‘Aging in place’ offers seniors a novel alternative to assisted living.
By CARL HOFFMANMIRA LEVINE with participants in the ‘Aging in Place’ program.(photo credit: RUTH WEINSCHENK-VENNOR)
You see it going on everywhere. In parks, on buses, in supermarkets and malls. Go outdoors, look around, and sooner or later you will see and elderly man or woman – walking, walking with a cane or a wheeled walker, or perhaps being pushed in a wheel chair. Sometimes alone or, more often than not, accompanied by a foreign caregiver, these senior citizens have one thing in common. At the end of their day being out and about, they will likely return to their own homes. Rather than spending their twilight years in what is variously called an “assisted living facility,” “nursing home,” “old age home” or here in Israel a “beit avot,” they are living at home in their own familiar surroundings.It is called “aging in place,” and it is certainly nothing new. But in the French Hill neighborhood in Jerusalem, members of a Masorti synagogue called Ramot Zion have decided to do something new and perhaps without precedent: they have organized a program that is enabling them to age in place as a group.In the words of Michael Lahav, age 73 and one of the organizers of the program, “The idea is that a whole bunch of people who have known each other for a long time, some of whom go back years and years ago to the Jewish Theological Seminary in New York and founded the congregation after arriving in Israel. They’ve grown up together in the congregation, sent their kids to school, sent their kids to high school, they have grandchildren. And now they’re getting to the age where they want to remain together in the community, as an alternative to assisted living.”THE AGING in place program at Congregation Ramot Zion was the brainchild of Mira Levine, who came to Israel with her husband, Hebrew University Professor Lee Levine in 1971.“You have to understand the history of French Hill,” she explains. “It was originally populated by one third olim from all over the world, one third Anglo Saxon olim, and one third Israelis who were crazy enough to buy up here because they thought it was the end of the world. That was back in the early 1970s. We put money down for the apartment here in 1969.“Out of that, there came many of our friends with whom we had gone to the Jewish Theological Seminary in New York, Summer Camp Ramah, Barnard and Columbia. We were part of that Anglo Saxon group who came in the early 1970s, and many of those people I have known since high school. Together we created the Ramot Zion congregation. We were living close together and wanted to pray together, men and women, egalitarian. Together we created the first Tali school, Tali High School, and the Tali school system is throughout the country now. They were involved in setting up the Masorti Rabbinical School, Machon Schechter. As we and our children got to different stages, we created institutions. All together with our friends.“So now as we are aging, we decided, ‘Why not do it around the congregation?’ Many of us were beginning to go to assisted living, so the idea was can we stay in the community and create not a virtual but real beit avot, while living in our own homes and creating activities and services that will get to us as though we were in a beit avot.”Confronted with a major undertaking, the elderly members of Ramat Zion were aware that they could not do it alone.“The program took about a year to get off the ground,” says Michael Lahav. “We started looking for an advisor and came across a company called Healthy Aging. We worked with them for a year doing surveys about what people need, surveys about what services were available in the country, marketing, etc. We finally decided to take them as the company that would operate the system.”The system they devised operates on two levels, “full” and “associate” membership, Lahav says.
“Full membership includes geriatric service, and that includes a physical assessment once a year, including a physical therapist, an occupational therapist, a long examination by the geriatric specialist, and a recommendation for the family doctor. There’s a follow up every year and you can call them any time with questions and problems.”Associate membership entails a slate of services that together are called “community management.” Lahav explains, “This involves advocacy for dealing with public institutions, organizing social events, cultural events, going out together as a group to a movie, play or concert. There have been several workshops, one of which was about memory, another about falling, there’s one coming up on qigong. There have been lectures on rights and other issues pertaining to aging.”Accessing all of these programs could no doubt be daunting if any one member were left to do this on his or her own. Fortunately, the members have this under control.“We have a wonderful community director. She is our one telephone connection,” says Mira Levine. “All the services we get from Healthy Aging we get by calling her. Everything is with one telephone number. We call her for everything from getting a taxi for us to getting us classes in tai chi. Getting someone a foreign worker when one is needed, accompanying someone to the hospital. And she sends us regular announcements about things that are happening. It’s a full range of services.”THE “SHE” that Levine is talking about is Ruth Weinschenk Vennor, Ramat Zion’s “one-stop shop” for Healthy Aging’s programs and services.Vennor declares, “The basic assumption of the project is that we do whatever is needed to help people stay home. People are living longer. They are staying healthier longer. These can be wonderful years. Therefore we provide different kinds of services. We have a geriatric doctor who provides screening and consultant services, a physical therapist, an occupational therapist who helps people to maintain physical, memory, mental, cognitive abilities. This is the more physical side of it.“But more than that, if something happens in the house, in the family, we provide assistance. We have a list of very good professionals in different fields. It could be computer guys, electricians, plumbers, insurance consultants, lawyers, whatever is needed. We provide the connection with these professionals. And we have activities, workshops, lectures. We also have fun things, Community outings in which we all go out together to shows, to concerts, and other cultural events. We also bring in people. These are all to help people make the best out of living at this moment, to make their lives be the best they can be.”Perhaps not surprisingly, both the company and the Ramat Zion members decided that most of their programs – particularly activities like lectures and workshops – should happen in the synagogue, the place where the community has, in effect, lived together since its founding more than 45 years ago. The rabbi is also very much on board, wanting to provide the congregation with all the services needed to keep people in the community. “It’s a mutual understanding, a win-win situation for the company and the synagogue,” Vennor says.Rabbi Chaya Rowen Baker adds, “The congregation was founded 45 years ago. The founders are aging, but they’re still very active, and they are pillars of the community.” Although a new generation of younger families is emerging, Rabbi Baker notes that the founders still “comprise most of the people who will come to services on Shabbat.”BOTH THE community and the company are aware that this project is probably the first of its kind, if not in the world, then at least here in Israel.Says Vennor, “This is the first. For us, it is basically a pilot project. We are learning a lot as it goes on. We are learning through our doing. We have built up the basic structure of the project with the community, and we are learning all the time.”The project is so new and potentially useful for possible replication elsewhere, it has even attracted the attention of an academic researcher, who is presently observing, documenting and evaluating the program. Ephraim Shapiro is Lecturer in Public Health at Ariel University’s Department.Asked if he thinks this project can be replicated for other aging communities, Shapiro replies, “I’m in the middle of my research now, but my preliminary opinion is that I do think it’s replicable. It might have to be adapted. There are some unique things with this congregation that are partially its strength and partially a challenge that would make recreating it somewhat difficult. Most congregations are not made up of people who made aliyah together 50 years ago. Most congregations are not Masorti. So there are some differences. But I think the idea that you have bonds with people, you pray together, you do social things together, that changes the experience. It’s not just that they’re getting these specific services from the program, but also that they have this connection that affects the impact of the program in a positive way. Anytime you have a congregation with these ties between them, you have the potential for replication.He concludes, “I think the program not only has the potential to help the people participating in it, but benefits society as a whole because when people are able to ‘age in place’ instead of going to assisted living or an old age home, they are often healthier, happier and more productive members of society while at the same time using fewer resources.”
