An Unusual Partnership : Center Lets AIDS Patients and the Elderly Share Their Strengths

Roger Duncan, in his fourth year with AIDS, lounges in a cozy sitting room, an intravenous tube snaking into his chest. It’s about noon, so Duncan gets set to join two other AIDS patients in the large, bright dining room, where they will share tables with their usual lunch-mates--a dozen people twice their age or more, feeble from the ravages of time.

Afterward, most of the seniors use the dining tables for games of blackjack, while the younger AIDS patients generally chat among themselves. But one 96-year-old woman joins the younger group, joking and starting up a song--you would almost call it flirting in another setting.

It is as unlikely a daytime crowd as you will find anywhere--two generations and a lifestyle apart--joined here by a simple, inescapable certainty.

“We’re both on the diving board, ready to jump into death,” said Duncan, 40, whose vision loss from AIDS makes it hard to see a movie or walk through a restaurant without bumping into a table. “We’re both at the same point.”

Duncan belongs to the nation’s only adult day-care center catering to two vastly different groups: people with AIDS and the frail elderly. At this experimental center, called Partners, one can find Holocaust survivors in their 90s from Eastern Europe alongside those facing the current era’s medical holocaust.

For five hours a day, at no cost, they share the compact first floor of a converted West Hollywood office building. It is part clinic, part recreation center. Seniors play bingo or cards or work on art projects in the main room. The AIDS patients gossip about movie stars or watch TV while taking their infusions.

State officials are considering duplicating the 1 1/2-year-old program--run jointly by the city of West Hollywood and Los Angeles Free Clinic--as a cost-effective way to provide medical attention to two vulnerable groups while letting them live at home.

Yet social service groups warned against the project when West Hollywood officials, facing an exploding AIDS rate and large elderly population, proposed putting both groups under one roof rather than building separate day-care centers. The skeptics said it would never work: Relatives would balk at placing frail loved ones with AIDS patients, they said, and the younger people would not get much out of a senior center.

But the city plowed ahead, enlisting the clinic to run the center under a host of grants.

Since opening in early 1992, it has weathered the departures of several key staffers, lower-than-hoped enrollment for people with AIDS and, as expected, the death of some members. But most days, the mood at Partners is intimate and upbeat. And, for those who do participate, the human part of the experiment seems to be working.

The center picks up Duncan, who has not driven in more than a year, on the mornings when he has the energy to get out of bed. The “blahs” have been bad lately, he says, and it sometimes takes a staffer’s call to do the trick.

The others who show up daily--three or four with full-blown AIDS and 10 to 12 elderly members with conditions from diabetes to heart disease--all require medical oversight by the staff nurse or part-time physician. All but one of the older clients have memory loss related to Alzheimer’s disease, stroke or senility.

The dining room is the hub of the center’s activities, ranging from simple exercises to guest singers and a haiku class. Besides their daily intravenous infusions of nutrients and antibiotics, the members with AIDS can get a massage in the physical therapy room or talk out their fears with a part-time psychologist.

For some, Partners is meant to relieve burdened loved ones at home. For others, it provides a temporary escape from the tedium and loneliness of living alone, and feeling helpless.

“I wouldn’t be alive today if it weren’t for this place,” said 34-year-old Chris Esposito, whose lover has shepherded him through a three-year battle with AIDS that has robbed him of sight in one eye and some hearing. “I could stay home, watch TV and worry about what disease I’m going to get next . . . Here I don’t think about it.”

One recent morning, a staffer led a group of elderly members, who were seated, through arm-limbering exercises while another aide took blood pressure readings.

At a nearby table, a screenwriter met four young men with AIDS as part of a creative-writing class. One participant, Arturo Tonyee, 45, said he had to move to a nearby homeless shelter three months ago when his family could no longer care for him.

Tonyee said he hoped to use the class to write his own obituary.

As the session wound down, Duncan showed the others a photograph from “before”--when his former 350-pound build won him work as a film double for actor John Candy.

The older members, many of them Eastern European immigrants in their 80s and 90s, seem untroubled by sharing the compact center with people with AIDS. Some of the old-timers helped make panels for an AIDS memorial quilt to commemorate two Partners clients who died.

The gay clients do not recall encountering a single incident of homophobia. Of course, some of the older people simply do not remember why the young men are there. “They’re sick, I guess,” 75-year-old Lou Hankin said with a shrug.

A few have become fast friends across the generational divide. Esposito spends much of his time looking after 96-year-old Mary Feiering, who was born in Poland. She, in turn, fusses over him on his low days.

Feiering sometimes launches into creaky renditions of “Old Kentucky Home” and “God Bless America,” and Esposito always joins in. The two are famous around Partners for their duets.

“The elderly people have become care-givers and role models for the young people,” said Denis Ouellet, a former seminarian and homeless advocate who has run Partners for seven months. “The people with AIDS get to see how people cope with chronic illness--you just keep doing it.”

Sometimes the two groups take field trips together: one was to Venice Beach, another merely across the street to West Hollywood’s weekly farmers market. In addition, an aide has started a Spanish class and a weekly manicure session that is a growing hit with both sets.

But with such a varied audience, you cannot please everyone. As a visiting singer belted out “Hello, Dolly!” on an electric piano, with an eye on the older crowd, one of the AIDS patients rolled his eyes and grimaced to a visitor. “I guess this would be the low point,” he muttered.

So far, state officials say they are impressed with the $530,000-a-year pilot program, funded mainly by the clinic and federal AIDS funds. Whether it is copied elsewhere will depend in large part on an upcoming evaluation.

“In an era of limited resources, are we going to be able to set up separate facilities for different populations?” asked Charlene Welty, who oversees 72 other adult health care centers for the state’s Department of Aging. “Is there a real difference between a person with AIDS and a frail elderly person? They may have very common needs.”

But some AIDS experts argue that the money would be better spent elsewhere.

Frank Paradise, a former director of AIDS Project Los Angeles, said he turned down an invitation to join the center’s advisory committee last summer because he believed it served too few people and was “mixing apples and oranges in terms of populations.”

“I would rather see the money be put into nurse’s aides that can visit in the home and take some of the load off the individual in terms of doing laundry and cleaning house and just visiting,” Paradise said. “The money they’re pouring into that place could pay for a hell of a lot of nurse’s aides to help a hell of a lot of people.”

Although the elderly enrollment has been steady, managers have been unable to keep as many people with AIDS--a problem they attribute to scant advertising and the brutal nature of a disease that can kill or hospitalize clients with little warning. The new management team promises more aggressive marketing for AIDS clients and more activities for the younger set.

Though a physician is on hand at the West Hollywood center five hours a week, members still see their own doctors and make periodic trips to the hospital.

After giving up on his Hollywood dreams, Duncan moved to his mother’s home in Florida last year, preparing to die there. But, he “kept on living,” grew bored and returned. He joined Partners on a friend’s recommendation.

Though he doesn’t expect to get any better, it’s enough these days to get a little human contact and an occasional diversion, he said.

“I’m mad most of the time because of the way my life has turned out. But I have to appreciate that I can be comfortable,” Duncan said. “Sometimes it’s great just to be comfortable.”