Gifts for a retiring boomer
For many baby boomers, retirement is just around the corner. Why not celebrate their hard work and this golden milestone with a retirement gift? Whether they plan to spend the next phase of life jet-setting or pursuing more domestic interests, they deserve something special to mark the occasion.
1. After years of subpar office coffee, your boomer buddy can now enjoy a rich cup of homemade Joe every morning with the COFFEE COLD BREW GIFT SET ($36). The set comes with a 60-ounce mason jar, a hand-sewn cloth filter, and flavorful Brazilian and Guatemalan coffee beans. ” target=”_blank”>etsy.com
Recipes: Smoked salmon sandwiches, chocolate paninis and more
Baby boomers have childhood memories of eating all sorts of comfort foods: meatloaf, macaroni and cheese, Campbell’s Cream of Mushroom Soup, french toast and tuna sandwiches.
Over the years, though, Julia Child and the Food Network did a lot to change these food habits, and helped boomers appreciate new, more eclectic food dishes. Macaroni and cheese might still end up on the dinner table once in a while, but now it’s more likely to be made with Roquefort or local goat cheese. And remember Mom’s old-fashioned meatloaf? It’s now lighter and tastier using ground turkey.
The boomer generation has become more adventuresome, more willing to try new food combinations at home. They eat in the swanky new restaurants and, in fact, many young boomers have become creative, celebrity chefs.
Here are some recipes that provide an innovative approach to some of the traditional dishes that were so popular in the past.
Preparing fresh and tasty mushroom soup is quicker than you can imagine by just going to the local farmers market to purchase a selection of exotic mushrooms, and replacing the classic tuna sandwich with a Smoked Salmon Panini is a divine substitute for an old favorite.
I promise that this turkey meatloaf topped with a light tomato glaze will become a family staple, especially when each slice has a hard-cooked egg in the center. And you won’t regret replacing french toast with a Bittersweet Chocolate Panini. It is a perfect breakfast treat when made with raisin-nut bread, or it can be served as dessert.
SMOKED SALMON PANINI
I have upgraded the smoked salmon panini, which are sold at the auto grills in Italy. The bread is sprinkled with olive oil and filled with smoked salmon, vegetables and herbs. The sandwich is then grilled while topped for a few minutes with a heavy plate, or use a panini press. This sandwich, cut into halves or quarters, makes an elegant appetizer or a simple and delicious addition to lunch.
1/2 cup Mustard-Dill Sauce (recipe follows)
12 slices Italian country style bread
12 slices smoked salmon
6 slices red onion
6 lettuce leaves
6 fresh basil leaves
Preheat panini press or grill.
Prepare Mustard-Dill Sauce, cover with plastic wrap, and chill.
Spread Mustard-Dill Sauce on 6 slices of bread; top each with 2 slices of smoked salmon and 1 slice of onion, lettuce and basil. Top with 6 remaining slices of bread.
Place the sandwiches in the preheated panini press and close the lid. Grill the sandwich until the bread is toasty golden brown. Slice in halves or quarters, and serve immediately.
Makes 6 paninis.
3 tablespoons Dijon-style mustard
1 teaspoon powdered mustard
2 tablespoons sugar
1 tablespoon red or white vinegar
1/3 cup olive oil
3 tablespoons chopped or snipped fresh dill
In a small, deep bowl, combine the mustards, sugar and vinegar; blend well. With a wire whisk, slowly beat in the oil until a thick mayonnaise forms. Stir in the dill. Cover with plastic wrap; refrigerate until ready to serve.
Makes about 1 cup.
3 tablespoons olive oil
2 small leeks, white part only, thinly sliced
1 onion, chopped
2 garlic cloves, minced
1 pound fresh white cultivated mushrooms, thinly sliced
1/2 pound shiitake or porcini mushrooms, thinly sliced
5 cups vegetable stock
Salt and freshly ground black pepper to taste
In a large saucepan, heat the oil; add the leeks, onion and garlic; sauté over medium heat until tender, 5 to 10 minutes. Add the mushrooms and sauté for 5 to 10 minutes, stirring occasionally with a wooden spoon. Add the stock. Bring to a boil, cover partially, and simmer for 20 to 30 minutes over medium-low heat until the mushrooms are tender.
Transfer the soup to a blender or processor; puree. Return soup to saucepan, season with salt and pepper, and mix well. Ladle into heated soup bowls.
Makes 8 to 10 servings.
ROASTED TURKEY LOAF IN TOMATO-WINE SAUCE
Just when you thought this all-time favorite couldn’t get any better, along comes this recipe for turkey meatloaf — filled with sautéed vegetables, and roasted like pot roast with a light Tomato Wine Sauce. It contains a surprise: hard-cooked eggs, hidden in the center. This turkey loaf is also great served cold in sandwiches with a heap of french fries.
Tomato-Wine Sauce (recipe follows)
3 tablespoons olive oil
3/4 cup finely chopped yellow onions
3/4 cup finely chopped green onions
1/4 cup finely chopped celery
1/4 cup seeded and diced red bell peppers
1/4 cup seeded and diced yellow bell peppers
4 garlic cloves, minced
3 raw eggs
1/4 teaspoon cayenne pepper
1 teaspoon ground cumin
1/2 teaspoon freshly grated nutmeg
Salt and freshly ground black pepper to taste
3/4 cup tomato ketchup
3 pounds ground turkey
1/2 cup fine bread crumbs
4 hard-cooked eggs, peeled
Preheat oven to 375 F.
Prepare Tomato-Wine Sauce; set aside.
In a large, heavy skillet, heat olive oil over medium heat and add yellow onions, green onions, celery, red and yellow peppers and garlic. Sauté, stirring often, until the moisture from the vegetables is evaporated, about 5 minutes. Let cool.
In a medium bowl, lightly beat raw eggs with cayenne, cumin, nutmeg, and salt and pepper to taste. Add 1/4 cup of the ketchup; blend thoroughly.
In a large bowl, combine ground turkey with the cooled vegetable mixture and the egg mixture. Using your hands, knead thoroughly. Add bread crumbs; knead 1 to 2 minutes.
Transfer Tomato-Wine Sauce into a long roasting pan. Dampen hands and shape half of the turkey into a long, flat loaf. Place on top of the Tomato-Wine Sauce in the roasting pan. Place hard-cooked eggs lengthwise along the center of the molded turkey loaf. Place the remaining meat mixture on top of the eggs, pressing to make a firm loaf and sealing the edges. Drizzle remaining 1/2 cup ketchup over top of loaf. Bake until the turkey is completely cooked through, about 1 hour.
Makes about 12 servings.
2 tablespoons olive oil
1 onion, thinly sliced
1 pound tomatoes, chopped
1 cup dry red wine
1 head garlic, separated into unpeeled cloves
In a saucepan, heat olive oil over medium heat and sauté onions until soft, about 5 minutes. Add tomatoes with liquid and wine; simmer 5 minutes. Add unpeeled garlic cloves, cover, and set aside.
Makes about 2 cups.
BITTERSWEET CHOCOLATE PANINI
8 small slices raisin-nut bread
1 (8-ounce) bar bittersweet chocolate, thinly sliced using a potato peeler
Garnish with cinnamon sugar, optional
Arrange the chocolate on 4 slices of bread, stopping 1/2 inch from edges. Cover with the remaining 4 slices of bread. Place on hot panini grill or in heavy skillet, cover with heavy lid, and grill until chocolate is melted. Sprinkle with cinnamon sugar. Cut in half and serve immediately.
Makes 4 servings.
Judy Zeidler is a food consultant, cooking teacher and author of “Italy Cooks” (Mostarda Press, 2011). Her website is JudyZeidler.com
Boomer-era movies reflect 50 years of change
Movies have long been a mirror of our culture, reflecting the attitudes, morals and fashions of the times. That’s as true for films made during the baby boomer era as any other time. But when Hollywood set its sights on this new demographic of box-office boosters, they were aiming at a moving target. Boomers came of age during volatile times in America. And those times, they were a-changing with great momentum — the placid atmosphere of the 1950s quickly gave way to the turbulence and civil unrest of the 1960s, propelling youths through a rapid cultural metamorphosis every few years. This pushed filmmakers to expand their minds, frequently reimagining genres in order to interpret the boomers’ fluctuating mood ring. Here are some pivotal films that illustrate those paradigms.
In 1963, American International Pictures (AIP), a studio that specialized in teen-oriented films, released “Beach Party.” This cinematic shindig of adolescent escapism presented the first generation of teenage boomers as energetic, clean-cut youths who lived for the surf, sand and sun of Southern California beaches. The dominant issues in these kids’ lives were dancing, surfing and dating, and their dispositions were as sunny as an August day. In the real world, racial tensions in America were escalating, the Vietnam War was intensifying, and the Cuban embargo was put into effect, but on the beach these problems were nonexistent. It was all just good, wholesome fun.
The studio cast ex-Mouseketeer Annette Funicello and teen idol singer Frankie Avalon as the leaders of these typical American kids, who had sex on their minds but never on their beach blankets. While Frankie made several overtures to get Annette out of her one-piece bathing suit, his libido was repeatedly wiped out by the bouffant-bearing virgin who was saving that party for her wedding night.
“Beach Party” was so successful that it spawned several sequels, including “Bikini Beach” (1964) and “Beach Blanket Bingo” (1965), along with a wave of copycat movies. These films helped create the mythology that inspired so many young people to go west in search of the California dream.
In 1969, only four years after the final Frankie and Annette beach movie, “How to Stuff a Wild Bikini,” was released, “Easy Rider” roared into theaters, reflecting the younger generation’s transition from surfboards, dancing and abstinence to motorcycles, drugs and free love. Hollywood was now producing films aimed at the emerging anti-establishment teen market, with AIP films such as “Wild in the Streets” and “Riot on Sunset Strip.”
But “Easy Rider” was the first counterculture film made by actual members of the counterculture. Actors Peter Fonda and Dennis Hopper were already staples of psychedelic-era films when they conceived the idea for a movie about two hippie bikers trying to “live free” in a country struggling through a severe cultural and generational gap.
The low-budget film was a surprising success, striking a chord with young audiences and critics alike. For the first time, a film realistically presented the disillusioned, lost-in-space generation who rejected the mores of contemporary society and wanted to “tune in, turn on and drop out.” For the film’s theme song, Hopper chose Steppenwolf’s “Born to Be Wild,” the anthem for this new generation of rebels with a cause. Thanks to its neorealist style, “Easy Rider” remains the definitive time capsule of hippie boomers at the end of the ’60s.
Where “Easy Rider” was an au courant snapshot of its time, “Saturday Night Fever” was slightly ahead of the culture curve when it was released in 1977. Based on a New York Magazine article written by Nik Cohn about a neoteric dance fad erupting at a Brooklyn nightclub, “Saturday Night Fever” ushered in the next phase in youth culture — the disco era. Once again, youths were dancing, but now go-go boots and jeans gave way to platform shoes and polyester suits accessorized with a sexual attitude that was much more casual than their meticulous fashion sense.
“Saturday Night Fever”
TV actor John Travolta boogied his way to global stardom as Tony Manero, a working-class kid expressing his personal freedom by hustling the night away on the dance floor. Men’s hairstyles got shorter and sculpted, while women’s hair got bigger and sprayed. Like “Easy Rider,” the movie was an unexpected smash, setting off an explosion of dance clubs and a new style of clothes. The double-album soundtrack of disco dance music, headlined by the Bee Gees, dominated the American and foreign music charts for most of 1978, selling more than 15 million albums and eight-tracks worldwide. The image of Travolta in his white suit, finger pointed to the sky, remains the iconic symbol of a gaudy era of excess.
Just as in real life, though, boomers in movies eventually have to grow up. One of the earliest films to explore this subject is “The Big Chill,” written and directed in 1983 by Lawrence Kasdan. In the film, Kasdan examined what became of counterculture boomers once they left college and faced adulthood.
“The Big Chill”
“The Big Chill” centers on the reunion of a group of now 30-something college buddies, brought together by their friend’s suicide. The once-idealistic students who were going to change the world are now immersed in the problems of adulthood, dealing with marriage, parenting, success, broken dreams, ticking biological clocks and death. For the most part, their anti-establishment behavior has matured into a more conventional demeanor, transforming the hippies of the ’60s into the yuppies of the ’80s.
But the film also dramatizes the boomers’ nostalgia for music and buoyant existence of their youth. In one of the film’s most memorable scenes, the camaraderie of the old gang is revived by dancing their way through an after-dinner clean-up fueled by ’60s Motown music. The problems of adulthood melt away as the music transports them back to happier times, and for a few magic moments their grief and guilt over their friend’s death is eased.
Today, baby boomers are deeply entrenched in their individual lives, dealing with a variety of personal issues. In recent years, films present a host of grown-up themes illustrating specific concerns of boomers. “The Company Men” (2010) demonstrated the effects of the 2008 recession that left millions of boomers without jobs, security or a sense of self-worth at a vulnerable age. In 2007, writer/director Tamara Jenkins shared her personal experiences of caring for parents suffering from dementia in her film, “The Savages.” And in “The Company You Keep” (2012), we get a glimpse into the covert existence of aging ’60s radicals, who are still on the FBI’s most wanted list, trying to survive under the radar.
On the lighter side, “The Best Exotic Marigold Hotel” (2011) addressed the limited choices offered to retired seniors with limited income, and the 2002 comedy “The Banger Sisters,” looked at what happens to rock groupies when they’re way past the age of Aquarius.
“The Best Exotic Marigold Hotel”
But leave it to Frankie and Annette to bring things full circle. In 1987, they went “Back to the Beach,” this time as Midwestern parents who return to their old sandy stomping grounds with their punk-rocker son — only to find their teenage daughter shacking up with a beach bum.
A new aging narrative for boomers from Milken Institute
When it comes to aging and retirement, the issues are big, the stakes are high, and the solutions are complex. This was the impetus for a recent gathering of innovative leaders exploring a new narrative of retirement at the inaugural Milken Institute Successful Aging Innovation Summit: Work, Productivity and Beneficial Purpose.
Underwritten by the John Templeton Foundation, the summit was hosted by the Milken Institute, a nonprofit, nonpartisan think tank focused on economics, policy solutions and health. A carefully curated group of approximately 30 guests, including academics, economists, journalists, social innovators, a politician and a faith-based leader, gathered for the summit at the Beverly Hilton Hotel from May 30 to June 1.
The essence of their conversation was poignantly articulated in an anecdote shared by Marc Freedman, 56, founder and CEO of San Francisco-based Encore.org and author of “The Big Shift: Navigating the New Stage Beyond Midlife” (2012). “There were three Jewish guys who called themselves the PIP squad — Previous Important Persons. Their motto was: The world may be done with us, but it’s just that we aren’t done with the world,” Freedman recalled telling the crowd.
The conference was organized by Paul H. Irving, 62, the Milken Institute president. Irving is also the author of “The Upside of Aging: How Long Life is Changing the World of Health, Work, Innovation, Policy and Purpose” (2014), a compilation of essays, many of which were written by summit participants.
Pointing to demographic reality, Irving explained to the Journal in an interview the need to rethink traditional retirement: “In the United States, there are 78 million [baby] boomers; 10,000 a day are turning 65. This is a phenomenon that is not just occurring in the U.S. — it is a … state of aging occurring throughout the world, with Japan’s population aging the most rapidly. So, this question about what people do in later life and how can we make longer lives productive and meaningful both for individuals and society is a very significant question for all of us — individually, and [as] societies and governments across the world.”
Participants agreed that a cultural change is imminent, and that developing a new roadmap for the largest group of aging Americans in history will involve discarding stereotypes and focusing instead on vitality, productivity and purpose.
“We feel that we are at the beginning stage of something really big and really, really exciting,” Irving said. “We have a longevity paradox. … As science does its miraculous work and enables us to live longer, healthier lives, what are we doing to take advantage of that incredible work that science has done? That is the question that we are trying to answer. ”
The summit brought together a cross section of leaders from diverse disciplinary fields. Those in attendance included Henry Cisneros, former mayor of San Antonio and former secretary of Housing and Urban Development; Leslie Stahl, “60 Minutes” correspondent; Pinchas Cohen, dean of the USC Leonard Davis School of Gerontology; and Lester Strong, CEO of AARP. The issues and perspectives discussed, and the slate of recommendations made, will be compiled and published by the Milken Institute later this year.
Laura Geller, senior rabbi at Temple Emanuel of Beverly Hills for 20 years and the only faith-based leader at the summit, said she came away from the meeting convinced that all faith communities need to pay attention to this cultural shift. Although focusing attention on the 20- to 30-year-old population has long been considered important for continued growth of the Jewish community, Geller believes it’s increasingly important to also focus on the critical cohort of what she refers to as the “panini generation.” These are the boomers who are squeezed between caring for their aging parents and the needs of adult children returning home to live because of economic challenges.
“For many people, the spiritual question relates to the fear of invisibility. Once I am no longer the senior rabbi at Temple Emanuel, who am I? Once I am no longer the senior partner at a major law firm, what am I? That’s a real question that boomers are dealing with.” Geller said.
To work toward solutions, Geller uses an organization model that involves a series of meetings held in congregants’ homes, where 50- to 75-year-olds gather to reflect on the challenges ahead — financial preparation, intergenerational connection, mentoring, health care, community, creating new rituals, spirituality and more. And Temple Emanuel is organizing a city-wide conversation Nov. 9 called “The Next Stage: Looking Forward and Giving Back.”
Freedman is also working on solutions through his nonprofit company Encore.org, which is a resource for connecting people who are making a social impact and helping others create their own second act. Encore.org offers a fellowship program — an internship for adults who want to transition from the private sector into the nonprofit world. In addition, Encore.org provides a “purpose prize” for social entrepreneurs to further their work. This year’s $100,000 prize was awarded to Judea Pearl, a UCLA computer science professor emeritus and the father of slain Wall Street Journal reporter Daniel Pearl.
“We are getting these mixed messages from society,” Freedman said. “Do we hang on to our fading youth — the 60s are the new 40s — or accept the new senior discount at 50 or 60 and accept premature old age? We are on the verge of changing the map of life [to one] that is suitable to the changing length of life. I think for many people, it’s a new crown of life.”
A number of viable strategies emerged from the discussions at the summit. One was the creation of an “individual purpose account,” similar in concept to the existing individual retirement account (IRA). Designed to help enable people to reinvest in their human capital, this plan would make available a year or two of their Social Security benefits, which they could withdraw without penalty early, in their 50s, in order to go back to school or participate in an internship. Then, they would be permitted to replenish what they’d taken out, and get back to their full benefits, by working later into life.
The idea that had the most momentum at the summit was the creation of a “Boomer Corps,” a national service program. Similar to the Peace Corps, which was originally created for this same generation, the Boomer Corps would offer opportunities at the juncture in life when people are looking for help resetting priorities, re-examining identity and finding new, rewarding kinds of experiences.
“We all learn, as Jews, tikkun olam,” Irving said. “Older people are extraordinarily valuable assets to improve the world. There is more to life than … golf, or shuffleboard or just this inextricable decline to death. There is a great opportunity later in life to do things that are even more important … than maybe what one has done earlier in life, more meaningful, and have the potential for more lasting impact for good in the world.”
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 firstname.lastname@example.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.
Discussing death: Advanced directives, living wills and more
Nobody likes to contemplate — let alone talk about — one’s own death or that of a loved one. However, now that medicine has advanced to the point that it can keep people alive, with or without consciousness, long past the stage that they themselves would have wanted to live in that diminished way, it is imperative that we all have these conversations with our loved ones. They need to know what we would want to be done to keep us alive and when we want just to be kept comfortable and let nature take its course.
As the philosopher Immanuel Kant pointed out, “can” does not automatically mean “ought.” The fact that we now can keep people alive through all sorts of medical interventions does not mean that, in every case, we should.
To make it possible for people to express their wishes about their mode of dying, all 50 states, beginning with California in the 1970s, have given legal authority to advance directives. An advance directive consists of two parts: a durable power of attorney for health care and a living will.
In the durable power of attorney for health care, a person designates a surrogate decision-maker when he is no longer capable of making his own health care decisions, and alternative people if the first surrogate is not willing or able to function in that capacity when the time comes. In California, the document must be signed by two witnesses or notarized.
In a living will, the document presents some decisions that people who are dying commonly need to make with regard to their health care and asks the writer to make choices among the various options. For reasons described below, it is best to give the person designated as the surrogate decision-maker authority over the living will.
Why should you fill out such a form in the first place? The reasoning as an American and as a Jew can be very different. In American bioethics, it is to preserve patient autonomy. This is based on a deep American commitment to individual liberty.
Most of us, however, are not trained in medicine. For instance, when I was helping my mother-in-law fill out her advance directive and we began talking about what interventions she would want, she first said she wanted “everything.” Then when I described to her exactly what was involved in each of the interventions listed in the will, one by one, she said “Oh, I wouldn’t want that!” — and it turned out that she did not want anything except to be kept comfortable through medication. So the very process of filling out an advance directive helps to clarify what a person really wants.
Even so, there are problems with the American rationale for advance directives. First, nobody knows exactly how they are going to die, and advance directives can ask only about some common issues that people face when they are dying. So it is quite possible that the directive will not address the actual questions that a person will face altogether. Furthermore, even if the directive discusses the exact condition that the patient ultimately has, how do we know that what the person said two years ago — before facing the ravages of a disease, perhaps — is what the person wants now?
With advance directives, as with any document, there are often problems of interpretation. If, for example, the patient wrote he does not want any “heroic” measures to keep him or her alive, how do we know what that means? Or what happens if the patient wrote that she does not want to be kept alive if she cannot recognize her near relatives, but she sometimes identifies them correctly and sometimes not?
Finally, the dirty secret is that despite the legal requirement that physicians follow an advance directive, doctors will usually consult family members or surrogate decision-makers and follow their wishes rather than abide by whatever is written in a directive — or at least try to get them to agree to interpret the directive in a particular way and to follow it with that understanding. This is because after the patient dies, the patient will not sue the doctor, but any one of the family members might.
A better reason for filling out an advance directive is for the Jewish concern for family harmony. You want to avoid situations that I have seen all too often, where, let us say, there are three adult children and two of them agree with the doctors that there is no hope that Mom will recover to what she would consider meaningful life and so they want to remove life support so that she can die in peace, but one of them wants to keep Mom on life support forever.
To help families avoid those situations, make multiple copies of the advance directive and give one to your primary care physician, lawyer and each of the adult members of your family. Then call a family meeting. Nobody likes to talk about death, least of all one’s own, but Jews know how to attack a text. You can go over the document, express what you decided and why, and answer questions anyone has. This will enable whoever is designated to make decisions for you to have a sense of what you would have wanted even if you did not specifically address the exact situation that ultimately confronts you as you die. Moreover, whoever makes the decisions for you will not feel guilty in doing so, for he is not imposing his own values but rather acting according to yours. This will not guarantee that the siblings will be able to have good relationships with each other after your death, but it will at least take away one of the sources of possible conflict.
Finally, filling out such a form is important in order to arrange for organ donation. The Conservative Movement’s Committee on Jewish Law and Standards has ruled that it is not only an act of chesed (loyalty, kindness) to provide for the donation of one’s organs after death to someone who needs them or to an organ bank; it is a positive obligation to do so. Representatives of all of the movements in Judaism have at least permitted cadaveric organ donation, and most encourage it. Filling out an advance directive enables one to carry out this mitzvah.
Normally, we think that people executing these sorts of documents are fairly advanced in years, for they, we reason, are facing death in the not-too-distant future and therefore need to confront such matters. All of the hard cases in American law, though — cases like those of Karen Ann Quinlan and Nancy Cruzan — have centered on people in their 20s, who statistically are the most likely to be involved in fatal traffic accidents or violence but think of themselves as being invincible. They therefore never communicate to relatives or others how they would want to be treated in the context of critical care.
My own view is that it is important for people to complete an advance directive for health care as soon as they get their driver’s license or as soon as possible. Boomers, keep that in mind for your children and grandchildren — and yourselves if you have not created one yet. The Conservative, Orthodox and Reform movements have all created advance directives in accordance with their own understandings of how to apply the Jewish tradition to our lives. So find the one that fits your outlook on Judaism, fill it out, and have that family meeting soon.
Rabbi Elliot N. Dorff is rector and distinguished professor of philosophy at American Jewish University.
The following websites offer advance directives for different Jewish denominations:
State of California: http://ag.ca.gov/consumers/pdf/AHCDS1.pdf