healthcare – Page 3

What if critical illness strikes?

(photo from flickr)

We all wonder and fear what would happen if we were diagnosed with one of many critical illnesses or suffered a heart attack or stroke.

You work hard to achieve personal and financial goals during your lifetime. Your plan is working and you have accumulated savings and investments, using tax-efficient investment strategies such as your registered retirement savings plan (RRSP). If you have to sell investments prematurely or stop investing in order to manage recovery costs, your future plans may never recover. So what should you do?

The survival rate of these critical illnesses has risen over the years and we are now most likely going to survive “the big one.” In Canada, these are the statistics: 63% likelihood of surviving at least five years after a cancer diagnosis, 90% will survive a heart attack, and there is an 80% survival rate after a stroke and hospitalization.

Here’s the problem

The issue is that there are significant costs associated with the treatment and recovery from such an illness. There can be large medical bills that are not covered by our various healthcare plans. In Canada, many will want to pursue treatments offered by private clinics at home or abroad, which can be extremely costly.

In addition to these costs, we often neglect to consider the other realities that people face, such as not being able to work. The most obvious is the loss of income suffered when one cannot work or run the family business or professional practice for an extended period of time. This might also affect the income of the spouse and other family members, those who are needed to provide home care.

What are the options?

To deal with the unexpected costs and loss of family income there are really two choices:

One may choose to self-insure, meaning that one accepts the risks and has put money aside to cover the eventuality, or
One may purchase critical illness insurance, which provides a lump sum after one is diagnosed with one of the critical illnesses covered in the policy.

The options in more detail

Removing the costs and lost income from one’s financial plan is a considerable setback to the financial plan. The projected retirement income is suddenly reduced and, for most people, it will never be made up. The impact is even greater if one is forced to withdraw from RRSP accounts, as these amounts are fully taxable as income.

As an example, if one needed to cover $100,000 of costs and had to withdraw it from a RRSP account, at a marginal tax rate of 50%, the person would have to withdraw $200,000 of savings intended for retirement.

The eventual impact on one’s projected retirement must be considered carefully, taking into account the income tax issues based on the source of funds, plus the loss of compounding that will no longer be enjoyed on the growth of those funds from the time of the critical illness until the time one planned to retire.

Suffice it to say, the decision to self-insure needs to be taken very seriously. Unfortunately, there are statistics that reaffirm the risks of falling ill with a critical illness are significant.

Critical illness insurance is sometimes referred to as “new insurance,” as it is a newer solution than traditional life insurance. In the past, before the many medical advancements we have enjoyed, life insurance was the solution because it was more rare to survive the illnesses.

Critical illness policies are designed to pay out a lump sum, say $100,000, typically 30 days after the diagnosis. The illnesses are defined and one can purchase a basic plan that covers heart, stroke and cancer, or the more comprehensive plans that have up to 25 covered conditions and include long-term-care insurance as well.

As of the end of 2019, one major life insurance company reported the following statistics:

It has paid out $520 million on 5,360 claims. In 2019, 67% were for cancer, 13% for heart attack, four percent for strokes and the remainder for coronary bypass, multiple sclerosis and other illnesses. The average age of claimants was 53 for women and 55 for men.

The lump sums paid out are used to cover medical costs, replace lost income, retire debt such as loans and mortgages, cover salaries within a business and often pay for time off and bucket list-type vacations.

There are programs available where, if one has been fortunate enough to not have made a claim, in other words, not have fallen ill with a critical illness, the policy can be canceled and all the premiums refunded. The only cost, in that case, is the time value of money on the premiums, as 100% is refunded.

It is even possible to model such a plan where one uses funds earmarked for a RRSP contribution to cover the premiums. This is more effective than one might first think, as the refund of premiums is tax-free.

The first step is to identify and understand the risks to one’s retirement plan. The second step is to consult a qualified professional to consider what protection works best for you.

Philip Levinson, CPA, CA, is an associate at ZLC Financial, a boutique financial services firm that has served the Vancouver community for more than 70 years. Each individual’s needs are unique and warrant a customized solution. Should you have any questions about the information in this article, he can be reached at 604-688-7208 or [email protected].

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Sources: Manulife Insurance – Critical Illness: Asset Protection: Keep Your Retirement Savings for the Future, and Critical Illness: Retirement Protection Handbook.

Disclaimer: This information is designed to educate and inform you of strategies and products currently available. The views (including any recommendations) expressed in this commentary are those of the author alone and are not necessarily those of ZLC Financial. This information is not to be construed as investment advice. It is for educational or information purposes only. It is not intended to provide legal, taxation or account advice; as each situation is different, please seek advice based on your specific circumstance. This commentary is not in any respect to be construed as an offer to sell or the solicitation of an offer to buy any securities.

Negev campaign goes virtual

In closing the Heart Stirring Negev Event on Zoom, Ilan Pilo, executive director of JNF Pacific Region, talked about the important work done by Save a Child’s Heart, the organization at the centre of this year’s fundraising campaign. (screenshot)

Jewish National Fund of Canada, Pacific Region, held its first virtual Negev campaign event on Aug. 30. The original Zoom was recorded and shown again on Sept. 13 and 16. The object of the fundraising campaign is Save a Child’s Heart (SACH), an Israeli-based global organization with the mission of improving “the quality of pediatric cardiac care for children in developing countries.”

“This year, we’re collaborating with Save a Child’s Heart to build a treatment room in the pediatric surgical wing,” explained Lance Davis, chief executive officer of JNF Canada. “Thanks to your support, JNF can fund the bricks and mortar to house the wonderful doctors and staff who perform life-saving surgeries. JNF will literally fund the foundation of the [new children’s] hospital to provide the necessary facilities to advance this beautiful tikkun olam project. Together with you, our generous donors, we truly are building Israel.”

This tagline – “Building Israel Together” – forms part of the new logo for JNF Canada. The change comes in part because, while JNF Canada continues in its environmental mission, it has become more involved in social infrastructure projects, such as youth centres, playgrounds and healthcare facilities. The current Negev campaign is the latest example of this shift: the treatment room is one of possibly two that JNF Canada will fund (depending how much the campaign raises), which are being constructed in the International Pediatric Cardiac Centre at Wolfson Medical Centre in Holon, Israel.

After Ethan Doctor, a King David High School student, sang O Canada, and Beth Hamidrash’s Rabbi Shlomo Gabay sang Hatikvah, Bernice Carmeli, JNF Pacific Region president, welcomed everyone to the virtual Negev event, which was emceed by JNF Pacific Region past president David Goldman.

Dr. Saul and Lindsay Isserow were honourary chairs of the evening. “Our family became aware of Save a Child’s Heart when my oldest daughter, Jenna, volunteered there one summer,” said Lindsay Isserow. The chance to support an Israeli organization that highlights the contributions Israel makes to the world and to the region is another reason the family was part of this event, said her husband, who specializes in preventive cardiology, among other areas. “The cardiology [aspect] is important to me, obviously, because this is something that’s treatable,” he said.

A video showed some of the work SACH has done – it has saved the lives of more than 5,400 children from 62 countries.

Co-campaign chairs Lana and Doug Pulver first visited Wolfson Medical Centre years ago. “I was moved by the way that this organization takes care of children from all over the world regardless of their background, regardless of where they come from, and ensures that their lives are saved,” said Lana Pulver, who was so taken with SACH that she joined its national board a few years ago.

“Each child that is saved is a whole world – and those worlds learn of the compassion of the Jewish people and the nation of Israel,” said Dr. Lior Sasson, lead surgeon at SACH, in his remarks and thanks.

The remainder of the evening was spent with David Shore, one of the producers of The Good Doctor and of House, interviewing Israeli TV show Fauda’s co-author, Avi Issacharoff, and actor Itzik Cohen, who plays the character of Captain Ayub (Gabi). They talked about many topics, including Fauda’s international popularity; how Cohen, a comedian who does musicals, got his (very serious) part as an interrogator; some of Issacharoff’s and Cohen’s favourite scenes; and, of course, SACH.

Ilan Pilo, executive director of JNF Pacific Region, wound up the program by thanking all those who made the event possible: the donors, the boards, staff and others.

After the Sept. 16 streaming, Pilo spoke with the Independent. About 250 people viewed the event over its three nights, he said, noting that it was just the first of two main parts to the local Negev campaign. The next is called Join Us in the JNF Virtual Sukkah, on Oct. 8, 7pm. “It is a Jewish cardiologist panel,” said Pilo. Isserow will spearhead that conversation, and the cardiologists on the panel with him are Drs. Arthur Dodek, Zach Laksman and Joshua Wenner. For more information and registration, visit jnf.ca/vancouver/campaigns/negev-campaign.

The annual Negev Dinner would have normally taken place in the spring or summer. Looking back to March, when COVID hit in full force, Pilo said, “We had plans, and then we were thinking about doing something in April or May, but we realized that people were not going to leave their homes and we had to reconsider our plans…. We had to do everything very quickly. In a month we had to put together an event. And it’s different. On the one hand, it’s in a way easier because you don’t have to serve dinner. On the other hand, you have to be very creative and prepare everything in advance for the online campaign.

“For instance, we have made videos of local young Vancouverites who had volunteered in the past for SACH,” he said. To do this, the former volunteers had to be tracked down and convinced to record themselves. “This way,” said Pilo, “they became part of the online campaign…. You need to get people’s attention and interest and this was a great way [to do that].”

He hoped that the Heart Stirring Negev events would inspire people to contribute to the SACH’s project, “a cause that brings so much pride to the Jewish people everywhere.” Donations are still being accepted at vannegevdinner.ca, 604-257-5155 and [email protected].

Louis Brier and the pandemic

The garden in the courtyard of the Louis Brier. (photo by David J. Litvak)

It hasn’t been easy for any of the staff and companions working at Dr. Irving and Phyliss Snider Campus for Jewish Seniors – which comprises the Louis Brier Home and Hospital and the Weinberg Residence – during the pandemic. Nor has it been easy for the residents and their families. However, seeing a 100-year-old Holocaust survivor happily walking down the hall or a beaming bubbe (who was born in Lithuania) wheeling herself from one end of the facility to the other, or another resident greeting everyone with a hearty “Aye Yai Yai,” I can’t help but smile. Despite the challenges, we have been lucky here, so far, to have escaped the worst of COVID-19.

My pandemic journey at the Louis Brier began in January, when I was hired on a permanent, part-time basis as a mashgiach (kosher supervisor) during an influenza outbreak that foreshadowed what lay ahead. I was hired to replace one of the Brier’s longtime mashgiachs – the facility employs two on a part-time basis – and I had big shoes to fill. The previous mashgiach not only provided kosher supervision in the kitchens but entertained residents with his piano playing, puppet shows and conducting of services in the Louis Brier synagogue on Saturday mornings and weekdays.

Being employed as a mashgiach at the Louis Brier during the pandemic has had many challenging moments – slicing meat and deboning turkey were particularly painful for me because I am a vegetarian, but, luckily, I am no longer required to perform those tasks. Anyways, prior to the pandemic, Shabbat services would be held on Saturday mornings, with a Kiddush lunch afterwards that featured herring, gefilte fish, pastries, challah and grape juice. It was a real highlight for the residents, particularly the lunch. However, due to the pandemic, the weekly services and special meal were canceled. In addition, the monthly Shabbat services that were led by Cantor Yaacov Orzech and the Kol Simcha Choir were canceled, as were Friday night services. It is only recently that Louis Brier chaplin Chazzan Rob Menes has resumed the Friday night services and, in response to a personal request from one of the residents, informal Saturday morning services have also returned.

photo - Chazzan Rob Menes sounding the shofar at the Weinberg Residence — Chazzan Rob Menes sounding the shofar at the Weinberg Residence. *(photo by David J. Litvak)*

On Rosh Hashanah, a full service for the residents was offered, thanks to Richard Wood and Adam Ben Dov, members of the Louis Brier’s religious committee, and Rabbi David Rosenfeld of Chabad, who sounded the shofar for the residents. Menes has been blowing the shofar every morning at the Louis Brier, as well as at the Weinberg Residence, on occasion. While no family members were able to join the services, Rosh Hashanah was celebrated, albeit in a low-key manner.

Other holidays that have occurred since the pandemic have also been observed quietly. Passover at both the Brier and Weinberg was particularly stressful, as kosher-for-Passover products that would normally be available could not be ordered. The facility’s food services manager valiantly persevered to make sure people were provided kosher food during the holiday, however, and the other mashgiach and I – with the help of Rabbi Mendy Feigelstock and Schneur Feigelstock of Kosher Check – worked to keep the home kosher and chametz free. It wasn’t easy. It was a subdued Passover in another way, because the seders at the Weinberg were canceled to ensure that the residents were kept safe from the virus.

That has been the underlying principle since the pandemic began – keeping residents safe. From the outset in March, the Louis Brier’s chief executive officer, David Keselman, has shown foresight. For example, he canceled the annual Purim Megillah reading and Purim parties, which would have taken place just as the coronavirus was taking off.

In addition, from the outset of the outbreak, companions and other employees at the Louis Brier have been prohibited from working at more than one job. These decisions and the dedication of the staff and administration ensured the safety of the residents. Not one resident of the Louis Brier or the Weinberg Residence has contracted the virus.

To show his appreciation of the job that has been done at the Louis Brier, one resident, a fellow North End Winnipegger, nominated the administration for the Order of British Columbia, the Order of Canada and the Nobel Peace Prize. The resident, who started the badminton club at the home and maintains a tulip garden in its courtyard – the only outdoor space residents have been able to go for fresh air during the pandemic – marveled at how lucky he and other residents are. In the Daily Blah, a newsletter he published, he noted: “The Louis Brier does not have the virus, has a beautiful garden and we can play badminton.”

While it is true that the residents have been physically safe and have not contracted the virus, the pandemic has taken a psychological toll on everyone in the building. Until recently, due to provincial prohibitions, residents were not allowed outside visitors, other than seeing loved ones through the glass of the front lobby, and talking to them on their cellphones. Now, residents are allowed to have scheduled visits with loved ones outside the front entrance of the Louis Brier and outside the Weinberg, as well. It is a small victory that will hopefully boost the morale of the residents.

As for me, I just keep thinking of 100-year-old Louis Brier resident who tells me that, as long as he can eat, talk and walk, it’s a good day! The resilience of residents like him reminds me to always be grateful for the basic things in life.

David J. Litvak is a prairie refugee from the North End of Winnipeg who is a freelance writer, former Voice of Peace and Co-op Radio broadcaster and an “accidental publicist.” His articles have been published in the Forward, Globe and Mail and Seattle Post-Intelligencer. His website is cascadiapublicity.com.

Drugs and teens

When we hear the word addiction, it often conjures up negative images or stereotypes. We might think someone has made poor choices, is down and out, or weak-willed; we might think that it’s a problem confined to the Downtown Eastside. Rarely do we think of the word disease or think of addiction as a mental health issue.

Jewish Addiction Community Services (JACS) is committed to providing opportunities for the community to learn together and, on April 4, JACS and the Jewish Community Centre of Greater Vancouver youth department are presenting a community forum called The Fentanyl Crisis: How It Affects Our Teens. This free event, geared to parents, teens and youth workers, is designed to help build awareness of illicit drugs, specifically fentanyl, and to teach how these drugs affect the teenage brain, and how to talk to teens about drugs.

According to a B.C. Coroners Services report, which was published last month, 86% of fatal illicit drug overdoses in 2018 occurred inside (i.e. not on the street) – 58% in private residences. The majority of these deaths were men between the ages of 19 and 59.

While the problem of addiction in British Columbia is well known, what is less well known or acknowledged is how our Jewish community is affected. In fact, denial that the problem exists is more the reality. Rabbi Shais Taub, a specialist in addiction and spirituality, who visited Metro Vancouver in 2012, said one in 10 people are touched by addiction – whether directly or through a close family member. It makes sense that those statistics are similar in our community.

Compare the reaction of when you hear about a friend who has recently been diagnosed with cancer, or another debilitating disease. While we may not know how to help, when a loved one is affected with a life-altering illness, we are usually motivated to offer assistance, whether it is making meals, visiting or giving money to a cause. In sharp contrast, addiction tends to push us away and we tend to blame the person who has a substance use disorder, instead of wanting to rally around and help them.

Why does a family feel shame and the need to shield others from knowing their loved one is affected by the disease of addiction? Why does the person themselves feel the need to hide? Clearly, the answers are complex. In a recent visit to an emergency department, a patient pleaded with a nurse that “no one in my community must know I am here.” That person was a member of our Jewish community. Not only are people struggling with an illness, but they often can’t reach out for help or don’t know where to turn.

We must and can work to reduce the stigma of addiction so that both families and people with addiction are supported. It begins with awareness of resources and education, with fostering a culture of being less judgmental, of being curious and open, and being willing to talk about how someone may have found themselves suffering from addiction. We also need to remind ourselves of the Jewish values of teshuvah (repentance), tikkun olam (repair of the world), community and chesed (loving kindness). People knowing that there are resources available, when they are ready, is key to recovery.

The April 4 community forum includes panelists Dr. Alana Hirsh, a physician working in the Downtown Eastside; Lee Gangbar, a registered nurse who works both at St. Paul’s Hospital’s emergency department and as an outreach healthcare nurse; and Anne Andrew, a parenting coach and author. To attend the forum, RSVP at eventbrite.ca (Fentanyl Crisis). For more information on the program or JACS, email [email protected].

Shelley Karrel is the manager of counseling and community education with JACS. She has her master’s in clinical counseling, is a registered clinical counselor and also has a private counseling practice. She can be reached at [email protected].

Experience a transformation

Owner Cynthia Miller in front of Sechelt Inlet at the Pacific Peace Retreat. (photo by Efraim Gavrilovich)

Travel can be one of the most stressful activities there is. The challenges of packing “light” so you don’t have to pay for a carry-on; getting to flights at ridiculously early times of the day; not to mention dealing with foreign currency, travel insurance, airport lineups, lost luggage, strange food and the fear of contracting some exotic illness while away.

When was the last time you took a trip that not only caused minimal anxiety but actually resulted in you coming home more relaxed and truly blissful? And, more than that, with the knowledge of how to maintain that calm once you’re back at home and the stress threatens to build again? Thankfully, we live in an area of the world where such vacations are an easy option within a day’s drive of the Lower Mainland.

Along the Sunshine Coast, less than two hours’ drive from Langdale, is the Pacific Peace Retreat, where owner Cynthia Miller enables visitors to learn how to shift their mindset by being mindful and aware in the moment.

“I help them see the bigger picture instead of focusing on the problem,” she explained. “Too many people talk about the problem without really seeing the deeper aspect of what’s holding them stagnant.”

Miller provides transformation and relaxation through hypnotherapy, reiki, yoga, aromatherapy, creative arts and mindset coaching.

“I believe that we inherently want to move forward and feel a sense of growth,” she said. “And, when you step back and see your life or past from a different viewpoint, you begin to open up to something new, and that’s when growth takes place. Being mindful of the energy you want to put into every situation – that’s what we practise here.”

Miller cautions that mindfulness does take repetition. “As you practise, it becomes automatic,” she said. “I think that’s why people come here.”

At Hollyhock Leadership Learning Centre on Cortes Island, guests can take one of 90 courses offered on everything from discovering your life’s purpose to mindful self-compassion. They range from several days to several weeks.

photo - Hollyhock Garden — Hollyhock Garden *(photo by Darshan Alexander)*

“It’s learning about yourself and how you operate in the world,” said Loretta Laurin, Hollyhock’s communications manager. “We play a part in making the world better through our own development.”

Although many of the courses are geared toward people who are in a leadership or change-maker role, there are also courses that focus on health and wellness, such as cooking courses that help boost the immune system, pilates, qi gong, and self-expression with sound, as well as excursions such as sea-kayaking and nature walks. Everyone is welcome to attend, said Laurin.

Calling itself a “centre for transformative learning,” the Haven on Gabriola Island helps bring balance to people’s lives through coursework, meditation and yoga.

“There’s a real shift in energy level and transformation,” said Jo-Ann Kevala, a Haven faculty member. “People feel more connected to others.”

Even simple activities like walking can be very mindful and meditative and a way to relax into the present, said Kevala.

The Haven offers courses for women or men, couples or singles, those with high stress and those with addictions. Its signature five-day Come Alive program is an “opportunity to revitalize your life, discover and activate your resources and realize your full potential.”

photo - Quantum Leaps Lodge in Golden offers a variety of practices that will get visitors in touch with their calmer selves — Quantum Leaps Lodge in Golden offers a variety of practices that will get visitors in touch with their calmer selves. *(photo from Quantum Leaps)*

A little further afield, in Golden, visitors can participate in shamanic drumming, Buddhist philosophies and First Nations activities, such as sweat lodges or vision quests, at Quantum Leaps Retreats.

Owners Brian Olynek and Annette Boelman have accumulated a wide variety of self-discovery practices.

One of the more popular activities is the transformational labyrinth, with several spots to sit and think about specific ideas or create something, according to instructions at each spot. The concepts for the labyrinth are based on those of Buddhist monk and world spiritual leader Thich Nhat Hanh, known for his writings on mindfulness and peace. People are encouraged to walk the labyrinth as often as they want and not worry about time.

While much of the world encourages stress and materialism, at Quantum Leaps, said Olynek, “people step out of fear and stress and tap into their own happiness and joyfulness.”

Baila Lazarus is a Vancouver-based writer and principal media strategist at bailalazarus.com.

Let’s talk mental health

Michael Landsberg will deliver the talk Darkness and Hope: Depression, Sport and Me on Feb. 13, as part of Jewish Family Services’ Family Life Education Series. (photo from JFS)

Michael Landsberg is a Canadian sports journalist and former host of Off the Record for TSN. He is also a passionate advocate for removing the stigma around mental illness, and will be coming to Vancouver next month to deliver the talk Darkness and Hope: Depression, Sport and Me. A Jewish Family Services (JFS) Family Life Education event, the talk will be held at Congregation Beth Israel on Feb. 13, with all proceeds going to support JFS mental health initiatives in the community.

Landsberg, who suffers from depression and generalized anxiety disorder, has in recent years been an ambassador for Bell Let’s Talk, an initiative that raises awareness and encourages dialogue about mental health. In 2013, his documentary, Darkness and Hope: Depression, Sports and Me, was nominated for a Canadian Screen Award for best history or biography documentary program or series. The Canadian Alliance on Mental Illness and Mental Health has named Landsberg one of its Champions of Mental Health. Landsberg is known for his Twitter hashtag #sicknotweak, which encourages discussion around mental health and creates a forum for those needing help.

“We’re thrilled and delighted to have Michael Landsberg come and do a talk at Beth Israel,” said Alan Stamp, clinical counseling director at JFS. “He has become an ambassador and a pioneer for mental health. He took a risk coming out about his struggles, [and] for him to come out and share his experiences is quite captivating. What he does best of all is he addresses stigma and, when someone in his role can speak out, it helps to lessen the suffering of the one in five Canadians – which is a conservative estimate in my opinion – who experiences a mental health concern over their lifetime.”

In Vancouver, Landsberg will be doing a one-hour talk with a question-and-answer period afterwards. He spoke to the Jewish Independent about helping people struggling with mental health issues.

“In general, sports mimics life,” he said. “When I speak about life and the stigma around mental health, I know we’re not as far ahead as we think we are. I don’t think we’re nearly as far ahead as we would want to believe. We’ve been working hard and it’s way better, yet I hear from people in the sports world all the time who are still in the closet, or they’re feeling shame.”

A major focus of Landsberg’s work is combating the idea that mental illness is a sign of weakness or is something “self-inflicted.”

“That is the arrogance of mental health,” he said. “Mentally healthy people sometimes believe that they would have been able to overcome the illness – they don’t understand the reality that people with mental health issues face, and how unchosen and beyond their control it can actually be. I try to educate the non-sufferer to better understand what mental illness is, and that it is like any other illness, no different from a physical ailment.”

There are a number of reasons why both Stamp and Landsberg feel sport is a good entry point for this discussion.

“I’m a huge believer that the best way to break people of the stigma is to find really strong people, like Clara Hughes, who have struggled with this, to talk about it,” said Landsberg.

Hughes, a Canadian cyclist and speed skater who has won multiple Olympic medals in both sports, has struggled with depression. “If [Hughes] was close at the end of the race, she would win. If you find that even a person of that strength and accomplishment can suffer from depression, it changes your perspective,” said Landsberg. “Everyone with depression feels that they are not understood, [but] when you hear someone else talk about it, then you know we all feel some things in common, and … that is incredibly empowering. Real-life examples are great.”

Landsberg has also partnered with firefighters who suffer from mental health issues, encouraging them to share their stories.

Landsberg and Stamp believe that reaching youth is key to changing the future, and sports can be key in doing that.

“We have to help younger people to understand that mental health concerns are a natural part of being alive,” said Stamp. “We have to do that much younger, like 6 or 7 years old. They need to know that when you feel distress, there is a way out.

“We have to start with language,” he said. “How do we describe somebody who is struggling? Children can be injured by the labels we use … we should be teaching youth and adults how to be listeners, how to approach someone and see if they need help. Having some education around a mental health problem is tremendously impactful. We need to be kinder, gentler and more empathic in our dealings with people.”

Tickets to hear Landsberg speak are $10 and are available from jfsvancouver.ca or 604-257-5151.

Matthew Gindin is a freelance journalist, writer and lecturer. He is Pacific correspondent for the CJN, writes regularly for the Forward, Tricycle and the Wisdom Daily, and has been published in Sojourners, Religion Dispatches and elsewhere. He can be found on Medium and Twitter.

Children are also stressed out

The most important thing as a parent is to be able to identify when your child is stressed. (photo from Psychology Foundation of Manitoba)

Despite the numerous technological advances we have achieved to make our lives easier, we are more stressed than ever. Even children are affected.

American psychologist Dr. Robin Alter moved to Toronto in 1980 to work at the city’s mental health centres. Her focus is on children’s health and, over her 36-year career, she has helped treat more than 10,000 families.

“If you’re just in private practice, you don’t get to do that…. You can’t see that many people,” Alter told the Independent. “So, I started thinking that I really need to start writing down what I’ve learned from this incredible experience and try to give it back.

“A lot of the things I was learning on the ground, in those face-to-face meetings, were things I couldn’t read about. It was not written in the studies I was reading. My experience, and what works for people or doesn’t, is different than what was written in books or journals.”

In addition to numerous articles, many of which can be found on her website (docrobin.com), Alter is the author of the book Anxiety and the Gift of Imagination and The Anxiety Workbook for Kids.

When she was in university, Alter’s teacher, Judy Levy, helped steer her toward working with children.

“I loved talking with them and finding ways they could express themselves so we could understand what they were feeling and why they were behaving the way they were,” said Alter. “Then, I came to Canada. I walked into these children’s mental health centres and looked around and I found all these people who shared the same mission as me…. I was ecstatic, realizing that I’m not doing this by myself. I’m doing this with an army of people who are passionate, who are inspired to dedicate their lives and energy to helping children and families.”

When the system switched to providing such care in a hospital setting, Alter opted to work from the outside, to educate people about how changes in society are affecting kids.

According to Alter, the effects of stress start at infancy for many kids, as they are thrust into a daycare environment for eight to 10 hours a day.

“That’s very hard for kids if you think about it,” she said. “When you’re with your family, you can let your hair down, right? You can be yourself, be relaxed. You’re protected, cared for, special. When you’re in a large group of other kids – even if it’s a good place – they have a number of kids to look after … there is always stress involved, some kids who want the toy you want to play with.

“You don’t have the skills yet to figure out a compromise, so you’re just fighting over the toy or feeling left out. Everybody seems to be playing with somebody and you don’t have anybody to play with. And, you know, there’s not always going to be an adult who notices that you’re under stress.

“The children leave their home early in the morning, spend all day in a competitive environment, and [are] picked up at the end of the day just to have dinner, a bath and go to bed…. Going to bed, too, is stress-inducing for all of us, but especially for kids. And we wonder why they are having trouble keeping up.

“I think there’s an epidemic of sleep deprivation,” she added. “Kids really don’t know how to unwind at night, how to take their worries and put them aside. I know most parents have a fairly good bedtime routine, where they read to their kids and turn out the lights, but I think it can be improved. Kids need to learn how to turn off their minds and put the day to rest.”

Alter has conducted nearly 6,000 psychological assessments and continues to do more. For this, there is a form that parents fill out – in 90% of these assessments, parents identify problems with sleep.

According to Alter, Vancouver’s Dr. Gabor Maté, an expert on child development, believes that many kids who are identified as ADHD (attention deficit hyperactivity disorder) are really just sleep deprived and misdiagnosed. And, if they get diagnosed as having ADHD, they will likely get medication – medication that causes sleep deprivation, further intensifying the problem.

The most important thing as a parent, said Alter, is to be able to identify when your child is stressed. The key to doing this is paying attention mainly to what is not being said. “Look for the cues,” she said. “Kids have a different response, but, usually, it’s a change in behaviour. They stop and, sometimes, their eyes get wider. We can do things to alleviate that stress, explain things to them. For example, the other night, at dinner, I drank a little bit of water, and then I was talking to Lewis [her 2-year-old grandson] and he turned to me and said, ‘Baba, you just spit at me!’

“He looked horrified at that. Why would his grandmother spit at him? Something he’s learned in daycare is that you don’t spit. He looked like I had just done this horrible thing. We explained to him that I didn’t spit at him, that it was water that came off my lips and that I’d never spit at him. Then he became unstressed.

“So, sometimes, just explaining what’s going on; giving the kid a good explanation can alleviate the stress. Those are minimal stresses. But, sometimes, there are big stressors going on.”

While stress can be overwhelming, it is important to remember that we don’t want to completely eliminate it. “Stress is our passport, or what we need to have an interesting life,” said Alter.

We have to learn that stress is a part of life and that we need to learn ways to de-stress. This is a main focus of the Psychology Foundation of Canada program Kids Have Stress Too, for kids 3 to 5 years old.

One of the strengths of the program is that it relays that stress is normal, everybody gets stressed. “And, you know, you can identify it in other kids,” said Alter. “When other kids are stressed, you can identify it in yourself and you can help yourself to feel better…. You can learn how to come back, bounce back from stress.

“I was at a session, my own personal professional session with a mother. She was very stressed by her daughter, who was 5 years old and had been diagnosed with epilepsy. The mother was very stressed by the diagnosis and the symptoms. The kids were in the room.

“The 5-year-old heard her mother talking about how stressed she was – and the kid had actually been through the Psychology Foundation program Kids Have Stress Too. Her ears perked up at the word ‘stress’ and she said, ‘Mom, I know what to do when you get stressed.’ The mother said, ‘You do?’ And the kid said, ‘You sing a song.’ She had a song she learned in the program and she sang it to her mother, and it was very cute and helpful, and the mother laughed. Laughter is a good way to alleviate stress.

“Another good way of helping kids alleviate stress is to encourage them to be helpful to others. When we are kind to others, when we reach out and give people food, and share – all those things alleviate our stress.”

The Kids Have Stress Too program teaches children to be aware of when they are stressed. Some kids feel nausea or a rush, as if an alarm system is going off in their body. Some kids feel it in their tummies. Others feel it in their heads. Once they learn what these feelings mean, it normalizes it and then it is not so scary. So, they are able to take care of themselves and sometimes take care of others.

“If you see other kids going through the program, someone stressed, they sometimes put their arm around them and say, ‘It’s OK. Everything’s alright, so let’s go play, let’s go do something fun,’” said Alter. “And that’s what it’s all about.

“There are wonderful little techniques,” she said. “The one I like most is the cloud push. You stand up and put your hands up and push the clouds away, like you’re pushing all the stress away. You’re getting rid of all the things you don’t want. Push them into the sky. Let them fly away.”

Alter shared a story about visiting a junior kindergarten class, where she read the kids a book about animals having a bad day and getting stressed. She was taken aback by the responses she got from the 4-year-olds when she asked them if they had ever had a bad day.

“I turned to them and said, ‘Well, the orangutan is having a bad day. Have you ever felt that way?’ And, I look up to see this whole sea of faces, all shaking their heads as hard as they can, saying, ‘No. No. Never!’ And, I was shocked. I realized that, even at this age, the peer pressure of how we’re not supposed to feel that way, not supposed to admit to others that we feel bad, was already instilled so early.

“Then, they went to little tables independently. We gave them crayons and paper, and each one of them drew these amazing pictures of things in their life that stress them out. One kid drew a picture of his mom having cancer and going to the hospital. Another kid drew a picture of his father leaving the family. And, I realized that they got the message, what I was reading about. They were not going to admit it in the group, but they were very eager to talk about it individually.

“We need to help kids realize that they are not alone with these problems or feelings,” said Alter. “That’s one of the biggest strengths of the program – an adult can help kids, too, by talking about their stresses.”

Parents need to be sharing their feelings with their kids, and then showing them how we move past them, she said.

“Kids don’t so much listen to what we say as much as what we do,” said Alter. “Kids are more doers. And so, for example, getting them out to the yard and doing exercise – throwing a ball around or something – is a good way to alleviate stress.

“Many kids stop talking because we use words they don’t understand, and they just don’t understand what we’re talking about. But, they understand action and behaviour. So, doing things with them and encouraging them to do things is a lot more helpful. Also, laughing is a way to alleviate stress. So, telling a joke, being silly, or just letting … stress out that way is great.

“Kids need to know that when they are out there in the ‘jungle’ of school that their parents are behind them and that they are not alone in whatever is going on,” she said. “Our daughter had a lot of trouble in grades 4 to 6 – bullying, mistreating stuff. Every night, we’d strategize what she could do, have long conversations. None of them worked. She’d say, ‘I tried that. It didn’t work.’ She knew that we were behind her, that she wasn’t alone. She had a team who understood how difficult the situation was. I think all those things help.”

For more information on the Kids Have Stress Too program and more, visit psychologyfoundation.org.

Rebeca Kuropatwa is a Winnipeg freelance writer.

Organ donation awareness

Left to right are panelists at a recent National Council of Jewish Women panel on organ transplants: Dr. Aviva Goldberg, Rabbi Yossi Benarroch, Marshall Miller and Na’ama Miller. (photo from NCJW)

On Dec. 11, the Winnipeg section of National Council of Jewish Women (NCJW) held an organ donation awareness event, featuring community members Rabbi Yossi Benarroch, Dr. Aviva Goldberg, and husband (organ recipient) and wife (organ donor) Marshall and Na’ama Miller.

Benarroch spoke first, after a welcome from organizers and a video about organ donation (youtube.com/watch?v=5cfaAWTH5zM).

“The short of it is, basically, that Jewish law permits organ donations,” he said. “There’s no question about that. Of course, when we talk about law, law is complicated and there are lots of opinions. There’s an ideal in Judaism, which is one of those foundations, and it’s called ‘pikuach nefesh doche hakol’ … which basically means that, in Judaism, there’s nothing more important than saving a life.

“I’m a very observant Jew and I keep kosher,” he said, “but if I had to eat something that wasn’t kosher – pork or whatever – in order to save my life, then Jewish law says you’re obligated to do that.”

Benarroch said it is written that, if someone saves a life, it is as if they have saved the entire world. Furthermore, he said, we are called to not stand idly by if another person is suffering. “We are obligated to intervene and actually obligated to help that individual,” he said.

Marshall Miller, who was diagnosed with progressive kidney disease more than 25 years ago, eventually required replacement therapy.

“Slowly, over time, my kidney failure began to get worse and worse,” he shared. “The disease progressed to the point where, a few years back, my GP at the time said, ‘Marshall, you’re now at the point where you have to go see a specialist because I can’t do anything more for you here … you need an expert to deal with your situation.’

“Everybody who suffers from kidney disease understands that, what kidneys do, among many things, is purify your blood. When your blood isn’t being purified properly, you can start to feel kind of lousy. I think my family can attest to the fact that I was starting to feel lousy. I think my whole family suffered along as I did, as I got sicker and sicker.”

When his kidney function was down to less than 10%, the specialist started talking seriously about replacement therapy. This involved dialysis three times a week until a matching donor could be found.

During the search for a donor, Na’ama Miller decided to find out if she might be able to help other people in her husband’s situation. As it turned out, she was a match for her husband.

“We were told it was a one hundred million shot,” she said. “And so, we were next faced with a bit of a dilemma … because it was scary for the kids. But Samantha and Maya were very much in favour of it, because they didn’t want me to be miserable anymore.”

She said, “People ask me, how I could do this … if it was hard. I give everyone the same answer. It was a no-brainer, a very easy decision for me. As Marshall said … we were all suffering along with him.”

“It’s worth it. You saved a life,” her husband added. “We hope this event here – even if only one more person signs up … hopefully, more and more people will choose to do it among the Jewish community after hearing the story.”

After the Millers spoke, a second video was screened, about a former Winnipegger who donated a kidney to save the life of a woman in California, who he has never met.

“Right now, in Canada, there are over 4,500 people waiting for an organ transplant – 4,500 Marshalls,” said Goldberg, who is the director of the Canadian Society of Transplantation and chair of the Transplant Manitoba kidney allocation review committee. “We don’t have 4,500 Na’amas. That’s why we need donors – both living and also deceased donors.

“That’s what we want to talk about today,” she said, “even if you don’t go forward to become a living donor, which is a really big deal. It’s not something that every person in this room is going to be able to do and that’s totally fair. But, there’s something that everyone in this room can do and that’s to sign up for organ donation after you’ve died – say that this is something I’d like to do, that you’d like to leave a legacy … you can save lives after you’ve died, either with organ or tissue donation. You can save lives by donating organs – heart, liver, lungs, pancreas, kidneys and even small bowel – but, also tissue donation.”

In some cases, people can donate their corneas to help improve the life of others. According to Goldberg, Manitoba, last year, was the fourth on the world list of most donors.

While Goldberg implored people to sign up as donors online, she further reminded them that talking to family about your willingness to be a donor is also very important – and not just immediate family, as they might be in the same car with you when you have a horrific accident, for example.

“The way that organ donation works in Canada, here, in Manitoba, is that after someone has died and they are potentially going to be an organ donor, their family is approached,” said Goldberg. “If you sign up for the registry, it’s a way of saying to your family, on the very worst day of their lives, that this is something your loved one wanted – wanted so much that they went to the registry, signed up, made that choice. It’s a hard discussion to have … [but] it’s so important to do.”

During the question-and-answer period, one attendee asked if there was an age limit for someone to donate an organ. The answer? “No.”

Another question was about the possibility of rejection and, to that, Marshall Miller shared his experience. “I suffered from a mild early rejection,” he said. “But, the ability to detect the rejection and be able to remedy it is incredible. They were able to treat me with medication instantaneously and, really, it was a non-issue for me. Even though there is a risk of rejection, it can easily be found if you attend your appointments and take your medication.”

For information on organ donation in British Columbia and to register, visit transplant.bc.ca.

Rebeca Kuropatwa is a Winnipeg freelance writer.

Limiting screen time is vital

Video Interaction Project coach Jenny Arevalo in action. (photo by Andy Reichsman/Ames Hill Productions)

With the ever-increasing number and variety of screens and gadgets grabbing our attention, pediatricians are asking us to take a step back. Some are even leading a counter-movement, warning parents and caregivers of the harm these technologies are inflicting on children.

Dr. Alan Mendelsohn, a general and developmental behavioural pediatrician, is an associate professor of pediatrics and population health at New York University’s School of Medicine and Bellevue Hospital Centre.

“The American Academy of Pediatrics published a statement designed to help pediatricians and parents think about toys for their children, in an era where toys have really evolved,” Mendelsohn told the Independent. “A very significant concern is that toys with bells and whistles, so to speak – with electronic gadgetry on the one hand or apps designed to engage children on the other – are likely to have very limited, if any, benefit to very young children.”

Mendelsohn has been working to use the pediatric primary care centre to support parenting activities most likely to help children’s development and school readiness. This has led to other programs, like Reach and Read and the Video Interaction Project, both of which teach parents the importance of reading and playing with their kids.

“We still have the same kinds of toys we’ve had in the past – simple, pretend kinds of toys,” said Mendelsohn. “But, at the same time, digital toys have become a high level of focus and priorities for many families. And, that’s in part as a result of the extensive messaging taking place about how electronics can be so important for children, and how apps and computers are going to help children learn.”

photo - Dr. Alan Mendelsohn — Dr. Alan Mendelsohn *(photo courtesy Alan Mendelsohn)*

According to Mendelsohn, there is limited or possibly even no good scientific evidence that screens can be beneficial for children under the age of 2 – with the possible exception of video chats in which the screen is functioning as an opportunity for interaction with family members that otherwise would not take place.

At the same time, he said, there is extensive data documenting that electronic add-ons, and screens more broadly, have a great deal of potential for harm.

“This is true for children of all ages, but it’s especially true for very young infants, toddlers and children who have not entered school yet … for whom that screen time … not only can lead to developmental challenges … but it can actually interfere with play and with parents being able to engage together with their children in the kind of rich, language-based interaction that advances children’s development,” said Mendelsohn.

The American Academy of Pediatrics recommends that children under 2 have no screen time, other than the aforementioned video chats. For children 2 and older, they recommend limiting screen time to one hour or less, and having that screen time be high-quality, i.e. educational, programming.

“This limited screen time should be used as an opportunity for interacting, rather than viewing it as an opportunity for babysitting, which is how it’s often used and viewed by parents,” said Mendelsohn.

“Parents using screen time as a distracter is not necessarily a bad thing…. The academy recognizes, and I think the pediatric community recognizes, just how hard it is to be a parent, especially of a young child. Parents spend the day working and come home to chores, housework and all kinds of things. Obviously, screen time can be very helpful to parents in that way. But, it’s important that parents realize the potential for harm to their children – recognize that screen time is unlikely to be beneficial for their children.”

Mendelsohn recommends that parents find opportunities to play with their kids and read books with them, as these activities are likely to improve their child’s development and help create a positive parent-child bond.

“The important thing here is that excessive screen time, regardless of age, has the potential to lead to problems and challenges for children by interfering with their capacity to pay attention once they start school, as well as by causing challenges with their capacity to regulate their own behaviour and learn in school,” said Mendelsohn.

Schools are using more and more screens and technology, and Mendelsohn doesn’t condemn the use of screens and technology in an educational, monitored setting. Rather, monitored use should extend into the home.

“Parents face a great deal of challenges as they seek to do that,” he said. “The important thing is for parents to be aware and to work, particularly as their children get older, to monitor their children’s screen time and to interact with their children when screen time is taking place, especially higher quality kinds of programming.

“Equally important is for parents look for opportunities to turn the screen off … to have those opportunities every day, whether through reading books together or playing together – always aiming to have quality time.”

Electronic games are not all created equal and those that are engaging and interactive, that foster playing with others – qualities many board games possess – are likely not harmful and might even be good.

“There are not clear answers,” said Mendelsohn. “But, what is clear is that screen time can be overwhelming in time, and that parents have difficulty limiting it. Limiting and monitoring it is the key to having screen time be one of many components of a child’s life as she or he grows into school age versus becoming the most prominent part of the child’s life.”

Mendelsohn suggested that parents ask their pediatricians for advice.

“Pediatricians are there as a resource for parents,” he said. “Parents should raise these issues with their pediatricians, and they’ll enjoy the conversations and guidance they receive.”

Rebeca Kuropatwais a Winnipeg freelance writer.

Wilderness helps youth heal

BaMidbar students hike in all weather conditions, learning to live and care for themselves in outdoor environments. (photo from BaMidbar)

When she was 15 years old, now-camp director Jory Hanselman had some family members who were struggling with mental illness and addiction. At the same time, a couple of close friends passed away in pretty quick succession. Hanselman was struggling to cope, until her parents sent her to a wilderness therapy program.

“It was an extremely transformative experience for me,” Hanselman told the Independent. “I was there over Passover and so, while the program I was at was not in the least bit Jewish, my identity as a Jew was really central to what I experienced and got from it.

“I really connected it to the narrative, and thinking about finding my freedom from narrow places and overcoming obstacles I’ve faced in life. So, I looked into how I could become more involved in wilderness programs.”

In college, Hanselman spent summers at Ramah in the Rockies and saw firsthand the beautiful integration of Jewish learning via meaningful, outdoor-based experiences. And, when Ramah in the Rockies started exploring the idea of opening a Jewish wilderness therapy program, their director reached out to Hanselman, knowing that she had been working in the field. Hanselman was asked to provide input on how to build a therapy program.

“They decided they would move forward and officially create BaMidbar and so I came on board at that time, in September 2016, to help move the program from a space of ideas to implementation and actuality,” she said.

One great thing about its location – literally, in the wilderness – is that it’s only an hour-and-a-half drive from Denver, Colo. However, said Hanselman, “To give you a perspective, we are an hour drive from cell service in any direction.”

The therapy retreat is for Jews from 18 to 28 years old who are struggling with mild to moderate social and behavioural challenges, including depression, general anxiety, social anxiety and more. The young adults in the program have reached the tipping point where the issues are getting in the way of their being able to fully engage with the people and things around them in life.

“We also see lots of folks who have co-occurring substance abuse disorders, who are also using substances in addition to working through challenges associated with other mental health challenges,” said Hanselman.

photo - Staff member Cliff Stockton teaches primitive fire building skills to students at BaMidbar — Staff member Cliff Stockton teaches primitive fire building skills to students at BaMidbar. *(photo from BaMidbar)*

“The idea of wilderness therapy (WT) is using wilderness- and adventure-based experiences as the vehicle for therapy, to grow. So, we joke a lot in the WT industry that it’s not about doing therapy in the wilderness, it’s about doing wilderness-based therapy. It’s not just going out and meeting with a clinician in a wilderness-based setting; it’s really using that experiential environment as a vehicle for working through different therapeutic concepts.”

The BaMidbar program involves the whole family. While students work with an individual therapist, their family is having weekly phone meetings with the therapist who, in turn, also works with the field staff to implement a treatment plan.

“So, our students are learning how to, for example, build a fire with friction, and they use this opportunity to build primitive skills to challenge themselves,” said Hanselman. “They learn what tools they need to work through and understand what they’re capable of.

“Wilderness-based experiences are used as metaphors and storytelling to support our students in connecting what is happening in the wilderness environment to life outside the program.”

The small-group environment at the camp is used as a way to help campers learn and rebuild communication skills and other tools.

“We provide feedback and strong support for them, as they determine how to have healthy emotional responses to different stressful situations, or anger management strategies, and things like that,” said Hanselman.

While there are many WT camps, BaMidbar is possibly the only one that uses a Jewish lens and framework in everything they do, including using the Jewish calendar as an opportunity to look at topics that are thematically relevant to campers.

“To give an example, for Passover last year, every day we had a theme we focused on that tied to the Passover narrative, as well as our student therapeutic journey,” said Hanselman. “Day One, we focused on our narrow place. Day Two, we talked about the story of Nachshon Ben Aminadav … jumping into the unknown and what it might look like to take a leap of faith and know that you need to change your situation, even if you don’t know what the future holds. Day Three, we looked at manna in the desert and talked about what sustains you physically, metaphorically, spiritually. Day Four, we talked about receiving the Torah on Mount Sinai and did a summit hike, talking about our personal value systems, what we live by, things like that.”

With BaMidbar being a kosher camp, Shabbat is a break from the routine, which, in this case, is wilderness. On Shabbat, they spend time in a cabin, while still studying texts through the lens of how they are relevant to one’s life. This is the perfect time, said Hanselman, to talk about family. For instance, “because, throughout Genesis, that revolves around challenging family dynamics…. I always joke that Abraham was the first wilderness therapy participant. He leaves everything he’s familiar with and goes off into the wilderness on this journey of self-discovery. So, we do a lot of programming around Shabbat.”

photo - BaMidbar’s program is rooted in Jewish ritual. Here the BaMidbar community celebrates Havdalah — BaMidbar’s program is rooted in Jewish ritual. Here the BaMidbar community celebrates Havdalah. *(photo from BaMidbar)*

BaMidbar (which means “in the desert” in Hebrew) is non-denominational and the organizers are dedicated to meeting every student where they are in their unique journey, recognizing and honouring that it can be very different for each individual.

“We are very dedicated to making sure that students understand that our goal is to explore meaning, values and purpose through a Jewish lens – not to tell them how to live Jewishly or what that ideal Jewish life might look like,” said Hanselman. “That’s not our goal. Our goal is to look at the wisdom Jewish tradition provides and to support students for whole health wellness.”

Participants can expect 10 to 12 weeks in the wilderness (Shabbat in a two-room cabin). Groups are small, with a current maximum of eight individuals, and the program runs year-round.

In winter, said Hanselman, “We fully outfit our students, so they receive all their gear from us. We make sure they have what they need to be safe and warm in a wilderness environment. We have a lot of staff practices around safety and support in that winter environment, and then we have tents that have wood stoves in them when it gets below a certain temperature.”

The camp fee is around $3,500 US per week. A nonprofit, the BaMidbar program offers scholarships and works with every family, regardless of their financial situation. Currently, about 75% of students receive scholarships provided mainly by private donors and foundations.

While BaMidbar has received many inquiries from Canadian families, they have not had any Canadian participants. “But, we can work with them – from Canada, or Israel, or other countries,” said Hanselman. “We just haven’t yet.”

For more information, visit bamidbartherapy.org.

Rebeca Kuropatwa is a Winnipeg freelance writer.