available medications and die much sooner than necessary. He does not see a “miracle” drug coming along, but the possibilities of an easier daily schedule is there.

He urged much wider early testing, and much greater encouragement to get on the available medications.

This conference was a very good start to understanding the ministry of NEAC to those older persons diagnosed with HIV, and how our Episcopal churches should be equipped to respond.

More information: www.hivoverfifty.org