Assisted living – at home

The nonprofit Yad Sarah organization offers a partial solution, with physical aids and information that can help make your home accessible, along with advice regarding cooking, cleaning, etc.

Illustrative (photo credit: TNS)
(photo credit: TNS)
Just over 20 years ago, a group of people from Kiryat Moshe began to worry seriously about the future. They had lived in the neighborhood for decades, raised their children together and shopped at the same stores.
But now, as they entered their 70s, they wondered what to do next. What if they lost their life partners? What if they became ill or disabled? What if, what if what if...
Of course, they knew that moving into a diur mugan (assisted living) facility would be an excellent solution. It would offer security, on-site medical care, apartment maintenance, social activities, someone to turn to with problems, complete accessibility and daily check-ins to make sure you were still breathing. It also would provide companionship if you wanted it and privacy if you didn’t.
But in order to move into assisted living, you needed not only a high enough income, but you had to be completely independent at the time you took that step. You also had to leave your home, your neighbors and often your neighborhood. Wouldn’t it be wonderful, said the group from Kiryat Moshe, if we could just remain where we are?
So they turned for help to Eshel, the department within the Joint Distribution Committee that develops programs for golden agers. Fortunately for the residents of Kiryat Moshe, Eshel worked out a plan for a group of services to meet most of their needs – and they were able to stay together. The program was called Kehila Tomechet (Supportive Community).
According to Ronit Nisenboim, Supportive Community director at Eshel, today just about everyone can take advantage of the program. The country’s 300 Supportive Communities are heavily subsidized by the Welfare Ministry, local councils and municipalities all over Israel and are found in every sector of the population. The cost is only NIS 135 a month, and even less for people with very low incomes. Holocaust survivors pay a maximum of NIS 25, no matter what their income.
The program is supervised by the Welfare Ministry, which requires any Supportive Community to provide at least the following services for seniors (women over 62 and men over 67) who have remained in their homes. These include:
1. A “father” or “mother” of the community (or both), responsible for the welfare of its members;
2. A doctor and ambulance available 24 hours a day;
3. A 24-hour emergency button;
4. Help in making sure members get the rights to which they are entitled – for example, assistance with the National Insurance Institute and other institutions;
5. Social activities.
According to Nisenboim, the community “mother” and “father” have the same official job description, which includes minor repairs in the home, contact with the members and crisis management. Once they are hired, they take part in intensive workshops and classes held by Eshel-JDC.
Twelve of the 18 Supportive Communities in Jerusalem are run by a private company called Tigbur, with the rest operated by various non-profit organizations. Yet like all the other Supportive Communities in Israel, they work from the same basic guidelines, with slight differences according to the needs of a particular population.
Tigbur runs the program in our surrounding area, so I contacted Ophira Shoam, director of national Tigbur, for more information. Shoam explained that in our neighborhood a “mother” and a “father” share responsibilities. The “father” handles minor repairs, and brings in more experienced professionals when necessary. He is charged with overseeing the repairs and must ensure that repair people do not take advantage of the seniors who require their services. In addition he visits members of the Supportive Community, lending an ear and a hand when they are needed. The Supportive Community “mother” knows each member and performs a variety of services (in one case that I know of, she brought medicine to a member who was laid up).
Everyone in the program has a button on the wall and a bracelet for calling in emergencies. In medical emergencies you are immediately connected to a doctor or can order an ambulance (which costs only NIS 25).
In a non-medical emergency, the person who answers will try to solve the problem. For instance, should you hear a noise and think someone is trying to break into your home, he will send out a security professional. The same switchboard will also take a message if you have a problem out of regular working hours and want the Supportive Community “mother” or “father” to contact you the next day.
When I contacted the director of the emergency company used by Tigbur, he assured me that, indeed, all of these services existed. And he added that new subscribers are asked to try out the service even when they don’t need help, so that they are familiar enough with it for use in times of crisis.
Each Supportive Community has its own program for social activities, built around the needs of its members. These can be classes and lectures, transportation for stay-at-homes to special activities, exercise classes and/or field trips etc.
After interviewing a number of people who belong to supportive communities I am convinced that they are a wonderful solution for people who want to remain in their homes – especially when they live alone and/or do not have an extended family in the area. That’s why I was astonished to learn that only 6% of the senior population takes advantage of the program. To find a Supportive Community in your area, call the municipal office for senior citizens: (02) 629-8003.
In addition, several organizations in Jerusalem offer services that complement, or overlap with, Supportive Communities. More than 3,000 people in the Jerusalem area subscribe to the Moked- 109 program offered free of charge by Melabev, a non-profit that also runs a network of day-care Memory Clubs for people with dementia and Alzheimer’s disease.
Moked-109 volunteers check on about a third of their subscribers daily, and the rest according to request. They also send someone out to make home repairs, can help with Passover cleaning and might even put up your sukka. When seniors are not mobile enough to get help outside the home, volunteers will make house calls to assist in filling out forms in Hebrew and in making phone calls to phone companies, the National Insurance Institute, etc. For more information and to sign up for this free service, call Cochav Cohen at 052-720-3032 or 170-070-0109 .
With all their good intentions, Supportive Communities and Moked-109 can’t possibly offer everything you get when you go into Assisted Living. A lack of accessibility, especially, can be a very real problem for people who stay at home in their golden years.
The nonprofit Yad Sarah organization offers a partial solution, with physical aids and information that can help make your home accessible, along with advice regarding cooking, cleaning, etc. You can also borrow a variety of mobility aids, from wheelchairs to crutches.
Transportation can be a major problem for seniors, even those in Assisted Living facilities (although there you have almost everything on site). One solution: Yad Sarah operates a fleet of vehicles fitted with special wheelchair lifts. There is a minimal fee for transportation to doctors’ appointments, shopping centers, even an evening at the opera. Call *6444 for Yad Sarah.
Golden agers living at home who have questions about their rights can call the Office for Senior Citizens, Sundays to Thursdays from 8 a.m. to 8 p.m. Phone *8840. Additionally, the Citizens’ Advice Bureau (SHIL) runs a hotline in Jerusalem that operates from 9 a.m. to 3 p.m. five days a week. At SHIL, volunteers answer questions and give advice about a wide variety of issues. Phone (02) 629-7028.
Although the Supportive Community program hasn’t altered a bit in the last 20 years, people are living much longer than they did two decades ago. An older population often becomes disabled, or simply requires – or desires – services different from those that are offered today. Therefore Eshel has begun several pilot programs that could become the Supportive Communities of the future.
One of them is a flexible basket, where you can, for example, opt out of the medical emergency button and get transportation to different sites, tickets for theater performances, or personal hygiene treatments instead. Another, very helpful for people who find it difficult or impossible to leave the house, is to bring culture of some kind right into their homes. A third lets people who are eligible for help in the home through the NII trade the day care they would otherwise get for a different service. And the newest pilot has residents of the neighborhood partner in the process of deciding what the Supportive Community will offer.
So far, no one body offers all – or even most – of the services people need when they remain at home in their senior years. Members of the Ramot Zion Conservative Synagogue in French Hill, however, are trying to do just that. They are working on a program for the entire neighborhood that would include a very wide basket of services, all of which could be accessed when a subscriber calls one central number. Still to be worked out: a solution to the community’s issues with transportation, security and accessibility. But if the program succeeds, it could be a model for other neighborhoods in which people can remain at home and get help and services with only one phone call.