Tuesday, March 16, 2010

Back to school

As of two weeks ago, after just about eight years out of university, I've been driving south weekly to Beer Sheva for a Master's in Gerontology at Ben-Gurion University (in the management track). Classes are Tuesdays and Wednesdays, so I stay in town Tuesday nights, and the rest of the week I'm still in Jerusalem. I'm learning a ton from both the wonderful professors and the well-versed students, and really enjoying the campus life. One student was so friendly in welcoming me to campus that when I asked her where I could find a jewelry store to replace the clamp on my chain, she just put in a spare clamp she had at home and brought it back to me. That gesture, a totally random favor for some dude looking for a jewelry store, really blew me away. And as Beer Sheva doesn't draw students the way that say Tel Aviv and her beaches do, the university supports events such as the Mashina concert I saw last week. They're one of my favorite rock bands, and probably the penultimate Israeli rock band out there. This year they're celebrating 25 years since they got together. For 40 shekels (about 10 bucks), I saw them tear the roof off the Forum, and that included a free beer to boot! Tell me if you can get just a beer that cheap at a stateside Springsteen show. Playlist at bottom...

At the end of February, I took part in the 2010 Melabev Geriatric Study Tour, which was back to normal--incredibly informative and educational. With another impressive participant base, the conversations between sessions again brought great added value to the overall experience.

The tour commenced at Yad Vashem, where Ephraim Kaye taught us that Israel's Holocaust museum's name (translated as "everlasting memorial") comes from Isaiah Chapter 56. Cynthia Wroclawski, head of the Names Collection Project, helped to spread the word on this amazing project, which has connected survivors who thought that each other had perished (we saw a video about such siblings). We then heard from the amazing survivor Eliezer Ayalon, who had been totally silent about his experiences in the Holocaust for 37 years before opening up. How incredible to meet Eliezer in Jerusalem, the city which was always on his parents' lips.

Our next stop was the Juabeh Hospital in Beit Hanina (the only geriatric hospital in Arab East Jerusalem). We learned that the title of the home carries a lot of meaning--"hospital" is culturally acceptable in the Arab sector, but "nursing home" is taboo, and seen as a sign of embarrassment to adult children, who are expected to care for their aging parents. Along those lines of the importance of children, we learned another interesting cultural tidbit--both men and women will go by a translation of "Ellen Em Eric" (my mom would be Ellen, the mother of Eric. Sorry sis--they go by the name of the first-born son).

Later that day, we heard from consecutive non-profits connected to the mega-non-profit Yad Sarah: Dvora Corn from Tishkofet (meaning "perspective)-Life's Door, which supports patients at the end of life and their families. Tishkofet coordinates its volunteer training with Yad Sarah; and the next speaker, Elisheva HaCohen from Mosaica (a center for conflict resolution by agreement), informed us that they are based in Yad Sarah.

We then took a tour of Melabev's state-of-the-art new Talpiot Center from Melabev Director Motti Zelikowitz. The center daily serves about 70 clients with dementia.

Day two started at San Simon's Neve Horim nursing home, which has been operating in Jerusalem (at various locations) for 130 years. We saw a thought-provoking movie that was produced by and featured actors who are residents of the home. The group lounged in style during a relaxing visit to the Snoezelaan Room, a multi-sensory therapy technique.

Then we heard from a municipality social worker who is responsible for neighborhood centers which serve as a first response in emergencies (helping low-income seniors to avoid having to pay for an ambulance) and in providing long-term services. An Ethiopian social worker educated us on her culture's take on elder care. "Shmagileh" is the Amharic word for elder, meaning one who has knowledge and wisdom. She said that nursing homes are not in any way in the picture at this time. In order to get participation from Ethiopian elderly, it is crucial that they come together in a group. We saw Ethiopian culture firsthand during our tour of Yad LaKashish (Lifeline for the Aged)'s creative workshop, where elders of countless backgrounds were creating beautiful works. Participants receive a salary for their work, allowing them to continue to contribute and function successfully in Israeli society. We subsequently helped pay those salaries and supported the cause in the adjacent gift shop.

From there we headed to Eshel, where Cindie Klein informed us that 96% of Israelis live in the community; the main focus within elder care is on aging in place (particularly at Eshel). Then Naomi Chanochi discussed her area, Health Promotion. Eshel develops services, and then municipalities run them. The programs are not typically expensive, and they are self-sufficient early on. A new program, French bowling (like bocce ball) has been a hit among elderly men, a demographic which had proven difficult to engage in physical activity.

We then headed to Shaare Zedek Hospital's cardiac rehabilitation department, where we heard from a geriatrician and took a look at the gym (whose director was familiar with Dad's gym's founder, Dr. Kenneth Cooper). After a quick tour of state-of-the-art assisted living facility Ahuzat Beit Ha'Kerem, I jotted back across the street to catch a minyan for mincha (afternoon prayers) back at Shaare Zedek's synagogue (these were my first services at a hospital). It was pretty powerful, and humbling, to pray for G-d to heal the sick (among the rest of the prayers) along with patients in wheelchairs and others with IVs and other treatment connected to them. Next was a lecture on swallowing problems by Sharon Ron, director of Maytav-Jerusalem center for speech and swallowing disorders. She taught us that dysphagia is the term for swallowing disorder; aspiration is when food enters the airway; aspiration pneumonia is the #1 cause of death for Alzheimer's and Parkinson's patients; and that there is a pinch test to check for dehydration--when the skin is pinched, a sign of dehydration is that it does not return quickly to its natural form.

The tour's final day started at Mevasseret Zion's elderly day center, which serves 80 local older adults and has been in operation officially since 1988. A nice touch to break through language barriers among this center's mostly illiterate participants is a pantomimist--everyone understands!

We then saw how Kibbutz Maale HaChamisha cares for elderly in its small-scale skilled nursing home. Geriatrician Dr. Zvi Buckman shed a great deal of light on Israel's preventive medical care for older adults. Within geriatrics, he said you must look a the function of the person, not the diagnosis; there should be a multi-disciplinary approach, with assessments by the doctor, nurse, and social worker; and you should look at typical geriatric syndromes--such as dementia, depression, sleep disorders, and incontinence. As such, it is preferable for a 50-year-old with dementia to visit a geriatrician. 50 to 75-year-old women should proactively have mammograms (ideally every two years). 50% of those who break a hip do not regain function within one year, and one-third end up in nursing homes. Improving vision (i.e. cataract surgery) actually increases the risk of fall; bifocals can also interfere. The only exercise that helps is balance exercise, such as tai chi. Blood pressure above 140/90 can increase the risk of stroke. It is not so clear how helpful vitamin D is for bones, but as one ages, their vitamin D absorption from the sun decreases. Glaucoma is the #1 cause of blindness in the world; anyone with diabetes should get their vision checked. At any age, stopping smoking will result in decreased health risks one year later. Medications aiming to lower cholesterol also lower good cholesterol. Niacin is the only known way to raise HDL. Mild forgetfullness and high blood pressure together are a risk factor for dementia. Vitamin B12, found in red meat and eggs, clearly prevents cognitive problems and gait disorders. Dr. Buckman disproved the myth that Israel's health care system is public--rather, it is government-subsidized. Health care takes up about 8% of Israel's GDP, nowhere near the roughly 17% in the US. Doctor salaries are roughly one-third less in Israel, but malpractice insurance is relatively microscopic. 90% of back pain goes away within three months. Whew-he was a wealth of information!

We finished the tour at Beit Ha'Ela, a 103-resident nursing home (with a Russian-speaking majority), which has been in operation since 1986, then wrapped up over a delicious dinner at a phenomenal restaurant with its own enormous greenhouse, on the outskirts of Beit Shemesh. Three jam-packed days...A great picture of Israel's diverse world of elder care...Fantastic connections...So much elder-care knowledge!

I have to get up early to head in the other direction, up north to Tzfat for a weekend with fellow OTZMA alumni (my volunteer program five years ago) along with the current participants.

The sad news of the day is that of the murder of a Thai greenhouse worker by a rocket launched over the border fence from Gaza.

Ever since an Israeli bureaucratic snafu led to unprecedented condemnation from the Obama administration, I have been swimming in websites covering the dispute. Please bear with me and my million links:

I'd start by asking those of you who are up for it to compose and send AIPAC's note re-affirming the Israel-US alliance to your senators and representatives.

Here's a good look at Biden's Tel Aviv University speech from American Thinker. I suggest you also follow the link to the speech, much of which was very good. I appreciated this line: "Every time progress is made, it’s made when the rest of the world knows there is absolutely no space between the United States and Israel when it comes to security, none. No space." Sadly, it doesn't seem that Biden's statement contrasting Obama's words to American Jewish leaders last July holds much weight in light of the latest crisis. Barry Rubin tells it as it is here on the American-Israeli relations snafu. Isi Leibler takes a look through Obama's tenure into his relations towards Israel. The Jerusalem Post covered Anti-Defamation League National Chairman Abe Foxman and others' denunciation of the Obama administration's assertion that apartments on the other side of the Green Line in Jerusalem endanger the lives of US soldiers. Here's some history on US legislation with regards to Israel's Jerusalem policy. An American Thinker columnist expresses her deep concern over the relations here. That website's chief political correspondent Richard Baehr puts it bluntly here (with his own great list of informational links). Here's the Israel Project's general response to the crisis. And here's an Arutz Sheva piece with some helpful info about Jerusalem neighborhoods.

As for some columnist for the Times named Tom (whose writing I once enjoyed), I would counter that Israel is driving straight. The US, on the other hand, seems to be swerving in my lane, distracted with all the wrong issues as Iran defies deadline after pathetic deadline on its push for nuclear weaponry. (Friedman also conveniently ignored that terrorists based in Hamas-controlled Gaza have fired more than 25 rockets and mortars into Israel in 2010.)

Here's the good news on the arrest of the terrorist who murdered many Israelis at the closest cafe to my apartment, a two minute walk away, back in 2003. Here we have news of a firebomb attack on a father and his baby son. If anyone heard the Obama administration condemn that one, please let me know. Here is the Israel Project's look at the Palestinian attempts to destabilize Jerusalem.

Lest we think Abbas and Fayyad's Palestinian Authority are genuine partners for peace, here's an interview with Itamar Marcus, head of Palestinian Media Watch on the countless examples of Palestinian demonization of Israelis and Jews. More of that here from the Jerusalem Post.

Hopefully next week I'll make it to the re-built Hurva synagogue since its Monday dedication. This Arutz Sheva piece includes a couple amateurish videos, but they're still cool to see. I vividly remember visiting the ruins of the Hurva as the first stop on our way into the Old City towards the Western Wall back on my high school teen tour in 1996. Check out the history of the Hurva synagogue going all the way back to 1700. Here's a look at the battle for the character of the newly rebuilt synagogue. A Jerusalem Post editorial ties this synagogue to Israel's general theme of redemption.

Here's a nice uplifting look at Israel's hi-tech success story as told by Saul Singer, co-author of Startup Nation. The interviewer gets a generous two stars, but Singer is definitely worth hearing (and I'll have to read the book at some point as well).

And with Pesach a week and a half away, Rabbi Oren Hayon from my parents' synagogue in Dallas is working on the remix of the Haggada on twitter.

Shabbat Shalom,
Eric/אריק

I missed a few of the Mashina songs, but here's most of the playlist:
  • להתראות נעורים שלום אהבה
  • את לא כמו כולם
  • בנות הים
  • התשובה
  • אז למה לי פוליטיקה עכשיו
  • אחכה לך בשדות
  • רני בפריז
  • ברחובות שלנו
הדרן:
  • תחזור תחזור: גיטרה אקוסטית ופסנתר, נהיה מין שירה בציבור, פשוט יפה
  • הכוכבים דולקים על אש קטנה
  • רכבת לילה
  • אין מקום אחר

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