A Friend In The Holy Land

Jerusalem — When his parents began to suffer health problems that made it difficult for them to continue living in Israel, Bruce Markowitz got busy.

Believing that his folks might have to return to the United States, he contacted a number of New York-area geriatric care-management agencies that arrange everything from meals on wheels and home medical visits to property management and round-the-clock nursing care.

Hoping that his parents might be able to remain in Israel, or at least be able to return if their health improved, Markowitz, a Baltimore native who made aliyah in 1992, also did some research on Israeli care-management agencies.

What he discovered shocked him.

“I learned that in Israel there’s nothing professionally organized in terms of an agency. There are some individuals providing help on an ad hoc level, but that’s all,” he said. “It was a real problem.

“In America, it seems like every major city has this kind of professional service. I couldn’t believe there was nothing like this here.”

Eager to fill the void, Markowitz, a former chiropractor who now studies in a yeshiva, turned to Marvin Schreiber, one of the few experts in elder management care practicing in Israel. Schreiber, a social worker originally from Ottawa, is an energetic 72.

Realizing they had common goals, the two this year founded Senior Services Plus, Israel’s first elder-care management agency.

Schreiber, a personal care management consultant for the past decade, evaluates a client’s needs and develops a care plan in coordination with medical professionals. Markowitz, who once owned a chain of chiropractic clinics in Maryland, is the executive director. The agency has offices in Baltimore and Jerusalem.

As with other such agencies, SSPI is generally contacted by a relative or friend following a medical crisis. Usually the elderly person has no loved ones nearby.

“I received an emergency call from the granddaughter of a man who had been brought to Ichilov Hospital,” relates Schrieber, describing a recent case. “He’s a 90-year-old Holocaust survivor with no family in Israel who suffered a heart attack on a bus in Tel Aviv.”

The granddaughter, who lives in Rome, was referred to Schreiber by the hospital’s geriatrician. Although she hopped on the next plane and was waiting for Schreiber at the hospital, she realized she could not stay in Israel indefinitely. She asked the agency to coordinate her grandfather’s ongoing care.

Mentally going down the list, Schreiber says, “I oversee the array of his home care services: home-delivered meals, a homemaker who comes in two hours a day. He’s a Holocaust survivor, so I was able to arrange for French and Yiddish speakers to visit him through [the survivor organization] Amcha. He has an emergency call system and, if necessary, I and two neighbors will be contacted. I also visit him twice a month and call him regularly by phone.”

Although the agency will help relocate a client to a nursing home or other long-term facility when necessary, “the goal is to enable people to stay in their own home as long as possible,” Markowitz says. “The key is to arrange the services that will enable them to do this.”

These services can run the gamut from setting up regular phone calls from community volunteers to full-time nursing care. Sometimes it means hiring a companion or nurse’s aide for a few hours a day, or ensuring that the client receives timely medical examinations. It could mean arranging for a driver to transport the client to checkups or the local seniors center, or simply ensuring that bills are paid.

“When you’re 85, even changing a light bulb can be difficult,” Markowitz says, adding that it is almost always the grown children or grandchildren who request assistance, not the client.

“Parents rarely recognize their own needs. It’s a combination of factors: denial, simply not being aware of the problem, not wanting to spend the money. The children call us to help their parents, but they are also doing it for peace of mind,” he says. “They want to know that someone will take care of a gas leak or a backed-up toilet, or that a doctor will make house calls.”

While the agency has clients whose children live in Israel, though generally not in the same city, it specializes in elderly immigrants whose families live overseas or who have no family.

One of the agency’s consulting physicians, Dr. Yoel Isenberg, says immigrants often are in a more difficult position than native Israelis, who tend to have an extensive support network formed over the decades.

“People without children nearby are clearly in need of more support,” he says. Furthermore, Isenberg says, the health and social welfare systems in Israel are more bureaucratic and fragmented than those in North America, “and to navigate them you really need family to help.”

“It’s too much for any one individual, and when a person is sick it’s even harder to assert yourself. You also need someone who speaks Hebrew to advocate for you.”

Isenberg calls it “ironic” that while “the army has a program for lone soldiers without family in Israel, it has nothing for older people.”

According to David Breslau, a leader in the “seniors” division of the Association of Americans and Canadians in Israel, at least 100 older immigrants requested additional information about Senior Services during a recent AACI convention.

“It doesn’t mean they’re all going to sign up,” says Breslau, a spry 86, “but it does indicate a need.”

He notes that many North American olim come to Israel after they retire, a fact that often limits their knowledge of Hebrew.

“They need an intermediary not only for medical things but for everyday things like bank statements,” Breslau said. “There’s also a difference in mentality, a difference that can try an American’s patience. A lot of misunderstandings arise because of it. Sometimes people need a little help.”

Or a lot. Such was the case with Anna Moses, who made aliyah at the age of 80 and enjoyed an independent lifestyle until her health began to deteriorate seven years later. A daughter who lived in Israel had young children and was unable to give her mother all the help she needed. Her other children were in the U.S.

“We were Americans living in America with an elderly mother living in Israel,” says Chaya Wolf, one of Moses’ daughters, a resident of Ohio. “We were running back and forth between countries. We didn’t know the system in Israel and didn’t know who to speak to.”

After agonizing over the dilemma, the family contacted Schreiber. “He just held our hands the whole way through,” Wolf says. “He found home-delivered meals, doctors, the general care she needed. He found a nurse to accompany mother back to America, and counseled us on what to expect when she got here. He advised us on which agencies to contact in America. Marvin treated our mother as if she had been his mother.”

Shrugging off the compliments, Schreiber says that “the most rewarding part is that you give the adult children, those who care very deeply, the peace of mind of knowing that you are their eyes and ears even though they’re not here. If that granddaughter [of the Holocaust survivor] had been in Tel Aviv, she would have done all the things I did.”

Growing introspective, he says, “I also get satisfaction knowing that we’re doing all we can to help the older person or couple stay in their own apartment, in familiar surroundings, for as long as possible.”

Having made aliyah as a grandfather, Schreiber says his calling is a “Zionist enterprise.”

“Many older people come to Israel from different countries as the fulfillment of their lifelong dream. Like me, they’ve come to live out their retirement years,” he says. “The dream is to be able to spend the years in Israel reaping great personal and spiritual fulfillment.

“If they were back home, they would have family or Jewish family services doing things for them. They’re here, and that’s where we can make a difference.”

Call Senior Services Plus toll free at (888) 779-4360; fax, (410) 764-9040; Web site, www.seniorservicesplus.com.