Debating profit vs. nonprofit

(photo from Humber Valley Senior Citizens Club)

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In Volume 28 of the Jewish Seniors Alliance’s Senior Line magazine, JSA members Kenneth Levitt and Larry Shapiro debated some of the arguments for and against for-profit long-term-care facilities. They offered their personal opinions in the debate, as JSA does not have a position on this topic. Their views are reprinted here, with permission.

For-profits here to stay
by Kenneth Levitt

The COVID-19 pandemic with its various mutations has caused a justified focus on long-term care (LTC) in Canada. Organizations such as the B.C. Health Coalition, the NDP, unions and other left-leaning activists or progressives, as well as some physicians, have called for the abolition of all for-profit (FP) facilities, recommending that they be taken over by provincial governments or government-approved not-for-profits (NP). This will not happen in the near future. For-profits (FP) are here to stay and, furthermore, provincial governments support them with LTC operating agreements.

The two main issues are profit and quality of care. In British Columbia, there are 27,000 persons in LTC. Approximately one-third are in each of government-operated, NP and FP facilities. When an FP builds or upgrades a facility, there is no government capital fund support. Capital funds for FPs come from investors and shareholders, whereas NPs depend on governments and their own fundraising efforts. FPs have saved governments billions of dollars in capital costs.

In general, residents are financially responsible for their room and board. Their care is paid for by the local funding authority. Should residents pay from their assets (as in the United States) or continue to pay based on income testing? Should residents who are capable contribute more for their room and board? Many NPs raise funds to subsidize care; others permit paid companions to provide extra care for residents. Should investors who put up their own risk capital (with government “ipso facto” approval) be permitted to make a profit? Is it immoral?

FPs did not do well in terms of COVID-19 deaths. Horrendous stories from Ontario and Quebec came to light that noted the squalor and the shameful living conditions of many vulnerable residents. In British Columbia, a number of NPs and FPs had too many COVID infections and deaths. Staff were not exempt from contracting COVID. How do we account for this? When we factor in those facilities with two or more residents per room, the number of COVID-19 infections, complications and deaths increase dramatically for NPs and FPs. In most cases, staff and visitors were responsible for importing the virus. Governments/health authorities were totally unaware, at the outset of the pandemic, of the extent of the problems. However, most care homes planned well, had few infections with a high percentage of vaccinated staff, and are faring well during the pandemic.

It is not just a move to single beds that will solve the problem of COVID and seasonal flu outbreaks, it is the design of the facilities. We need new and upgraded buildings now. It is also imperative that all staff be vaccinated, and that they be supported by management to better prepare for future health crises.

Canada needs FPs. FPs have the capacity to provide needed accommodation for older adults who qualify, and can build more LTC beds faster than governments. They can provide improved efficiency and greater innovation than NPs. The naysayers want to nationalize all private-sector nursing homes in Canada. The National Institute on Aging at Ryerson University in Toronto recently noted, “Some of the FPs are doing well because they have deeper pockets and much better planning procedures than NPs. It is not clear that one class of ownership is better than the other.”

In an April 2021 report, Isobel McKenzie, B.C. Seniors Advocate, criticized FPs for apparently short-changing the number of direct care hours for which they were paid and making a profit by doing so. At the same time, McKenzie noted that capital costs (building maintenance) is one area where FPs outperform NPs.

There is one FP LTC operator in Ontario, Schlegel Villages, that is at the cutting-edge of services and programs for their residents. Schlegel is a family-owned company that has about 5,000 residents and about 5,000 staff in 19 villages. It did not escape COVID-19, but they have excelled in what is known as “best practices”:

Their philosophy: a purposeful life for each resident.
Each village is accredited.
Staff are unionized and pay is the same as at NPs.
Owners are committed to providing exceptional care, and are good corporate citizens who are involved in and contribute to the communities they serve.
Newer villages are 60% private rooms and 40% with two persons per room. Moving forward, all new construction will be single rooms with ensuites.
Each resident has two bathing opportunities per week.
Villages have several neighbourhoods, with 32 residents residing in each self-contained neighbourhood that is well-supported by seven staff with a variety of skills.
Each village has programs and space open to outside community organizations and they encourage locals to hold events in the available space.

How can we move forward in a constructive way that includes government-operated facilities, not-for-profits and for-profits?

The federal government, in partnership with the provinces, needs to develop and to legislate a set of standards of care and service that will be enforced with consequences. This can be done through accreditation, which is currently voluntary. Once the feds have placed standards of care and service into law, each province should enact similar legislation to require that all LTC facilities be accredited. A provincial accreditation body would be responsible for accrediting, monitoring and enforcing standards.
Accreditation would ensure every LTC facility is delivering the hours of care and support for which they are receiving funds.
Wages and benefits for full-time staff should be uniform for all LTC facilities and part-time staff should be equally entitled to the same wages and benefits.
Hours for home care and Better at Home need to be increased. The financial threshold needs to be lowered to allow more persons in need to take advantage of such a service. This has the potential to put less strain on waitlists for LTC admissions.
When an FP is for sale, give preference to a quality NP to purchase it or allow a local (new) society to purchase and operate it.
Require all LTC facilities that plan to expand to have only single rooms with ensuites.
Develop a timetable and a budget for NPs to upgrade/replace current outdated institutional/hospital-style buildings.
Healthcare leaders, their boards of directors and seniors should be the ones who are advocating and pushing for changes. The status quo is not acceptable.

To eliminate FPs is specious and politically and/or ideologically motivated and is a short-sighted non-pragmatic position. Canada’s Parliament last year voted against such a proposal put forth by the NDP. The issue is not between the NPs or the FPs. The issue is how to ensure that the interests of the residents come first.

The billions of dollars that would be required to eliminate the FPs can better be used for increased and quantifiable quality programs and services. This would be the best and the most ethical way to honour those lost in the pandemic and to ensure it will never happen again. The issue is how we treat our most vulnerable older adults. After all, is it not a matter of human rights and choices?

No place for profits
by Larry Shapiro

photo - Policy decisions have encouraged raising the profits of private long-term care facilities by replacing union staff with contract workers, which has resulted in creating personnel shortages, declining working conditions and less access to public funding, argues Larry Shapiro — *(photo from cdc.gov)*

My goal in this debate is to paint a comprehensive picture illustrating conclusively why many of the for-profit long-term-care facilities (LTCFs) are squandering public funds, with little transparency or few accountability requirements to honour any predetermined set of standards in the areas of quality of service, accountability and profit. We need to see profit taken out of long-term care and need new investments in public and nonprofit beds so that we can reduce our dependence on the private, for-profit sector.

Decades of budget cuts, underfunding and privatization by successive governments have resulted in the catastrophic state of the many private care facilities that have been the sites of the loss of a great number of our loved ones. Nobody should be profiting from the care of our senior citizens. Policy decisions going back 20 years have encouraged raising the profits of private LTCFs by replacing union staff with contract workers, which has resulted in personnel shortages, declining working conditions and less access to public funding. The centre of most COVID-19 outbreaks in British Columbia and throughout the rest of the country have been in our LTCFs.

Let us examine the causes and effects of some of the common characteristics of for-profit LTC facilities that negatively affect the quality of care being dispensed to our seniors. Statistically, 67% of LTC in British Columbia is supplied by both nonprofit and for-profit organizations with the remaining 33% being supplied directly by provincial health authorities. The practice of sub-contracting care services occurs when service providers like LTCFs and assisted living facilities, which are contracted by regional health authorities to provide care, proceed to sub-contract with other companies that offer care workers, kitchen staff and maintenance crews.

These sub-contractors are able to bid lower than qualified unionized staff would cost, all to the detriment of the senior residents who are being served by these workers who are receiving lower wages and poorer benefits and who enjoy fewer full-time positions. The prevalence of sub-contracting in elder care began about 22 years ago, when the B.C. government, by virtue of Bills 29 and 94, stripped out no-contracting and job-security provisions from the collective agreements governing healthcare workers. These laws resulted in the loss of 8,000 jobs by the end of 2004. These laws (which were repealed in 2018) provided health-sector employers, including private LTCFs, with unprecedented rights to lay off unionized staff and hire them back as non-union workers through sub-contracted companies. Predictably, this negatively impacted wages and working conditions.

Reduced funding for and access to publicly funded seniors care, from the early 2000s, resulted in the rationing of care. This meant that access to publicly funded care is limited to those with more acute needs, leaving seniors with less complex needs without access to support services that could keep them from deteriorating and requiring institutional care. So, as staffing levels have declined, the care needs of many LTC residents have increased. More of the publicly funded services are being delivered by for-profit companies, often in LTCFs that combine publicly funded and private-pay beds. The latest data shows that more than 35% of beds are run by the for-profit companies. The health authorities pay for the services through block funding, which accounts for the direct care hours that each resident is to receive per day, and the cost of other services and supplies such as meals. There are no restrictions on how operators spend these dollars and health authorities do not perform payroll or expense audits to ensure public funds are actually spent on direct care.

A report from the Seniors Advocate exposed the fact that most direct care (67%) is delivered by care aides, the lowest paid care workers. For-profit care companies generate profits by underpaying the workers who provide most of the direct care, despite receiving funding based on the assumption they pay union rates contained in the master collective agreement (industry standard). Operators are not monitored to ensure that they are providing the number of care hours for which they are being paid. Without adequate oversight and reporting, companies also make profits by understaffing, which impacts the amount and quality of care that residents receive.

Many LTCFs have a combination of publicly subsidized and private-pay beds, but the co-located private-pay beds are not consistently included in the calculation of care hours delivered. This practice results in publicly funded care hours used to cross-subsidize the care of private-care residents who pay out-of-pocket (for the generation of greater profits) and, at the same time, exacerbates staffing shortages, as companies use the same staff to cover both publicly funded and private-pay beds, which should have their own dedicated staff.

Notwithstanding that the last period for which data is available is 2017-2018, it is noteworthy that while receiving, on average, the same level of public funding, contracted not-for-profit LTCF operators spent $10,000 more per resident per year than did for-profit providers. In addition, and not surprisingly, the for-profit LTCFs failed to deliver 207,000 funded direct-care hours while the nonprofit LTCFs exceeded direct-care hour targets by delivering an additional 80,000 hours of direct care beyond what they were funded to deliver.

Low staffing levels and resulting poor working conditions deteriorate the quality of care, as low staffing places both workers and residents under increased stress and reduces the amount of time care workers can spend with residents. The combination of low pay and understaffing makes it difficult to recruit and retain staff. There is adequate proof that staffing levels and staffing mix are key predictors of resident health outcomes and care quality, and that care provided in for-profit long-term care facilities is generally inferior to that provided by public- and nonprofit-owned facilities.

The B.C. government’s long-standing reliance on attracting private capital into the seniors care sector has benefited corporate chains with the ability to finance and build new facilities. In the decade between 2009 and 2018, British Columbia invested less than one half of one percent of the total healthcare capital spending (which is not very much money). More than one-third of all publicly subsidized and private-pay long-term care and assisted living spaces are controlled by large corporations, while the balance is owned by either nonprofit agencies or health authorities.

Corporate chain consolidation in seniors care has become popular among investors in this sector because the business is real estate-focused, resulting in care facilities being treated and traded as financial commodities. This being the case, the care chains are prone to engage in risky business practices. These chains are routinely bought and sold after using debt-leveraged buyouts, ultimately leaving the chains with debt-servicing costs that revenues, including the government funding, cannot cover, resulting in financial crisis and creating disruptions that undermine the quality of relational care due to high staff turnover.

The evidence is clear: profit-making has no place in seniors care. Public dollars are flowing into profits not into frontline care as intended.

Let us strive to provide the care and support for our parents, grandparents, siblings and others who gave us so much and for whom we care so much. Nobody should be profiting from the care of our seniors and that, dear readers, is why profit should be eliminated from long-term care.

Kenneth Levitt is a past president of Jewish Seniors Alliance, former chief executive officer of Louis Brier Home and Hospital, and a past chair of Camp Miriam. In 1985, he co-edited, The Challenge of Child Welfare, the first textbook on child welfare in Canada. Larry Shapiro studied accounting and worked at major firms as well as with the federal government. In 1977, he studied real estate and opened his own business. Since moving from Montreal to Vancouver, Shapiro has been an active member of the JSA board.

Health workers’ courage

Judith Anderson speaks at the Wallenberg-Sugihara Civil Courage Society’s Raoul Wallenberg Day event last month. (photo by Masumi Kikuchi)

This year’s commemoration of Raoul Wallenberg Day took place April 10 at Congregation Beth Israel because COVID-19 restrictions prevented the gathering in January. The event honoured the courage of B.C. frontline healthcare providers during the pandemic.

Hosted by the Wallenberg-Sugihara Civil Courage Society, Judith Anderson welcomed attendees. She asked them to take a moment of silence to think about Ukraine and “all the victims of this humanitarian crisis, and to thank the countries welcoming refugees, especially Ukraine’s closest neighbours – Poland, Romania, Slovakia, Moldova and Hungary. In addition, let’s remember the many organizations and volunteers who are stepping forward to help.”

Anderson spoke about gratitude. “We are blessed to live in a peaceful society, where threads of various cultures are woven together to make a fabric that is stronger and warmer than any of the threads would be alone. Let’s recognize two special qualities of that fortunate fabric that we are thankful for today.

“First, we appreciate our shared land. Here in Vancouver, we are meeting on the unceded territories of Musqueam, Squamish and Tsleil-Waututh people. We thank them for sharing, and for having cared for these lands and waters for thousands of years.

“Second, we are thankful for our health care. Modern medicine has developed from diverse cultural threads, including science, people skills, systems management and the professional commitment of thousands of healthcare providers. Our routine expectations of health and longevity could scarcely have been imagined, just 100 years ago.

“And today,” she continued, “we are thankful, in particular, for the civil courage of those who have provided health care to British Columbians during the COVID-19 pandemic. They have faced a new, deadly, communicable disease with unknown risks to their own and their families’ health. They have worked to exhaustion under the most stressful conditions, saving lives and comforting families. Then, when vaccines became available, healthcare workers extended themselves yet more to immunize us all. Unfortunately, as some people have tired of public health restrictions, medical workers have been subjected to harassment and threats. And still they are there for us when we need health care, whatever the problem might be.”

Deputy Mayor Christine Boyle read the Raoul Wallenberg Day proclamation from the City of Vancouver, recognizing Jan. 17 as the day of its commemoration.

The Civil Courage Society’s Alan Le Fevre introduced the three speakers: Barb Nederpel, president of the Hospital Employees Union of British Columbia; Sherri Kensall, board chair of the Nurses and Nurse Practitioners of British Columbia; and Dr. Ramneek Dosanjh, president of the Doctors of British Columbia. They described the challenges and courageous responses of hospital workers, nursing professionals and doctors during the COVID pandemic.

The one-hour documentary Zero to Zero was screened at the event. Filmed over 15 months, it offers an unfiltered look at what it’s like to be a healthcare worker during the COVID-19 pandemic. It follows the staff of a hospital from the moment they admit their first patient in June 2020, till after the third wave. Filmed by a healthcare worker with unprecedented access to the hospital frontline, it deals with patients during life-and-death situations, but the focus remains on the indomitable strength of the human spirit.

After the screening, the guest speakers fielded questions from the audience about what they thought of the documentary, about long-COVID in healthcare workers and about the harassment they faced and how they responded to it.

The annual commemoration is held in memory of Raoul Wallenberg, a Swedish architect, businessman, diplomat and humanitarian, who became Sweden’s special envoy to Hungary in summer 1944 and, at great personal risk, saved tens of thousands of Jews from deportation and death. He disappeared into Soviet captivity on Jan. 17, 1945, and his fate remains unknown.

Wallenberg has been made an honorary citizen of Canada, the United States, Hungary, Australia and Israel. In 2000, the Canadian government proclaimed Jan. 17 as Raoul Wallenberg Day.

The event is also in memory of Chiune Sugihara, a Japanese diplomat who served as vice-consul in Lithuania during the Second World War. He chose to act, at clear professional and personal risk to himself and his family, issuing transit visas that allowed about 2,000 Jews, more than 90% from Poland, to escape almost certain death.

Both Wallenberg and Sugihara have been designated by Israel as Righteous Among the Nations.

The Wallenberg-Sugihara Civil Courage Society, said Anderson, defines “civil courage as an act entailing personal risk or sacrifice, intended to improve or save the lives of others who endure misfortunes attributable to social context. In even the best-managed societies, some people may suffer from conflict, injustice or threats to health and well-being – such as the COVID pandemic – that are intimately tied to our social structures. And those who help despite personal risk, show the same inner strength as wartime role models like Wallenberg and Sugihara.

“In 2006,” she continued, “the former honorary Swedish consul to Vancouver, Anders Neumuller, began Vancouver’s annual commemoration of Wallenberg Day. He later envisaged a nonprofit society dedicated to honouring acts of civil courage. And so the Wallenberg-Sugihara Civil Courage Society was formed in 2013 by members of the Swedish and Jewish communities in Vancouver.”

The Civil Courage Society honours the legacy of Wallenberg and Sugihara by acknowledging British Columbians who have demonstrated civil courage and by promoting civil courage.

“To that end, each year, we formally recognize a person or group of people who have displayed civil courage in British Columbia,” said Anderson. “We also screen a film intended to get the audience thinking about the importance of civil courage and how to encourage it.”

For more information, including photos and video of the commemoration, visit wsccs.ca.

– Courtesy Wallenberg-Sugihara Civil Courage Society

The effects of isolation

How technology can connect people and reduce social isolation was the topic of the Jewish Seniors Alliance’s fall symposium. (photo from pixnio.com)

At the fall symposium of the Jewish Seniors Alliance, which took place on Zoom Nov. 21, attendees heard from experts on the topic Triumphs and Trials Using Technology: Social Isolation Among Older Adults.

Dr. Kristen Haase, assistant professor of applied science at the University of British Columbia School of Nursing, and Dr. Megan O’Connell, professor of geriatric psychology at the University of Saskatchewan, were welcomed by Gyda Chud, co-president of Jewish Seniors Alliance. Chud pointed out that this session related to the key pillars of JSA:

Outreach: to seniors in the community.
Education: we can learn from the professors’ study results.
Peer support: JSA has projects that help combat loneliness and isolation.

Of their study on social isolation among older adults during the pandemic, Haase said they wanted to explore how the inability to interact in person during the pandemic has impacted seniors. She mentioned that two scientific publications – The Lancet and The Journal of the American Medical Association – had commented on the detrimental effect of isolation on seniors. Haase and O’Connell wanted to look at the effects and what could be done to alleviate them.

There is empirical evidence that social isolation impacts mental, physical and cognitive health. Since technology can facilitate social connection, the idea was to train older adults to use these facilities to lessen their isolation. Use of both the telephone and Zoom was embraced by many older adults, and even those people with some cognitive impairment could be trained to use Zoom and other such tools.

Haase and O’Connell reached out to groups and individuals in British Columbia and Saskatchewan for participants. Four hundred individuals and 41 seniors groups were involved in the study, including JSA. Two of the questions were: How did they change their programs? and How did they maintain social connections?

Some groups opted to meet outdoors. The advent of a vaccine helped alleviate some fears. One of the findings was that introverted people, as well as those who lived in rural areas and those who had family nearby, fared better than more extroverted people.

Many community groups rose to the challenge and introduced new technology to their members. In addition to providing training, they also kept in touch with frail members. In rural areas, where broadband access was problematic, groups had to make major use of the telephone. A 1-800 line was purchased to facilitate contact in these areas. These types of disparities in access were highlighted by the pandemic.

A few community groups closed during COVID, but many rose to the occasion by staying in regular contact, providing iPads to clients and helping them learn how to use them.

Haase and O’Connell then turned to the audience for any questions or other information that would help with their research.

One question was how do we find the truly isolated, as we usually rely on people to self-identify if they are in need. The poser of that question, Larry Shapiro, pointed out that, in the United Kingdom, they use the postal service to check on isolated individuals.

Another issue raised was whether groups should continue with a hybrid model of services – this would involve in-person events plus a Zoom possibility. Hybrid models make programming more accessible for those who are ill or who have a disability that impedes mobility. As well, many older adults are still fearful and need help to re-enter society. Funding would be needed to facilitate such programs.

Tammi Belfer thanked the speakers for their research, which was helping improve the lives of older adults.

Shanie Levin is program coordinator for Jewish Seniors Alliance and on the editorial board of Senior Line magazine.

City’s only Jewish firefighters?

Firefighters Daniel Greenberg, left, and Adam Bender. (photo from Adam Bender)

There are not many Jewish firefighters in Vancouver – but two of them serve together in Fire Hall #2 in the Downtown Eastside.

Being Jewish is not all Daniel Greenberg and Adam Bender have in common. They are also both Ontario-born men, about 40, who came to firefighting comparatively late in life after other careers. And both have young families who they get to spend quality time with because the shift work inherent in their profession offers a flexibility that the 9-to-5 grind does not.

The two met while stationed together in the Downtown Eastside, a posting unlike any other in the city. The vast majority of calls to which they respond are drug overdoses and related emergencies. The leading minds of politics, policing and healthcare have not been able to resolve the epidemic of addiction that grips the neighbourhood and, if firefighters had the solution, it would have been implemented by now, but they don’t.

“This issue is often discussed amongst the firefighters,” said Greenberg. “We obviously don’t know the solution. It’s a terrible situation. It is difficult to see. You are seeing human beings living in a state that, honestly, you don’t expect human beings to live in…. Safer places for them to go, more permanent housing situations, access to treatment programs – any and all of the above sound wonderful and ideal.”

Vancouver Fire and Rescue recognizes the toll that serving in this challenging hall can take and they have a limit of 80 shifts – or about a year – before being transferred to a more conventional hall.

When he started, Greenberg got some advice from a veteran firefighter.

“Don’t make their emergency your emergency,” he was told. This may be easier said than done, of course, and Greenberg said the fire department takes the risks seriously. During recruitment, trainees go through resiliency training to prepare them in advance for what they might encounter, and the department is sensitive to the impacts tough calls can have.

“If we witness a particularly troubling call, you are essentially taken out of service and you are provided with counseling,” said Greenberg.

This is a major advancement from the old-style approach, which Greenberg characterized as “Tough it up, shake it off, on to the next.”

“We are all made to feel really supported,” he said of the current atmosphere.

Greenberg became a firefighter in Ontario after working in construction and teaching physical education and kids with special needs. He moved west when his wife, Emily Greenberg, was hired as head of school at Vancouver Talmud Torah. They have three kids, ages 12, 10 and 6.

“I was really searching for a career path that I’d be very passionate about, that would suit my strengths and my interests. Frankly, also, a job that could support my family and my wife not only financially but also me being able to be around the family a lot more than a simple 9-to-5,” he said.

Jewish people may be overrepresented in many helping professions, but not this one. Greenberg isn’t sure why.

“I think, historically, whether I’m generalizing or not, most Jews are steered towards professions that are more of the white-collar variety: lawyers, doctors, builders, entrepreneurs,” he said. “Certainly anything that involves a level of danger, perhaps, doesn’t speak to Jewish people. Mothers are probably a key ingredient there.”

Coming to firefighting after wider experiences, Greenberg has no regrets.

“It’s really exceeded my expectations,” he said. “Every firefighter I speak to truly loves the job.”

He sees his work as an embodiment of the value of tikkun olam.

“I’m fortunate to have a job and a career where I may not be helping the world at large per se, but to an individual in that moment, in their most dire moment, it feels pretty good to be there with my crew helping them and potentially saving lives,” he said.

Greenberg also picks up some shifts as a supply teacher and he is starting a new side business involving cosmetic tattooing for hair loss. He noted that he may be the only Jewish vegan firefighter in North America.

Greenberg met Adam Bender at the hall. It was a total coincidence that two practising Jews – maybe the only ones on the job – would end up in the same station.

Bender was born in Oakville, Ont., but spent formative years in Israel. His parents moved there when he was a year old and they returned to Canada around the time of the first Gulf War, when Bender was in Grade 1.

In Hamilton, Ont., at this point, Bender admitted he was not a model student.

“To say that I was kind of a piece of crap would be an understatement,” he said. He was kicked out of school and, to avoid being kicked out of his house, he made a deal to go on a five-month ulpan on a kibbutz in Israel.

But Bender’s parents got more than they bargained for when he returned home from ulpan with a surprise.

“I did something my parents I don’t think thought was part of the deal when I signed up for ulpan,” he said. “I signed up with the Israeli army. I broke the news to them when I came home that I was going back in a month.”

He served two years (since he was joining at age 21, rather than 18, he was not required to commit to the usual three years) and made it into the paratroopers and special forces.

“Special forces unit [was] probably the biggest influence on my character in terms of understanding the ability to accomplish goals,” said Bender. He returned to Canada, intending to study at the University of Toronto but, again, school wasn’t a good fit and he joined the Canadian military. There, he also served in the special forces.

He met his now-wife and proposed shortly before a six-month deployment in Iraq. The understanding was more intuitive than explicit that, for the marriage to work, a career other than the military was required.

They married in 2017 and now have two kids, 3 and 1. He joined Vancouver Fire and Rescue in 2018.

Like Greenberg, Bender isn’t sure why more Jews don’t choose their path, but suggests “the Jewish grandmother card” may play a role. “There’s a lot of other professions that are a lot more attractive, let’s say, and safer. Firefighting is a blue-collar job at the end of the day.”

The Greenberg and Bender families hope to get together for Shabbat dinner one of these weeks, but the pandemic has thwarted that hope so far. Meanwhile, Bender said, it’s a happy coincidence that the two tribe members ended up together.

“There obviously wasn’t any strategic implementation of putting the two Jewish kids together on one crew,” said Bender. “We’re kind of lucky that that happened.”

BGU studies health tweets

Dr. Odeya Cohen (photo by Dani Machlis/BGU) and Dr. Rami Puzis (photo courtesy)

Ben-Gurion University of the Negev (BGU) researchers discovered patterns of significantly decreased joy, increased sadness, fear and disgust among healthcare professionals (HCP) in the largest social media study to track emotional changes and discourse during the COVID-19 pandemic.

In the study, a multidisciplinary BGU team analyzed more than 53,000 HCP tweets from followers of several hundred Twitter accounts of healthcare organizations and common HCP points of interest. The most significant topics HCPs discussed during the pandemic were COVID-19 information, public health and social values, medical studies, as well as daily life and food. Approximately 44% of their discourse was about professional topics during the entire 2020 year.

The research indicates data-driven approaches for analyzing social media networks are helpful as a method for exploring professional health insights during both routine clinical situations and emergencies. The study will be published in the Journal of Medical Internet Research. A preprint is already available online. It was funded by the BGU Coronavirus Taskforce and by an Israeli Ministry of Science and Technology coronavirus research grant.

“Our findings, which track increasing sadness and decreasing joy, should be a warning to health organizations of the importance of better mental health support to help HCPs cope with the emotional consequences of the pandemic,” say Dr. Rami Puzis of BGU’s software and information systems engineering department (SISE) and Dr. Odeya Cohen of the department of nursing. “Most interestingly, HCP tweets expressed greater levels of fear just prior to pandemic waves in 2020. This indicates that many HCPs, beyond those working in epidemiology, observed, and were adequately qualified to anticipate pandemic development.”

Puzis goes on to say, “This suggests that decision-makers could benefit from investing additional resources into listening to the broader HCP community to track and anticipate bottom-up pathways for developing health crises.”

– Courtesy Canadian Associates of Ben-Gurion University of the Negev

Haas talks acting and BGU

Israeli actor Shira Haas was the featured guest at the Canadian Associates of Ben Gurion University of the Negev’s virtual gala July 7. (photo by Shula Klinger)

On July 7, the Canadian Associates of Ben Gurion University of the Negev held their second virtual fundraising gala. More than 1,200 participants logged on to the An “Unorthodox” National Virtual Gala event, which raised $850,000 for brain research at BGU’s Zlotowski Centre for Neuroscience.

The Zlotowski Centre is a group of researchers dedicated to finding cures and management tools for neurodegenerative diseases including Parkinson’s, Alzheimer’s, ALS and epilepsy.

photo - As part of the gala event, attendees received a special dinner package — As part of the gala event, attendees received a special dinner package. *(photo by Shula Klinger)*

Months in the making, the virtual gala was the work of a countrywide team of BGU staffers and numerous volunteers. Every participating household in Metro Vancouver received sweet and savoury kosher treats from Café 41. The accompanying gift box also brought olive oil from the Negev, a copy of Deborah Feldman’s memoir, Unorthodox: The Scandalous Rejection of My Hasidic Roots (Simon & Schuster, 2012), appetizer dishes and a commemorative cutting board.

Danny Chamovitz, BGU’s president, spoke about the work of BGU’s academics in general, in disciplines ranging from public health to brain research. Canadian Senator Linda Frum conducted the feature interview – with multiple-award-winning actor Shira Haas.

Describing herself as “very, very shy” as a young person, Haas said she had considered psychology or graphic design as professions, until a casting director approached her on Facebook. Sixteen years old at the time, she said, with respect to that first project, “I understood that this is what I want to do, it was like the door to Narnia.”

Haas does not take her success or popularity for granted. “It was always a dream to work internationally, in different languages, for different audiences, but I never imagined it,” she said. “It was always about the work. I am very, very lucky to be in this position.” She added, “My parents deserve to be talked about! They are the most supportive and amazing parents.”

Known for taking on demanding roles, Haas approaches acting in a scholarly fashion. She studied musculoskeletal diseases to play a terminally ill woman in the film Asia, and researched Russian, Yiddish and Charedi culture for the series Shtisel and Unorthodox. She said she finds beauty in hard work, explaining that Asia was “challenging in the most beautiful way. It was a lot of physical and emotional work, and very personal for me.”

When playing a part, Haas said she is motivated by two things. First, she must be passionate about the role because “that’s what brings everything alive.” About Shtisel, she said, “I fell in love with it immediately.”

Her second principle is to portray “subjects that matter to me.”

Haas’s idealism was evident in the way she spoke about Asia. “It’s not really about death,” she said. “It’s about relationships, about appreciating the time we have and what we do with it. The highest form of art is to bring light to the darkness.”

About Unorthodox, she said, “It didn’t occur to me that it is about the Orthodox world. It was just a story about people who want to be loved, their doubts, desires and failures.”

And Shtisel, she noted, had a huge impact on people all over the world. The show helped change people’s view of Orthodox communities, she said: “It’s universal.”

Of her forthcoming portrayal of Golda Meir in her early years, Haas described a woman with “a very interesting life. She was very passionate, with many dreams and desires.”

Since David Ben-Gurion and Golda Meir were friends, she laughed, “this event was meant to be!”

Haas spoke of her personal connection to BGU. Her sister studied at the university and a close friend is there now. Haas wanted to participate in the gala for several reasons, including, she said, “I am Jewish, I am an Israeli. I want to keep on doing events like this! I am even more proud to do it for Ben-Gurion.”

As for the brain research being conducted at BGU, which the gala funds will support, there has already been groundbreaking progress. Claude Broski’s group has identified a protein that can slow down the degeneration brought on by Parkinson’s. The social robots developed by Shelley Levy-Tzedek and her team will have an impact on stroke patient recovery – the robots offer motivation, feedback and performance-tracking during the rehabilitation phase. Epilepsy researchers are developing wearable hardware and software that could alert patients to an oncoming seizure, an hour before it happens. And Deborah Toiber’s Alzheimer’s team is exploring questions about brain aging, such as, Why does the disease affect so many of us, when only 5% of cases are genetic?

David Berson, executive director of CABGU, British Columbia and Alberta, said, “It has been very gratifying to see how the Metro Vancouver community has embraced BGU students and faculty in recent years. Many new supporters have stepped forward during the last year to engage with us. We are especially grateful to our community partners, who helped us promote this Unorthodox event.”

Among the many contributors to the gala were board members Jay Eidelman and Si Brown. Rachelle Delaney helped Berson with the goodie boxes at the crack of dawn on July 7, while volunteer drivers delivered the boxes. Adrian Cantwell and I were co-chairs for the Metro Vancouver team.

Shula Klinger is an author and journalist living in North Vancouver. She was Metro Vancouver co-chair of the CABGU gala with Adrian Cantwell.

CHW’s Brunch with Bakan

Joel Bakan spoke at a CHW Vancouver Book Club event May 30. (photo from thecorporation.com)

The Canadian Hadassah-WIZO (CHW) Vancouver Book Club hosted a far-reaching 90-minute discussion with author, filmmaker, musician and University of British Columbia law professor Joel Bakan on May 30. Moderating the event, entitled Brunch with Bakan, was Toronto-based writer (and former Vancouverite) Adam Elliot Segal.

Bakan’s widely acclaimed 2004 book The Corporation: The Pathological Pursuit of Profit and Power explored the formation and behaviours of modern-day industrial behemoths. It was later turned into an award-winning film. His new book, The New Corporation: How “Good” Corporations are Bad for Democracy, released in 2020, also has a film attached to it – The New Corporation: The Unfortunately Necessary Sequel, which Bakan co-directed with Jennifer Abbott.

In the CHW event, Bakan shared tidbits about his upbringing, first in East Lansing, Mich., then moving to Vancouver at age 11. “I was a very young draft dodger,” he recalled, as his parents decided to move north at the height of the Vietnam War.

“Family and Judaism have been two of the pillars of my life,” he said, recounting how much of his current activism could be traced to his immigrant grandparents.

“Jewish people, by virtue of their history, understand persecution, they understand injustice. They haven’t had a choice but to understand injustice. Injustice has always been in their face. It’s no coincidence that Jewish people were leaders in the civil rights, labour and other movements,” said Bakan.

“Jewish people have always had an activist sensibility and I think it’s rooted, not only in that history, but in the ethics of the religion – chief among them is tikkun olam, that we have a duty to repair the world, which is very much a duty I take seriously,” he added.

In his recent book, which moderator Segal called a “tour de force” and “meticulously researched,” Bakan tackles such subjects as deregulation, the aviation industry and what he describes as the destructive dependence on technology. In it, he interviews not only influential legal and economic scholars but also references pop culture to explain more difficult concepts.

“I wanted the book to be readable,” he said. “I am an academic by trade, but I am a writer. I want the reader to feel pulled into a story. In all my writing for a popular audience, I try to get away from the academic notion of laying out the facts and instead lull the reader in by telling some good stories. And, once I have the reader, I try to engage them with some more analytical or informational kinds of things.”

Segal asked about Bakan’s Trump-era trip to the World Economic Forum in Davos, Switzerland, for the recent Corporation documentary project. It turned out to be a coup of sorts for a film crew to be allowed access to the normally secretive meetings of the world’s political and corporate elites in the Swiss Alps.

In this work, Bakan discusses the concept of corporate social responsibility, which, he contends, cannot do nearly enough to combat rising global social and environmental threats. He distinguishes between individuals at the top of corporations and the corporations themselves.

An example of this approach is Lord John Browne, the former chief executive officer of British Petroleum, whom Bakan portrays as a very cultured man and one of the “good guys,” who tried to get his firm to be at the forefront of corporate responsibility. However, the problem is that even the most benign, well-intentioned CEOs are hamstrung by their fiduciary and legal responsibilities to their shareholders, according to Bakan.

“A CEO can go a certain distance in trying to do a better job in terms of social or environmental responsibility, but you can’t go further in that direction in terms of what will be profitable,” said Bakan. “It’s great if corporations try to be a little better, but let us not be deluded into believing that they can go far enough to get us out of the mess we are in, be it the social mess or the environmental mess.”

The conversation turned to sports and the recent failed attempt by Europe’s top soccer clubs to form the Super League. The common thread with other societal issue is the goal of corporations or capitalism to commoditize everything, whether it be water, utilities, education or entertainment. In the case of the Super League, the vested corporate interests behind the initiative were trying to increase profits by “taking the local out of sports.”

“If you put the Toronto Maple Leafs in Dubai, they would make more money,” said Bakan. “The Super League stopped because the people and governments rose up.”

The discussion ended on an uplifting note for the future. Bakan advocated extolling the virtues that our societies value, such as democracy, freedom and equality, to create a world “in which people can flourish, where they can thrive, where they can be free, not just of government restrictions but ill health, hunger and poverty, where they can live lives of meaning and purpose in which their material needs are met.”

The past 40 years have seen corporations as drivers of policy rather than as tools, argues Bakan. “We need to understand that our democracy is what matters and its capacity to serve human flourishing and planetary survival. When we think about our policies, they need to be aimed at how we can use markets and corporations towards those ends – not how they can use us to serve markets and corporations.”

The film version of The New Corporation is available on several streaming services in Canada. As well, the CHW talk is available for anyone who donates $18 to CHW, for which a full tax receipt also will be provided. Visit chw.ca/thenewcorporation to register, or call the CHW Vancouver office at 604-257-5160. CHW supports programs and services for children and women, in healthcare and education, in Israel and Canada.

Sam Margolis has written for the Globe and Mail, the National Post, UPI and MSNBC.

Pushing for more oversight

Members of the Jewish community, as well as members of various professional organizations, are calling on the government of British Columbia to do more to regulate practising therapists and counselors in the province.

According to the Federation of Associations of Counseling Therapists in British Columbia (FACTBC), which is at the forefront of the campaign for this change, there is currently no regulatory body for counseling therapists in the province and, therefore, there are no regulatory standards for the work that counseling therapists do.

As it stands, they claim, someone can call themselves a mental health professional in British Columbia without having the checks that exist elsewhere in Canada. This, FACTBC points out, differs significantly from Ontario, Quebec and Alberta, which have all established regulatory bodies to oversee who can become a mental health professional. And, they add, the remaining provinces have done more than British Columbia when it comes to the consideration of implementing regulation.

A member of the Jewish community recently came to the Independent with her story. In her attempts to remove a social worker from her mother’s life, she encountered what she believes were numerous inadequacies within the present system regarding the protection of the public’s interest and confidence.

“When we seek the help of doctors and nurses, there is a protected title that tells us the person is qualified and safe and that there is a professional regulator to back up this promise,” she said. “Regulation protects people from harm. I cannot change the events of the past, but I can take from that experience and do what I can to ensure that all our citizens are protected, moving forward.

“I knew,” she added, “and had confirmed by other counselors and social workers that what this registrant was doing was in violation of their professional code. I saw my mother become further isolated from friends and family, while her health continued to decline both mentally and physically, while in this registrant’s care.”

The community member filed a complaint with the B.C. College of Social Workers (BCCSW). “Through this experience, I saw firsthand the lack of transparency in the complaint and discipline process that gives social workers the ability to enter negotiated complaint resolution agreements (CRAs) in exchange for keeping matters confidential. How can the public have confidence in regulators if the public is not aware of actions taken by regulators to protect them?” she wondered.

The community member then did what many who lack the financial means could not: she filed a civil claim against the social worker. She was not looking for money, she told the Independent; rather, she was looking for accountability and safety.

In the end, the woman and her family received an apology from the registrant and a promise to not repeat the following conduct: failing to differentiate between professional and personal boundaries; creating a situation of dependence with clients; and failing to limit their practice within the parameters of their competence.

“The college, in their inquiry decision, acknowledged that the time the registrant spent with my mother and the amount the registrant billed were not reasonable. I am not sure I will ever be able to fully reconcile with the events that occurred over a three-year span at the hands of a social worker, who was a friend at the time, and [that] I helped facilitate the introduction to my vulnerable, senior mother,” the woman said.

“To help with my own personal healing,” she added, “I elected to join FACTBC’s stakeholder table. I hope to lend my voice to ensure social workers, counseling therapists and emergency medical assistants who deal with our most vulnerable citizens are recognized as health professionals and regulated under the Health Professions Act.”

For Shelley Karrel of Jewish Addiction Community Services (JACS) Vancouver, the importance of regulation for counselors in British Columbia cannot be overstated. “For counselors working in the area of addiction and recovery, it is critical to know the importance of assessment, understanding the various stages of addiction, being able to identify the options available for treatment and recovery,” she said.

Karrel explained that understanding co-morbidity – i.e., the presence of one or more additional conditions – of mental health issues with addiction requires psychotherapists and counselors to have the proper training and education to know how to help clients deal with their various challenges.

“Having counseling fall under a regulated body will give clients the assurance they are dealing with qualified professionals who have to meet professional standards of practice, ongoing continuing education and clinical supervision,” she stated.

According to Glen Grigg, a Vancouver clinical counselor and the chair of FACTBC, “proper regulation will prevent consumers from harm. A consumer should not have to guess whether the therapist is equipped to deliver the services they promise. Moreover, when harm is done, it is important to know that a registrant’s college has the power to bring restoration and remediation when harm has occurred.”

FACTBC, which is comprised of 14 professional organizations that represent 6,000 mental health professionals in the province, is asking for safety and accountability. On professional title, it recommends one legislative authority and one coherent and fair process that prevents harm and has the power to act accordingly when harm has been done.

The B.C. government has said that it will first implement modernization of the health professions regulatory system – a step that FACTBC enthusiastically supports – and then give attention to the mental health system.

To Grigg, “this response comes down to saying, in effect, ‘despite the opioid crisis and mental health fallout from the pandemic, we can defer this issue.’ When pressed for what is intended after a new regulatory process is put into place, timeline unknown, the response is that government will ‘recommend’ that professions, such as counseling therapy and social work, become a ‘priority.’ A recommendation to a yet-to-be created bureaucracy falls far short of commitment and action.”

Grigg added, “FACTBC has been advocating for public protection where counseling therapy is concerned for more than 20 years and have heard, over and over, variations on the theme, ‘Yes, of course, we are going to protect the public, but later, at a time we’re not prepared to specify.’”

FACTBC does give the province credit for creating a Ministry of Mental Health and Addictions – a huge step forward, in their view, as was the $5 million the province put towards increasing mental health services. What the government needs to do to follow up on this momentum is to regulate counseling therapy, they assert.

At present there is no way of accurately ascertaining how many practising counselors there are in British Columbia. However, Grigg cites what Ontario discovered. In that province, in the time since they implemented statutory regulation on counseling therapists, they found that half the people providing services did not have any form of registration or certification.

“That’s dangerous,” said Grigg. “And we suspect that the situation in B.C. is similar but, because there is no central authority, even the scale of the problem is guesswork.”

He stressed, “It’s easy to see why this is so crucial. Suppose you were sick or injured and went to your local clinic or emergency department and discovered that it was up to you to figure out whether the people working there really were nurses and doctors, and whether they were qualified to provide care? That’s what people looking for counseling services are up against every day in B.C. There is no single title, like doctor or nurse or dentist or pharmacist, that identifies qualified and accountable counseling therapists.”

Sam Margolis has written for the Globe and Mail, the National Post, UPI and MSNBC.

HIPPY fêtes trailblazer

Carol Slater (photo from mothersmattercentre.ca)

Carol Slater, a former vice-president of National Council of Jewish Women of Canada, was presented with the first-ever Trailblazers Award for helping bring to Canada an innovative Israeli-founded education program that empowers mothers of preschool children.

The award, presented by the Mothers Matter Centre, was part of a virtual event May 5. (See jewishindependent.ca/mothers-importance.)

Slater was one of a small group of people who brought the program Home Instruction for Parents of Preschool Youngsters (HIPPY) to Canada two decades ago. The initiative, which has taken off in countries worldwide, began out of the Britannia Community Centre and Britannia Community Secondary School, in East Vancouver. The national headquarters of the program remains in Vancouver, under the auspices of the Mothers Matter Centre. HIPPY Canada changed its name in 2017 to the Mothers Matter Centre to reflect the fact that they deliver a range of programs, although HIPPY remains the core of the organization.

Slater spoke with the Independent recently, along with Wazi Dlamini-Kapenda, a Vancouverite who was the first HIPPY director in Canada and remains head of the national program.

HIPPY was started in 1969 at the Hebrew University of Jerusalem by the late Dr. Avima Lombard.

“When the first wave of African immigrants came to Israel and spoke no Hebrew, [Lombard] realized the disconnect between the children and the parents,” Slater said. “The parents didn’t know what was expected of the children, or of the parents.”

Slater and Dlamini-Kapenda take pride in the relative simplicity of the HIPPY structure. A new program is developed when a community identifies HIPPY as a program that would be of benefit to mothers and children. The community then approaches the Mothers Matter Centre to help with starting it up. In other cases, MMC approaches the community to let them know about the program and support them in implementing it, providing seed funding to get it off the ground, said Dlamini-Kapenda. The community can start with a minimum of two to four home visitors, depending on the size of the community, then each visitor recruits 10 to 12 families. The home visitor drops in on each family every week for at least an hour during the school year, and teaches the mother the week’s activities using the HIPPY curriculum. The lessons are taught using role-play, in which the home visitor and the mother take turns being the teacher (mother) and the student (child), practising the lesson before the mother teaches the week’s lessons to their preschooler.

“The basis of this program is that all parents want the best for their children, all parents want their children to succeed and to enter school ready to learn,” said Dlamini-Kapenda. “The parents themselves can play a role in this in building capacity within the home. Instead of parents relying on sending their children to preschool, which some parents couldn’t afford, we could go into the home, which is actually important because the home is where success begins. We all know that.”

“One of the very critical things,” Slater said, “is giving the parent the confidence that she can go to [her child’s] school because what has very often happened in immigrant situations is that the mother may not speak the language very well and, if she doesn’t go to school, she doesn’t follow her child and if she doesn’t follow her child, her child can fall behind and she doesn’t know about it. One of the most important things is the empowerment of the parent to understand that she is the first teacher of her children. It’s a fantastic concept when you think of it. So simple.”

The program is offered free to mothers and all supplies are provided, although almost everything that the mother will need to do activities can be found in the home. The families targeted for the HIPPY program are those with low literacy or deemed “at risk.” Special emphasis is given to immigrant and refugee communities and Indigenous populations. HIPPY has separate streams for multicultural and Indigenous families, recognizing different approaches to learning. Home visitors will usually be recruited from within the linguistic communities they serve.

Slater’s award recognizes her work in getting HIPPY off the ground in 2001.

“Carol was very instrumental in getting the funding and knocking on doors and talking to every person in a position to be able to get us the first funding to run the first four or five years of the program here in Canada,” said Dlamini-Kapenda. “I don’t know, without Carol, how far we would have gone.”

Dr. Debbie Bell, founding director of Simon Fraser University’s community education program, was working on developing strategies to create access to education for low-literacy communities. Slater and Bell connected after Slater happened upon a brochure about the nascent program. Slater, who has lived in Israel, Vancouver and, now, Montreal, saw it as an ideal fit for National Council of Jewish Women.

Seizing the moment, Slater beat the bushes for financing. Bell was emphatic that they should not launch HIPPY without a budget for several years of programming because that would be unfair to participating families. Slater went to Ottawa and, with the help of several key figures, obtained funding from the federal health ministry to get HIPPY up and running.

She credits Dr. Hedy Fry, member of Parliament for Vancouver-Centre, as an early supporter.

“She was so excited about the program,” Slater recalled. “She met Debbie and myself and we used to meet in her office. She sat me at a desk, she gave me a list of all the cabinet ministers and their secretaries and their private phone numbers. I just sat there and I phoned.”

An assistant to Allan Rock, who was then minister of health, was equally supportive. Slater left the meeting with a commitment for $250,000, which jumpstarted HIPPY Canada.

Slater also credits late Vancouver philanthropist Jack Diamond and the Diamond Foundation for crucial support that got the program started. The Vancouver Foundation also committed to four years of funding, something they had never done before, said Dlamini-Kapenda, who was then hired as the first HIPPY coordinator in Canada.

At the awards ceremony earlier this month, Canada’s chief public health officer, Dr. Theresa Tam, and Dr. Cindy Blackstock, a Gitxsan activist for child welfare and a professor in McGill University’s School of Social Work, received the Because Mothers Matter Award for their noteworthy professional accomplishments while giving back to their community. Two HIPPY mothers with extraordinary stories, Nusrat Awan and Jessica Seegerts, were also honoured.

Dementia care is self-care

Karen Tyrell, founder of Personalized Dementia Solutions, spoke recently at an online event hosted by Beth Tikvah and the Kehila Society. (photo from dementiasolutions.ca)

To care for people with dementia, caregivers must first ensure they care for themselves. That was a message from Karen Tyrell, an expert with 25 years’ experience assisting people with dementia and those who care for them.

May is caregiver awareness month and Tyrell, who founded Personalized Dementia Solutions, was speaking at an online event May 19, sponsored by Beth Tikvah Synagogue and the Kehila Society of Richmond. Tyrell, who is also author of Cracking the

Dementia Code: Creative Solutions to Cope with Changed Behaviours, teaches people how to deal with dementia in loved ones through one-on-one and group consultation.

Common symptoms of dementia include impairment of memory and thinking, judgment and communication problems and personality changes.

Tyrell noted that the stress caused by caregiving for a person with dementia can result in physical and emotional health issues, some of which themselves can exacerbate the causes that bring on dementia. So, it can become a cycle in families.

She offered a range of strategies, such as breathing exercises, for caregivers dealing with stress. She also emphasized the need to share your concerns with others before they evolve into a crisis.

“As soon as you notice your stress levels are starting to climb and you’re having a hard time to breathe because of what you’re going through, please reach out, tell someone,” she said. “Reach out to your community, reach out to your doctor, reach out to a counselor, reach out to the Alzheimer’s Society in the community that you’re in. Reach out to someone to tell them, because, when you talk about it, then others will give you suggestions on what you can do.”

She urged caregivers to accept help when offered.

“Please don’t think that you’re going to be fine or that you’re going to be an inconvenience to others,” she said. “You need that help. Nobody can handle caring for someone with progressive dementia all by themselves. It’s not humanly possible from the beginning to the end.”

Another tip is to have realistic expectations.

“If you are thinking, I can do this all on my own because I’m the wife and this is my duty, in some ways, I would tell you, that’s great. You’re doing great,” Tyrell said. “But is it realistic that you can do this all on your own?”

Setting boundaries is another key.

“It’s hard to say no to people, but, when you’re setting boundaries for what you will and will not do, and say no to certain things, then you’re going to take better care of yourself,” she explained. For example, some people accept that they can continue to care for their loved one at home until, for example, the person becomes incontinent more than once a day, or until the person with dementia is no longer able to go to their twice-a-week adult day program, giving the caregiver a short respite.

An inability to get proper sleep is a dangerous cycle, Tyrell warned. Exhaustion on the part of the caregiver is a recipe for disaster. Melatonin for the caregiver or the person with dementia could help, or a paid worker to sleep on the couch for a limited period in case they are needed, she said. If possible, the caregiver might get away for a couple of days or the loved one could go into a few days of respite care.

Developing negative emotions and responses is understandable, she added, but finding ways to be positive is critical.

“Try to find some of the positives of your situation,” she said. “One fellow said him and his dad never got along all of their life, they had a really rocky relationship, but when he started to develop dementia, his personality changed and they became best friends. He looked at the positive: ‘It’s not fun to see my dad go through this but I found something good in this.’”

Laughter is a medicine, she added. Remaining social – even via the computer if the pandemic makes in-person socializing difficult – and having laughs with friends can go a long way to keeping a caregiver healthy.

Meditation, yoga, prayer, relaxing exercises or activities are also important tools.

“Exercise is proven to help us burn adrenaline,” she said. “So, when you’re stressed, go for a walk, try to burn off some of that adrenaline. Move that body. Walking is a great exercise.

“Eating healthy is helpful,” she added. Dark green vegetables and all sorts of berries, but especially blueberries, have antioxidants that help slow the aging process.

The presentation is available for viewing at btikvah.ca.

For-profits here to stay by Kenneth Levitt

No place for profits by Larry Shapiro

For-profits here to stay
by Kenneth Levitt

No place for profits
by Larry Shapiro