For the Jewish Home, helping to maintain employee health and wellness is a priority. This encompasses wellness of the body, mind, and spirit. Urban Zen, a program recently added to the many healthy activities offered by the Home for employees, is quickly gaining popularity.Urban Zen was created by visionary designer Donna Karan. As her husband, Stephen, battled lung cancer, he was very aware that his caregivers — doctors, nurses, other medical staff, and family members — seemed to be even more stressed than he was. He asked Donna to do something for caregivers. "The hope was that, by helping caregivers, it would create a ripple effect that would benefit patients as well," explains Susan Jefferson, a certified Urban Zen therapist at YogaWorks and facilitator of sessions at the Jewish Home. "Seeing your caregiver crumble can create a great deal of stress in someone who is ill."Stephen's request led to the conceptualization of Urban Zen, a holistic healthcare practice created to give people another option for treating pain, anxiety, nausea, insomnia, constipation, and exhaustion. This practice combines five techniques — yoga, Reiki, essential oils, nutrition and contemplative care, such as meditation — and is often used as a supplement to conventional care. Urban Zen uses movement, reflection, visualization, and sensory stimulation as tools to help participants achieve a state of Zen, or calmness.Urban Zen incorporates some of the basics of yoga, in particular focus on breath and use of restorative movements. "As we begin each session, we evaluate three main components: the levels of pain, anxiety, and insomnia the employees may be dealing with at that time," says Susan. Based on need, essential oils are recommended to help alleviate those problems, followed by some gentle movements and a body scan, which helps you to become more mindful of your body and how it feels.The benefits of Urban Zen can be experienced at any age. "Everyone's body, whether young or old, recuperates and restores better when there is balance between the body, mind, and spirit," Susan explains. "Healthcare workers put the concerns of others first, often without taking time to focus on their own needs." Urban Zen can provide the time, space, and tools to slow down and look inside.Sharon Ginchansky, vice president of human resources, explains why it was important to bring Urban Zen to the Home's employees: "We want to help our employees be healthy and happy. A big part of promoting employee wellness is lessening their stress levels, and Urban Zen is an excellent way to do this." She adds, "Taking a few minutes out of our day to focus on our own well-being can help us recommit to the work at hand and bring a sense of inner peace. Urban Zen is a great de-stressing practice because it can be as simple as inhaling fragrant oil or focusing on breathing."Through ongoing research surveys, people who participate in Urban Zen classes report greater relaxation, a renewed sense of peace and calm, reduction of aches and pains, clearer thinking, and better sleep and digestion. "The best part is you can take what you learn in a session and use the techniques on your own to help prevent symptoms from recurring," says Susan."Urban Zen provides a wonderful break from my work stressors," says Debbie Fishel, a regular member of the Grancell Village employee group. "The relaxation techniques I've learned help get me through the rest of the week." Dr. Rick Smith notes that sometimes it's difficult to make time to attend, "but I'm always glad I did."

On Monday, January 12th, Jewish Home residents Evelyn Selbert, Beatrice Hoffman, Jan Crane, Grace Peshkin, and Ida Garber assembled in the Eisenberg Village Boardroom to be part of a brand new activity — Flower Arranging.Equipped with wire cutters, scissors, vases, red and white silk roses, and an assortment of artificial grass and sprigs, the five women had everything they needed to start their project.As the group grew quiet and began to focus on the task at hand, activities director Caryl Geiger explained, "We have enough supplies to create 72 arrangements — one centerpiece for each table in the dining room. So be sure to make each and every bouquet as beautiful as possible." And with that, the room began to buzz as the women grew excited at the thought of their artistry being exhibited in such a public place.Energized by the collaborative environment, the project was successfully completed within the hour. The beginner florists then gathered the collection of completed arrangements and took a moment to admire their handiwork. Beatrice Hoffman commented, "We're all novices here. None of us have taken any lessons on how to arrange flowers. To see completed arrangements all together is simply gorgeous. What a wonderful experience."In reflection of the activity, Caryl commented, "By displaying the hand-arranged floral centerpieces in the dining room, we are able to enhance our seniors' dining experience while showcasing the excellent work done by our new florists."The program was an incredible success and the group of budding florists are looking forward to meeting again in a few months to create new arrangements for the spring season."You know what's funny?" Evelyn asked. "I've never arranged a bouquet in my life. I don't even consider myself a flower person." To which Caryl replied, "But now you are, darling!"

It is a well-documented fact our health is influenced by factors that include our social well-being. Studies demonstrate a direct link between the number of significant relationships in our lives and a reduced risk for disease, mental illness, and early death. It turns out that feeling cared-for, valued, and part of a community make a profound difference in the quality and duration of our lives."People with social support have fewer cardiovascular problems and immune problems, and lower levels of cortisol — a stress hormone," says Tasha R. Howe, PhD, associate professor of psychology at Humboldt State University. "Why? The evolutionary argument maintains that humans are social animals, and we have evolved to be in groups. We have always needed others for our survival. It's in our genes. Therefore, people with social connections feel more relaxed and at peace, which is related to better health."Relationships are an essential part of health. What's more, they help keep our brains from getting rusty, especially when augmented by a healthy lifestyle, a nutritious diet, and regular physical activity.As study after study notes, friends are a key asset. They help us face adverse events, provide concrete assistance if we need it, offer emotional support and information that can help us deal with the stress in our lives. Friends can encourage us to take better care of ourselves.People with wider social networks are also typically higher in self-esteem, and feel they have more control over their lives. On the whole, people with extensive networks of good friends and confidantes outlive those with the fewest friends. Conversely, isolation and loneliness create responses in the body similar to those of stress.The body functions best when we are connected to other people. Activity is crucial to our happiness. Doing something fun and new expands our repertoire of experiences, and lets us see ourselves in new ways. Individuals who continue to maintain close friendships and find other ways to interact socially live longer than those who become isolated.Social workers at the Jewish Home understand how important friendships are for our residents. Through exciting activities such as arts and crafts, exercise classes, field trips, movie nights, concerts, and discussions, our seniors can gather, interact, and play. "We believe that, however you may feel, get up, dress up, and show up," says Devorah Small-Teyer, director of social services for JEKMC. "You'll feel better with friends."

MNO Update - Douglas Tucker, Amanda Powell, and Ashley Teal met with Assembly member Matt Dababneh on December 18th to discuss the Jewish Home’s MNO project. Matt agreed to be the champion for a bill to raise the reimbursement for residents in Assisted Living, and to make sure that it continues to go up with the cost of living. We are currently working with him to draft the legislation.

Recently, we celebrated the start of a New Year – the time of year when people do soul-searching and make resolutions on what they want to do in the coming year. Tomorrow is the Jewish holiday of Tu B’Shevat – the holiday which is known as the beginning of a New Year for trees. Naturally, this could be a time for trees to engage in making New Year resolutions just as humans do. Here is what I think a tree’s New Year checklist might look like. I divided the checklist into three areas of focus: Quality, Safety, and Service – three areas at the center of the health care improvement movement, three areas the Jewish Home excels in. Quality:Did I ensure that my fruits were sweet and did not make those who partook in them sick?Did I drop my leaves and eliminate what was no longer necessary in my life?Did I grow towards the sun as a tree should, reaching up higher and higher towards that which I could never grasp, but which nurtured me all the same the more I stretched towards it?Did I grow in strength and wisdom as signified by the new ring that was added this year? Safety:Did I bend in the wind, accepting what God sent without breaking or giving up hope?Did I make sure my roots remained firmly planted in the soil that nurtured me and connected me to my origins? Service:Did I make sure my fruits were available to all that could enjoy them?Did I shelter the seedlings that lived in my shade – so that they would grow up to become the next generation?Did I provide a place for others to benefit from my presence?Did everyone walk away from me feeling better? Come to think of it, this checklist might not be too bad for anyone working in healthcare.Noah MarcoChief Medical OfficerLos Angeles Jewish Home

If you're interested in giving aid to Medically Needy beneficiaries, we suggest doing one of the following:Write and mail a personal letter to your California RepresentativeIf you don’t know who your representative is, visit this website: https://www.opencongress.org/p...Spread the word to your friends and family members about our cause and get them involvedSend The Home a letter of support from yourself or your business that we can pass onto our elected officials on your behalfMail your letter of support:Attn: Amanda Powell, Activities Team Leader18855 Victory Blvd.Reseda, CA, 91335 Participate in The Home’s activities to support our cause - see our blog for calendar details and dates on our website.

There are approximately 75 residents in the Los Angeles Jewish Home’s assisted living that qualify for the welfare (Medi-Cal) Medically Needy Only (MNO) program. There are close to 12000 individuals across the state that qualify, and that would greatly benefit if this program is expanded. The MNO program recipients are provided just $20/month as a personal spending allowance. This $20 must cover over the counter drugs, clothing, shampoo and a variety of personal items such as hearing aid batteries and denture repairs. Twenty dollars is insufficient to cover these basic necessities. This amount does not even begin to address the various drug store sundries essential to keeping up one’s health. The dignity of our MNO recipient population is not being preserved by only providing $20 as a monthly stipend for their needs. Join the Jewish Home’s efforts, and spread the word about our initiative to help our residents get what they need.

In 1983 a documentary was made entitled “A Generation Apart,” which explored the impact of the Holocaust on the survivors’ families. It was described as a “testimony to the power of love.” Over 30 years later, as I walked through the Los Angeles Jewish Home’s Eisenberg Village, I witnessed another testimony to the power of love related to the Shoah. A small group of the Holocaust survivors who live at the Jewish Home were meeting.The group was led by resident Ernest Braunstein. Although I had only been CMO at the Home for a few weeks, I knew several of the participants. One was even from my mother’s city of Lodz, Poland. He and his wife are now my patients. Their daughter was also participating in the group discussion.The number of living Holocaust survivors is dropping dramatically. Resident survivors of the Home may number less than 20 in a community of 1000.The deaths they once barely escaped are now palpably close again, and they react to that in different ways. Some exude their exuberance for just being alive, and a few live in a perpetual fog of fear. In others their paranoia is paramount, and in many the guilt of survival continues to germinate.Author Jane Gross quoted Rabbi Simon Hirschhorn in an article published Oct. 23, 2014 in The New Old Age. “Some of the elderly survivors cry inconsolably but wordlessly, incapable or unwilling to articulate anything about the past. Others, often dry-eyed, incessantly discuss the terrible things they saw and had to do to save their lives. And they often flip, all but overnight, from one way of coping to the other as the end of life approaches.”In senior communities around the world that have a significant number of survivors, support groups try to help them cope. One challenge the facilitators face is that many survivors have spent their entire lives not talking about their psychological pain and are not going to “open up” as the facilitators encourage them to do.Regardless of the town they came from or the camp they were in, Shoah survivors are not like other aged residents in senior living. They are truly a generation apart.The survivors’ adult children, like myself, are also unlike their generation. We are also a generation apart. In Gross’s article, Rabbi Hirschhorn, who is the son and grandson of survivors and is a nursing home clergy, said survivors’ children struggle more than others with the guilt of placing a parent in an institutional setting.According to Rabbi Hirschhorn, survivors’ children, often called Second Generation or “2G” for short, “grow up, from the time they are little, with the unconscious wish to make it better, to take away the pain.’’ Both my wife’s parents and my parents were survivors of the Shoah, and we also had the desire not to add any pain to our parents’ lives by our decisions. We, like Charlotte Dell in the article by Gross, always had “an overwhelming feeling of responsibility that there is no additional suffering.’’Staff that care for survivors and their adult children have a significant task to guide these families through what is likely the most difficult transition of their lives.Perhaps the most challenging medical issue adult children struggle with is whether or not to consent to a feeding tube when their parent can no longer safely eat. Many encouraged by their clinicians choose to have a feeding tube placed. I once overheard a doctor yell at a daughter of a patient with advanced dementia, “You don’t want your Mother to starve to death, do you?” In addition to the bias of some doctors, survivors and their surrogates typically choose any medical interventions that have the goal to prolong life. Unfortunately, what this daughter was not told, and what many children struggling with this decision are not told, is that placing a feeding tube typically means their parent will not be allowed to eat ever again. In addition, numerous medical studies have shown feeding tubes in patients with advanced dementia may increase pain, and often worsen the quality and length of life.The struggle around whether or not to place a feeding tube is even more challenging for second generation. They wonder whether their action may actually cause additional suffering to their survivor parent by triggering the painful memories of the starvation they had in the war. Since they are not allowed to eat after placement of the tube, it also takes away the basic physical pleasure of eating that is so important because it had been previously denied to them. Not allowing a survivor to eat also creates tremendous guilt in their children. One of my 2G friends told me when they declined having the feeding tube placed in their dad, it felt like they had put on the black uniform of a SS soldier.I was thinking about the various challenges of caring for aging Holocaust survivors as I watched the small group gathered around a table in the Zuckerman Board Room at the Jewish Home. Thankfully, those thoughts quickly left and were amazingly replaced by the warmth, love, and friendship that were evident. I saw in their eyes and heard in their strong voices that this group was different than one seen in typical nursing homes. It was full of hope. I am looking forward to the next time I have a chance to sit down with them, listen, and hopefully help bring the generations together.

Each year, Skirball Hospice, a program of the Los Angeles Jewish Home, helps over 500 individuals and their families move through the final phase of life's journey. The following is based on one family's story. Sarah* came from a distinguished Jewish family, and, although she was raised with knowledge of Jewish rituals, she identified herself as more of a cultural Jew. What mattered to her was championing causes for people in need, making sure they were fed, housed and clothed. She studied anthropology and travelled all over the world, making friends with people from different cultures and religions. Her Judaism was more focused on the universal, rather than the particular. Having grown up during the Great Depression, Sarah had learned to be frugal and spent money on things that really mattered to her. She wasn't frivolous; she gave monetarily in ways that reflected her values and on causes she believed in. Her four children knew exactly how she felt about the importance of caring for others, both emotionally and financially.At age 90, Sarah was dying from heart disease and was admitted to Skirball Hospice. Her devoted children cared for her around the clock with the help of the hospice team. Her oldest daughter was a great cook and prepared the foods her mother loved. She would sit with her for hours, holding her hand and kissing her cheek. The middle daughters both worked in the medical field and provided the physical care their mother needed. The youngest child, Sarah's son and a bit of an insomniac, stayed with her at night so she wouldn't be alone. Hospice made sure she had the right medications, oxygen when she needed it, and provided emotional support to the family. Their questions were answered and the hospice staff was always available when they needed reassurance. The partnership between the family and the team made a huge difference in the quality of Sarah's last few weeks, and made the prospect of losing her more bearable. Her family was very appreciative of the support they received.When Sarah died, her children knew there wasn't going to be a funeral, memorial, or shiva service, in keeping with their mother's wishes and values. Still, for them, something was missing. There was no coming together to mourn and tell stories, no sense of closure, and no kaddish prayer. Sarah's children had reclaimed some of the Jewish rituals their mother had discarded, and wanted something more for themselves. How could they get that and still be true to what Sarah had wanted?A few months later they received an invitation to attend the annual Skirball Hospice Memorial Service. It was truly an answer to a prayer. All four children attended this touching tribute. Candles were lit, a stone was placed to honor the deceased, and family members were given the opportunity to say a few words in memory of their loved one. Prayers were said, the names of the dead were recited, and the kaddish was read. For Sarah's children, they finally received the solace and comfort they had been looking for. Surrounded by others who had also lost someone dear, they felt embraced and held by the atmosphere of love and acceptance. The staff who had cared for their mom were there to reconnect. With both tears and laughter, Sarah, and all the other former hospice patients, were remembered as only ones who have been through this experience can truly understand.Skirball Hospice will be holding its annual Memorial Service on Sunday, February 22, 2015 at the Skirball Cultural Center. Family members and service providers of people who were on hospice in the past year are invited to attend. For more information, please call Skirball Hospice at 818-774-3040.*fictitious name