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Doing more with less

'A serious concern'

The increasing number of elderly Jews presents a “serious concern,” says Lisa Fedder, executive director of the Jewish Family Service of Bergen County and North Hudson.

Still, she said, “At age 65, people vary in the kind of services they need. It’s not necessarily a magic age. Some may be employed at 65 and not planning to retire until 70 or 70+. We’re not necessarily talking about that [particular] age, but about an aging population.”

In addition, noted Leah Kaufman, who heads the JFS of North Jersey, “While we talk about 60+, sometimes we see people younger if they’re disabled but eligible for the same services, like kosher Meals on Wheels.”

As people get older, they are likely to have more medical needs, “health and wellness issues, issues of balance,” said Fedder.

Most important, she said, is that people want to age in place.

“They don’t want to go into higher levels of care if they don’t need to,” she said. “We do what we can as a social service provider to provide support emphasizing health and wellness, allowing them to age in place gracefully and with dignity.”

“We do whatever we can to keep someone at home,” said Kaufman. “The longer they stay at home, the longer they live” – a fact, she said, that has been borne out by research studies. “If you can keep them within their community safely, they will thrive longer. But for this we need support and financing.

Esther East, executive director of Jewish Family Service in Clifton, said one of her greatest challenges is to “help people maintain autonomy when [they’re] facing diminished capacity.”

Safety a concern

“People would like to stay at home. But we have to make sure they’re safe,” she said. Her agency also has to help them resist the tendency to isolate themselves as they become frail, she said.

According to Charles Berkowitz, president/CEO of The Jewish Home Family, whose Home at Home program is specifically dedicated to keeping seniors in familiar surroundings, “This is what the federal government is emphasizing” in the awarding of grants.

Said Berkowitz, “With the right support system, [seniors] can remain at home” – and most of them already do.

When he pitched the idea of Jewish Home at Home to the Jewish Home Family board, he told them they were only reaching 6 percent of the Jewish elderly through the facility’s existing programs, including a nursing home, assisted living facility, and day center.

“I told them 94 percent of seniors remain at home and we can be doing more,” he recalled.

Fedder noted that not only do people want to age in place and remain connected to their community, but remaining home is cost-efficient – requiring no extra insurance, as does assisted living.

For those at home, however, transportation is a huge need, she said. Thus, volunteer drivers are a prized commodity at all the agencies working with seniors.

“They may not have kids to take them” to doctors or recreational activities, Fedder said, pointing out that Bergen County lacks the kind of transportation grid found in such places as New York City.

Another problem faced by seniors is that they are generally more vulnerable financially, she said, particularly when they stop working and their income is stagnant.

“A finite set of dollars may be adequate up to age 75, but not much good if you live to 95 or 100,” said Fedder.

People who live longer need more money, she said, whether for an extra hip replacement or for more home health care.

Huge task

Fedder, like her counterparts in other social service organizations, said agencies such as hers “have enough stuff to do to work 24/7.”

The Bergen JFS runs a kosher Meals on Wheels program – mostly for individuals in Bergen County but also for some people in North Hudson.

“We deliver 23,000 meals a year,” she said, “though this year we will probably deliver 24,000. And we don’t just deliver meals but [also] do a full assessment of participants.”

In any one year, she said, the program serves about 270 people. In addition, “We connect them to other services if they need them, whether we provide it ourselves or refer them to others.”

Funding for the program is obtained through grants, donations, and fees for service – although, said Fedder, “not a large fee.”

She noted that the Bergen County group reaches some 400 seniors a year “in terms of eldercare management.” While the agency does not maintain a home health aide service, it helps clients find one, if necessary. In addition, it runs a friendly visitor program as well as a telephone reassurance program, where teens “adopt a buddy” and call once a week.

“The teens develop fabulous relationships with grandparent-types,” she said.

Recently, the agency opened a small food pantry for its clients, as it became clear that some of them were hungry. “Elders on fixed incomes can benefit from extra food,” she said. “If costs go up, they may eat less, and nutrition is very important to keep them healthy.”

She pointed out that older people, more cautious and having “so much anxiety about the unknown, are terrified now about spending anything.”

Fedder said her agency has a large clinical care department and is working together with the Jewish Home at Home when that group’s clients need these kinds of services.

Can’t do it alone

“We have our skill sets – others have theirs,” she said, explaining the benefit of partnering. “Nobody can do this alone. It’s difficult work.”

She added that when some seniors have needed to go back to work, the Bergen JFS has worked with them to help them get jobs through its Job Search Network.

“We recently got a job for a 70-year-old as a receptionist,” she said.

Kaufman, of the North Jersey JFS, said, “The needs for seniors have grown tremendously as the population has aged.” She estimates that her agency serves more than 750 seniors each year. “It’s a catch-22,” she added, pointing out that as needs are growing, funding for programs is limited.

She said that “many seniors are struggling, trying to live out their lives in their community, with limited home support.” Yet, she added, “They may fall between the cracks and not be eligible for government assistance.”

Kaufman said that over the past year, her client load has increased between 10 and 15 percent, and the agency’s kosher Meals on Wheels program has had to add a fourth route.

In addition to care management, geriatric assessment, and counseling, the North Jersey JFS, with the help of some 70 volunteers, keeps track of the elderly through home visits and phone calls.

“Care management is time-consuming,” she said. And the ancillary work that takes place to accomplish that is often non-reimbursable.

“Funding has to come from somewhere,” she said.

Like the other JFS agencies, the group relies primarily on private donations, foundations, grants, and some fees for service.

Kaufman said in addition to helping seniors themselves, “We serve adult children who don’t live in the area but whose parents do. We meet with families to talk about their concerns and then contract to monitor their parents’ situation. Social workers provide adult children with updates.”

More with less

Esther East, director of JFS in Clifton, said her group sees about 300 seniors a year.

Over the past several years, her agency has actually increased the services it offers, even as funds continue to dry up.

“We have an in-home program left over from a 2006 NORC grant that was not renewed,” said East. “We continue to deliver those services in three locations in Clifton and Passaic.” NORC stands for Naturally Occurring Retirement Communities, a federal program. (See sidebar page 7.)

In addition, she said, thanks to a faith-based initiative grant, the Clifton JFS has partnered with St. Lukes Church in Paterson to deliver services to a senior building there.

“The rest of our programs are suffering diminished funding every year,” she said. The agency received a five-year endowment from the sale of Passaic’s Temple Emanuel, “but that money is now finished.” “It’s bad all over,” she said. “All sources of funding are drying up.”

East said that her JFS has also taken over the senior program formerly offered by the recently closed YM-YWHA in Clifton. Most participants, she said, are “well into their 70s and 80s,” although some are even older.

“We have the capacity to take more,” she said, pointing out that the cost – “There’s a small fee but no one is turned away” – includes transportation.

While frail seniors clearly require health-related services, “Some come to our day group just to play Mah Jongg, not to talk about health,” she said. “It’s an enormously vibrant group of seniors.”

A fund-raiser for the group, featuring jazz guitarist Bucky Pizarelli, will be held on Nov. 13.

“Our principal way of sustaining programs is through fund-raising,” she said.

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