Regaining control: Two activists' long fight for elderly protection, autonomy

Dr. Meytal Segal-Reich, Adv., and Dr. Mickey Schindler, Adv., have been fighting for elderly rights for a long time.

By YONAH JEREMY BOB
Updated: JUNE 29, 2015 17:23
Elderly Israelis wait for their turn to vote (photo credit: REUTERS)
Elderly Israelis wait for their turn to vote
(photo credit: REUTERS)
Lawyers Dr. Meytal Segal-Reich and Dr. Mickey Schindler have been fighting for elderly rights for a long time.
Finally, after years of planning, town-hall meetings to network and rally support and vetting for the right test case, they and their supporters won a major trailblazing victory on April 8 in the Haifa Family Court.
Judge Esperanza Alon ruled that elderly persons can appoint a family member, friend or specially trained individual to assist the elderly person with certain functions, instead of a legal guardian, while empowering the elderly person to maintain overall control of much of their legal and financial affairs.
Sitting around a table at a café, the excitement and the energy the two activists exude regarding the ruling is palpable and contagious.
Until now, when elderly people started to lose some of their mental capacity, the state appointed a legal guardian to take over their affairs, even if for portions of each day they were still mentally coherent.
Under the old and current way of doing things, the elderly lose autonomy over their legal, financial and some other affairs in favor of the legal guardian.
Even if the elderly were coherent part of the time, a legal guardian was necessary to protect them from exploitation or self-destructive decisions for the part of the time that they were mentally impaired.
Also, at the time when the entire idea of guardianships was created, there was less of a sense among medical, social science and legal experts of distinguishing between elderly people who were mentally impaired on a very limited basis versus those who overwhelmingly had lost control of their mental faculties.
Segal-Reich, academic adviser of the Bar Ilan Legal Aid Clinic for Holocaust Survivors and Older Persons, and Schindler, director of Yad Riva Legal Aid for the Elderly, say they hope the ruling will break wide open a national paradigm-shift on the issue.
The two activists seem to complement each other and know each other well, jumping in sometimes to finish each other’s thoughts.
In the activist field, they also seem to both handle all sides of the issue.
But if there is any breakdown of work between them, Schindler, whose real expertise is social science, likes to speak a little bit slower, painting pictures with his words like a visionary waiting for society to follow.
Segal-Reich, who initially comes from the legal world, talks a bit faster and is very exact, logical and meticulous in deconstructing distinct problems with the current law on the issue.
Nearing 50, Schindler has some years on Segal-Reich, who’s at 38, but both of them have been down in the trenches of trying to improve conditions for the elderly for some time.
In fact, their current initiative seems to have developed quite organically from the very small and closeknit community of elder-rights activists in Israel.
The activists say that whereas elder rights in the US and some other Western countries is already a “booming business” or at least a field full of professionals, Israel’s field is still small.
While they have been in the field for even longer, it seems the current path of changing the legal architecture of guardianships in favor of a less cumbersome and more complimentary helper through the courts started around four to five years ago.
Curiously, they say the original idea developed in an organic grassroots manner, with certain enlightened doctors and social workers approaching them and claiming that guardianships were the wrong move and that there should be an alternative.
“Lots of time we heard this from” professionals in the field with them telling us that their elderly patients “have some level of reduction in cognitive capacity, but I still feel that they do not need a guardian,” Segal-Reich said.
Schindler explained that while some health professionals have been thinking out of the box on this issue for years, many others do not, and “if a doctor only knows about the guardian option” for someone starting to experience cognitive difficulties “so he’ll just say ‘guardian’” without thinking about alternatives.
Once they decided there might be support for change, they started holding town hall meetings and field interviews around the country to gather more data, increase support and refine their ideas.
About two years ago, they started closely vetting cases of elderly persons who both had clear early symptoms of cognitive impairment combined with clear signs that much of the day they had strong retention of their mental faculties.
Finally, they met their “test case” who ended up filing the case leading to the Haifa court’s order endorsing a legal helper in place of a guardian.
Like the African-Americans who broke color barriers in the US, it was important for them that the elderly person be “very strong and very consistent about her need to decide” her affairs without a guardian taking over her life decisions.
They said their careful choice made a big difference when the woman, whose name is under gag order for privacy reasons, came into court and personally convinced Judge Alon that she was still mentally competent and independent most of the time.
The activists hope the ruling and their ongoing efforts will lead to a change to the 1962 law governing the issue.
Segal-Reich complained that the “law has trouble with complexity. The social work world knows that human beings are complex, that each individual is their own world” and can have unique circumstances in their level of mental impairment and continued capacity.
Schindler said that even for people with dementia, “it is not black and white. The more you live with it, you see different levels of functioning” and that cognitive reduction does not always move in the same linear direction.
For example, he said Alzheimer’s disease can take up to 10 years to seriously degrade a person’s cognitive capacity.
They say the last Knesset, with some support from Yesh Atid MK Karin Elharar, had made some progress on reforming the issue, but that they are unsure where the new Knesset will come out on it.
The Haifa court ruling does not bind other courts, but with its reliance on UN conventions, which Israel has ratified, and some grassroots support, the activists are committed to continuing to push the issue until they complete their revolution.