Executive Summary
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 better—by 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:
- Long-term care
- Voluntarism and productive aging
- Housing and aging in place
- Educational programs
- Planning and development of services
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.
AICE Executive Director
April 1995
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