community agencies can be a great
help in alleviating the emotional
trauma. It really helps to talk about
it," says Ralph Yamron, who went to
Jewish Family Service (JFS) and felt
like the man taking his bag of woe to
the synagogue and discovering that
everyone else's bag of woe was bigger
than his.
"There is no magical solution to
the problems members face," says
David Hoptman of JFS, but there is
an approach to be made aware of.
Many group members feel that they
should have come up with an answer.
We can reassure them that they're
doing the best they can."
Most programs consist of a series
of sessions, dealing not only with emo-
tional problems, but with most aspects
of coping with the dependent elderly.
"Perhaps the most valuable thing we
got out of the class was an understand-
ing of the physical ailments," says
Yamron, whose father suffered,
among other things, from intermittent
blindness. The family had thought it
might be a ploy to get their attention.
We learned that he really could
be like that and we realized how
frightening it must be for him," says
Marlene.
Understanding the physiological
changes that occur with age and being
aware of its most common diseases can
be a great help in dealing with an el-
derly relative. Regular health check-
ups are an important first step. Old
age itself is not a disease, and physical
complaints, properly diagnosed and
treated, can often be arrested.
Of the diseases associated with old
age, one of the' most feared is Al-
zheimer's, the "disease of the
eighties." There has been so much dis-
cussion of its increased incidence that
any mental confusion in the elderly is
apt to bring the dread of irreversible
senility immediately to mind. It is true
that five percent of people over 65 do
suffer from some type of demehtia, and
that Alzheimer's is estimated to ac-
count for 50 - 70 percent of all dement-
ing illness. However, as a study pub-
lished by the Texas Educational Insti-
tute on Aging points out, mental
change does not always denote ir-
reversible dementia. It may be a symp-
tom, or side effect, of treatable physi-
cal disease. The elderly heart attack
patient, with no pain, may have symp-
toms of confusion because his brain is
getting an insufficient blood supply. A
person with pneumonia may be called
senile because a lack of oxygen slows
his brain functioning," the Texas
study says. All too often, unfortunate
people with new thinking problems
will be called 'senile' and ignored, or
put in an institution. Their underlying
and often treatable illness will go un-
detected."
Mental confusion can also be a re-
sult of drug reaction, a common prob-
lem among the elderly, particularly
since they are prone to chronic and
multiple illness, and therefore require
multiple medications.
Important to anyone assuming re-
sponsibility for the elderly, says
Elizabeth Sullivan of the Area Agency
- on Aging, is sensitivity to the predo-
minant fears which can sometimes
make them intractable. Many, she
says, "are reluctant to accept help be-
cause they are afraid of a stranger in
their home, or of giving up control of
their own life." The loss of indepen-
dence, individuality and dignity, par-
ticularly through institutionalization,
are especially feared. So is social isola-
tion.
The Jewish Welfare Federation's
survey shows that more than one-third
of Detroit's Jewish .elderly live alone
and that about one in five talk with
someone else as little as once a week,
or less.
Vital
Statistics
Since 1900, the percentage of
Americans 65 and over has tripled
(4.1 percent in 1900 to 11.9 percent
in 1984), and the number increased
nine times (from. 3.1 million to 28
million).
By 2030, there will be an esti-
mated 65 million elderly, constitut-
ing 21.2 percent of the population.
The average additional life ex-
pectancy of persons reaching 65 is
18.7 years for women and 14.5 years
for men.
Since 1980, the 85 and over
population has grown by 19.4 per-
cent.
By 1990, one in six Michigan
residents will be 60 or over.
Thirty-seven percent of people
over 60 are over 75. By the year
2000, the number will increase to
an estimated 51 percent.
Sixty-seven percent of the non-
institutionalized elderly live in a
family setting.
Nationally, 13.7 percent of the
Jewish population is 65 or over.
In Metropolitan Detroit there
are between 10,000 and 12,000
Jews over 65:
20 - 30 percent have problems
carrying out the activities of daily
living.
-
10 percent live at, or below pov-
erty level.
28 percent earn $10,000 or less.
Physical frailty, lack of trans-
portation, living alone and low in-
come are their most commonly ex-
pressed problems.
Marlene and Ralph Yamron:
His father's last months
left them embittered
46 Friday, June 27, 1986
THE DETROIT JEWISH NEWS
Most of these fears come to a head
for the old and frail when, in consulta-
tion with their families, they must de-
cide where they should live. Many old
families cling tenaciously to their de-
termination not to move from a place
which is redolent with memories of
youth and achievement, which sym-
bolizes independence and security and
on which, importantly, the mortgage
is paid.
This often conflicts with the views
of their children, who have probably
moved away from the old neighbor-
hood (often in a part of town which is
now unsafe) and who, though as anx-
ious as their parents to avoid in-
stitutionalization, are concerned that
physical or mental frailty make a
move inevitable.
In fact, whether from choice or
necessity, 80 percent of the frail el-
derly do live in their own homes and
are able to maintain themselves with
some help, from the family or an
agency or both, says David Hoptman.
Several community services are
available to provide alternatives to
nursing home care: visiting nurse
service, homemaker service for light
cleaning and chores, Meals on Wheels,
sitting and personal care services for
aid with lifting, bathing, etc., respite
programs to give care-givers a week, a
weekend, or even an hour's valued re-
lief, shopping services and transporta-
tion, crucial not only for necessary vis-
its to the doctor, for example, but in
combating social isolation.
Sinai Hospital, with a grant from
the Shiffman Foundation, has recently
initiated a "Lifeline" emergency re-
sponse system, allowing the elderly to
be in touch with the hospital at the
touch of a button on a paging device,
which can be carried at all times.
Day care centers can be the an-
swer for families who are able to pro-
vide care in the evenings, but need
help during working hours. The
Jewish Community Center, for exam-
ple, principally at its Jimmy Morris
Prentis branch in Oak Park, provides
a variety of activities and services
ranging from educational and rec-
reational programs to the provision of
hot kosher meals.
Other alternativ es include shared
housing, such as the congregate hous-
ing scheme run by the Jewish Family
Service, and specialized retirement
apartments, like the Jewish Federa-
tion Apartments, which offer the el-
derly as much independence as possi-
ble but provide a certain amount of
assistance when it is necessary.
Several such facilities exist, but
they should be chosen carefully. The
help and amenities can vary widely, as
can the cost, and little things can make
a big difference says one resident of a
local retirement community, who
moved there at the recommendation of
her family. The decision was taken
just after her husband's death, when
she was depressed and exhausted after
nursing him and not alert enough to
question her family's choice.
She is, she says, "very unhappy"
there. Most of the residents eat com-
munal meals, which she cannot afford,
and in any case she likes to cook. But
the kitchens are badly designed and
the ovens have no light. Since her
vision is impaired by cataracts and she
cannot reach the cabinets, cooking has
changed from a pleasurable activity to
a hazardous chore.
"Transportation is provided, but it
only goes to certain places. It won't
take me to see my old friends," she
says. Most of the other people here are
a lot older than I am and sicker. I'm
very bored and lonely." Above all, she
feels the change in her economic cir-
cumstances. "My old apartment was
beautiful. I know I can't afford it now,
but this just isn't the same."
Money is a root problem for the
elderly and those who undertake their
care. Most older people are living on
incomes much reduced from working
days, and the Federation survey indi-
cates that ten percent of the Jewish
elderly live at or below poverty level.
Twenty-eight percent earn $10,000 or