In their book, Putting People First: How We Can All Change America, Bill Clinton and Al Gore wrote of older Americans: The generation that worked its way out of the Great Depression, won the Second World War, and endured the worst of the Cold War has seen harder times than these. But older Americans know that we can do betterby them and by future generations.
Older Israelis have certainly seen harder times. Many are Holocaust survivors and veterans of Israel's six wars. In Israel, as in most Western countries, the number of older persons continues to increase: both the disabled elderly, who require some form of long-term care services, and the well elderly, who need assistance and encouragement to continue to lead productive and independent lives.
Jewish tradition emphasizes respect for the elderly and Israel has always made meeting the needs of its older Jewish and non-Jewish citizens a priority. Because of our belief the United States could learn valuable lessons from the Israeli experience, the American-Israeli Cooperative Enterprise commissioned this study, which describes 16 innovative Israeli programs for the elderly that could be imported for the benefit of older Americans. The report is divided into five sections:
The programs included here were selected by American and Israeli experts on the basis of their success in Israel and their uniqueness to the American scene. They were identified through questionnaires distributed to the government ministries, universities, service providers and other public, private and voluntary organizations working with the elderly in Israel. Each report includes a description of the program's objectives, operation (including program content, target population and staff), and financing, bibliographical resources related to the program and sources to contact for further information, as well as special features that distinguish these programs from other programs for the elderly.
One program is used to monitor and improve care in nursing homes. Several others are aimed at avoiding institutionalization and incorporating the elderly into the community. At the national level, for example, Israel provides benefits for seniors that are supplements to family care, which have delayed or prevented institutionalization of the less severely disabled by reducing the burden on the family and increasing the well-being of the older person.
Day care centers have also been established at a lower cost than in the United States, which are based on a social rather than medical model and emphasizes care by the community rather than institutions. These centers also provide special assistance for the cognitively impaired (e.g., people with Alzheimer's). Israel has also developed intergenerational housing arrangements that do not separate older people from the rest of the population, but rather encourage young and old to develop stronger bonds and assist each other.
With a population that includes a disproportionate number of people over 75, the cost of care might exceed the nation's means if it had not successfully developed innovative models of volunteer assistance, including networks that provide medical supplies, equipment and services, counseling centers and monitors of the condition of older citizens and the quality of their care. This spirit of voluntarism is shared by Americans, but has not yet been mobilized for the benefit of our older citizens to the extent it has in Israel.
Israel also believes its older citizens can make significant contributions to the nation. Programs encourage them, for example, to volunteer themselves for activities such as aides at preschools. They also are given opportunities to work as craftspeople in workshops that are adapted to their needs. Special programs have been created to allow older Israelis to attend college, and to take special courses in areas like basic computing, so they can continue their educations and learn new skills. One program was designed to utilize their expertise and experience to conduct research on issues of particular interest to the aged.
Most of the programs described in this report can be adapted for use in the United States at minimal cost. Some programs cannot be transferred without being modified and others may have elements that are more innovative than others. The study is meant to give policymakers, care-givers, professionals and advocates ideas of how we can do a better job in caring for older Americans. Additional information on the programs discussed here is available either directly from the sources listed in the report or from AICE. Anyone interested in importing one of these exciting programs should contact AICE and we will work with you to make the necessary contacts and to assist in securing funds for a pilot project.
Mitchell G. Bard, Ph.D.