Of Breath and Kisses by Rabbi Janet Madden

For almost a week now, it’s been my turn to oversee my father’s care. I have been at his side, liaising with physicians and nurses in order to bring his pain under control, reassuring him that he is not a burden, assisting him to eat whatever he is able to eat, helping him with personal care and engaging in conversations around what his life will look like now, post-fall. Each time I leave his room, I kiss him gently on the cheek and tell him that we love him.

My father, who began his ninth decade of life with a birthday admission to the Emergency Room, does not experience cognitive deficits. He continues to be clear-minded and resolute about his end of life decisions. What is less clear for him—and for his children—is how, exactly, we will navigate the narrowing straits in which we now paddle: how we can reach the best possible balance between how he wants to live with the living arrangements that are now possible for him. The only certainty is that we recognize and are adjusting to the reality that a limit has been reached and that he is no longer able to live independently.

This life-changing time is different from, yet similar to, bereavement. It is a transitional time, a time that will require adaptability and sensitivity to many adjustments and ongoing changes from now until the end of my father’s life. Like so many of the families that I serve as a hospital chaplain, my family, too, now inhabits this liminal place of anticipatory grief—a grief that is no less real than bereavement and which comes from knowing that we are grieving not just what was and what now is but also what we know lies ahead.

With every injury and illness and every experience of recovery, we are reminded that our bodies are complex physical embodiments of fragility and resilience. Aging teaches us that our bodies are not well suited to long lives; our bodies are created to break down, to disintegrate into elements. As I witness the many complications that have resulted from his fall, I think, ruefully, of how my father’s physical experience of growing old is not that of Moses, who, we are told, died at age 120, with eyes “undimmed and vigor unabated” (Deuteronomy 34:7-8). My father’s aging is following a more common physical pattern: slow, incremental losses and then a precipitating, life-and-circumstance-changing event.

But as we spend these long days together and I continue to learn from my father, I’ve also been thinking that the Torah’s description of Moses’ clear vision and intense energy might not in fact refer to Moses’ physical body, but rather to his spiritual condition. Perhaps what the Torah is really telling us is that Moses’ many years of being in deep relationship with the Divine both sustained him through the disappointments and difficulties during his life and also supported him in old age, right up to the moment when he died “al pi Adonai” (“by the mouth of God”), which the midrash interprets as a loving, gentle kiss—the original “Kiss of Death.”

Like many of the elderly patients I’ve served in chaplaincy, my father is striving to cooperate with and accomplish everything that occupational therapists, physical therapists, nurses and aides ask of him. He is apologetic when he cannot. He is unfailingly polite, expressing thanks to everyone who cares for him, appreciative of the smallest things. Because he is a man of deep faith, he has shared with me how he is actively praying for Divine guidance in coming to acceptance of his new reality and in making decisions even as he is grieving his loss of independence and trying hard to recover sufficiently to transition to the next stage of his life, should he survive. He is aware that the combination of his pre-existing conditions and these recent injuries mean that he will never be as he was just weeks ago and that he may not live much longer. He is engaging in life review and sharing thoughts, reminiscences and instructions.

As my siblings, my father and I progress through this liminal, sacred time, the self-care practices that are sustaining me include meditation and chanting. These breath practices are important to keeping my spiritual and emotional balance. They keep me from becoming complacent about the miracle of breathing. They keep me mindful of how, on the physical level, life literally begins and ends with breath. They keep me mindful of how the Divine breath sustains me in my own spiritual life.

I pray the Mi Shebeirach for my father, knowing that healing comes in many forms, including in the cessation of breath. The prayer of my heart is that when that moment that breath ceases comes for him and for me, it will come gently, and we will know it for what it is: the breath-taking, unifying and loving kiss that comes by the mouth of God.

Rabbi Janet Madden PhD was ordained by The Academy for Jewish Religion-California. She serves as the rabbi of Temple Havurat Emet and Providence Saint John’s Health Center and has been a student of the Gamliel Institute. She is a regular contributor to this blog.

Rabbi Janet Madden

Rabbi Janet Madden




The Gamliel Institute will be offering course 5, Chevrah Kadisha: Ritual, Liturgy, & Practices (Other than Taharah & Shmirah), online, afternoons/evenings, in the Winter semester, starting January 9th, 2018. This is the core course focusing on ritual, liturgy, practical matters, how-to, and what it means (for everything other than Taharah and Shmirah, which are covered in course 2). The instructors will be Rabbi Stuart Kelman and Rabbi SaraLeya Schley, with some guest instructors during the course.


The course will meet online for twelve Tuesdays (the day will be adjusted in any weeks with Jewish holidays during this course).

There will be an orientation session January 2nd.

Information on attending the online orientation and the course will be announced and sent to those registered.


You can register for any Gamliel Institute course online at jewish-funerals.org/gamreg. A full description of all of the courses is found there.

For more information, visit the Gamliel Institute website, or see the information at the Kavod v’Nichum website. Please contact us for information or assistance by email info@jewish-funerals.org, or phone at 410-733-3700.


Gamliel Café

Gamliel Students are invited to an informal online monthly session, held mnthly. Each month, a different person will offer a short teaching or share some thoughts on a topic of interest to them, and those who are online will have a chance to respond, share their own stories and information, and build our Gamliel Institute community connections. This initiative is being headed up by Rena Boroditsky and Rick Light. You should receive email reminders monthly. The next scheduled session of the Gamliel Café is December 20th with a discussion of the creation of the Chai Mitzvah curriculum on discussing Jewish dying and death by Rena Boroditsky and Rabbi Joe Blair.

Starting in January 2018, the Gamleil Café will move to Thursday evenings at the same time. Watch for information on these events.

If you are interested in teaching a session, you can contact us at j.blair@jewish-funerals.org, or info@jewish-funerals.org.


Gamliel Continuing Education Courses

Gamliel students should be on the lookout for information on a series of “Gamliel Graduate’ Courses, advanced sessions focusing in on different topics. These will be in groups of three sessions each quarter (three consecutive weeks), with different topics addressed in each series. The goal is to look at these topics in more depth than possible during the core courses. The first course took place in Fall 2017, focusing on Psalms. The next course will be in April, and will look at death as seen in the Zohar, taught by Beth Huppin. Registration is required, and there will be a tuition charge of $72 for the three sessions. Contact us for information, by email info@jewish-funerals.org, or call 410-733-3700, or simply register online at www.jewish-funerals.org/gamreg/.


16th annual Kavod v’Nichum Chevrah Kadisha and Jewish Cemetery Conference

Mark your calendar and hold the dates! June 3-5, 2018, in the Washington D.C. area. Details to be forthcoming soon.



Donations are always needed and most welcome to support the work of Kavod v’Nichum and the Gamliel Institute, helping us to bring you the annual conference, offer community trainings, provide scholarships to students, refurbish and update course materials, expand our teaching, support programs such as Taste of Gamliel, the Gamliel Café, and the Gamliel Continuing Education courses, provide and add to online resources, encourage and support communities in establishing, training, and improving their Chevrah Kadisha, and assist with many other programs and activities.

You can donate online at http://jewish-funerals.org/gamliel-institute-financial-support or by snail mail to: either Kavod v’Nichum, or to The Gamliel Institute, both c/o David Zinner, Executive Director, Kavod v’Nichum, 8112 Sea Water Path, Columbia, MD  21045. Kavod v’Nichum [and the Gamliel Institute] is a recognized and registered 501(c)(3) organization, and donations may be tax-deductible to the full extent provided by law. Call 410-733-3700 if you have any questions or want to know more about supporting Kavod v’Nichum or the Gamliel Institute.

You can also become a member (Individual or Group) of Kavod v’Nichum to help support our work. Click here (http://www.jewish-funerals.org/money/).



If you would like to receive the periodic Kavod v’Nichum Newsletter by email, or be added to the Kavod v’Nichum Chevrah Kadisha & Jewish Cemetery email discussion list, please be in touch and let us know at info@jewish-funerals.org.

You can also be sent a regular email link to the Expired And Inspired blog by sending a message requesting to be added to the distribution list to j.blair@jewish-funerals.org.

Be sure to check out the Kavod V’Nichum website at www.jewish-funerals.org, and for information on the Gamliel Institute, courses planned, and student work in this field also visit the Gamliel.Institute website.


Sign up on our Facebook Group page: just search for and LIKE Chevra Kadisha sponsored by Kavod vNichum, or follow our Twitter feed @chevra_kadisha.



If you have an idea for an entry you would like to submit to this blog, please be in touch. Email J.blair@jewish-funerals.org. We are always interested in original unpublished materials that would be of interest to our readers, relating to the broad topics surrounding the continuum of Jewish preparation, planning, rituals, rites, customs, practices, activities, and celebrations approaching the end of life, at the time of death, during the funeral, in the grief and mourning process, and in comforting those dying and those mourning, as well as the actions and work of those who address those needs, including those serving in Bikkur Cholim, Caring Committees, the Chevrah Kadisha, as Shomrim, funeral providers, in funeral homes and mortuaries, and operators and maintainers of cemeteries.




What is wise aging? It starts with staying engaged — And sometimes it takes a village

One of my favorite biblical verses is Psalm 118:5, “Min ha metzar Karati Ya; Anani b’merchav ya — From the narrow place I call out to God, who answered me with the Divine Expanse.” It’s a verse that speaks to me especially now, at this stage of my life.

The narrow place: Those birthday cards that suggest anyone over 50 is over the hill. The ones that start coming when you turn 60: “Think of it this way: You’re not losing it, you are just not using it as often.” Or the ones this year, age 67: “There are three ages of a person: youth, middle age and ‘You look good!’ ”

The narrow place: What am I? What words do I use to describe myself? Retired? Yes, but I still am engaged in projects that matter to me. Senior? Well, I do like that movies and the Metro are less expensive, but I don’t like the word. Elder? Sounds too old or too pretentious.

The narrow place: Ageism, stereotyping and discrimination on the basis of a person’s age — the last socially sanctioned prejudice. The way you become invisible as you grow old; the fear of becoming isolated or dependent.

The narrow place: Internalizing popular stereotypes — that wrinkles are ugly, that it is sad to be old, that old people are incompetent.

The narrow place: Denial. Not being willing to admit that we deserve or need help in certain situations. Not facing the truth that we will die someday, like Woody Allen, who said: “I don’t want to achieve immortality through my work. I want to achieve immortality by not dying.”

Yes, there is a narrow place. But we don’t have to stay there. The challenge is to transform this paradigm of decline into one of possibility and opportunity. I can tell myself that 60 is the new 40, or that 70 is the new 50, that I’m really not growing older. But the truth is I’m 67. And 67 is the new 67.

The challenge is to reimagine the narrow place as one of Divine expanse, an invitation to growth. The word our tradition uses for this stage is “zaken,” the same word as “beard,” “elder,” “sage” or “old.” I prefer the interpretation that views zaken as an acronym for “One who has acquired wisdom.”

So that is the challenge at this stage of my life. It begins with admitting there is less time ahead than behind me. How do I make meaning out of however much time I have left? How do I discover purpose in the years to come?

Confronting that question is the concept behind wise aging.

Focusing on what wise aging means began at my congregation, Temple Emanuel of Beverly Hills, after a community organizing effort several years ago when we talked with more than 250 congregants over the age of 55 in small house meetings about what matters to them at this stage of their lives. Four themes emerged: spirituality, community, giving back and concerns about people they loved, particularly end-of-life issues. Three fears emerged: being isolated; becoming invisible and becoming dependent.

Spirituality includes asking what I need to do now to become the person I want to be in my 80s. And who are the people who can be my teachers, the over-age-80 congregants who are engaged in the world, joyful, grateful, compassionate, patient, funny, curious, optimistic? I see them and I think of the scene in “When Harry Met Sally” when Estelle Reiner says, “I’ll have what she’s having.” I want them to teach me how to have what they are having, and how to work on myself now to cultivate those characteristics.

Spirituality opens me to move from the narrow place to notice those moments when we touch the Divine expansiveness — moments of transition. These could be important birthdays, becoming grandparents or taking on a new challenge. That openness leads me to ask what are the new rituals we need to create to mark those transitions.

We learned more about how to explore such issues together by bringing in the Institute for Jewish Spirituality’s training program for “Wise Aging” and its creators, Rabbi Rachel Cowan and Linda Thal. But that was just the beginning.

Our focus on community blossomed into the creation of ChaiVillageLA, which just celebrated its first anniversary. It turns out that the majority of our baby boomer congregants want to age in place, remaining in their homes and neighborhoods, enriched by a supportive community.

Research led us to the village movement, which began 15 years ago in Boston when neighbors got together to figure out how they could age in the homes they loved. Now there are more than 200 such villages around the country and 200 more in formation. A national movement called Village to Village Network (vtvnetwork.org) holds an annual conference and has best practices and software tools to make organizing a village more viable.

We thought people would join because they would want to get or give services. But just as the AARP suggested, we discovered instead that people really want social connections — that those are the antidote to the fears of becoming invisible and isolated.

A village is a membership-driven, self-governing, grass-roots “virtual” community. It is a not a contiguous neighborhood or a social service agency, but the embodiment of the radical old idea of neighbors helping neighbors through services like walking the dog when someone is out of town, bringing meals when someone is sick or providing transportation to medical appointments.

As important as these services are, however, many villages are finding that social programs are even more valuable in helping members continue to build “social capital.” Research by AARP has shown that village members experience reduced isolation, increased independence and a deeper sense of purpose. We thought: What a good idea for a synagogue!

Supported by a generous Cutting Edge Grant from the Jewish Community Foundation of Los Angeles, we joined with Temple Isaiah to found ChaiVillageLA, the only synagogue-based village in the country. Members, who must be members of one of the partner synagogues, pay a membership fee of $100 for an individual or $150 for a household and commit to providing at least four hours a month of service to the community. That service can be responding to the needs of another member or organizing a program, like a backyard gardening group or volunteering at one of the synagogues. People access the services via our website (chaivillagela.org) or our director, Devorah Servi.

We thought people would join because they would want to get or give services. But just as the AARP suggested, we discovered instead that people really want social connections — that those are the antidote to the fears of becoming invisible and isolated. Since launching last July, our membership has grown to almost 200 members and has inspired more than 21 member-run interest groups, 185 member-led events and a handful of major events like the village seder attended by more than 100 people.

The village has been a huge win for our synagogues. People are joining the synagogue in order to become members of the village. Young people from the synagogue are beginning to volunteer with village members. And we are strengthening our synagogues by re-engaging boomers and those slightly beyond — people with skills, energy, experience, wisdom, resources and discretionary time that will make a difference.

It is a work in progress; we have lots still to figure out after our first year. As we celebrated the occasion, our keynote speaker, Los Angeles City Attorney Mike Feuer (whose mother is a member), asked what the traditional gift is for a first anniversary. It’s paper, a tradition that goes back to the Victorian Era, in the 19th century.

No one knows why it’s paper, but there are many theories. One is that paper represents a blank page, and that the first year is the beginning of the writing of a future together. A second is that paper reminds us of the fragility of starting something new. A third is that paper, while fragile, is actually created by weaving fibers tightly together, so that what results is interwoven and strong. A fourth is that paper — which can be made from trees, bamboo, cotton or plants — connects us with life and growth.

All this is true of our village. Our recent anniversary is the beginning of the future we are writing together. We are making it up as we go along, trying new ideas, taking risks, finding ways to give one another joy. But like paper, we have become an increasingly interconnected community, weaving individual fibers together, making a difference in individual lives now, and eventually, we hope, in the larger fabric of our neighborhoods and cities.

Although we don’t want to be dependent, we know that none of us is, or ever was, independent.  We are interdependent.

Although we don’t want to be dependent, we know that none of us is, or ever was, independent.  We are interdependent. And we are no longer afraid of becoming invisible or isolated. All of this is part of wise aging.

So is dealing with the concerns we have about the truth that we will die someday, as will the people we love. The best gift we can give to our families is a clear understanding of what kind of care we want at the end of our lives.

Temple Emanuel and other congregations in Los Angeles, led by IKAR, want to facilitate these difficult conversations, sacred conversations, by holding a series of Death Over Dinner gatherings. Based on a secular project — and infused with Jewish sources and wisdom by IKAR (deathoverdinner-jewishedition.org) — congregants will be invited to host such a dinner with a small group of friends or family for a conversation about end-of-life issues. We have held several practice dinners over the summer and are ready to kick off the project in the fall.

Then there is another of the four themes identified in the meetings of our congregants: Giving back. I’m reminded here of psychoanalyst Erik Erikson’s vision of generativity, the impulse of older generations to invest in younger ones. We are working with Encore.org, a national movement, to encourage those in midlife to imagine an encore career of service to the larger community, to create connections between older people and younger people through its visionary program called Generation to Generation (generationtogeneration.org/communities/la). It is a five-year campaign “to mobilize a million adults age 50-plus to dedicate their time, talent and experience to help young people thrive, and to unite all generations to create a better future.” Research suggests that more than 30 million people — 29 percent of adults age 50 and older — have indicated interest in the campaign. Imagine the difference that could make in our country. 

And giving back includes not just leaving a legacy — through our philanthropy and through the tradition of writing an ethical will or making a video for those generations who will come after us — but also, and even more important, by living our legacy through a commitment to continue to lead a life of purpose and meaning.

So, after considering all this, I ask again: What is wise aging? It is summed up in another biblical verse I love, this one from Psalm 92, A Psalm for Shabbat: “The righteous will blossom like a date palm, still fruitful in old age, full of sap and freshness.”

Still fruitful. Still juicy. Still curious. Still adventurous. Still grateful. Still engaged in the world.

That is what I would call wise aging. I also would call it wise living, at any stage of life.

RABBI LAURA GELLER is the emerita rabbi of Temple Emanuel of Beverly Hills. She and her husband, Richard Siegel, are working on a book called “Getting Good at Getting Older: A Jewish Catalog for a New Age,” to be published by Behrman House in 2018.

A cannabis plant was brought to the Knesset on Nov. 24, 2009 for the Labor Welfare and Health Committee, which was addressing the issue of medical marijuana. Photo by Kobi Gideon/Flash 90.

Can cannabis turn back the aging process?

As our brain ages, our cognitive abilities naturally decrease and it becomes more difficult to learn new things or devote attention to several things at the same time. Researchers long have been looking for ways to slow down or even reverse this process.

Scientists at the University of Bonn in Germany and the Hebrew University of Jerusalem report in the journal Nature Medicine that they have achieved this goal in mice by administering a small quantity of THC, the active ingredient in the hemp plant (cannabis).

Mice have a short lifespan and begin displaying pronounced cognitive deficits even at 1 year old. The researchers gave doses of THC to lab mice at the ages of 12 and 18 months over a period of four weeks. A low dose was chosen to avoid any intoxicating effect in the mice. After the regimen of treatment, the scientists tested learning capacity and memory performance in the animals — including, for instance, orientation skills and their ability to recognize other mice.

Mice that were given only a placebo displayed natural age-dependent learning and memory losses. In contrast, the cognitive functions of the animals treated with cannabis were just as good as the functions of 2-month-old mice used as a control group.

“The treatment completely reversed the loss of performance in the old animals,” reported professor Andreas Zimmer from the Institute of Molecular Psychiatry at the University of Bonn.

This study was carried out following years of meticulous research, according to the scientists involved. First, the researchers discovered that the brain ages much faster when mice do not possess any functional receptors for THC. These cannabinoid 1 (CB1) receptors are proteins that act as docking stations for cannabinoids like THC from substances such as hashish or marijuana. THC imitates the effect of cannabinoids that are produced naturally in the body and fulfill important functions in the brain.

“With increasing age, the quantity of the cannabinoids naturally formed in the brain reduces,” Zimmer said. “When the activity of the cannabinoid system declines, we find rapid aging in the brain.”

The study suggests that “restoration of CB1 signaling in old individuals could be an effective strategy to treat age-related cognitive impairments.”

To discover the precise effect of THC treatment in older mice, researchers at the Hebrew University of Jerusalem, led by Dr. Mona Dvir-Ginzberg and the late professor Itai Bab, examined the epigenetic changes in the mice’s brains after sustained low dosages of THC.

“The THC treatment induced molecular and epigenetic changes, which no longer corresponded to that of untreated old animals but rather were similar to what we see in young animals,” said Dvir-Ginzberg, who works at the university’s Institute of Dental Sciences.

The THC treatment caused the number of links between nerve cells in the mice’s brains to increase to younger levels. Such links are essential to the brain’s ability to learn.

“It looked as though the THC treatment turned back the molecular clock,” Zimmer said.

Cannabis products already are used widely for medical indications including pain relief. As a next step, the researchers involved in the mice study hope to conduct a clinical trial to investigate whether THC also reverses aging processes in the brain in humans and can increase cognitive ability. 

Turning 92 — With Gratitude

I lived my younger years with three anchors: to live in service, in adventure and in love.

My service was 60 plus years in many fulfilling projects in Israel and numerous community and political leadership roles in the US.   My adventure with long treks in exotic countries, climbing mountains in the Himalayas and elsewhere, constant tennis and bicycle touring everywhere.

My love was always a growing path with dearest Lois, three sons, then their wives, then grandchildren and ever-widening circles of relationships.

But now as I near 92, my service and adventures are only wonderful memories, never to be lived again at those levels.  Today there are new experiences like arthritic aches, knees a little weaker, a few strange pains in my back, and a serious loss of balance.

But my aging days are filled with much love and joy.  My wife of 69 plus years is still my true love, and I will never understand how I was so smart at age 22 to grab her for life.  My family is well. I love and feel loved, and I am aware of having lived a life filled with much excitement, a reasonable success, and feel I have given my contribution to tikkun olam – repairing the world.  I still support the liberal humanistic causes as in the past, only today this support is more financial and less physical.

A gift of my senior years has been a contentment level I had never felt when younger.  I had always been too busy, constantly on to the next thing. Never stopping to meditate and revel in the life I had created.  Now age and perhaps a little wisdom have directed this change in how I live.  I have time to read for pleasure and not just for data.  Time to watch a beautiful sunset over the Pacific.  To move slower and open my eyes to so much of what I had been missing.

For me the overriding emotion at this time in my life is a magic word —gratitude.  A deeply felt satisfying joy for all the blessings that fill my heart.

Growing old ain’t so  bad.

Israeli startups on cutting edge of aging tech

The world’s fast-growing over-60 population needs tech solutions for issues ranging from retirement planning to health monitoring, and Israeli companies are stepping up to meet the challenge. Some of the most promising products were displayed earlier this year at the Israel Aging 2.0 startup contest during the Conference for Technologies for Aging Well at Bar-Ilan University.

“We see the entry of more and more high-quality Israeli ventures in this field, and more interest from the investor community,” said Dov Sugarman, the Israel representative for Aging 2.0, a global platform to accelerate innovation to improve the quality of life of the aging population.

The competition was part of Aging 2.0’s worldwide startup search. Winners of 40 local events were featured on the Aging 2.0 website for popular voting and expert judges’ review. A chosen few will vie for prizes and mentoring at a San Francisco event in October.

Sugarman said that Israeli entrepreneurs and marketers — who tend to be young — are becoming aware of the opportunities in aging technology.

“We have so many great apps, but most 85-year-olds don’t have smart devices, and we need to address that with new solutions,” he said.

The Aging 2.0 competition was hosted by the Conference for Technologies for Aging Well, a program of the Israeli Society for Aging Well of the Society of Electrical and Electronic Engineering in Israel.

The 250 members of the society, ranging from social workers to doctors to engineers, look at the future role of technology not only for health needs but also to help combat loneliness, aid in retirement planning, make devices like computers and cellphones easier to use, and provide assistance to caregivers.

“In the last four years, we’ve seen big progress in Israel’s aging technology,” said Yael Benvenisti, chairwoman of the society and the conference. “In Israel’s startup incubators, there are more and more companies with solutions for the aging population. Nobody used to think about this population, and now they see it’s a good market.”

From left: Dov Sugarman, Israeli rep for Aging 2.0; MyndYou co-founders Itay Baruchi, Ruth Poliakine Baruchi and Dan Sztybel; Yael Benvenisti, chairwoman 
of the Israeli Society for Aging Well. Photos courtesy of Israel21c


Sugarman, a Tel Aviv-based aging-tech consultant, manages strategic partnerships for SafeBeyond, a platform for creating and storing personalized messages for distribution later in life or after death. SafeBeyond pitched at the first Israeli Aging 2.0 competition last year.

He noted that monitoring, sensing and tracking technologies — delivered via apps, smart TVs and robots, for example — is becoming critical in extending the independence of people in declining mental and physical health.

“The megatrend is aging in place [aging at home], and we need technology for that,” Sugarman said. “We’re seeing activity in Israel across all those spectrums. I expect that 2016-17 will see Israeli companies playing a growing role in global innovation and the generation of new business ideas.”

The U.S. caregiving market is estimated to be a $279 billion opportunity, with some $100 million in venture investment going to tech-enabled home care in 2015. 

Israeli startups are making significant contributions in this aging-tech sector, and here are 11 to watch.

MyndYou: Winner of the Aging 2.0 Israel competition, MyndYou is developing a mobile platform to help people with early stage cognitive deterioration maintain independence. The monthly subscription platform will monitor cognitive, physiological and behavioral parameters, alert family members to changes and offer actionable insights, according to CEO Ruth Poliakine Baruchi.

A $1.2 million funding round is going toward finalizing development and launching in the U.S. next year; the startup is now in the ICONYC Labs accelerator.

Vitalitix: Following a new phenomenon called “crowd-caring,” the Vitalitix social-responsibility platform provides three-way communication among seniors, caregivers and community “social angels,” as well as volunteers from existing networks. The idea is to reduce loneliness, improve safety and allow more freedom at home and out. The senior can access the app, now in beta, through any wearable device or smartphone.

Pharmpool: Pharmpool is developing a mobile app that evaluates the safety of a particular drug therapy regimen for a specific patient, and includes features to increase medication adherence and management.

Steps&: Steps& has created a virtual smartphone assistant who guides and encourages physical therapy patients through home exercises. The interface, managed by the physical therapist, includes instructional videos, a motivation boost, and goal-setting, pre-scheduling and tracking features.

Kytera: Kytera, a graduate of the Microsoft Ventures Tel Aviv Accelerator, is working on a smart wristband and motion-sensor technology to monitor seniors who are aging at home. It automatically detects and alerts to “stress situations” that vary from a person’s usual activity patterns. It’s being piloted in the United States ahead of commercialization by the end of this year.

AbiliSense: According to the U.S. National Institutes of Health, 1 in 3 people from age 65 to 74 has hearing loss and nearly half of those older than 75 have difficulty hearing. AbiliSense is developing apps that continuously listen to the world around the user, analyze the sounds and transform them into alerts — delivered to smartphones, wearables and other devices — ranging from “the doorbell is ringing” to an emergency SOS.

HelpAround: Founded in Tel Aviv in 2013, the HelpAround platform for chronic patients and caregivers enables organizations to match patients with appropriate resources to improve access to care. The founders applied their knowledge of mobile health and data-driven, targeted advertising to build a smart “safety net” of helpers for chronic patients similar to the way ad tech pairs buyers with sellers.

HelpAround was one of four Israeli startups chosen as regional finalists in the 1776 Startup Challenge, and visited Washington, D.C., in June for the global competition.

Mybitat: Mybitat, a company in Herzliya, partnered with Samsung to develop a suite of smart-home solutions aimed at helping the elderly remain at home longer with better quality of life. Advanced sensors, cloud-based software and behavior analytics monitor daily routines and wellness. If a change in behavior or health is detected, the system alerts preselected contacts.

Perlis: Haifa-based Perlis is developing an artificial intelligence and robotic system to identify early symptoms of diseases commonly affecting the elderly, such as Parkinson’s and Alzheimer’s. The system serves as a support tool for physicians, caretakers and family to address health problems quickly enough to enable the elderly to retain independence at home.

E2C: Easy to Connect (E2C) in Ramat Gan offers a Basic smartphone (available in the United States and Israel) and a Basic tablet (available in Israel) designed to help seniors easily access the latest communication technologies with large print, one-button navigation and other streamlined processes. A Basic smart TV and Basic smartwatch are coming next.

PowerTags: PowerTags are miniature low-cost wearable tags providing location-based tracking capabilities for institutional caregivers of the elderly, among other applications. A proprietary “position engine” presents the tag’s real-time and historical movement patterns on a cloud-based dashboard viewable on smartphones, tablets and laptops. An emergency alert button is embedded in the tags. 

Senior living facilities: 5 topics to consider

Making the choice that an aging parent is ready for a senior living facility is not easy. Finding the right place to call their new home can be even harder.

When going through the process of finding a facility that’s the right fit for a parent or other relative, it’s important to be thorough and ask all the right questions. Here are some topics suggested by experts in the field.

1. Quality of life

It’s important not to be swayed by what a facility looks like on the outside, but to see how it functions on the inside. “A large percentage of children look at the aesthetics and beauty of the community instead of taking into consideration what’s best for their parents,” said Sandra Heller, founder of Compassionate Senior Solutions.

Instead, prospective clients should focus on whether the quality of life matches their loved one’s current standards. “You go into the food and the amenities that are available,” said Bette Bergsman, executive director at STOP CANCER, a Los Angeles-based nonprofit that funds research to fight cancer.

She found found her 87-year-old mother a facility with the help of Jennifer Saginor, a senior retirement placement specialist with Saginor Senior Solutions, based in Beverly Hills. “Ask if there’s a washing machine on the floor. Is laundry and cleaning [done] once a week?” Bergsman said. “You’re putting your parent in a venue where they may not be able to do the normal basic things they do at home.” 

2. Staff 

Negligence is a huge problem in the senior living industry, according to Saginor. That’s why it’s crucial to find out the backgrounds of the nurses and staff who work there and to discuss the facility with others already living there. “I would talk to residents who live there and need the same level of care,” she said. “You’re going to hear the truth from the people who know what’s happening.” 

When Bergsman was doing her research, she asked specific questions about care — including about what happens in case of an emergency — and met with the heads of the nursing departments. She inquired about the nurse/caretaker-to-resident ratio, the ability to dispense drugs and monitor vital signs, and activities available to stimulate body and mind. 

3. Fees

Websites for assisted-living facilities list the costs, but what about if seniors need more care down the line? What if a resident becomes sick and needs more help? It’s imperative to figure out what costs will go up in case further assistance is necessary. “You don’t want to overspend,” Heller said. “Ask, ‘What can I expect in the future in terms of expenses?’ ” 

4. Making introductions

When older adults go into assisted-living facilities, they may be scared that they’ll feel isolated because they don’t fit in. Saginor said that to prevent this, visitors should ask if their parents can talk to current residents. “It’s always important to meet people so they can relate to one person. I introduce my clients to a few of the residents that live there so they can feel like they can relate to someone,” she said.

5. Food

It may not sound like a deal breaker, but meals matter. Many assisted-living facilities offer a set menu every day. If people are spending a lot of money on a facility, they should know what they’re paying for. 

Saginor said that visitors should ask about the chef — is he a rookie or someone with reputable restaurant experience. “There are a few communities I tend to always recommend because of the chef specifically,” she said. 

Also, if parents have special food requirements — for example, they keep kosher — inquire about how accommodating the facility is with its menus. “Ask, ‘Is there a set menu or can you order off a menu?’ A lot of places have a limited menu, but that won’t work for someone who has dietary constraints,” Saginor said.

It’s up to the children and the concerned family members to ask these questions because seniors are often hesitant to go into facilities. “Very few elderly people will wake up and say, ‘I’m ready to go to senior living,’ ” Heller said. “It has to be driven by the children because they’re worried about the parents.”

There are many reasons behind such worry — even beyond immediate health worries, which can be costly. According to UC San Francisco researchers, more than 43 percent of adults older than 60 said they have experienced feelings of loneliness, and a report by the National Social Life, Health, and Aging Project revealed that older adults who are socially isolated are at higher risk for mental and physical health problems. 

By doing research for her mother and asking questions, Bergsman said she found a facility that’s been a great fit. 

“The ability to socialize is rejuvenating, to say the least,” she said. “There are all these different outings and movie screenings. It’s a positive way to live versus living in your own home, which is clearly much more isolating. It’s been an excellent experience.” 

Embracing senior moments with humor, insight

Aging — and dying — may be an inevitability, but it need not be a tragedy. Just ask octogenarian Bernard Otis, the author of “How to Prepare for Old Age (Without Taking the Fun Out of Life),” who has learned through personal experience, extensive observation and interviews that aging with dignity and joy is a choice.

In real life, an infectious grin stretches across his face, and joy radiates down to his strong and lively handshake. Although he originally started his blog, seniormomentswithbernardotis.com, and his book as a way to deal with the loss of his wife, Anna, reactions he gets from his readers of all ages have given him renewed purpose and great personal satisfaction.

“I drew the conclusion that when people weren’t prepared for death, they weren’t necessarily prepared for life, either,” he said. “They were not living their lives in a way that counted, and not aware about what was happening around them. Many people have a misconception that they will retire at 65 and that will be the end. However, the truth is that life goes on, no matter what stage of it you’re in. You need to embrace it.” 

Otis, 86, currently lives in a seniors residence in West Hills, but he is still a man about town. He maintains his blog and recently found romance with a woman visiting one of his fellow residents.

His book, put out by Incorgnito Publishing Press in May, touches on a lifetime of lessons that he has acquired. It is made up of chapters, which he playfully calls “Senior Moments,” filled with stories and observations that cover “the journey of life, the boulders in the highway and how to get around them,” according to Otis. 

It is dedicated to the late Rabbi Harold Schulweis of Valley Beth Shalom in Encino, who, Otis said, mentored him during the writing process and editing of the book and is quoted in one of the chapters. 

The concept grew out of Otis’ preparation for and coping with the loss of his wife, who died of cancer in 2012; Schulweis provided moral support for him in those days as well. The whole experience was cause for reflection for Otis.

“If you knew this was going to be the last day of your life, how would you live it?”  he asked aloud, rhetorically. “Most people don’t think about that, but how would you live it? I would get up in the morning and find somebody who needed my help. After that, I would do something I really enjoyed, and at night, I would go home to the arms of the person I love. Even if I don’t know what day will be the last day of my life, that’s how every day should be lived.” 

Otis says in the book it is easier for a person of any age to comprehend the most important truths about life when they also understand how they can be distracted by everyday “small stuff,” as well as petty arguments and conflicts that can potentially tear apart families. He also stresses the importance of starting preparation for aging as early as possible in one’s life.

“This is a major problem among seniors — the falls and the broken hips that lead to their dying, and families are oblivious or often afraid to address this,” Otis said. “Families should prepare themselves for these situations, have family discussions to prepare themselves for the eventualities of family members getting older. … Parents should explain to their children about what happens to people at different stages of life and death, and they need to know how to handle it. 

While the book project, which involved interacting with people at his residence and other senior centers over 2½ years, helped him come to terms with his wife’s passing, Otis grew to embrace the notion that he could provide a public service and create a philosophy that could serve as a manual for people of all ages and backgrounds on how to accept life as it comes — from birth to death, while fortifying one’s relationships with family and friends along the way. In other words, being adaptable, grateful and open-minded.

One idea Otis came to advocate: Never hide from death. Parents should not shield children from that fact of life, but instead teach them how to face it and explain what happens to people at different stages of their life and death. He recalls how he was bothered by the fact that his parents wouldn’t allow him to see his grandmother while she was in declining health, in the days and weeks before her passing.

“I believe the best way to [deal with aging] is to connect life and death in a way that makes sense, as a continuum between past present and future,” he said. “If people understand it, they won’t fear it.”

Otis likes to precede his personal observations and anecdotes with jokes as a way of keeping the attention of readers and lightening the mood between serious topics. One of his favorites, about dating after 60, involves three women sitting by the pool at an assisted living center. An elderly man walks by them and jumps into the pool. The first woman says, “You must be new here. I have never seen you before.” He replies, “Yes, I just got here yesterday.” The second woman asks, “Where are you from?” and he says, “I just got out of prison after 25 years.” The third woman says, “You’re single!”

Born in Detroit, Otis grew up in a traditional Jewish home and enjoyed a long career as a food service and restaurant facilities architect/designer. He continues to stay in touch with relatives throughout the country, including his first wife, who lives in an assisted living center in Dallas near their adult children. And therein lies another important life lesson, he said.

“Everybody who comes into this world has two significant assets: Awareness about what is happening around you and the ability to make friends, maintain family connections and build relationships,” Otis said. “Even with those gifts, some people forget how to use them. That loss, in turn, makes the aging process and facing mortality all the more difficult. With my book and blog, I want to remind people of how to make those skills work for them again, at any point in life.”

CORRECTION [Aug. 24, 2015]: This article originally mispelled the name of Incorgnito Publishing Press.

A view from age 90

I recently had my 90th birthday, and from this elderly perch there are some observations I want to share on the most important lessons I have learned about living a full and gratifying life.

I have tried to live by three rules:

• Live life as an adventure.

• Live with service.

• Live with love.

By adventure, I don’t mean only exciting travel, although I’ve been fortunate to have done plenty of that. I trekked three times in the Himalayas, visited the high Andes in Peru, bicycled all over the United States, Western Europe, Asia and South America. I ran a marathon, spent six weeks in a VW bus bouncing over East Africa, climbed Mount Kilimanjaro and Mount Fuji, and so much more. 

It was particularly thrilling to have my family share in many of these outdoor adventures; to have taken separate trips with each of my three sons; and, most of all, to have my wife, Lois, with me over those many years, sharing the excitement, exhaustion and fascination of these experiences. 

But there were also nonphysical adventures, such as my work helping in the development and funding of the Gunther Depths of Space exhibit at the Griffith Observatory; discovering myself through years of therapy; and experiencing the anguish and joys of being a risk-taking entrepreneur, plus many others. 

At this point in my life, my 90-year-old body no longer allows for physical adventures, but I have so many wonderful, wonderful memories. Today, living with adventure can mean more of an awareness each day of the wonder and awe of being alive — of watching my children live their lives and my grandchildren grow, of continuing to read and learn, of sharing life with close friends. These can also be adventures.

Then there is living with service. I chaired my division in the United Jewish Appeal at age 28 — 62 years ago — and have been involved with Jewish activities in Los Angeles, on the national scene, and in many programs in Israel, including my years chairing Project Renewal in Jerusalem, ever since. 

That doesn’t count service in various sectors of the secular community, including creating a nationwide program for AARP, serving on commissions for the city and county of L.A., plus California state appointments, and being active in politics even before being named to Nixon’s enemies list more than 40 years ago.

Whether this commitment to service came from my Jewish genes or just from being an aware, caring human being, I don’t know. But it is always there as a part of my life. And I am grateful for that gift. 

Now, though, as with adventure, my aging body has imposed limitations. No more long travels and five-hour meetings for me.

But then there is love — and love is different.

With each passing year, it seems to grow wider in outreach and deeper in commitment. I feel fortunate that the girl I married is still the love of my life, that my sons have grown into responsible, contributing men, and we have three unique and charming grandchildren. 

And my love has only expanded as time has passed to include so much more in my life and so many people. That is why I am filled with gratitude at age 90, and I look forward with enthusiasm and wonder as I move toward 91. 

Richard Gunther is an entrepreneur and political and social activist. He is a member of Leo Baeck Temple and divides his time living in Century City and Santa Barbara.

Improving the aging experience: completing life’s story

My interest in the active aged has been stimulated recently by hanging out with several of them and reading Dr. Atul Gawande’s powerful book “Being Mortal: Medicine and What Matters in the End.” My curiosity was heightened, of course, by an event that occurred last October — my 80th birthday.

“For human beings,” Gawande writes, “life is meaningful because it is a story. A story has a sense of a whole, and its arc is determined by the significant moments where something happens. … Why would a football fan let a few flubbed minutes at the end of the game ruin three hours of bliss? Because a football game is a story. And in stories, endings matter.” 

Much of Gawande’s book is devoted to the sick and their final years or days. But his words also extend to old people in good health, or at least in fairly good shape.

I happen to know such people, including members of the Brandeis Men’s Group, one of the organizations around the country that help support Brandeis University. As Roberto Loiederman wrote of the local men’s chapter in the Jewish Journal in February 2013, “Finding a place where you feel at home is crucial for retired men. Even though you may still be mentally and physically active, when you’re no longer working, you feel cut off from lifetime routines. For retirees, it’s not uncommon to feel uprooted.”

Al Gomer, 91, retired head of a steel company, started the group several years ago. Men who had accompanied their wives to meetings of a women’s Brandeis support group, part of the Brandeis University National Women’s Committee, enjoyed getting together. The men formalized their casual getting together into the Brandeis Men’s Group. That happened around the country, and it’s all been combined — men and women — into the Brandeis National Committee.

The local group meets for breakfast monthly. They have speakers ranging from political candidates to physicians who explain the more complex part of medical practice. There are book groups. Some members volunteer in food banks. A major activity is raising money for Brandeis’ Sustaining The Mind Project, which is researching Alzheimer’s disease, Parkinson’s disease and many other neurological ailments. Brandeis National Committee chapters in other parts of the Los Angeles area and nationally are engaged in similar efforts.

The Brandeis Men’s Group combination of fellowship and good works is an example of what is being studied by experts finding ways to enrich old age. Why is it that some older people flourish and others decline? Granted that Alzheimer’s is incurable and the journey into oblivion faced by those diagnosed with it is still unstoppable. But what of the majority, who escape that fate? How can they remain physically and mentally active? Are they sharing their wisdom with the world and helping others, or are they home watching television alone all day?

“Why is it if you feel you have a valuable role in the lives of others, you actually have a better aging experience?” asked Tara L. Gruenewald, an assistant professor who heads the Healthy Aging Lab at USC’s Davis School of Gerontology. “Why do you tend to be healthier over the years as compared with folks who don’t feel that way, who don’t feel they’re playing that vital role in the lives of others?”

Research, she said, is showing the value of knitting clubs, photography clubs, anything that has a social function and challenges individuals to learn new things. These are examples of ways we might engage folks with challenging activities in a way that keeps folks wanting to do them, because crosswords get boring after a while.

“Get people out of their houses,” she said. “As we get older, people spend a lot of time watching TV and are engaged in passive activities. There is a precipitous increase in the later adult years in the time spent watching TV.”

The USC gerontology school is engaged in a novel examination of ways to improve the aging experience through its Zekenim project, financed by a three-year, $250,000 grant from the Jewish Community Foundation of Los Angeles.

Now in its early stages, Zekenim will involve older Jewish people — 220 of them — brought together in small groups for two-hour workshops over a three-week period. They’ll talk about turning points in their lives, sharing them with each other and with young high school and college artists who will translate the stories into pictures.

Afterward, the work will be exhibited, both in shows and online. The participants, their friends and families will view the work, along with the young people who created the works and other members of the Jewish community. Instead of being shunted aside, the older Jews will be the stars, along with the young artists who illustrated their lives. 

“We know the life-review process has some benefits,” Gruenewald told me. “We also think that the visual translation of life experiences into an artistic form that can be shared with the community also gives credibility to that life’s story and permits one to share it with others.”

As is the case with members of the Brandeis Men’s Group and similar organizations, the Zekenim participants will be completing their life’s story. The Zekenim folks will be doing it by actually telling their stories while engaging with peers and young people. Others will engage in different ways, such as raising money for Brandeis research on the brain and nervous system. Hopefully, these varied chapters in their stories will lead them to an active conclusion to their lives, rather than one spent on the sidelines.

Bill Boyarsky is a columnist for the Jewish Journal, Truthdig and L.A. Observed, and the author of “Inventing L.A.: The Chandlers and Their Times” (Angel City Press).

Swinging with The 5th Dementia

Twice a week, four older men get together to make music. There may be nothing unusual about that, but aging has not been kind to them: To varying degrees, they’ve been affected by dementia or Parkinson’s disease. 

Nevertheless, when they get together and play standards from the American songbook — from “You Are My Sunshine” to “Fly Me to the Moon” — they can’t stop smiling.

Gene Sterling, a skilled drummer, leads the quartet. When he plays, there’s hardly any sign of his usual tremor. “Let’s do it bossa nova style,” he calls out before laying out a tempo. 

Paul Livadary, on piano, follows the beat, but Irwin Rosenstein, on electric keyboard, seems lost for the moment, and Sam Mayo, on harmonica, sways to a tempo all his own. When the song is over, Sterling jokingly suggests that for their next piece, they all play different songs — at the same time.

“Let’s see how that sounds,” he says. 

Livadary offers the reminder that “in this group, there aren’t any wrong notes”; Sterling laughs and nods.

Welcome to The 5th Dementia, a musical group with a name so self-mocking, it clearly doesn’t need to follow normal rules of rhythm and tempo. It was founded this past summer, along with parent organization MusicMendsMinds (motto: “restoring the rhythm of life”), by Carol Port Rosenstein and husband Irwin, the group’s aforementioned electric keyboardist, who is a 78-year-old retired attorney with Parkinson’s and early-stage dementia. 

The inspiration for creating The 5th Dementia (a play on the name of the 1960s band The 5th Dimension) occurred when Carol Rosenstein was participating in TimeOut@UCLA, a UCLA program designed to give respite to caregivers. She was taking a needed break, and her husband was at OPICA (Optimistic People in a Caring Atmosphere), the adult day-care center associated with TimeOut@UCLA, where there happened to be a piano. That’s when Irwin began picking out tunes he remembered from his college days. 

The first time he played, he didn’t get much of a reaction from the others; he thought his piano-playing had been a failure. But the next time Irwin gave it a go, others at the day-care center circled him and joined in by singing, including UCLA student volunteers who were paired with the seniors. When he came home afterward, Carol remembers, he was animated and happy. 

“At OPICA, they gave me a job,” Irwin said. “They asked me to be the music man.” 

Carol noticed that when her husband played music, he seemed to change in positive ways. He was more focused, more alive. 

“At night, when Irwin’s medication dose was low, playing piano would change his mood,” she said. This led her to ask Dr. Jeff Bronstein, a UCLA neurologist, if it was possible that music had “pushed despair aside” in Irwin’s brain. 

“Dr. Bronstein told me that it was not only possible, it was probable.” 

Apparently, the parts of Irwin’s brain that contain musical memory and skills have not been drastically affected by his ailments. And he’s not alone: MusicMendsMinds.org draws on scientific studies to explain that rhythmic responses don’t require cognitive processing and that a person’s ability to engage in music can remain intact despite dementia.

Dr. Gary Small, director of UCLA’s Longevity Center, told the Journal that “music has a powerful effect on the brain.” Not only can playing music improve dementia symptoms, he said, just listening to music can have a positive effect on those with cognitive impairment.

Originally from South Africa, Carol is a dynamic 69-year-old redhead who met Irwin 30 years ago by way of the Jewish Journal personals. They were later married at University Synagogue in Brentwood. She told the Journal she’s a retired chiropractor who has been a “pioneer and educator in the field of holistic mind/body medicine.” Speculating that others like her husband might benefit from playing music, she mentioned the experience to her meditation group, InsightLA. 

That’s where Sterling, 68, with a tremor in his left arm, heard about it and asked about playing music with Irwin. The meditation teacher connected Carol with Livadary, 78, a piano-playing former attorney with short-term memory loss. And Mayo, 83, a retired Pierce College history professor, added his harmonica to the group, thanks to a contact at UCLA’s dementia-treatment center.

The 5th Dementia faced one immediate challenge when they learned that Mayo’s harmonica was appropriate only for songs played in the key of C or G. The others in the group shrugged that off as a minor issue, though — they decided all their songs would be in those keys. 

“Playing music with the others is the happiest time of the week for Irwin,” Carol said. “And I know it’s true for the others, as well. Each one of these men has had a thread of depression, and playing music has improved that.”

The men meet twice a week. On Mondays, they get together in the chapel of Brentwood Presbyterian Church, and on Wednesdays they jam at Windward School in Mar Vista, both of which have provided space for group. 

Recent rehearsals have been focused on preparing holiday songs they’ll play at their first public concert, Dec. 19 at Brentwood Presbyterian. At the end of a run-through of “Rudolph, the Red-Nosed Reindeer,” Livadary, on the piano, added a flourish, drawing applause and thumbs-up signs from wives and caregivers, as well as from several young music students at Windward who play with the older men.

“This has been a godsend for these men,” Carol said. “They’ve developed enormous camaraderie. It’s become a new family for them. It’s not just therapeutic, it’s life-saving.”

She said she’s trying to find more musical seniors with Parkinson’s or early-stage dementia. 

“There’s no reason why we can’t have many groups like this throughout L.A.,” she said. “Ultimately, we’re hoping to change how mild dementia is handled. In the past, once it sets in, even in the early stages, patients were already waiting to die. But that does not have to be. When these men play music, they feel human. They feel connected to one another.

“I’d like the word to go out to all early-dementia patients who can play music — they don’t have to be skilled musicians. Come here and join us, see if it changes your life just as it’s changed the lives of these men. Since Irwin started playing music again — after not doing it for decades — it’s given me back a part of my husband.” 

How I plan to die

One Sunday last November, 86-year-old Joy Johnson laced her running shoes and ran the New York marathon for the 25th year in a row.  At mile 20, she tripped and fell, but quickly got up and finished the race. After celebratory hugs from her family and a quick interview with Al Roker, she returned to her hotel room, took a nap and died.

She is my idol.  

Who wouldn’t want to go out that way?  And yet, for many elderly people, the reality of life at 86 doesn’t involve marathons, but frailty, physical disability or Alzheimer’s, straining the resources of the grown children who care for them. At 55, I’ve already made my children promise that if I become demented, they will not write a heartbreaking memoir about how they bravely fed me prunes while I stared dully into space with food all over my shirt or, as Karl Ove Knausgaard vividly recounts in the international best-seller “My Struggle,” hauled my week-old festering corpse out of the home I’d trashed in my senility.   As human beings live longer and longer, extreme elderliness is a likelihood for many of us. But if we can’t choose to be elderly like Joy Johnson, do we want to live like Knausgaard’s father? Is there an opt-out clause?

Yes, says Dr. Ezekiel Emanuel, whose recent article in The Atlantic, “Why I Hope to Die at 75,” went viral immediately, racking up thousands of comments. Emanuel objects to what he calls the “American immortal” ideal of prolonging life as long as possible. Life after 80, Emanuel contends, is likely to involve physical or mental diminishment. Over the objections of his family, Emanuel has decided that he will accept no medical care after he is 75, and if diagnosed in his late 60s with a terminal illness, he will choose not to be treated. Ideally, he hopes to die of an infection like pneumonia, which will kill him swiftly and relatively painlessly.  

I’m fascinated with Emanuel’s argument. What’s most appealing to me is the idea that if I chose it, I might avoid what horrifies me most: that I would become a burden to my children, a shell of the full human being I believe myself to be. I am a control freak. I fear indignity more than death, and if the passionate public response to Emanuel’s article is any indication, I’m not alone.

But the more I think about his argument, the more dubious I become. One of his central arguments is that as people age, they experience a slowdown in memory and problem-solving ability. For him, this slowdown represents a dire and unequivocal loss of humanity. The average age of Nobel Prize winners, he argues, is 45. For the majority of elderly people, “Creativity, originality and productivity are pretty much gone.” Because they often feel happy anyway, they are oblivious to the fact that they are “aspiring to and doing less and less.” 

I think of my mother, a very lively 80, who retired several years ago from her career as a psychologist; though she remains extremely active and takes many classes at Northwestern University, she’s often content to take life a little more slowly than she once did. On a recent trip to Laguna Beach, she was happy to walk into town and sit on a bench for much of the afternoon, watching the ocean. But really, why in the world should she aspire to do more? What’s wrong with taking time to breathe the fresh air and watch the gulls swoop over the waves? Couldn’t that be called wisdom? Or even enlightenment? Three years ago, she caught a bacterial infection that nearly killed her; after a brief course of antibiotics, she was back on her feet. If she’d refused antibiotics and died by choice, how would that have been different from suicide? For the rest of my life, I would have felt personally responsible, guilty and even angry. And how would her beloved grandchildren have felt, knowing that a quick death was more important to her than being at their college graduations? Is that really how she would want to be remembered?  

I don’t want to sentimentalize the reality of aging. Too many of my friends know the pain of caring for an elderly parent who is suffering from dementia. We roll the dice when we choose an uncertain future. But our lives belong to the people we love as much as to ourselves, and making a unilateral, radical decision in the midst of a healthy life may cause more pain than it prevents.  Our legacies are as complex as the lives we have lived. And old age, for all its losses, is not only loss.  

I respect Emanuel’s choice, but to me, making a proclamation like his in the midst of a healthy life feels like a defensive crouch, a way of denying uncertainty. It also feels deeply unfair to the rest of the family — and does an injustice to how much our elderly relatives and friends often give to us. The same medical system that gives some people the illusion of immortality also gives us the illusion that we can control when we die without causing suffering to others. Instead of focusing on how Joy Johnson died, I’ve decided to focus on how she ran her race: full-throttle, joyous, undaunted by pain. I can’t promise to live that way when I’m 86, or when I’m 76, or even, let’s face it, tomorrow. But I can try to live that way today.  And maybe that’s enough.

Ellie Herman is a writer, teacher and life coach.  She blogs at gatsbyinLA.wordpress.com

Turning off the aging process

Studies in yeast, worms, flies, monkeys and even humans seem to prove that restricting calories is one of the few sure ways to combat the effects of aging. But Israeli doctoral Keren Yizhak is out to prove that there may be a more agreeable way to achieve long life than dooming ourselves to perpetual hunger. 

Working in the computational biology laboratory of Eytan Ruppin at Tel Aviv University’s Blavatnik School of Computer Science, Yizhak and colleagues at Bar-Ilan University have developed a computer algorithm that predicts which genes can be “turned off” to create the same anti-aging effect as calorie restriction.

Their findings were reported in the journal Nature Communications and could someday lead to the development of new pharmaceuticals to slow or stop the aging process. 

“Most algorithms try to find drug targets that kill cells to treat cancer or bacterial infections,” Yizhak explained. “Our algorithm is the first in our field to look for drug targets not to kill cells, but to transform them from a diseased state into a healthy one.” 

Her team’s algorithm, which she calls a “metabolic transformation algorithm,” or MTA, can take information about any two metabolic states and predict the environmental or genetic changes required to go from one state to the other. 

In the study, Yizhak applied MTA to the genetics of aging. Yeast is the most widely used genetic model because its DNA is, surprisingly, similar to human DNA. 

After using her custom-designed MTA to confirm previous laboratory findings, she used it to predict the genes that can be “turned off” to make the gene expression of old yeast look like that of young yeast. 

“Gene expression” is the process in which information from a gene is used to make a product, usually a protein, inside a cell. Genes can be turned off in various ways to prevent them from being expressed in the cell. 

Some of the genes that the MTA identified were already known to extend the lifespan of yeast when turned off. Of the other genes she found, Yizhak sent seven to be tested at a Bar-Ilan University laboratory. There, researchers Orshay Gabay and Haim Cohen found that turning off two of the genes, GRE3 and ADH2, significantly extended the yeast’s lifespan.

“You would expect about 3 percent of yeast’s genes to be lifespan-extending,” Yizhak said. “So achieving a tenfold increase over this expected frequency, as we did, is very encouraging.” 

Because MTA provides a systemic view of cell metabolism, it can also shed light on how the genes it identifies contribute to changes in genetic expression. In the case of GRE3 and ADH2, MTA showed that turning off the genes increased oxidative stress levels in yeast. This mild induced stress may be similar to the stress produced by calorie restriction. 

Next, Yizhak will study whether turning off the genes predicted by MTA prolongs the lifespan of genetically engineered mice. 

She also theorizes that MTA could be applied to finding drug targets for conditions and diseases in which metabolism plays a significant role, including obesity, diabetes, neurodegenerative disorders and some types of cancer.

Boomers looking forward to what’s next in life

The stages of a life are measured differently now from the days of Pirke Avot, a classical Jewish text from the second century. But in some sense, the work of those of us who have reached a mature age remains the same as it was back then: How do you apply the wisdom you have acquired to the rest of your life? 

As senior rabbi of Temple Emanuel of Beverly Hills, I noticed that the people joining my synagogue tend to be families with young children and surprisingly, at least to me, baby boomers. Of the latter, each seemed to understand that there was less time ahead than behind, and were looking for ways to bring meaning and purpose to whatever time was left. Out of that curiosity, our project “The Next Stage: The Boomer and Beyond Initiative” began. All congregants between the ages of 50-75 were invited to be part of the initiative. More than 200 responded positively. 

We held a series of house meetings to reflect on several questions. First: What does this time, this phase, this stage, mean to you? What are you looking forward to? What concerns do you have? Second: Was there a time when Jewish tradition and the Jewish community have been there for you at this stage? If not, can you imagine what “being there” might look like? Third: What kinds of changes would we need in the larger community to help us navigate this next stage? 

Just bringing people together for these conversations was empowering. For many, especially the men, it was the first time they had ever shared their feelings about these questions … and though it was difficult, it was liberating. For others, being together like this was the beginning of creating community. The challenge that echoed through the conversations and has become the focus of the project is this one: Will our generation have the bravery to reimagine and redesign our own paradigms of living?

After four months of these house meetings, four themes emerged: What kind of communities do we need to cultivate now in order to age gracefully? What does Jewish tradition have to offer at this new stage of our lives? How do we give back and continue to learn from others? How do we plan for our future and the future of those we love? 

These themes turned into research groups, which spent the next six months exploring the issues and eventually creating plans to translate this energy into concrete action. Along the way there have been low-hanging fruits. One is the revelation that mentoring isn’t only about professional issues but also about the sharing of life experience. Congregants have come forward asking for help navigating some of the challenging waters of life — dealing with a parent with Alzheimer’s, for example, or with their own recently diagnosed chronic illness. Others have offered to share their experience with similar issues, and we are trying to figure out how to be the shatchan, the matchmaker. 

A second is the awareness of the need for creating new rituals for this stage. Just one example: Not long ago, I got a call from a congregant on her way to clean out her mother’s home after she and her sister had moved their mother to an assisted-living facility. She asked: “Rabbi, what is the prayer you say when you begin to close up the home you grew up in?” Yes, there should be a prayer! 

A third is the understanding that our religious tradition offers spiritual tools for acquiring the wisdom that will help us age gracefully: cultivating character traits of gratitude, forgiveness, compassion. These take practice, spiritual practice. And they can be cultivated through prayer, meditation, study and the deepening of community.

Where will all this lead? I don’t know. But I do believe that our congregation will look different in the future because of this work. I believe that more baby boomers will stay connected to our congregation and that others will join because of this work. And maybe the larger Jewish community will begin to look different as well. 

Who knows? Perhaps the cities of Los Angeles or Beverly Hills or Santa Monica will look different because we have advocated for changes in zoning that would permit intergenerational co-housing, or because we have pushed for thinking about traffic and public transportation in new ways. Maybe some of us will even live together, or live differently, because we have been conscious about choosing to age gracefully. But most important, perhaps people will understand that Jewish tradition and community can bring meaning and purpose to every stage of life. 

Because this is so important, Temple Emanuel is organizing a city-wide Jewish community conversation on Nov. 9 called “The Next Stage: Looking Forward and Giving Back.” It will feature Marc Freedman, the creator of Encore.org and the author of “The Big Shift,” and will be co-sponsored by many other synagogues and the Kalsman Institute on Judaism and Health at Hebrew Union College-Jewish Institute of Religion. It will feature workshops on alternative visions of community, spirituality, synagogue best practices for engaging boomers and more. For more information contact nextstage@tebh.org. Come join the conversation.

Laura Geller is a senior rabbi of Temple Emanuel of Beverly Hills (tebh.org). This article was adapted from her comments made at the recent Milken Institute Successful Aging Innovation Summit.

When the extreme elderly slip away

When I woke my nearly 97-year-old mother at noon one day recently, she was delighted with my presence. Leaning in closely so she could see me, despite her macular degeneration, and hear me, despite her near-deafness, we talked about sweet nothings.

Her new normal is confusion. She didn’t know the time or where she was, but she knew me and that was enough. I just let her talk, about anything.

She was once keenly intelligent and aware, well-read and engaged, social and interactive. She has lost much of those capacities to dementia and her disabilities, and what’s left is her generous spirit, sense of gratitude and deep love for family.

Her nine brothers and sisters have all died except one. Yet, in her imagination they are still very much alive. She “speaks” with them regularly, and I don’t disavow her fantasies.

She looked at me intently and said, “John — you look older!”

“Mom! I’m 64!”

Stunned, she asked, “Where did all the years go?”

“You’ve been here all along and haven’t missed a thing. You’ve just forgotten.”

She loves to reminisce about her early life, so I’m now hearing stories (true but confused) that might have taken place 80 or 90 years ago.

In the middle of a sentence, she grimaced, “I feel pain.”


“Here, in my heart — pressure. It hurts.”

I called the nurse. Her blood pressure was elevated. The nurse asked if she should call 911.

“Call my brother first [he’s a doctor], and ask him what he thinks we ought to do.”

Michael and I had decided a year ago that because of our mother’s advanced age, disabilities and dementia we would not send her to the emergency room  unless she had broken a bone, was in intense pain or couldn’t breathe. Otherwise, on-site nurses would treat her.

While the nurse called him, Mom announced to me, “I’m not ready to die, and I don’t want to leave all of you; though I could die now and I look forward to seeing everyone and finding out about them and what they’re thinking.”

Stroking her hair, I was half-certain that this was it. I felt not yet ready to lose her, though so much of who she was has already dissipated into the ether, as she is but a shadow of her former self.

As it turned out, her pain was caused by acid reflux (or heartburn), which Michael diagnosed over the phone, and it passed quickly.

It’s very, very tough to be her age. Roger Angell, a 90-plus essayist and sports commentator, wrote movingly in last month’s New Yorker of the experience of people in their 90s. For all very old people, he said:

Decline and disaster impend. … Living long means enough already. … We geezers carry about a bulging directory of dead husbands or wives, children, parents, lovers, brothers and sisters … all once entirely familiar to us.

Years ago, I read a piece written by a very old woman who complained that no one ever touched her any longer and that she missed dearly that most concrete of human interactions. Ever since, I made it a point to touch, hug or kiss the very old, for their need for human contact never abates. This is certainly true for my mother. She drinks in physical connection and emotional attention like water on the desert floor.

Angell said it well:

Our unceasing need for deep attachment and intimate love [remains]. We oldies yearn daily and hourly for conversation and a renewed domesticity, for company at the movies or while visiting a museum, for someone close by in the car when coming home at night. …Those of us who have lost … the sweet warmth of a hip or a foot or a bare expanse of shoulder within reach … whatever our age, never lose the longing.

He writes of the extreme elderly’s invisibility and how insignificant they feel even at the hands of those who love them most: “Honored, respected, even loved, but not quite worth listening to anymore,” he mourns.

There are so many ways in which we can help our elderly parents and grandparents feel that they still matter and have value. We can ask them to recount their early memories and stories from childhood and young adulthood, their courtships and marriages, their school experiences and work life, their best friends and anything else they recall. 

Recounting memories invigorates and affirms their lives even now. We can ask them, as well, what essential life lessons they have to impart to the next generations in their families, what has really been of value to them, what wisdom they carry.

When we actively engage with the extreme elderly and listen to them without interrupting, interjecting, correcting or adding to their stories, it is empowering to them. That empowerment adds to the dignity of their lives and their sense of self-worth. 

Aging Creatively

As my friends and I navigate our 60s and 70s, we notice — with amusement and consternation — how our conversations have changed. Instead of talking about our kids’ college applications and the best camping sites, we find ourselves discussing back pain and long-term care insurance. The bottom-line concern, of course, is how to create the best quality of life as we age. 

My father, who died a few months ago at 94, is one of my best models for aging well. Although Dad could hardly move his body in the past year, he still made people laugh with his quirky sense of humor. He continued to use his imagination and kept sharing his philosophies about life with anyone who would listen. (Sometimes even with those who wouldn’t.)

In many ways, my father never grew up. He viewed the world with curiosity, he sought new experiences and he saw endless possibilities — as children do. I think this is the secret to aging creatively. 

Keeping that inner child alive is not always easy, says Stephen Cohn, a Burbank composer who has taught classes on creativity.

“From the time we’re children, we’re told not to daydream,” Cohn said. “We’re expected to focus on the external necessities of survival and practicality. We’re not trained to take our dreaming and our imagination seriously. And yet that is the source of all great ideas. Great art, great physics, great medicine … it all came from somebody’s imagination.”

Of course, focusing on what’s practical allows us to make decisions, raise families, manage our finances and handle day-to-day responsibilities. That’s what adults do

The problem is we become identified with a role, a job or certain physical abilities. Then, as we grow old, our lives change. A role or job ends. The activities we enjoyed — whether skiing, driving, traveling or cleaning house — aren’t as easy or aren’t possible at all. This transition can be frustrating and painful.

But along with the grief, a vitally important question might then be asked: “Now what?” 

“I think too many people buy into the societal myth that when you reach a certain age, you’ve outlived your usefulness to yourself and society,” said Ronnie Kaye, a psychotherapist and author from Marina del Rey. “Accepting that belief is guaranteed to diminish your quality of life. Why settle for that when there is a world of possibilities out there?” 

How does one discover new possibilities? How do we tap our imagination as we grow older?

Kaye suggests starting with brainstorming exercises. The purpose is to allow ideas to emerge, to bypass the practical, critical voice that often stops us from seeing outside of the box. 

Here’s an example: Ask yourself, “What do I like to do?” Write down everything that comes to mind.

Gardening! Traveling! Hugging babies! Cleaning! Hugging dogs! Skydiving! 

Don’t stop to assess whether you can still do it or whether it’s practical. Keep asking, “What have I enjoyed?” Then ask yourself, “What are my skills?” They might include balancing the checkbook, fixing things, organizing, reading, cooking or listening to other people. Write every word that randomly comes to mind — again, without judging.

OK, now use your rational mind — maybe skydiving isn’t such a good idea. Look around your home or community for opportunities to express pleasures or talents. It could be organizing the garage, coaching new entrepreneurs, taking a writing class or reading to children. The options are infinite. Consider brainstorming with others to enhance the process. 

Aging creatively doesn’t have to mean that every senior citizen takes up watercolor painting or yoga; it’s about learning to think about your place in the world differently.

When Kaye turned 65 four years ago, for example, she started to rethink her career plans. 

“After having been a therapist for 20 years, I wanted to know more, reach people in a different manner and use myself, my skills and my profession in new ways,” she said.

Her answer was to enter a doctoral program in psychoanalysis. Now, at 69, she is in the final phase of completing her doctorate at the New Center for Psychoanalysis in Los Angeles.

Kaye also described an 80-year-old friend who led a very productive life, but is now barely able to walk. Many things she used to do are impossible. After thinking about what she still has to offer, however, the woman started reading to blind people several times a week. 

“Finding a solution that would allow her to be useful and engaged, despite her limitations, was a genuinely creative act,” Kaye said.

Richard Braun, 82, is a retired thoracic surgeon from Encino. Since he stopped working, Braun, a violist, joined the Los Angeles Jewish Symphony and plays in a weekly chamber group. He also teaches anatomy on a volunteer basis at UCLA. 

“I wanted to use my medical knowledge in some way,” Braun said. “This requires me to invent stimulating ways to convey ideas. I’m so busy since retiring that my wife says I’ll have to go back to work to find more free time!” 

As an artist and art therapist, Tobes Reisel often finds herself helping seniors discover a creative part of themselves. 

“I work with many people who are not artists. I ask them to scribble with me,” said Reisel, 87, of Sherman Oaks. “They get into their childishness, and many say, ‘You know what? There’s a kid in me that isn’t having any fun!’ So we talk about how they can add that to their life.”

Creativity often evolves from one’s passions. This is definitely the case for artist Peachy Levy. At 82, the Santa Monica resident still gets commissions for creating her unique Judaic textile art. 

“I am a passionate person,” she said. “I think a lot of people don’t make time or space for their passions; their life is too frenetic. It might help to look back to your youth, to what you were passionate about. Perhaps those feelings are still there for you!”

Passion is what led Carey Okrand to want to become an entrepreneur at 60. Realizing she could go from preaching about the environment to doing something active and positive, she’s decided to start a business in Los Feliz that will be called The Refill Place. Based on an old concept of reusing containers instead of filling the earth with plastic, the idea will be for people to bring their empty containers to her store and refill them with environmentally friendly cleaning and personal care products.

“The everyday decisions and choices I have to make let me be creative,” said Okrand of Van Nuys. “Growing a business feels like working on a piece of art.” 

Discovering or inventing new possibilities at  60 or 80 isn’t the same as it was at 20 or 30. 

“To be creative at an older age,” Reisel said, “involves reviewing how you’ve lived your life and then using that in the way that is most honest and fulfilling and enjoyable for where you are now and what you can do now.” 

Aging creatively, then, involves rediscovering passions, taking an inventory of current skills and keeping in check any tendency to tell yourself that you are too old to be useful or to have fun. It means reawakening the child inside that can laugh and imagine and create something new, in spite of — or sometimes because of — limitations. 

Every day that my father woke up and remembered he could no longer drive or work or get from his bed to the bathroom by himself, I believe he asked himself, “Now what?” Then he made a choice to see possibilities. I hope I can follow his lead. 

Ellie Kahn is a licensed psychotherapist, oral historian and documentary filmmaker. She can be contacted through her Web site,

Paul Auster’s haunting view of aging

Paul Auster is best known and often praised for his postmodernist novels and short stories, including “The New York Trilogy” and “Sunset Park,” but his lifetime of literary achievement actually began with a 1982 memoir, “The Invention of Solitude,” his first published work under his own name.  Now, 30 years later, he has returned to autobiography with “Winter Journal” (Henry Holt, $26), a haunting and even afflicting valedictory that also sings out in celebration of life.

Auster is now 65, an age when thoughts commonly turn to the longevity of Medicare, IRAs, and life itself.  Composed as a series of diary entries, a fugue of seemingly random but carefully chosen moments of reflection, and written as if he were addressing himself, “Winter Journal” announces from the first page that its is concerned, quite literally, with matters of life and death.

“You think it will never happen to you, that it cannot happen to you, that you are the only person in the world to whom these things will ever happen,” he muses, “and then, one by one, they all begin to happen to you, in the same way they happen to everyone else.”

It’s a shattering thought for all of us, of course, but especially for someone who has aspired to — and achieved — literary genius.  After all, we like to think of our favorite writers as literally deathless, and so do they; one persistent motif in the stories of Isaac Bashevis Singer is the appearance of someone who, against all logic and experience, is still alive and well.  For Auster, however, the word “deadline” suddenly takes on a new and dire meaning.  “Speak now before it is too late, and then hope to go on speaking until there is nothing more to be said,” he writes. “Time is running out, after all.”

“Winter Journal,” then, is not a cheerful book.  “[A]t one time or another nearly every part of your body has been subjected to assault,” he observes. “Eyes and ears, head and neck, shoulders and back, arms and legs, throat and stomach, ankles and feet, not to mention the enormous boil that once sprouted on the left cheek of your ass, referred to by the doctor as a wen, which to your ears sounded like some medieval affliction and prevented you from sitting in chairs for weeks.”

Auster casts his memory back and forth across the years —the tender years of early childhood when all of life lay in the future, the explorations and discoveries of adolescence, “breaking the North American masturbation record every month throughout the years 1961 and 1962,” and the years of vigorous adulthood when he was capable of believing that he was the master of his fate.  He catalogues the cars he has owned (and crashed), the places where he lived, the moments of triumph and celebration, both at childhood sports and more adult endeavors, including the prostitute in Paris who recited Baudelaire in bed, and the other carnal pleasures he has experienced: “Sexual pleasures first and foremost, but also the pleasures of food and drink, of lying naked in a hot bath, of scratching an itch, of sneezing and farting, of spending an extra hour in bed…” 

Death begets the fear of death in Auster as when he recalls “the first full-blown panic attack of your life, which occurred just two days after your mother’s death, followed by several others in the days immediately after that, and for some time now you have felt that you are disintegrating, that you, who were once nature’s strongman, able to resist all assaults from within and without, impervious to the somatic and psychological travails that dog the rest of humanity, are not the least bit strong anymore and are turning into a debilitated wreck.”  Yet he refuses to confront the inevitable: “No, you do not want to die, and even as you approach the age of your father when his life came to an end, you have not called any cemetery to arrange for your burial plot, have not given away any of his books you are certain you will never read again, and have not begun to clear your throat to say your good-byes.”

By now, Auster finds himself compelled to make a concession to his own mortality. “Outside, the air is gray, almost white, with no sun visible,” he muses. “You ask yourself: How many mornings are left?”  And yet “Winter Journal” is actually an act of defiance.  Auster is raging on against the dying of the light, and the sheer strength of his prose is the best evidence that he is still capable of feats of strength as a stylist and a storyteller.

Jonathan Kirsch, author and publishing attorney, is the book editor of The Jewish Journal. His next book, “The Short, Strange Life of Herschel Grynszpan,” will be published by the Horace Liveright imprint of W. W. Norton in 2013 to coincide with the 75th anniversary year of Kristallnacht. He can be reached at books@jewishjournal.com.

The Torah of our lives: On writing the next chapter

“Boomers [people born between 1946 and 1964] are the first generation in human history … to reasonably anticipate living well and wholesomely into their 80s and 90s, if not beyond,” sociologist Steven Cohen writes. “But not only are Jews (as others) living longer, they are living in an age of meaning-seeking, with the interest and wherewithal to make living a life of meaning an ultimate and reasonably obtainable objective for any point in their lives.”

I just turned 62; I’m a boomer. My grandparents experienced their lifetimes in three major life stages: childhood, midlife and old age. (The idea of adolescence as a distinct period between childhood and adulthood didn’t develop until early in the last century.) For my parents, there was childhood, adolescence, adulthood and then retirement (to Florida) at 65 and the beginning of old age. For me, it will be different.

There is a lot being written about a new life stage between maturity and old age. Sara Lawrence-Lightfoot, in her book “The Third Chapter: Passion, Risk, and Adventure in the 25 Years After 50,” writes: “The arc of life and learning is continually being expanded and redefined. … [N]ot only are people living longer and thus facing interesting questions related to how to compose their lives, but also that what I am calling the Third Chapter represents a significant and new developmental period in our culture. … This is a chapter in life, then, when the traditional norms, rules and rituals of our careers seem less encompassing and restrictive; when many women and men seem to be embracing new challenges and searching for greater meaning in life.”

One of the places that Jewish boomers are going in search of this “greater meaning in life” is the synagogue. Along with families with young children, they are the next largest group coming to synagogue, whether or not they are actually joining. Boomers are our adult learners; they populate many of our worship services and they come to their rabbis and synagogues for help dealing with their aging parents. At the same time that they are responsible for elderly parents, many still have older children at home or who have recently returned because of the difficulties of this economy. How can they navigate these competing claims? What does it really mean to honor one’s mother and father? How does one parent an adult child? What ought to be the role of grandparents?

We boomers are in the process of composing and reinventing our lives as we realize that time means something different when there is less of it ahead than behind. What will be our legacy? How can we continue to create lives of meaning and purpose when we can no longer define ourselves primarily in terms of our careers or even our families? What would constitute meaningful volunteer work and a chance to give back? Where might there be the opportunity to mentor a younger generation, to share professional and life wisdom? What kind of travel offers the opportunity to do service as well as experience a different culture? What kinds of intentional communities might offer attractive alternatives to living alone in our homes? And what kinds of spiritual resources does our tradition have to offer us as we write this new chapter of our lives?

It turns out that Judaism has a great deal to teach about aging wisely, particularly about the spiritual practices of forgiveness and gratitude that seem to be so central to the work of this stage of our lives. Judaism teaches that God is present in every moment; we acknowledge God’s presence by blessing, ritual and ceremony. Traditional Jewish life cycle rituals of brit milah, bar mitzvah, marriage, and illness and death might have been sufficient for my grandfather’s life, but they don’t acknowledge the reality of my life experience. We first learned this in the early ’70s when the Jewish feminist movement challenged us to think about the Torah of our lives and acknowledge the divinity present in all of our experiences. While one could certainly argue that there are many other rituals that our tradition offers connected to other moments of transition, such as affixing a mezuzah when moving into a new home or expressing gratitude for surviving an illness (Birkhat ha-Gomel), the claim that all of our experiences are Jewish experiences and therefore deserve to be acknowledged through ritual suggests that we turn to creating new rituals to help us think about this new chapter as well.

What are those moments? They include retirement, moving out of the homes where we raised our children, becoming a grandparent, giving up our cars, major birthdays, reaffirmation of marriage vows, and even choosing whether to begin a new relationship when a beloved spouse no longer recognizes us because of advanced Alzheimer’s.

As USC anthropologist Barbara Myerhoff taught, there is danger in creating new ritual. It needs to feel authentic and convincing by somehow echoing the power of more familiar ritual and linking us to the cosmic narrative of our people reflected in Torah. We need to touch not only the Torah of our own lives; these new rituals must also connect us to the Torah of tradition.

The norms, rules and rituals of this stage haven’t yet been written; we are writing them together as we compose this next chapter of our lives enriched by the insights of Jewish tradition. I look forward to a challenging and engaging conversation.

The closure of Motion Picture Home makes the future uncertain for residents

One day last spring, Jill Schary-Robinson Shaw was walking through a quiet, darkened corridor in the long-term care unit at The Motion Picture Home, the iconic Woodland Hills nursing home for entertainment industry veterans and their families. Hardly anyone was around — lights were dim, residents alone in their rooms — as Schary-Robinson Shaw, the daughter of Isadore “Dore” Schary, who ran MGM in the 1950s, wheeled her husband, Stuart Shaw, a resident of the home, around his desolate indoor neighborhood.

“There used to be wonderful entertainments,” Schary-Robinson Shaw said. “Pianists, musicians. But it’s all changed. Replaced by a mood of tension — a foreboding.”

It wasn’t always like this. In fact, the home, originally known as the Motion Picture & Television Country House and Hospital, was once considered a pristine palace, inhabited by a bustling community of industry workers — like Bud Abbott of Abbott and Costello, Oscar winner Hattie McDaniel from “Gone With the Wind” and Maurice Costello, a vaudeville actor whose granddaughter is Drew Barrymore. Even amid the home’s obvious signs of decay, there is still nostalgia for a happier past. Throughout the place, memories of the home’s glory days loom large through the lingering spirits of Hollywood’s ghosts.

“Sadie, you won’t believe this,” Schary-Robinson Shaw said to a passing nurse on the ground floor of the Jack H. Skirball Health Center.

“What happened?” the nurse asked. “Don’t give me bad news …”

“It’s good news,” Schary-Robinson Shaw said with a smile. “He wants a sandwich.”

The nurse laughed, relieved.

Shaw, 82, suffers from Parkinson’s disease and related dementia, so it had been awhile since he’d asked for anything, and the request delighted his caretakers.

Lately, the only joy around here seems to be in the movie memorabilia lining the hallways — where Rosalind Russell smiles a toothy, actress smile in a photo on the Rosalind Russell Wall. But even that tends to deepen the contrast between the rollicking fantasy of the movies and the home’s now-diminished quality of life. For 70 years, the Wasserman Campus was the crown jewel of the Motion Picture and Television Fund (MPTF), serving as home to generations of elderly movie stars, producers, directors, their crews and their families. But everything changed in January 2009, when MPTF, the nonprofit that operates the home, announced plans to shutter its long-term care and hospital facilities. Long-term care was costing the fund $1 million per month, they said, and threatened to bankrupt the entire fund.

The decision to eliminate long-term care marked the end of an era. The campus would no longer accommodate the industry’s most elderly and infirm — its most vulnerable clients — a move many felt was contrary to the fund’s founding purpose. According to entertainment industry lore, the fund was created in the 1920s by affluent Hollywood stars — Charlie Chaplin and Mary Pickford among them — and built its reputation on a bold and inviolable promise: to always take care of industry members in need. Over the years, the home has become highly regarded, both for its beautiful setting and for its continuum of care — the promise that once a person retired, he or she could count on finishing life there.

But even as MPTF chose to close long-term care for financial reasons, the fund continued to invest in other newer facilities on campus. In July 2007, the Saban Center for Health and Wellness opened, a $20 million, state-of-the-art fitness facility that stretches over 36,000 square feet and includes the Jodie Foster Aquatic Pavilion, with its shimmering warm-water pool and a high-tech gym.

Meanwhile, in the 19 months since the closure announcement, the home’s resident population has dwindled from 134 residents to just 47; at least 33 were moved to other facilities, a dozen more resettled elsewhere on the campus, and another 60 have died. The remaining few have launched a fierce resistance, casting themselves as refuseniks in a complicated saga that has sparked moral outrage among many in the entertainment community. Bolstered by a pending lawsuit, the conflict has gotten repeated play in the press and divided the entertainment community between those who support the closure (read: the fund, its leaders and administrators) and those who don’t (the residents, their families and mainly blue-collar workers).

The battle has often been ugly. Just last week, a report from the California Department of Public Health was released, reportedly saying the fund violated state law in transferring more than 30 residents out of the facility without official 30-day discharge notices explaining their rights, including the option to appeal relocation. This is just one in a long line of twists and turns in a saga that has cast a dark pall over the fund’s once-virtuous image.

But the fund is not solely responsible for the problem. Much of the imbroglio stems from changing trends in health care: With people living longer and birth rates declining, the need for elder care is rising, along with the requisite costs, while the pool of available caregivers is shrinking. This new reality poses an additional challenge to heath-care organizations like the MPTF, which have adopted a new ethos in elder care that promotes “aging in place”  — at home, instead of in a facility.

A Moral Dilemma

But while there’s no clear villain in this fight, there are, unfortunately and indisputably, victims. Because stewing beneath the surface of all the drama is actually a profound moral dilemma: What happens when escalating costs of health care get stacked against the dignity of human beings? And what will become of the 47 residents still living in limbo, caught tragically in the crossfire?

Last April, Schary-Robinson Shaw considered her answer.

“[The fund] figured, I’m sure, let the people who are here stay …” she said, lowering her voice to a whisper, “until they are … [dead], but it changes the character of the place.”

She and Stuart have been married 30 years, and he’s been living at the home since 2008.

“We thought it would be forever,” Schary-Robinson Shaw said. So word of the closure came as a shock. “I thought, ‘Well it can’t happen. We’ll fight it,’ ” she said, adding: “Stuart heard about it and said, ‘You’ll never find me again. They’ll take me somewhere, and you’ll never know where I am,’ ” she recalled. “They sense in the air what’s going on because the energy here has changed so radically.”

Early on Jan. 14, 2009, MPTF management gathered some staff in an activity room and told them the plans to close long-term care and the campus hospital by the end of 2009. Within hours, letters were delivered to residents’ rooms stating, “No one will be moved for at least 60 days,” although some residents’ family members say social workers immediately began knocking on residents’ doors, urging them to relocate. Families were distraught — where would they find comparable care? Residents believed they would stay at the home for the rest of their lives, so many had invested in their own care by donating what savings they had to the fund; as a result, their dependence on Medi-Cal narrowed their options. Because the MPTF had Hollywood behind it — and because the presence of a campus hospital merited a higher rate of reimbursement from state and federal health entitlements — almost anywhere else residents could go would be a compromise in care.

Creativity Cracks the Aging Code

As we age, creativity often peaks, and our need to create soars: Georgia O’Keeffe, for instance, did some of her best work in her later years, and Grandma Moses didn’t start painting until she was in her 70s. Likewise, Laura Ingalls Wilder was in her 60s when she began to write her “Little House on the Prairie” books.

Besides the satisfaction of giving in to the urge to create, more and more research is pointing to the value of taking up a new interest, hobby or craft as you age — learning an instrument, challenging yourself with word games and crossword puzzles, seeking out unique experiences. Not only can these creative activities help you stay active and interested in life, but they also have potent mental and physical effects, too, which researchers are only now beginning to explore.

What they’ve learned so far: We need the charge of doing something creative to feel good mentally, particularly as the decades pass. According to neuroscientist Gregory Berns, associate professor of psychiatry and behavioral sciences at Emory University and author of “Satisfaction: Sensation Seeking, Novelty, and the Science of Finding True Fulfillment” (Henry Holt, 2005), that’s because the level of the brain chemical dopamine, which brings on a natural high, declines as we age. By seeking out novel experiences, we can trigger dopamine surges and regain that feeling of satisfaction.

George Washington University psychiatrist Gene Cohen, author of “The Mature Mind: The Positive Power of the Aging Brain” (Basic Books, 2005) and an expert on the health benefits of creativity for older adults, says that trying new things and being creative also promotes brain plasticity (flexibility and growth) and even prompts our brains to rewire, which may fend off dementia and help to maintain health. “When you challenge the brain, your brain cells sprout new connections, called dendrites,” he explains, “and new contact points, called synapses, that improve brain communication.”

Cohen has the data to prove that creativity has a powerful anti-aging effect on the mind and body: In a two-year study of healthy older adults (over age 65) sponsored by the National Endowment for the Arts, he found that those who engaged in painting, writing, poetry, jewelry making or singing in a choir had better overall physical health, made fewer visits to the doctor, used less medication and had fewer health problems than a control group that didn’t participate in cultural programs. The “artsy” group also had better morale and reported less loneliness thanks to a feeling of self-control and mastery, and from maintaining their social engagements. “This study proves that you can’t have a real health-promotion program for the elderly without an art component,” he said.

Another benefit of creative activities: They’re sustainable.

“Art has been in the soul of the species since [the time of] cave people, and its benefits make us keep coming back to it,” Cohen said. So while you may not stick to an exercise program, you may stick to an art program — which will not only give you a psychological boost, but also a brain boost.

Creative pursuits can also help us relax and distract us from stressful situations — and the better we are at relieving stress, the longer we’ll live and the healthier we’ll be. Harvard’s Dr. Herbert Benson reports that rhythmic and repetitive activities such as knitting and sewing can reduce blood pressure, heart rate and other physical measures of stress. And Harvard’s Dr. George Vaillant, who followed 824 people from their teens to old age for over 50 years, found that creativity is one of the pursuits that makes retirement rewarding and satisfying.

The ‘If Not Now, When?’ Phenomenon

Cohen says that as we enter our 40s and 50s, our brains start firing on all cylinders. We begin using both sides of our brain more (the logical and analytical left side and the artistic right side), which stimulates us to be more creative — and being more creative prompts us to integrate both left- and right-brain capabilities in a happy cycle of artistic energy. As an added bonus, we become more confident and comfortable with ourselves as we age, and so we may cast off the need to conform: After 40, we want to showcase our true selves through the way we speak, act, dress and the things we do. And we may shed the “should have” way of living we previously endorsed, embracing instead the life we really want to live.

“There is a lovely interlude in middle age, when we haven’t lost the mental nimbleness of youth and yet we’ve gained wisdom,” said Sue Shellenbarger, author of “The Breaking Point: How Female Midlife Crisis Is Transforming Today’s Women” (Henry Holt, 2004). This is when creativity can blossom with age, she notes, and become a means for validating who we are now.

Cohen agrees that many people in mid- to late life go through a psychological “liberation” phase characterized by an increasing urge and feeling of freedom to do the things they’ve always wanted to do. They hear an inner voice that asks them “If not now, when?” and “Why not? What can they do to me?” that gives them the courage and confidence to try something new and self-expressive.

Boosting Your Creativity

So where and how do you start to put more creative oomph in your life? “Creativity is a form of problem-solving,” explains Tera Leigh, an artist and author of “How To Be Creative If You Never Thought You Could” (North Light, 2003), so it can apply to almost any situation in life. What’s more, small changes in your attitude can have a big impact on your creative output:

• Take your creative urges seriously. Shellenbarger encourages thinking about what truly is going to make you happy in old age. “Go toward what gives you joy and allot time to pursue these things — an hour or two a week, at least, and hopefully more.”

• Find your creative personality. Relax; you don’t have to search for it. “Your creative personality is already inside of you,” Leigh said. “You don’t have to do anything except invite it to come out and play.” That said, some people are Martha Stewart types who like detail-oriented arts, like quilting, beading or decorative painting, while others may have a passion for plunging in and making a mess, so they might prefer ceramics, cooking or scrapbooking. Experiment to find which creative pursuits best suit your style.

• Start thinking of new ways to do old things. Rearrange your furniture, throw a new ingredient in an old recipe or learn a new dance step. Or “challenge yourself to come up with five new ways to do something at work that bores you now,” Leigh advised. “These are simple ways to train yourself to think of life in a new way. The more you think outside the box, the more it will become a habit.”

• Create an artist’s space for yourself. Even if it’s just a couple of boxes for your art materials that you hide on a shelf or under the bed, it’s important to honor your artistic urges by claiming a space to express them, Leigh said.

• Take a class or join a group. One of the major benefits of creativity is that there are lots of classes to enhance it and they offer lots of opportunities for socializing — both important, since aging studies indicate lifelong learning and having a strong social network are critical to a happy, healthy old age.

Nancy Monson is the author of “Craft to Heal: Soothing Your Soul With Sewing, Painting, and Other Pastimes” (Hats Off Books, 2005).

Never Too Old to Write a Letter … of Torah

The Jewish Home for the Aging has never had a Torah it could call its own. Since the home first opened in 1912, synagogues or individuals have donated Siferei Torah to the senior-living community, but the scrolls were often old and tarnished, with faded letters or finger smudges on the parchment. These Torahs are considered pasul, or unfit for public reading, but they were the only ones available to the home for religious services.

Now the Reseda-based home, which provides care to about 2,200 seniors through its in-residence housing and community-based programs, is in the process of creating its own kosher Torah — a “Torah for the Ages,” as the project is being called.

“It’s upsetting to this point we haven’t had our own Torah,” said Corey Slavin, vice president of fund development, who with home CEO Molly Forrest conceived the project.

Slavin said the $200,000 raised for the project more than covers its costs, and remaining funds will be dedicated to various programs and services at the home. The home expects its Torah, begun April 13, 2008, to be completed sometime in 2010.

Rabbi Shmuel Miller, who has worked locally as a sofer (Torah scribe) for 15 years, was commissioned to write the Torah, which will rotate between the home’s synagogues at the Eisenberg Village and Grancell Village campuses when finished. Officials hope the Torah will inspire its residents and their families to remain or become connected to their faith and community.

The Torah’s production is quite a community effort. In keeping with the 613th and final commandment mentioned in the Torah — “Now write this song for yourself and teach it to the Children of Israel” (Deuteronomy 31:19) — residents, family members, sponsors and anyone else who wants to may write a letter in the home’s Torah. Thus far about 100 people have written in the scroll.

Rabbi Sheldon Pennes, the home’s spiritual life director, said that writing in the Torah is considered the responsibility of each Jew.

During a writing session on Feb. 22, 101-year-old Cedelle Weiner found herself up close and personal with the Torah for only the second time in her life.

The first time was a year ago.

She said she did not feel very Jewish until coming to the home and found she was inspired to study with Rabbi Anthony Elman, who works at the home’s Grancell Village campus.

“This is a completely new life for me,” Weiner said as she underwent the ritual hand washing and said the appropriate blessings.

After sitting down next to Rabbi Miller, the scribe, Weiner put her hand on his and watched as he filled in a silhouetted letter from the word hamoftim (“wonders”) from the Torah’s penultimate sentence: “He had no equal for all the signs and wonders which the Lord sent him to perform in the land of Egypt against Pharaoh and all his servants….” (Deuteronomy 34:11).

“The home is fantastic,” Weiner said when she was done. “I have been entertained, and now I’m getting a Jewish religion I have never had. At 101, I’m doing something different, and I am now writing [in the Torah], which I never did before.”

Rose Bentow, 86, almost couldn’t contain her excitement as she fulfilled the commandment. She was one of several Holocaust survivors who were sponsored by family members, community members or total strangers to come and write a letter in the scroll.

The moment harkened her back to her small Polish town, circa 1928. Her grandfather told her to stay out of a particular room because a man was writing the Torah and couldn’t be bothered.

Little Rose’s curiosity got the better of her, so she quietly opened the door.

“I said, ‘He’s playing with a feather. He’s not writing,’” she recalled. “I asked my grandparents, ‘Why can’t I go in?’ They said, ‘This is how you write the Torah.’”

Pennes, the home’s spiritual life director, said everyone experiences the moment differently.

“It looks like just someone writing letters on a piece of parchment,” he said. “But it’s a spiritual event. People feel it spiritually, emotionally. It’s hard to put into words.

“Children see it simply. But when you’re older, you appreciate it differently, especially when we recite the Shehecheyanu. The idea of living to this point is amazing. That process heightens sensitivity to the mitzvah that’s about to happen.”

For more information about the Torah for the Ages, visit http://www.jha.org.

Active living is the key to successful aging

Dr. Roger Landry wishes senior citizens would stop acting their age. Landry, president of Masterpiece Living, LLC, a consulting firm for senior communities that emphasize healthy aging, observes, “Nothing in our DNA dictates that we can’t stay vital into old age. We need to adopt a ‘use it or lose it’ approach to our minds, bodies and spirit.”

After all, Landry points out, Grandma Moses began her illustrious artistic career in her late 70s and lived to 101, painting more than 20 canvases in her last year of life. “I hear inspiring stories like this every day,” he said. “Recently, I met a woman who parachuted down to her 90th birthday party.”

You don’t need to parachute into active senior living, but modest exercise is essential. Not only does exercise build muscle tone and strength, it also creates a feeling of confidence and competence. “When you are physically engaged in life, you’re more ready to try other activities,” Landry says.

Ed Abramson may be living proof. Now 86, the L.A. resident is a highly decorated World War II veteran whose bravery earned him a Purple Heart, Bronze Star, Presidential Citation, Combat Infantry Badge and numerous other medals. As a member of the Army’s 90th Division, Abramson participated in the landing at Normandy on Omaha Beach.

Abramson retired 17 years ago, having run a sales company specializing in high-end furniture for architects and designers. In that time, he’s developed new interests, taking up oil painting, studying the Torah and exercise — all avidly. His seascapes and still lifes grace the homes of friends who admire his work, and one of his granddaughters has asked him to paint Jerusalem’s Western Wall for her apartment.

He enjoys spending quiet evenings with his wife of 40 years, June, as well as playing with his four great-grandchildren. And, barely one month after surgery to remove a cancerous tumor on his lung, Abramson still hits the gym three times a week, where he does an eye-popping 125 sit-ups each time, 45 minutes in a combined walk/jog on the treadmill and a variety of other exercises.

“Sometimes I don’t feel like working out, if I’m tired or have aches and pains,” he admits, “but I force myself to go, since I know I’ll feel a lot better afterward. Working out is a key to feeling good,” he says.

A combination of mental stimulation, social connections and physical challenge is a perfect example of what Landry calls successful aging.

“Research has smashed the stereotype that aging means automatic feebleness or crankiness. People who remain physically, mentally and socially active can maintain high levels of functioning well into their 80s and 90s,” he said.

Landry points to exciting research in the last few years that has focused on the importance of “social connectivity” and its connection to overall brain fitness.

“We’ve always known that it’s good to be with people, but there is a physiological basis for it,” Landry says. “The DNA looks different in those who are socially connected than in those who are not.”

For example, the telomere, which is the end of the strand of DNA, gets shorter and shorter as people age. However, Landry says telomeres shorten more slowly in people who stay socially connected, appearing as a younger cell.

People who maintain strong connections with friends, loved ones and confidants also have lower risks of just about every type of illness, including cancer, heart disease and Alzheimer’s. Left unchecked, older adults who lose meaningful engagement with people and activities can become depressed, marginalized by society, losing their physical and mental vitality and becoming at greater risk for assisted living.

“It doesn’t have to be that way,” Landry said. “Older people can not only continue to have meaning, purpose and activity in their post-retirement years, they may even find a new purpose, unencumbered by work and parenting obligations.”

Landry recommends that older people do the following each day: exercise for at least 30 minutes (though sedentary individuals should check with their doctors before beginning an exercise program), learn something new to stimulate brain function, meet with or call friends, and do anything they find meaningful, such as joining a book or other special-interest club, doing volunteer work or picking up an old hobby.

“Think back to things you may have enjoyed earlier in life, whether it was stamp collecting, crafts, gardening or politics. Whatever you’re interested in, there’s a group out there for you,” he said.

Judy Gruen’s most recent book is “The Women’s Daily Irony Supplement.”

Israel’s geriatrics study tour inspires professionals

At the Beit Shirley senior residential and day care facility in Dimona, the staff has installed motion sensors to help cut falling incidents by half. But it’s the addition of a backup system that caught the attention of visitors participating in the first International Geriatric Study Tour in Israel — small dogs have been trained to notify staff when an older resident falls. These same dogs also do double duty at Beit Shirley during physical therapy, providing a lighter atmosphere to encourage greater participation by its senior clientele.

“It is a pleasant place to spend time. It makes me think of improving the nursing facilities in my community,” said Karen Alexander, director of Eldercare Services in the United Jewish Communities of Metrowest New Jersey.

Nearly a dozen eldercare professionals and paraprofessionals spent three days in January on a whirlwind tour of Jerusalem, Beersheva and Dimona, visiting day-care centers, sheltered housing arrangements and full-service facilities; listening to lecturers addressing such topics as how different ethnic groups care for their elderly and innovations in Alzheimer’s care, and learning about new developments in aging-related services.

The Jan. 8-10 tour was jointly organized by the American Society on Aging (ASA), one of the largest U.S. organizations of multidisciplinary professionals in the field of aging, and Melabev, an award-winning Jerusalem nonprofit care agency for elderly people with Alzheimer’s and other dementia-related diseases.

“On my last trip with Melabev I was amazed by the energy and enthusiasm of the volunteers and professionals in Israel in this field,” said Amy Eisenstein, an ASA representative and education coordinator with Rush University Medical Center in Chicago. “I thought of bringing the innovations to the attention of other professionals to enable them to think outside the box.”

“We’re going on our expertise,” tour co-coordinator Rakel Berenbaum of Melabev’s Resource Center said. “In Israel’s compact area, its multicultural population has different approaches and frameworks for the elderly. While similar facilities may exist in the United States, they’re spread out in a much larger area. For the itinerary we looked for places that offer quality care with innovations that participants can learn from.”

Those participating in the tour hailed from the United States, Australia, South Africa, the Ukraine and Israel, and qualifying participants earned 30 continuing education units from the National Association of Social Workers.

“We had an outstanding taste of many aspects of care for older adults,” said Paul Bennett, project director of the System’s Change Grant at the University of Illinois at Chicago.

Bennett’s research focuses on changing the system of services to older adults from nursing homes to home and community-based programs.

“In recent years the trend throughout the United States is towards nursing home diversion in order to save federal funds. It would be ideal if older adults in nursing homes could reenter and reestablish themselves in the community. At home the older adult doesn’t need services around the clock, but rather intermittent services,” he added.

Bennett was particularly interested in a presentation by JDC-ESHEL, a nonprofit organization founded and supported by the Israeli government and the American Jewish Joint Distribution Committee, which strives to improve the status of the elderly in Israel through planning and developing new and innovative services.

The organization has about 200 supportive communities that enable the elderly to remain in their own homes among friends and familiar surroundings as long as possible, even when they become frail, by delivering necessary services to their homes. “These communities have an av kehilla [community father] similar to a case manager. The av kehilla is almost like a son whom the older adults can turn to,” Bennett said.

Tour co-sponsor Melabev, a Hebrew acronym that means “heart-warming,” operates nine day centers throughout Jerusalem. The organization’s efforts ease the burden on families, enabling them to keep elderly relatives with dementia in the warmth of the family home and in the familiar community for longer than might happen otherwise. By forestalling or preventing institutionalization, Melabev’s services are considered a cost-effective strategy.

The centers provide a therapeutic and social framework that enhances the quality of life for those afflicted with Alzheimer’s disease or similar disorders. Family members continue their daily activities, knowing their relatives receive care in a supportive environment while enjoying activities like physiotherapy, occupational therapy, art, music, dance therapies and cooking.

Melabev also runs memory clubs for those suffering from mild memory loss, a memory assessment clinic and home care. The centers’ counseling and support groups for family and caregivers are offered in a few languages for the city’s immigrant populations. Savyon, an innovative computer program developed at Melabev, helps activate patients and stimulate cognitive functions.

The centers’ multifaceted services are backed up by a devoted cadre of volunteers, including retirees and healthy older adults who want to assist those less fortunate.

Volunteerism in Israel is a major ingredient in many thriving social enterprises. During the tour, the group visited Jerusalem’s Yad Sarah House, headquarters of Israel’s largest voluntary organization with 6,000 volunteers in 103 branches throughout the country.

Yad Sarah provides a range of free or nominal cost services designed to make life easier for sick, disabled and elderly people and their families, thus saving money for the government.

“The volunteer guide at Yad Sarah had such a sense of pride in her volunteer work that I was wondering what we can do to inspire our volunteers to have such a sense of pride,” Alexander said.

Plans are already under way for a new study tour to northern Israel next year.

“By participating in the tour and seeing many programs and ideas, I’m kept motivated,” ASA’s Eisenstein said.

Amy Eisenstein will give a presentation about the tour and provide details about a 2009 tour at the American Society on Aging and the National Council on Aging conference (www.agingconference.org) in Washington, D.C., March 26-30.

Science of hearing loss moving near speed of sound

The music coming from Bob Dylan and his band at the indoor concert is awesome, but what I can hear of his vocals suggests that people backstage are strangling frogs and stepping on ducks.

Sure, Dylan’s voice is throaty and growly, but he can articulate his songs as well as anyone. I know it from his CDs. At a distance of more than 50 yards from the stage, however, the form of his words, especially the higher frequencies of his consonants, are lost in the hurricane of sound from the mighty speakers and the reverberations of the theater’s vast interior.

If I were a hearing-impaired person, I might switch my hearing aid to the “T” setting and get the best of Bob with sound of near-studio CD quality, while the hearing-normal folks around me were still worrying about those frogs and ducks.

At least I could do that if the concert were taking place at the DeVos Performance Hall in Grand Rapids, Mich., or the Rialto Cinemas Lakeside in Santa Rosa. These are among the growing number of facilities equipped with induction loop systems that broadcast directly from the output of instruments and microphones to hearing aids equipped to receive them.

Science is ringing in a new era in the world of the hearing-impaired, and the technologies to accommodate, treat and prevent hearing loss — and even cure it — are advancing at almost sonic speed. And that’s welcome news, considering how doctors are wringing their hands over study after study predicting hearing loss for a generation that seems constantly connected, almost from birth, to MP3 players.

Age is the major cause of hearing loss, and your level of predisposition to it is genetic. If your parents lost hearing with age, it’s likely you will, too. Age-related hearing loss is found in about one-third of people older than 60 and half of people older than 80.

The hearing loss comes from breakdown of the “hair cells” in the cochlea (the spiral-shaped part of the inner ear containing the auditory nerve endings). There are some 16,000 to 20,000 of them in each ear, and each hair cell is believed to have about 100 tiny hairs known as stereocilia. Sound causes pressure variations in the cochlea, which makes the stereocilia vibrate and send impulses to the brain.

First lost with a combination of age and excessive sound — like loud music from your iPod — are the hair cells that resonate to higher frequencies, which is why speech becomes harder to understand as the ability to hear the higher frequencies of consonants disintegrates. But that could change, thanks to research at the House Ear Institute in Los Angeles.

“We’re developing totally implantable hearing aids, so we may some day implant a device allowing a person to hear without having an [external] aid,” said John House, the institute’s president.

Within five years, such hearing aids should be sufficiently developed that the institute will be implanting them in children on a regular basis, House said

Among other projects at the House Ear Institute are hearing aids that completely bypass the ear and wire sound directly into the brain.

“Many years ago, we developed a process of implanting electrodes directly applied to the surface of the brain in the area of what’s called the cochlear nucleus, where the nerve attaches to the brain,” House said. “Now we’re working on penetrating electrodes, not only to go on the surface but to penetrate the surface of the brain. That’s called a penetrating auditory brainstem implant. We’ve implanted eight or 10 now.”

Founded in 1946 by House’s father, Dr. Howard P. House, to advance hearing science and improve the quality of life, the institute is among the world’s leading centers of hearing-related research and education. The connection of hearing to cognitive function is taken seriously.

“We’re now screening newborns for hearing loss, something that was developed at the House Ear Institute,” House said, “identifying them at birth, rather than waiting until parents notice they’re not responding at the age of 1, or 2 or 3 years old.”

Besides surgical and other medical interventions, the institute also does research and development on hearing technologies, such as signal processing algorithms applicable in hearing aids. Hybrid electrical-mechanical hearing aids are another example: The cochlea is implanted with an electrode for high frequencies associated with subtle voice recognition, while standard hearing aids provide the lower frequencies.

“We’ve been working on that for the past five years, and it’s still investigational,” House said. “Maybe within five years, we’ll be able to implant hybrid [hearing aids] in people who have residual hearing but not enough to understand speech.”

The hearing aids of today are digital, with increasingly powerful microchips and software that can customize to the individual’s frequency spectrum of hearing loss and can adjust to the conditions of a noisy gymnasium or a quiet garden. Hearing aids are moving toward unprecedented abilities to convey subtleties like footsteps in another room, the sound of the wind, the nuances in music or the voices of loved ones.

“Analog tends to amplify everything, whereas with digital we can actually tune it to respond only to whatever frequencies are needed, and we can insert different programs so the hearing aid can respond to different sounds,” House said. “There have been tremendous advances in hearing aids in the last five years.”

One example, House said, is that of multiple-microphone hearing aids available just in the last two or three years, which help filter out background noise and tune in on close-up speech. The newest, he said, available in just the two or three years, is the “open-fit” hearing aid. It uses a narrow and inconspicuous tube to carry amplified higher frequencies into the ear, leaving the ear largely open to a natural inflow of the lower frequencies without completely plugging the ear like the traditional ear mold.

“In the past, hearing aids couldn’t do that because they couldn’t eliminate the squeal, the feedback problem,” House said.

Joe ‘Master Blaster’ Weider still going strong

Bodybuilding guru Joe Weider, who discovered and trained Arnold Schwarzenegger, among other champions, walks with a slight limp into the second-floor conference room in one of the buildings bearing his name in Woodland Hills. Outside, Tuscan columns of this Greco-Roman building support a frieze of Olympians engaged in wrestling, archery, running and weightlifting.

Even at 86 years old, Weider gives you the sense he might have once been one of those Olympians. As he approaches the head of the table inside this wood-paneled room, Weider appears dapper and powerful, his muscular torso still filling out the gray pinstriped suit he wears with a starched white shirt and red power tie.

A young assistant helps Weider into his chair, a concession to his age. But the man who says he was “born with a barbell in my hands” in his book, “Brothers of Iron: Building the Weider Empire” (Sports Publishing, 2006), retains a strong handshake even after undergoing a heart valve operation and back surgery in recent decades.

Weider’s twin interests in history and art are reflected in the Frederic Remington bronze sculptures of cowboys and Indians on horseback that adorn the conference room, as well as sculptures of Abraham Lincoln and Weider himself outside the room. A teacher once told him that he should be an artist, and indeed he says that that could have been his career had he not chosen bodybuilding.

His artistic sensibilities can be seen in his illustrations of the male body framed in the downstairs lobby, which appeared in the inaugural issue of Your Physique, the first publication in his magazine empire and the precursor to Muscle & Fitness. In 2003, he sold Weider Publications titles, including Muscle & Fitness, Shape, Flex and Men’s Fitness, to American Media, Inc., for roughly $375 million, Weider says. Not bad for a Depression-era kid with a seventh-grade education who invested his life savings of $7 into putting out the first issue of Your Physique in the late 1930s.

On this spring day, he sports an adhesive bandage around the tip of his nose to cover a precancerous growth he had removed. Were he a younger man, one might assume that he had gotten into a fight, as he once did as a teen in Montreal, knocking out an anti-Semitic French Canadian bully with one punch. However, Weider, who immigrated to the United States after World War II, has not gotten into any fights since that scuffle in Montreal.

Weider grew up in an era when many Jews fought for a living, but he did not fight in the prize ring; he fought to keep a business afloat.

“Judaism made me,” he says. “It taught me to be a good boy, respect women, study and apply myself to work.”

Weider and his brother and business partner, Ben, never denied their Judaism, even when Ben was making contacts in Arab countries like Egypt, Iraq and the Palestinian territories as part of their effort to promote bodybuilding worldwide.

Over the years, they had to battle fierce competitors within their field, including Bob Hoffman, founder of the York Barbell Company and a U.S. Olympic weightlifting coach, who published magazines for weightlifters and served as head of the Amateur Athletic Union.

Joe Weider, who casually drops in references to Freud’s pleasure principle, also had to battle psychologists, who claimed that weight training “would do you no good.”

Looking resplendent with a full head of silver hair and matching silver moustache, Weider speaks for many young weightlifters when he says that “It made me feel I can change myself,” then he adds, “and change other people.”

Although bodybuilding improved the self-esteem of Weider and his disciples, he says that he had to counter another notion propounded by psychologists at the time — that those who built up their physiques were “latent homosexuals” who liked to stare at their bodies. It seems an odd point to mention and certainly less serious than charges back then that lifting weights would leave one overly muscle-bound, that muscle could turn to fat and, worst of all, that weight-training could result in so-called “athlete’s heart.”

Like former pupil Schwarzenegger, Weider did have surgery for a leaky heart valve, but he says that both were born with the condition.

“Arnold’s mother had it and died from it,” he says.

Weider also says that his back problems were due to a freak accident and had nothing to do with weight training. However, he admits that handling weights improperly can damage the body. He is also well aware of the drug abuses of too many body builders and athletes in other fields, a scourge that has led to severe health concerns, including heart attacks, strokes and cancer.

In “Brothers of Iron,” which is equal parts memoir, business primer and popular culture history, Weider stresses that he and Ben were always opposed to steroids. He writes that, “like much of the world’s evil … steroids … came from the Nazis and the Communists,” a point that resonates when reflecting on the multitude of East German Olympians, both male and female, who cheated their way to gold medals with bloated musculature through the late 1980s. Although the International Olympic Committee banned certain performance-enhancing drugs in 1967, steroids were not added to the list until 1975.

Ironically, many of those Eastern Europeans got their weight-training methodology from Weider, whose publications have been circulating the globe for nearly 70 years.

In 1950, Weider made his famous 10 predictions, some of which ended up being remarkably prescient. None more so than Prediction No. 1, “I predict that civilization will speed up in every phase, and that the stresses and strains on mankind will continue to increase,” and Prediction No. 2, “I predict that the resulting increase in mental and physical illness will force the world to recognize the importance of systematic exercise and physical activities.”

Most satisfying of all, he says, has been Prediction No. 10, “I predict that body building will one day become one of the greatest forces in existence, and that it may be hailed as the activity that actually saved civilization from itself.”

My second childhood

It took eight decades, but at last I know what is meant by “second childhood.”

In my first childhood, my social life consisted of dating attractive young women. This second time around my calendar is just as full but my partners are all doctors.

The world looks different to me now that I have reached 80. It isn’t that I feel any older, it’s just that everyone else appears so much younger. And more distant. And a bit blurry around the edges. And much more difficult to hear. My ears have taken early retirement and last year, out of consideration for my fellow citizens, I gave up driving at night.

I am told that this last one is almost like a rite of passage; if you move to a retirement home to become one of its few available males, your popularity depends on your ability to drive at night. I will report to you further on this when and if the occasion arises.

The world sees me differently as well. What used to be bad taste (sloppy clothing, for example) is now acceptable. People are much more helpful; they see my four-legged cane and pause to open doors. If I should sit in my car for a few minutes trying to figure out the intricacies of cruise control, someone will rap on the window and ask if I am all right. At the supermarket I have been presented with my own key for the electric carts that are not equipped, thank heavens, with the latest gadgets dreamed up in Detroit. Besides, I no longer walk: I shuffle.

There is yet another problem. There are rows of keys on my computer’s keyboard whose meaning I fail to comprehend and icons on its screen whose purpose passeth all understanding. The makers of these gadgets assume that their customers are all graduates of MIT. In 688 pages of “Mac OSX for Dummies” there is not a single definition of the oft-used phrase “default position.” My wife and children, all highly computer literate, have given up trying to explain these matters to me; they use PCs and regard Macs as childish toys suitable only for the technologically challenged.

Despite this litany of whiney self-indulgence there are some advantages to being long in the tooth.

Even though the Iraqi quicksand is gradually swallowing us up, I am not likely to be drafted again for military service. Nor am I personally threatened by global warming, awakened in the morning by an alarm clock, paying for anyone’s college tuition or worrying about the state of my (nonexistent) portfolio.

Three sessions a week of cardiac rehab do much, I am told, for one’s physical well-being and has led to a discovery that will please the Bush administration.

They were expecting to find weapons of mass destruction in Iraq? Well, I found them right here in my home city of Providence, R.I., at Miriam Hospital’s cardiac center.

And my brain, upon which I used to depend for solving The New York Times Sunday crossword puzzle, now is exercised by following the antics of Brad, Angelina, Britney, Paris, Nicole and their exes.

I used to imagine that life in the Golden Years would feature an endless series of visits from adoring grandchildren, all yearning to sit at the feet of the Fount of Wisdom so as to benefit from his experiences and profound utterances on issues of great moment. I have since discovered that grandchildren tend to live thousands of miles away and have interests of their own that rarely include the accomplishments of the Yankee teams of the 1930s or the pleasures of riding on the Sixth Avenue El all the way to the Battery. Instead, they chatter on about Game Boys, text messaging and other modern time-wasters, which will, in due course, turn them into members of the genus illiterati.

I know that it will all come to an end in a month or a year or perhaps another decade, but I don’t know how or when. Nor am I particularly anxious to find out. If there is one thing about which we elderly codgers are aware, it is that in becoming elderly we are riding a wave of good fortune.

After all, consider the alternative.

Yehuda Lev, The Journal’s first associate editor, lives in Providence, R.I., where his business card reads Editor Emeritus. He can be contacted at yehudal@cox.net.

Alter Kayakers make waves in Newport Bay

Every Thursday morning, 11 supremely fit old men come thundering into Newport Bay, rounding up all the good rental kayaks on the Balboa Peninsula and singing at the top of their lungs.

Most are major fundraisers for Heritage Pointe, Orange County’s Home for the Jewish Aging, and they call themselves the Alter Kayakers.

The name was a natural, said Stan Sackler, 70, of Newport Beach, a retired fuel dealer, who was already a member of a Jewish cycling group in Fullerton called Shlemiels on Wheels.

Sackler and Steve Fienberg, 67, of Irvine assembled the group four years ago, and let Howard Weinstein, 72, of Corona del Mar coin the name. They’ve never had a slow moment since.

“I look forward to this all week,” Weinstein said. “I can’t wait for Thursday.”
Not that Weinstein, or any of the other Alter Kayakers, lives in the slow lane the rest of the week.

Weinstein hiked and rode horseback through Patagonia for 18 days last fall. He plays tennis four times a week, works out with a personal trainer twice a week and he’ll have to miss the Alter Kayakers’ February cruise to Mexico because he’ll be in Botswana.

“I figure that if I stay active when I’m 72, I’ll still have a life when I’m 92,” Weinstein said.

The Alter Kayakers stand out for their awesome endurance and robust bearing, and they cram their days with endless bicycling, hiking, tennis, martial arts and river rafting. But no one has to quit when his abilities falter.

Seymour Lobel, 77, a retired auto financier from Corona del Mar, for example, has lost much of his vision. Other members of the Alter Kayakers drive him to Newport Bay each week, and in the water, someone always keeps an eye on his kayak.

Members love to reminisce about their Kern River rafting trip last September, when the raft overturned and all the members were dumped into the churning river’s Class 4 rapids. Stronger members helped stragglers get back onto the raft, and the team spirit that prevailed made even these tough men of steel mist up for a moment.

Two seconds of sober reminiscence passed, and then Weinstein said, “Stan Sackler, wearing a hearing aid, came damn close to getting electrocuted.”

Ephie Beard, 75, a Newport Beach resident of 13 years who owned car auction businesses in Anaheim and Fontana, introduced the Alter Kayakers to whitewater rafting.

“I’d been doing it for 21 years,” he said. But the day the raft flipped, he said, “it was pretty scary for some of those guys.”

But all this running around without performing a few mitzvot is against Alter Kayaker rules.

“We all try to do something for the Jewish community,” said David Stoll, who owns a boat engine business in Newport Beach. “Most of us are Diamond Donors to Heritage Pointe in Mission Viejo. My personal feeling is that you have to pay your Jewish dues. If you don’t pay the community back, it really gets on our nerves.”

Two of the Alter Kayakers aren’t Jewish, but they’re treated like Members of the Tribe. Stan Angermeir, 67, a nursing home operator who lives on Lido Isle, belongs to Temple Beth Sholom in Santa Ana with his Jewish wife. Wayne Harmon, 69, of Corona del Mar, the other non-Jew in the group, has a serious relationship with a Jewish woman.

“Believe it or not,” joked Stoll, 68, “we made Wayne our treasurer.”

“But we don’t have anything in the treasury,” added Stackler, a former director of the Orange County Jewish Federation.

Every year, the Alter Kayakers hold an awards ceremony.

“Everyone wins first place in something,” Stoll said. “Wayne Harmon won first prize for looking the least Jewish.”

Most of the Alter Kayakers are retired or semiretired professionals or businessmen.

Arthur Friedman, 71, of Balboa was a dermatologist. Sid Field, 77, who lives in Newport Coast, was a dentist. Robert Baker, 64, of Newport Beach and Fienberg were lawyers.

Weinstein was a pharmacist who became a pharmaceutical manufacturer. Harmon was an executive with J.C. Penney. The rest were entrepreneurs.

When they gather, they are sure to sing “Kayakers’ Spirit,” their own anthem, sung to the tune of the “Illini Fight Song.” Field, a University of Illinois alum, wrote the words. The anthem concludes their weekly Thursday ritual, which starts with a 4-mile, one-hour kayak expedition into Newport Bay and progresses to lunch at Newport Landing Restaurant.
“Same seats or we forget the name of the guy next to us,” Sackler explained.

Same menu, too, it turns out: A half portion of Caesar, Cobb or chicken avocado salad. Ironmen feasting on salad fragments?

“Some members are on diets or too cheap to buy a whole salad,” Weinstein said. “One member who shall remain nameless orders a sandwich off the menu, and he is penalized by getting a separate check.”

The Alter Kayakers say they don’t accept new members.

“Our membership is now closed because the group has such good chemistry, and we don’t want to tamper with it,” Fienberg said. “Also, the place we rent kayaks from only has about 11 good kayaks, and more than 11 for lunch is a bit much.”

They also discourage lunch guests.

“You must be mishpachah,” Weinstein said. “You can be a ninth cousin, but you have to be in the family.”

All but one of the Alter Kayakers are married, nearly all to their first wives — Stoll for 42 years, Baker for 41.

“My wife loves it,” Weinstein said. “It gives me an opportunity to socialize with the boys and to go out and exercise.”

There are no greens fees or memberships to eat away at the family budget; it costs $10 to rent a kayak.

So far none of the Alter Kayakers’ wives has taken to renting a kayak of her own.
“My wife came out with me in a tandem in Newport once,” Sackler said, “and loved it as long as I did the paddling.”

Hitting the century mark doesn’t stop this translator

Most afternoons, you can find Eva Zeitlin Dobkin working. Undaunted by the 100-year marker she passed last month, she pulls her wheelchair up to the hospital bed in the room she shares at the Jewish Home for the Aging — her side is separated by a curtain — and spreads her work out over the lavender bedspread. While her roommate rests or watches television with the volume turned high, Dobkin spends a couple of hours editing “Burning Earth” (“Brenendike Erd” ), a historical novel she has translated from Yiddish to English.

She began working on the book in 1984, then had to put it aside to complete other translation projects.

Now, despite limits to her endurance, she is reviewing her final version for the fifth or sixth time, making corrections in longhand — she gave up the computer two years ago — and occasionally referring to a Yiddish-English dictionary to verify her word choice. The book, by Aaron Zeitlin, who may be a cousin, was written in 1934 and centers on a group of Zionists who spied for the British, prior to the Balfour Declaration of 1917.

This is the fourth or fifth book Dobkin has translated, in addition to innumerable articles, letters and personal memorabilia. Her best-known book is “Profiles of a Lost World: Memoirs of East European Jewish Life before World War II” by Hirsz Abramowicz, published in 1999.

Recently, Dobkin did take one afternoon off to celebrate her birthday — she was born on Nov. 20, 1906. Dressed in black slacks and a black sweater trimmed in white, her gray hair pulled neatly back, she sat in one of the home’s conference rooms at the head of a large table. Her son, Jack Forem, flanked her on one side, her youngest sister, Hannah Doberne, on the other. A cake, frosted in chocolate with brightly colored flowers, was set before her, as well as two balloon bouquets.

Friends joined her at the table. A second group, in chairs and wheelchairs, formed an outer circle. They clapped and occasionally sang along to “Bei Mir Bist Du Shein” (“To Me You Are Beautiful”), “Di Grine Kuzine” (“The Greenhorn Cousin”) and other Yiddish songs played by a pianist and violist. Staff members, most in red uniform smocks, clapped along.

“I regret that when you’re 100, I probably won’t be able to come to your simcha,” Dobkin, told her guests, including about 25 fellow residents at the Eisenberg campus, where she’s lived two years and is known as Eva Forem.

It was her day to shine, though, with 19 residents currently ranging in age from 100 to 108, centenarians are surprisingly common at the Jewish Home. Dobkin, however, is among the lucky ones, in that she is well and alert enough to be able to keep working.

Dobkin doesn’t play bingo, and she doesn’t own a television. She occasionally attends a lecture or musical event, but generally, when she isn’t working, she is reading, usually The Forward in Yiddish or English or The Jewish Journal. She reads without glasses, except for very small print.

She also spends about 45 minutes each afternoon discussing her work by telephone with her son, 62, who is a writer and lives in Yucca Valley, and who has been collaborating with her on the book’s final stages. Dobkin is hoping to find a publisher for it.

She has been translating Yiddish since 1932, when she was hired by the Jewish Telegraphic Agency at $15 a week to work as a Yiddish and English typist. By the end of the first week, however, she was writing stories in Yiddish and English off the cable transmissions, eventually working her way up to $35. However, she left after two or three years to study for her teaching credential.

In 1936, she married Leon Forem, and in 1946 her son was born. She separated from her husband five months afterward and moved to Los Angeles in 1957, supporting herself by teaching public school from 1957 to 1972, mostly at Pacoima’s Telfair Avenue Elementary School.

Born in Waterbury, Conn., to parents who had just emigrated from Russia’s Mohilev Province, now Belarus, she was the oldest of seven children, and her youngest sister, 85, is her only surviving sibling. She grew up bilingual in Yiddish and English, and at age 3 she was taught by her father to write her name in Yiddish.

“There were Jewish periodicals coming into the house, and I would look at them whether I understood them or not,” she said.

Dobkin attended public school in Waterbury and later, after moving at age 16, in the Bronx. She also received a Jewish secular education, taught primarily in Yiddish, and considers herself not religious but “very Jewish.”

She often had to care for her younger siblings while her parents worked but nevertheless managed to acquire an A.B. in German, with a minor in English and education from Hunter College, as well as a master’s degree in journalism from Columbia University. The family was poor.

“We had nothing. Sometimes we didn’t have a quarter to put in the gas meter,” she said.

She attributes her success, and that of her siblings, to her parents’ emphasis on education and the availability of free schooling. Her longevity, she believes, is due to genetics.

“Pick the right parents and grandparents,” she advised, wryly. She won’t commit to a future translating project but is considering writing a family history.

“Have a few more birthdays,” her son said as the party wound down.

“I wouldn’t mind,” Dobkin retorted, “if they’re not any worse than this one.”

For more information, call (310) 456-2178

Jewish Home’s makeover: yoga at 3, facials at 4

After strolling down the hall from your room for breakfast, you duck into the art studio to work on your latest ceramics project. Then you head down to the club room for a yoga class.
You have lunch, then sit in a shaded outdoor courtyard, listening to the sound of a nearby fountain and chatting with a friend. The two of you step into the salon for facials and hair styling before heading to the dining room, where you select from a choice of dinner entrees.
Oh, and by the way, you’re 84-years-old and you live in a skilled-nursing facility.

While this may not sound like life in a nursing home, it could be a typical day at the Joyce Eisenberg-Keefer Medical Center, which will be dedicated Oct. 29 as the newest facility at the Jewish Home for the Aging in Reseda. The $58.5 million, 249-bed center, the largest building in the home’s nearly 100-year history, is designed to provide emotional and spiritual, as well as physical, well-being to its residents.

“There are few, if any, skilled-nursing facilities that truly foster healthy living,” said Jewish Home for the Aging President and CEO Molly Forrest. “We firmly believe in investing in healthy living programs and facilities that reinforce life and are focused on quality living each day.”
Located at the corner of Tampa Avenue and Sherman Way, at the home’s Grancell Village Campus, the center includes three interconnected buildings. Two of them — the Hazan Pavilion and the LaKretz-Black Tower — are residential structures, while the Brandman Research Institute houses an in-patient acute psychiatric-care unit, research offices, a computer center/library, art studio and fitness room.

The center’s new acute in-patient psychiatric-care unit was especially needed given the psychological issues faced by many seniors, Forrest said. According to the Department of Health and Human Services, people older than 65 have the highest rates of suicide of any age group, and men account for 84 percent of those suicides. Forrest notes that many of the Home’s residents, whose average age is 84, have outlived spouses, siblings, friends and sometimes their children. In addition, more than 50 of the home’s residents are Holocaust survivors, who often have particular psychological issues.
The Joyce Eisenberg-Keefer Medical Center will provide a new home for 114 of the 350 individuals currently on the home’s waiting list for skilled-nursing care. In addition, 125 residents currently living in an outmoded, 50-year-old building at the Home’s nearby Eisenberg Village Campus will be transferred to the new facility. The remaining 10 beds are in the psychiatric unit.

Featuring small, intimate settings, each of the building’s five floors are divided into three donor-designated “neighborhoods” (among them, for example, Boyle Heights and Chicago) each delineated by its own color scheme and artwork. Each floor has three dining rooms — the main dining room, a smaller room for those who cannot feed themselves, and a medium-size “transitional” one for residents who are relearning feeding skills — and a family visiting room.
In addition, the floors are equipped with their own computer room/library, with a reading area, cable television, computer and phone for communal use. A “club room” on every floor offers fitness classes such as Tai Chi and stretching, while the creative studio, staffed 12 hours daily, enables residents to engage in painting, woodworking and other crafts.
“We want to give residents the opportunity to improve their lives and build on their skills,” Forrest said.
With decor more suggestive of a hotel than a skilled-nursing facility, carpeting takes the place of linoleum in hallways and resident rooms. Birch bookcases and armoires grace the interior of each room, while outside a mounted “memory box” displays personal photos and memorabilia.
Residents, visitors and staff can also patronize Gerald’s Deli, a pareve eatery featuring soups and sandwiches. And then there’s Maxi’s, a salon offering hair cutting, coloring and styling, makeup, facials, waxing and shaves.

Forrest said that the new facilities also will enable the home to hold more community programs. Brawerman Terrace, located on the roof, will be the site of future holiday gatherings, garden parties and other events, while the computer center will host classes open to the public.
The Joyce Eisenberg-Keefer Medical Center is the second major project of a $72 million campaign launched in 1999 to build new facilities and upgrade existing ones. The first project was the Goldenberg-Ziman Special Care Center for patients with dementia, which was dedicated in 2002. Next year, the home plans to begin construction of Fountainview at Eisenberg Village, a 108-unit, upscale independent-living facility. Plans also call for establishing a facility on the Westside, and potential locations are currently being considered.

Sex at the Skirball

When sexy authors like Erica Jong and Jerry Stahl get together onstage, you expect fireworks. But when I drag my friend Kay up to Skirball for the Writers Bloc conversation, the room is too bright, and Kay tells me Jong’s blue-framed eyeglasses and gold necklace make her come off more Carol Channing than “sex goddess.”

“Sex goddess” is how Writers Bloc founder Andrea Grossman introduces Jong, known for her 1973 literary sensation, “Fear of Flying.” Now 64, Jong has a new memoir, “Seducing the Demon,” which seduced most of the middle-aged women into coming tonight.

“Of course that’s why I’m here,” says a woman in a Princess Cruises pumpkin-colored pantsuit. “Her book had such a big effect.”

“I wanted to see what she’s up to now,” adds the female half of a baby boomer couple sitting near us.

Two hipsters in berets and leather (Stahl fans?) complete the scene in the Skirball’s Haas room.

Stahl wrote his own 1999 sexual memoir, “Perv — A Love Story,” and his first book, 1995’s “Permanent Midnight,” a memoir about his time as a drug-addicted TV writer, became a Ben Stiller movie. Kay finds heroin a tired literary cliché. But at the first mention of “sex” she perks up as a bent smile lifts one side of Stahl’s mouth.

And we’re off!

But instead of gland-to-gland combat, what we’re witnessing is an intimate exchange — sex talk in the salon. Jong, called by Grossman “a lightning rod for the last 30 years,” comes off strong in front of a crowd. Stahl plays it self-deprecatory. The one-time creator of Penthouse Letters mixes the right combination of dirty talk and fawning to coax Jong into going for the water bottle. In her newest confessional, Jong writes about sleeping with Martha Stewart’s husband. Stahl quips that he did the same with Stewart’s husband.

“Martha’s a sister,” Kay whispers. “Erica shouldn’t go around bad-mouthing her.”

But she digs the quick, black-clad Stahl. He generously lets Jong bang her political gong to make points against fundamentalist anti-Semites and fixed elections. And when she mentions Justice Sandra Day O’Connor “worried about a drift toward fascism,” Stahl says he slept with her, too.

“How was she?” Jong asks.

“Brittle,” Stahl replies. “But rightward leaning.”

He teases Jong into enticing us with a tale from “Seducing the Demon,” about a British poet (her demon muse) whom she resisted with a sudden revelation: “I can’t [sleep with] this guy … he’s an anti-Semite!”(Didn’t Larry David do something similar on “Curb Your Enthusiasm”?)

Then, in keeping with a Skirball tradition, someone in the audience shouts out: “Can’t hear you!”

“Sorry,” Stahl says. “We’re all getting old. Some go deaf. I just speak quietly.”

This segues into what we came for: Jong taking on taboos.

Her next book? A study of her father’s death. She says death and aging are taboo because we’re in denial. But being 64 offers a unique perspective.

“Death starts taking everyone around you,” Jong says. And at the same time, “your kids in their 20s become very needy. So here you are in between these two generations.”

Sounds like a whole new area for her “to blow open,” Stahl prods.

“We all end up a heap of chemicals and a black spot on the ground,” Jong says. “Within a year there’s nothing there except the words you left behind.”

Aging and death. How the baby boomers have turned! Luckily, these two discuss elderly sex.

People with Alzheimer’s make love, Stahl says, “like there’s no tomorrow.”

Jong describes nursing homes where bed hopping has become de rigueur.

“I’m thinking about investing in designer diapers,” says Stahl, drawing laughs. “Seriously.”

Wham bam, pass the Depends? By the time the gal in the orange pantsuit asks about Jackie Collins, Kay has heard enough.

“How about an interview with the Skirball landscape artist?” she says. “That’s impressive work.”

Hank Rosenfeld just helped Irv Brecher compete his memoir on aging and sex and Groucho Marx, called “Go for the Jocular!”


Center’s Studies Aid Care for Frail Elderly

Rose Sino sits in her wheelchair as lunch is placed before her. Her son offers her a forkful of cheese blintz, which Sino quickly chews before accepting another bite.

While this scene might appear routine, its significance is not lost on her son, David Swartz, or her caregivers at the Jewish Home for the Aging of Greater Los Angeles (JHA). Sino, 88, is a resident of JHA’s Goldenberg-Ziman Special Care Center, a facility that serves elderly residents with dementia. Five years ago, Sino lost all interest in eating and required a feeding tube to get sufficient nutrition.

For Sino and many other frail, elderly nursing home residents, lack of appetite is a common problem, one which can lead to a rapid decline in health, said Dr. John Schnelle, director of the Anna and Harry Borun Center for Gerontological Research.

Weight-loss prevention is one of the principal areas of investigation at the Borun Center, a joint venture between JHA and UCLA’s David Geffen School of Medicine. Housed on the JHA campus in Reseda, the center was established in 1989 to identify and test nonmedical measures that could improve daily care and quality of life for nursing home residents. Given that the number of people 85 years or older is expected to almost double in 25 years, the center’s research is of growing interest to the government, private industry and the public.

While the Borun Center utilizes JHA to test and pilot numerous interventions, it also conducts research at facilities throughout the country. In addition to preventing weight loss, current projects focus on preventing mobility decline, detecting pain, preventing pressure ulcers and managing incontinence.

The center has used research findings to develop protocols, available on its Web site, for use by nursing homes. The strategies focus on everyday routines, rather than on medical interventions.

“Once a person is frail enough to enter a long-term care facility, they’re usually taking five to six medications,” Schnelle said. “They are less inclined to do surgical or pharmacological interventions. What they want is for their pain to be managed and their incontinence taken care of and for staff to treat them in a reasonable way.”

The Borun Center is currently working with the federal government’s Center for Medicare and Medicaid Services to improve methods of evaluating nursing home care. Current methods don’t always provide the most reliable information, according to Schnelle. Not only are the elderly less likely to complain, he said, but the phrasing of questions can influence their responses.

“Asking, ‘Are you satisfied with how often you are taken to the bathroom?’ will typically generate a yes response, even if that is not the case,” he explained. “Asking, ‘How many times would you like to be helped to go to the bathroom?’ and ‘How many times are you taken to the bathroom?’ is more likely to reveal the discrepancy between what residents want and what they get,” he noted.

Schnelle said that most nursing homes are understaffed and that in the typical facility, residents are taken to the bathroom only once a day. (He also said that, in all measures the center looks at, JHA exceeded all other facilities studied.)

The Borun Center’s nutrition and weight-loss study at JHA identifies strategies to prevent the decrease in eating and fluid intake common to nursing home residents. Schnelle cited depression and appetite change as two principal causes.

“Food doesn’t taste as good, and they simply don’t care as much about it as they once did…. But you can reverse the decline if meal time becomes social.”

Sino’s improved eating came about not because of a change in her food, but in how it was presented and served. Using Borun Center study results, JHA’s Special Care Center systematically incorporated eight measures — including greeting residents by name and providing verbal encouragement — which had been shown to boost caloric intake among certain residents by about 300 calories a day.

“At some facilities, a food tray is placed in front of the resident, and that’s it,” said Susan Leitch, community manager for the Goldenberg-Ziman Building.

In her facility, servers take plates off the serving tray and place them, restaurant style, before the residents. Containers are opened and meat is cut for those who require assistance. Residents are greeted by name and offered substitutions for foods they dislike.

Nursing aides and other staff sit with residents or stop by their tables with encouragement. “Try this. This is good,” one says. “I know you like chocolate,” says another as she presents a bowl of ice cream to a resident.

In addition, snacks are incorporated into activities as a way to boost caloric intake, and family members are encouraged to bring treats that they know their relative enjoys. Sino, for example, ate the pieces of chocolate her son offered her, even when she was still using the feeding tube. He credits the chocolate with renewing her interest in eating.

Not surprisingly, the interventions identified by the Borun Center require greater staff time. That means higher costs.

Molly Forrest, JHA’s CEO, acknowledged that those costs present a challenge. Approximately 80 percent of JHA residents are on Medi-Cal, and the reimbursement received does not cover the expenses incurred.

“Quality is a costly item,” Forrest said. “The needs are so great, and those needs can only be met by the hands of a caregiver.”

Schnelle suspects these interventions also prevent hospitalization and prolong life. But even if they did not improve clinical outcomes, he believes improving quality of life for the frail elderly is justified from a moral point of view.

“I think we have to be very clear about the staffing requirements needed to provide good care and let people make choices,” he said.

For David Swartz, the choice is clear. Sitting with his mother at lunchtime, he beams. By the time she’s done, only one tiny bite of blintz remains on her plate.

For more information, visit www.borun.medsch.ucla.edu.