By Noachim (Noah) Marco, MD, CMD - Chief Medical Officer - Los Angeles Jewish HealthOriginally published here by the California Association of Long Term Care Medicine (CALTCM).I have been a primary care doctor for over 36 years. Over that time, many of my older patients told me a goal of theirs was to get to age 100. It is a landmark birthday, that in 2024 only 0.03% of the US population achieved. The Today show on NBC, continues to honor centenarians by showing their images and briefly describing what they enjoy doing.Therefore, it was surprising to me when a few years ago one of my nursing home residents told me that she wanted me to get her to 99 and one day. I asked Evelyn why her goal was 99 and one day, rather than age 100. Evelyn who was 96 at the time, said that when she hits 99 and one day that she will be able to tell everyone that she is in her 100th year. I responded to her like I had to my other patients that expressed a goal for longevity. I told her that I would do everything medically appropriate to help her reach her goal.Once again, Evelyn responded atypically. She said, “Not so fast, Dr. Marco. I know you are busy, but I’m not done. I have to tell you it’s not just hitting 99 and one day, but how.”She then went on to remind me how she loved to walk. She said that when the weather is bad, and she could not walk around “The Home”, (Grancell Village of Los Angeles Jewish Health) she would walk the hallways of her floor. She told me, “The nurses have even put a chair at the end of each hallway so when I get tired I can sit and rest.” I hoped that I masked my reaction thinking about the possible citation the fire marshal would give us if that was discovered.She went on to describe how she noticed that there are a lot of people in wheelchairs in her building, and divided them into two groups. One group could “self-propel” (her phrase) and go where they want, when they want. The other group are taken out of their beds in the morning, and placed in a wheelchair. Then they are rolled into the common areas. Later, returned to their bed when the nurses decided to do so.I immediately understood what made Evelyn’s two groups of non-ambulatory residents different. The second group predominately had advanced dementia.Evelyn then said, “Dr. Marco, I want to get to 99 and one day, but not if I am like the people who can’t self-propel their wheelchair.” She asked that I do what I could to keep her walking, but life would be acceptable to her if she had to be in a wheelchair. As long as she could go where she wanted, when she wanted.Those few sentences spoken by Evelyn were not stimulated by any question that I asked, and they were much more powerful than the typical answers I got by the questions I asked to understand my patients’ goals of care.I reviewed with Evelyn, and her family that based on what she told me, our team would send her to the hospital if we could not control an acute exacerbation of her chronic conditions, or if she developed a serious acute issue, such an infection. Later, when the nurses called me telling me Evelyn wanted a sleeping pill, I told them (and later told Evelyn) that prescribing it was not consistent with her wishes. It could increase her risk of falling, which might cause her to end up in a wheelchair or even worse have a severe brain injury.I walked into Evelyn’s room on her 99th and one-day birthday and wished her a happy one hundredth year. I asked her “Evelyn are we done?” As expected, she told me her new goal (with the same conditions) was to get to age 100. A similar question and answer occurred on her 100th birthday. On her 101st birthday, the response was quite different.Evelyn shook her head no when I asked if the plan we had followed should stay the same. At that point, she was mostly in bed, on continuous supplemental oxygen, and could not speak more than a few words at a time. She then made a horizontal back and forth motion with her hand across her neck. Signifying she was done. I asked a few more clarifying questions, and looked up at her daughter, who gave me a confirming response. I then put in the order for Hospice, and discontinued all medications not devoted to her comfort.Three months later, I got a call from her nurse saying that Evelyn was transitioning. I quickly walked the few hundred feet from my office to her room. I had the all too rare fortune of watching my patient take her last few breaths, in comfort and peace, and in the place she called home. Her family and the staff who loved her, shared her last moments and honored her remarkable life.I tell Evelyn’s story at least every other week when I mentor the Internal Medicine Residents, and Geriatric Fellows that rotate to my facility. I explain how unfortunately rare it is for patients, their families and clinicians to have such clear and stress-free, end of life decision making. I stress that our standard questions don’t get us the richness of information that we need to replicate Evelyn’s story. I suggest to them that establishing that longevity is a goal is not enough. A question such as “Is there any situation where you would not want to live longer?” should be asked and the responses explored. I hope that our sessions inspire them, and that when they are having end of life conversations that they, and you, remember Evelyn’s words, “Not so fast”.Noachim (Noah) Marco, MD, CMDChief Medical OfficerLos Angeles Jewish Health

At Los Angeles Jewish Health (LAJH), we are enormously proud of the dedicated staff members who help care for our beloved residents. Each person on the team brings their own unique talent and history to the organization, together weaving a beautiful tapestry of care, compassion, and love.Tapestries are right up the alley of Radka Falk, director of LAJH’s popular Arts & Crafts Room, located on the Eisenberg Village campus and a key component of the Lifestyle and Enrichment Department. For nearly 20 years, Radka has been a supportive, engaging, and steadying force at LAJH, helping residents channel their creative energies as they make extraordinary objects of art.Radka FalkA native of Bulgaria, Radka emigrated to the United States in 2000—a single mother of two in search of better economic opportunity.“I worked for a big newspaper and also as a teacher in Bulgaria, but once my son was accepted to university there, I knew that, even with multiple jobs, I wouldn’t have been able to pay his tuition,” she recalls. “It was time for me to make a change.”When she arrived in the U.S., Radka found employment as a private caregiver. In addition to introducing her to her future second husband (a friend of the owners of the caregiving company), the job enabled her to develop critical skills for working with seniors.“One of my clients had Alzheimer’s, and when she was accepted at LAJH, I came and stayed with her for a time,” she says. “The wonderful people I met there offered me a position helping with activities, and that was almost two decades ago. I’ve never looked back.”What many do not know about Radka is that she is an accomplished writer and painter who has authored multiple well-received volumes of poetry. Securing her position at LAJH allowed her to combine her interest in the arts with her newfound abilities in senior care. Under her direction, the Arts & Crafts Room has become a beloved retreat for residents, many of whom visit several times a week. She shares her passion for textile-making and helps others create beautiful handcrafts, from sweaters and skirts to quilts. The participants also work with Radka to explore a wide array of other artistic mediums and to explore their culinary side by cooking delicious baked goods in the onsite kitchen.“I love to knit and to sew, and I also love to help people,” Radka says. “In this job, I get to do both. I am so grateful to have found a home at LAJH.”Both Radka’s colleagues and residents at LAJH say the appreciation is mutual.“It is a pleasure working with Radka,” says Annette Weinberg, campus lifestyle and enrichment director for Eisenberg Village. “There’s something very special about her: She’s such a positive force and a loving person, and her creativity is just amazing. Whether someone needs a hem stitched or we’re seeking blooms to decorate the dining room, she always says ‘yes.’”It’s a sentiment repeated again and again by all who know her.“Radka and I have been close,” says resident Norman Garber. “It’s a pleasure collaborating with her because she’s so talented; there isn’t a thing she can’t do. And she is so compassionate and kind—always with a positive word for everyone.”Radka helps display artwork from resident Norma GarberRadka’s cheerleading offers residents a big boost as they undertake new creative endeavors.“She’s so fantastic at helping me explore my sewing abilities, and she helps me push the limits of what I can learn to do,” says resident Casey Joseph. “I love how understanding Radka is and how she can listen to your ideas, then figure out a way to make them real. It’s such a feel-good environment that I look forward to coming to Arts and Crafts five days a week!”Arlene Bercu, another LAJH resident, is equally glowing in her praise.“I knew at once after touring the Arts and Crafts Room that it would be my happy place,” she says. “Everything Radka does is original and creative, from the beautiful handbags down to the made-from-scratch mandel bread. I actually wore a dress she made me in our recent Purim play. I always tell her she should have owned her own couture shop!”In March, Radka brought the world of high fashion directly to LAJH, working with Annette and the rest of the Lifestyle and Enrichment team to run a fashion show featuring clothes she has made for residents. The clothes were modeled by the residents themselves.Radka at the Newman Building fashion show featuring clothes she has made for residents“We had a runway for our models, and nearly all of the women who spend time in the Arts and Crafts Room participated, including some who actually had careers as fashion models!” she says.Whether coordinating a runway or supervising a cross-stitch, Radka brings her signature creativity, energy, and enthusiasm to every endeavor.“I enjoy doing all this stuff, and it’s exciting because I am able to create something new every day,” she says. “I absolutely love this job.” 

The Jewish holiday of Purim is known for many things: delivering baskets filled with goodies to friends and loved ones; providing gifts to the needy; and perhaps most famously, the Purim shpiel—a fun, festive play that retells the story of the Book of Esther. While versions of the shpiel are produced each year on the campuses of Los Angeles Jewish Health (LAJH) and typically performed by staff who volunteer for the roles, this year, the talented residents of the Joyce Eisenberg-Keefer (JEK) Medical center mounted their own Purim production, complete with colorful costumes, songs, and prodigious amounts of laughter.The decades-long tradition of LAJH staff performing the Purim play continued this March at the Taper Building and at Fountainview on the Eisenberg Village campus. The staff dedicated their time for rehearsals and performances, entertaining residents with their comical retelling of Mordechai’s pride, Haman’s evil cunning, and Queen Esther’s bravery. But residents of JEK flipped the script and stretched their acting chops as they brilliantly infused their own creative ideas and energy into the holiday skit—making it the most special one yet.The cast of the 2025 Joyce Eisenberg-Keefer Medical Center Resident Purim Shpiel“Traditionally, we as staff would do the entertaining during Purim, but the residents were excited to play a role, so they ‘fired’ us in the most beautiful way,” says Ilana Springer, JEK’s CEO and administrator. “We were thrilled to witness this turn of events because it meant our residents were feeling empowered to run programs and to lead their lives proactively and intentionally. It’s wonderful to see them taking so much initiative.”Orchestrating the event was JEK’s Director of Therapeutic Activities Susan Leitch, who helped organize rehearsals, run technical aspects of the production (such as sound), and provide other key support.“What was so amazing about this year’s shpiel is that the whole thing was resident-driven,” she says. “From choosing the script, to adding songs and dialogue, to casting, they were the ones calling the shots!”Resident Barbara Fallick delighted in the opportunity to dip her toe in the world of theater. “It’s so much fun being dramatic!” she says. “We can be childlike in our portrayals of the villain Haman, as beautiful as Esther, and as dignified as Mordechai.”Fellow cast member Steven Horowitz also loved participating.“Coming up with a play that was original to the story, but a different adaptation in a humorous way—it was really fun,” he says. “All of our rehearsals made a big difference, and it was an awesome experience.”The Purim shpiel was just one in a series of LAJH events related to the holiday. Other celebrations on the Grancell Village campus included a Purim concert by well-known singer-songwriter Cindy Paley (who also performed at Eisenberg Village) and a traditional reading of the megillah (the Scroll of Esther) by Orthodox Rabbi Hershey Spitzer. At Eisenberg Village, in addition to the Purim shpiels, there was also a resident-led megillah reading and an Arabian-themed buffet dinner complete with professional belly dancers.“The energy here at LAJH during Purim was truly infectious across the board,” Ilana says. “Everybody came together as part of a warm and cohesive community.”Fountainview at Eisenberg Village residents and staff PurimLAJH staff put on a shpiel at the Mark Taper BuildingEisenberg Village staff perform a shpiel for residents of the Newman BuildingNature Gan Preschool visit to the Joyce Eisenberg-Keefer Medical Center for PurimLeo Baeck Synagogue 7th grade visit to the Newman BuildingResidents of the Joyce Eisenberg-Keefer Medical Center welcomed a visit from 4th-grade girls from Yeshiva Ketana of Los Angeles.Residents from both the Newman Building and Fountainview at Eisenberg Village read chapters of the Megillah for Purim in the Eisenberg Synagogue. Chief Mission Officer Rabbi Karen Bender visits residents for Purim, bringing joy and silly disguises