Issue No. 4,
(This article first appeared in Israel's Hebrew online news service NRG)
The joyous holiday of Chanukah has always been associated with family gatherings and reunions, the stuff from which warm and lasting memories are made. But the passage of time is dual-edged. Watching the faces of our loved ones shine in the light of the Chanukah candles, we of-times see changes—sometimes physical, sometimes cognitive. Our parents or grandparents, or we ourselves, are no longer as young as we/they once were. Sometimes there is partial impairment. And in this setting, our gathering could well be characterized by a feeling of adjustment to a new family reality.
According to tradition, our forefather Abraham asked God for the gift of old age. Before that, old age did not exist – young and old looked and behaved alike, and were not differentiated. Modern and post-modern thought holds the old world in disdain, as well as those who grew up in that world, and thus relates to Abraham’s request as odd at best, and cursed at worst. There are vast amounts of money involved in the business of old age, not always to the benefit of the elderly, yet our latent desire is to banish old age from our world and from our consciousness. We perceive aging as depressing and something to fear, and our aspiration to eradicate it finds expression in many forms.
Yet tradition teaches us that Abraham demanded old age. “For if a man and his son enter a place, one does not know to whom respect is due! If you adorn him with old age, it will be known.”
As a spiritual caregiver and head of a training program for spiritual caregivers, I often encounter the shame of old age that contrasts with the honor traditionally accorded it. Spiritual care-giving is a new and developing profession in Israel. The training program for it resembles those in other western countries, but in Israel, unlike in North America and Europe, people who choose this profession are not necessarily clergy; in fact, rabbis refrain from presenting themselves as such in hospitals and other settings where spiritual care-giving is offered. This obviates religion-based friction and also allows development of a varied cadre of caregivers. Students training to be spiritual caregivers learn to diminish their personal worldviews and, together with the people they are caring for, to seek the most suitable way towards finding spiritual strength in the face of distress. The caregiver employs tools such as joint learning, song and conversation that fit the worldview and milieu of the person receiving the care.
First group of chaplains in Israel certified by the Israeli Network of Spiritual Care, including founding director of Schechter's Marpeh program, Einat Ramon (front row, second from right).
There are a number of housing facilities for elderly people, mainly old age homes run by the Joint Distribution Committee, that employ spiritual caregivers, thanks to long-term funding provided by the Jewish Federation of New York. This funding supports the training program and employment of trainees and graduates. Different types of care are provided depending on the individual situation, the most challenging of which is caring for people suffering from dementia or Alzheimer’s. In an attempt to preserve their cognitive abilities, we ask these elderly to read aloud from a book that interests them, or to share with us their knowledge on a particular subject, be it Talmud or physics. We pore over family albums together with them, and if we are in a home setting, cooking and folding laundry can also be a form of care-giving.
Caregivers know that song and music can almost always reach any person, even if he seems to be asleep in his wheel chair. Song is a prominent part of Jewish culture, whether it take the form of traditional prayer or secular Israeli songs, and serves as a wonderful channel of spiritual communication.
I have heard of many cases where a family shuts itself up in the home when a parent is diagnosed with Alzheimer’s or dementia. The person’s inappropriate or irrational behavior in public, and lack of social awareness, often result in his/her isolation from family members and from familiar social circles. There are even some sheltered housing facilities that will not accept a spouse suffering from dementia, even if s/he is quiet and disturbs no one.
Ironically, keeping these people isolated from social settings only leads to a deterioration of their situation. In contrast, if the family embraces the ailing parent and adapts to his/her situation on a daily basis, the illness progresses more slowly. The secret lays in the fact that daily care for a person with debilitated understanding will reveal small but amazing fragments hidden within the soul. Several months ago, Udi Aloni eulogized his mother Shulamit and described her last years. At the end of her life, in her confused state, a gentleness suddenly emanated from within this woman who had been strict and rational her entire life.
In fact, every family who cares for someone suffering from dementia is engaging in spiritual care-giving. Society must adjust to this reality, just as it has accepted the fact of special needs children in the educational system. We who care for parents or spouses who are “not what they used to be” need to relate to them as they are, with understanding, gentleness and restraint, at home and in the public sphere. When we learn to accept our loved ones who have withdrawn into themselves, we are rewarded when we observe glints of understanding that we never noticed before. A surprising, unexpected statement that comes from deep in the heart of an Alzheimer’s patient is a miracle worth preserving and remembering, just like a child’s first words that are engraved on the collective family memory.
English translation by Penina Goldshmidt.
Dr. Einat Ramon is a certified spiritual caregiver and Founding Director and Counselor of the Marpeh Progam for Spiritual Care at the Schechter Institute of Jewish Studies. She is a Senior Lecturer in Jewish Thought and Women’s Studies at the Schechter Institute.