January 24, 2019

Mom, Dad: Welcome home — to Israel

When Shoshanah Kahn, now 57, made aliyah from the United States with her husband and children 24 years ago, her parents were an active Los Angeles-based couple in their 60s.

But as her parents, Adaire and Manny Klein, grew older — they’re now 84 and 87, respectively — they began to miss their three adult children, who lived out of state and in Israel.

“They were very happy in L.A.,” Kahn said, “but they finally came to the realization they needed to move closer to one of us.  It took a long time but they decided to live in Jerusalem.”

Kahn said the move took some getting used to for everyone, but that she and her parents — including her mother, the long-time librarian at the Simon Wiesenthal Center — feel blessed to finally live in the same city. 

“There’s no question it’s been a big adjustment,” Kahn said. “For one thing, it’s taken time for them to get used to the medical system. They had the same doctor for 30 years, and here they had to start from scratch.”

One decision that eased the transition was the Kleins’ eagerness to move into an assisted living facility.

“They both have physical challenges, and in the beginning needed me to take them everywhere. Now they get themselves into a taxi and go everywhere. I try to give them as much independence as possible and they want that independence,” Kahn said.

While millions of members of the boomer generation are caring for aging parents, additional factors come into play when boomers who made aliyah bring their parents to live in the Jewish state, experts say. 

“As with boomers everywhere, just when your kids are getting out of the house, mom needs to move in,” said Josie Arbel, director of absorption and programming at the Association of Americans and Canadians in Israel. “But those stresses are complicated by distance.” 

Although some elderly parents decide to make aliyah because they have a lifelong dream of living in Israel, Arbel said, more often than not the catalyst is the death of one of the parents or the illness of both that prompts a move to Israel to join family. Arbel advises olim who bring their parents to have a frank talk with them before the latter’s aliyah. 

What are your expectations and their expectations? How involved do they want and expect you to be? If your parents are relatively independent, they will still need to rely on their Hebrew-speaking children to deal with Israeli bureaucracy: the health care system, city taxes and various appointments. 

Although Israel’s excellent universal health care system must provide medical care to citizens of any age, in any condition (the first year is free for new olim), the supplementary insurance provided by the various health funds (HMOs) for an additional fee may deny coverage because of pre-existing conditions, Arbel said. Immigrants must be in Israel at least 183 days per year to be eligible for government health care.

Where newly arrived elderly parents will live is arguably the most important decision a family can make, she said. 

“Sometimes a parent will say, ‘My kids want me to move to Modi’in [located between Jerusalem and Tel Aviv] but I’d like a social life, so want to live in Jerusalem.’ How does the parent see his or her retirement? There are many opportunities for seniors, a huge amount of volunteer opportunities and learning enrichment,”  Arbel said.

Those who can’t live on their own can choose from a wide assortment of assisted living facilities and nursing homes all over Israel. Others choose to live in their children’s homes, an adjoining “granny flat” or a separate apartment with or without a caregiver. 

Barbara Brown, director of Aliyah121 Private Aliyah Assistance and Consultation Services for Seniors, is a geriatric social worker. She advises family members to really talk and listen to one another when considering aliyah at an older age. That’s good advice for any parent making this kind of transition, but especially important for a change of this magnitude. 

“Children, find out what your parents want, what you can do for them, what they can do independently. Parents, you need to think where you want be in relation to your adult children as you grow older and may need some assistance and support,” Brown said. “For some, joining their children in Israel can be an excellent move, while in some situations, if they are settled safely and have good support abroad, perhaps they might consider not moving. Good pre-aliyah planning and consultation can help make for a better decision.” 

Brown said that, just as in North America, many Israeli retirement homes and assisted living facilities have a nursing branch on-site. 

“Dad may need nursing care on the sixth floor while mom is much more independent on the second floor. They can eat and spend time together if they like, even while living in different departments based upon their different needs.”

Some facilities require a deposit, which range from  tens of thousands to hundreds of thousands of dollars, but charge lower monthly fees, while others require no deposit but can cost around $3,500 and upward per month, Brown said. Nursing home beds can range from around $2,600 to nearly $5,000 per month. Nursing homes and some assisted living facilities receive government subsidies for those who cannot afford but need the care.

Brown’s own mother moved into an independent living residence in Jerusalem after selling a home in Canada. This enabled her to pay an entrance fee and a “fairly reasonable” monthly maintenance fee that covers security, on-site medical services as well as activities. 

A free, comprehensive, step-by-step guide to the issue of elderly parents and Israel has been written by Fern Allen, who based it on her own experiences. “An Informal Guide to Bringing Your Elderly Parents to Israel,” available by emailing jewishpapercuts@gmail.com, covers topics ranging from finding the best health fund to finding a paid caregiver. 

Allen said caring for an elderly parent requires an extraordinary amount of time and energy, but it’s worth it. 

“Your work and family life will be tremendously disrupted,” Allen said, “but this is a precious time you’ll never regret.”