April 1, 2009

Briefing from Steve Schwager, Executive Vice President and CEO, JDC

During the Hebrew month of Nissan, our Jewish communal activities slow down somewhat as we focus our personal lives on preparing for Passover. I have used some of the quiet time in the office to review the contributions that JDC’s current long-term volunteers are making to JDC’s activities around the globe.

Our foremost volunteer service opportunity is the Ralph I. Goldman (RIG) Fellowship. Each year, after an intense competition, JDC’s RIG Fellowship Committee, currently chaired by Dr. Deborah Lipstadt, selects an outstanding young Jewish leader to be the Ralph I. Goldman fellow and offers him/her a year of diverse work assignments throughout the JDC world. The current RIG fellow, Andrea Siegel, is in Israel working with JDC Israel and Eshel, which is JDC's partnership with the Israeli government to plan and develop services for the aged in Israel.

I share a portion of Andrea’s recent report with you so that you understand the complex nature—and importance—of the projects we assign our volunteers.

My primary project is an initiative on Spiritual Care (temicha ruchanit, Israel’s rough equivalent to pastoral care/counseling), one of Eshel’s responses to the Brookdale Institute’s findings that depression and poor levels of well-being plague a significant percentage of Israel’s elderly.

Spiritual Care is that aspect of support that attends to people’s sense of the transcendent in the midst of physical and/or emotional pain. Although religious support can be an element of Spiritual Care, it is not a necessary component. In the scientific literature on Spiritual Care, the term “religious” refers to a person’s identification with and belief in a specific group tradition—its tenets, leadership figures (rabbi, imam, priest, etc.), mythology, and rituals; “spiritual,” on the other hand, refers to a person’s own quest as an individual—questions one may have about life’s purpose, an appreciation of beauty, ideas about end-of-life ethics and the afterlife, the desire to be recognized in the eyes of another person, and/or the struggle to make sense out of trauma.

Here in Israel, given the religious-secular divide, any attempt to treat the person and not only the disease—that is, to twin the investigation into a patient’s physical pain symptoms with an investigation into his or her psycho-social-spiritual suffering—is extraordinarily fraught. For many of the religious, the wide definition of “spiritual” can be interpreted as an affront to orthodoxy. For many of the secular, anything “spiritual” can seem to be a cover for a back-door conversion or “kiruv” agenda. Add to the religious-secular divide the communal divides between adherents of Judaism, Islam, Christianity, etc.—and the situation gets even more complicated. Add to all of this the fact that even candidates for the officially-recognized rabbinic profession here receive no training in pastoral care—and it becomes clear that there is much work to be done.

Yet why should Eshel and JDC get involved in trying to further the development of the Spiritual Care field here in Israel?

Essentially, the answer lies in Eshel’s desire to make its institutions—senior daycare centers, “supportive communities,” and old-age homes—as life-affirming as possible for participants. There are numerous studies in the international published literature that support the contention that elders (and their families) who experience higher levels of spiritual well-being also report higher levels of physical well-being. In the United States (as well as in places such as Hong Kong, England, and Australia), Spiritual Care is an already-recognized competency field for nurses, social workers, psychologists, and other medical professionals who often work side by side with chaplains as part of a patient’s overall care team. Much of the work being done today in the United States, for instance, is aimed at teaching medical professionals how to conduct spiritual care assessments of a patient, how to bring an element of concerted presence into their bedside manner, and how to recognize when a patient needs the expert-level intervention of a chaplain.

Eshel would like Israel to join the international community’s efforts to make advances in this realm of healthcare, for the benefit of all of Israel’s citizens and particularly for the vulnerable elderly sector. Furthermore, as a few different organizations with the stated goal of training Israel’s equivalent of chaplains have recently sprung up here, Eshel wants to ensure that the spiritual needs of the elderly are included on the list of competency requirements in the developing field of chaplaincy.

Under Yaakov Kabilou’s guidance at Eshel, I put together a two-year plan designed to begin changing the public conversation in Israel about end-of-life, palliative, and spiritual support for the aging. The plan includes creating an orientation group on the concept of Spiritual Care for medical professionals who work in Eshel’s old-age homes and senior daycare centers; placing newly-trained Spiritual Care workers in a few of these institutions; printing a Hebrew Spiritual Care anthology of articles compiled from international journals in the fields of social work, psychology, religion, and medicine (with an emphasis on geriatrics); organizing day conferences for members of target professions in Israel; and publishing a quarterly Hebrew newsletter on Spiritual Care.

In creating this two-year plan, I have had the opportunity to visit Israeli hospitals and speak with physicians who are in ongoing dialogue with Eshel, to meet leaders of aging-sector services in municipal government and local NGOs, to attend training forums for senior daycare center managers and palliative care medical professionals at Eshel’s Tel Hashomer Training Center, and to exchange ideas over email and phone with major chaplaincy experts in the United States. While we wait for our funders to respond to the two-year Spiritual Care proposal, Yaakov has asked me to conduct a related needs-assessment survey of Eshel’s old-age homes and senior daycare centers in the Jerusalem area.

In addition to this primary project at Eshel, I am currently engaged in some smaller ones—all sharing points of contact with the Spiritual Care initiative. For instance, I am about to start leading a weekly Hebrew poetry-reading group for seniors with mild dementia at a daycare center in Tel Aviv, and I am collecting examples of English-language educational materials that Eshel may consider adapting for Israeli family caregivers.

As you can see, Andrea is engaged in a very intricate project which could have a major impact on Israeli society and how it cares for its elderly. Each of our other long-term volunteers—JDC’s Jewish Service Corps—is equally active in helping the respective communities in which they are placed. Irv and I believe that JDC should engage and empower more young volunteers, and so it is imperative that we seek out and create more service opportunities for young American Jews.

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