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.

With a Song returns to forum

Left to right are Joan Beckow, Claire Klein Osipov, Wendy Bross Stuart and Jessica Stuart, in 2010. (photo by Ron Stuart)

Canceled more than two years ago because of COVID, With a Song in My Heart, a special concert for Jewish Senior Alliance’s spring forum, is back. And it’s even more special.

The May 15, 2 p.m., performance at the Peretz Centre, led by Wendy Bross Stuart, is dedicated to Claire Klein Osipov and Joan Beckow.

“We were originally scheduled to present this program in March 2020. We were well-prepared. Even Claire came over to rehearsal on March 16, 2020 – so she could shep naches from her daughter Lisa’s singing, and she gave us some ‘notes’ to include. Lisa [Osipov Milton] and I were using the very musical arrangements I had created for Claire. Then, COVID happened and the program was ‘postponed.’ In August 2020, Claire passed away.

“Fast-forward to 2022. Two of the singers [David Urist and Osipov Milton] were unavailable. Erin Aberle-Palm was available, and I was thrilled to have her on board. Kat Palmer and Chris Adams had been involved in the recording sessions for the Joan Beckow Legacy Project, completed in February. Chris agreed to join us for a Beckow duet – with Kat.”

Beckow passed away in January 2021.

“About 18 months before,” said Bross Stuart, “my daughter Jessica had come with me to the Louis Brier Home to visit Joan. She asked Joan for her blessing for us (mother and daughter) to record and orchestrate many of Joan’s songs. Joan was visibly touched. She gave us her blessing to proceed. And proceed we did. The Joan Beckow Legacy Project, funded generously by the Canada Council and the Ontario Arts Council, has included the recording and orchestration of 22 of Joan’s pieces, by 30 musicians, in Toronto and Vancouver. Plus a documentary on Joan’s life (directed by my husband, Ron Stuart) and much more. Assistance and support also came from Joan’s son, David.”

Most of the project has taken place during COVID. About the pandemic’s effects, Bross Stuart said, “To make an effort to be positive, I would say, having more time has allowed Jessica and I to create the Joan Beckow Legacy Project and collaborate in every way. The music and the mutual respect have been well beyond my expectations and – as [fellow community member] Sharon Kates added – a mitzvah for everyone. Especially for people who do not yet know the breadth of Joan’s musical output, it will be a stunning discovery.”

With the developments of the past two years, the musical program for the JSA forum has changed from what it was in 2020.

“It includes Yiddish songs – for example, ‘Tum Balalaika,’ ‘Rozhinkes Mit Mandlen’ – in Claire’s memory, and many Joan Beckow songs, recently recorded in studio, including ‘On the Other Side of Nowhere’ and ‘Tov L’Hodot,’” said Bross Stuart, noting that every composer of every song in the program is Jewish.

The Yiddish songs are from the repertoire that Klein Osipov and Bross Stuart presented over the many years they worked together.

“We have a piece of music which says, ‘Because I knew you, I have been changed … for good,’” said Bross Stuart, referring to the song “For Good,” written by Stephen Schwartz. She added, “David Beckow chose his mother’s own lyrics to inscribe on her gravestone: ‘When this life is over, we will meet somehow, on the other side of nowhere, on the far side of now.’ Kat will sing it.”

The Stuarts and Beckows are longtime friends.

“We met Joan about 50 years ago, when her husband, Jack, was Ron’s anthropology student at UBC. Joan’s music was absolutely magic. When she asked me to assist her with the music direction of a show she was working on, I said yes as soon as I saw/heard one of the lead singers – Claire Klein Osipov!

“Joan and I worked together on choral pieces, on musical theatre pieces, on Jewish liturgical pieces and on classical pieces. I organized the publication of a number of her works, and public performances as well. Her music and her friendship enhanced our lives – and inspired my daughter, Jessica, to become a composer and musician. Joan was a mentor.”

Bross Stuart explained her interest in Yiddish music.

“Growing up in a New York City suburb (Yonkers),” she said, “my grandmother lived with us while I was growing up. Although her most comfortable language was Yiddish (Galitzianer variety), she spoke accented English to me. Yiddish was not what my parents wanted me to speak. This, of course, made Yiddish so much more interesting to me. Years later, in Vancouver, working with Claire and creating musical arrangements for all those songs – four CDs’ worth – required a detailed understanding of the Yiddish. The German I had studied in high school and at McGill was helpful, but working with Claire was even more helpful. We did a lot of concert work together, and I would say that our daughter Fiona grew to love Yiddish as a result. Another mentor for us!”

With a Song in My Heart is JSA’s first hybrid event, taking place live at the Peretz Centre, with streaming links available for YouTube, Vimeo or Zoom. Registration is required in both instances. If attending in-person, proof of vaccination is also required. Visit jsalliance.org, email [email protected] or call 604-732-1555.

A full life post-career

The latest JSA Snider Foundation Virtual Empowerment Series session was co-sponsored by Jewish Seniors Alliance (JSA) and Jewish Family Services (JFS). Held on April 26, it continued with the theme “Be Inspired.” Titled Retired, Rewired and Inspired, it featured three older adults expressing their feelings, ideas and experiences of “retirement.”

Gyda Chud, co-president of JSA, started things off by describing the series – which involves co-sponsorship with other community organizations, such as JFS – and its theme.

Program committee Fran Goldberg then introduced the speakers: Rosa Tesler, who was a counselor for abused women when she retired in 2018; Dr. Paul Steinbok, who retired from neurosurgery in 2017; and Tony DuMoulin, who retired from his law career about a decade ago.

The first speaker was Tesler, known as Chully. She described retirement as an up and down road. She missed her clients. She lost her husband and her mother within the same time period. She feels privileged that she had the support of a loving family. To weather the downs, she said, a person must develop patience, determination and self-compassion. It took her a year to overcome health issues, but now, with the correct medication, she is able to live her life. She thanked her many friends, her therapist and her yoga teacher for their ongoing support.

Chully took a course on friendly aging and also the peer counseling training at JSA. She is now an active peer counselor. The pandemic caused major changes in many of her pursuits, but she continued with tai chi, yoga and peer counseling, all virtually. She did have to forgo travel. Adapting, reframing and hope kept her going. We are defined not by what happens to us, but by what we do, she said, ending with a quote from a friend in Argentina who teaches healthy aging: what is in your power, continue; stop what you didn’t want and can’t do; and initiate what you do want to do.

Steinbok had been a pediatric neurosurgeon and, when he retired, he pursued his love of photography, walking and travel. He had been part of an amateur camera club for many years and won an award in 1970. After retirement, he joined a photo group at the University of British Columbia, and learned digital photography. He began looking at nature from a closer perspective, especially its textures and patterns. He started to use his camera more creatively. He shared some of his close-ups of tree bark, stumps, mushrooms and flowers. There were shots of manhole covers – many of which have lovely designs on them. The photos are beautiful and artistic and have been in many competitions. Steinbok said the art of photography adds meaning to his life and he shares them with family, friends and the photo club. He said it feels as if he is continuing to teach, as he did in neurosurgery.

DuMoulin was a practising lawyer for 40 years, managing a firm for 24 years and teaching law. He retired at age 67, because he had many interests that he wished to pursue but not the time or energy to do so. He also wanted to retire at the top of his game.

DuMoulin calls himself a recovering lawyer – he said he needed to rewire and although he was told that he would be bored, the opposite has been the case. He feels his worldview has widened and that he is lighter and freer. He is involved in many activities and spends time with his five grandchildren. He is also reading more and has started a book club. Before COVID hit, he was traveling more, and he is exercising more. He has designed and built a cabin and has done some watercolour painting. He teaches and plays chess. He is active in JSA – on the executive and board and as a member of the editorial committee of Senior Line magazine; he chairs the advocacy committee. He is inspired by volunteers in the nonprofit sector and said the future is our responsibility – and belongs to us as well.

Tamar Stein, seniors outreach coordinator for JFS, thanked the speakers. She said JFS’s programs take place on Tuesdays at 11 a.m. – on May 10, there is a talk on grief and loss and, on May 24, on Medical Assistance in Dying.

Chud brought up the three Rs that she had heard from a friend: relationships, reflection and restorative practice. DuMoulin commented on the recording of family histories and a specific program that helps with this, called Story Worth. Larry Shapiro, co-president of JSA, added that the speakers had been inspirational and that a senior should speak at every event, while Chud thanked Jenn Propp for her contributions, Stein and the speakers.

The next JSA event is its spring forum on May 15, which features the concert With a Song in My Heart, led by Wendy Bross Stuart. The final Empowerment Series session for 2021/22 is in June, with the Kehila Society of Richmond. Visit jsalliance.org.

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

Care for the caregiver

On Feb. 14, Jewish Seniors Alliance presented the third of its 2021/22 Empowerment Series. The event – Care for the Caregiver – was co-sponsored with L’Chaim Adult Day Centre and the Council of Senior Citizens’ Organizations of British Columbia, and the program was presented by Royce Shook of COSCO’s Health and Wellness Institute and Leah Deslauriers, administrator of L’Chaim.

Gyda Chud, co-president of JSA welcomed everyone and thanked the agency’s partners for participating.

Barb Mikulec, vice-president of COSCO, explained that COSCO is a nonprofit group for seniors helping seniors and that its Health and Wellness Institute presents many free workshops on seniors issues. She introduced Shook, who has been in the field of education for more than 40 years and has worked in curriculum studies. He advises or serves on various seniors committees/councils.

Shook spoke about the stress and burnout experienced by caregivers. In Canada, he said, there are approximately five million unpaid caregivers supporting family members; an economic value of $6 billion to $9 billion.

Caregivers provide both physical and emotional support, he said. This role could involve home management, such as bill paying, grocery shopping, driving to appointments, cooking and cleaning. For the caregivers, they may benefit from a sense of personal satisfaction and a sense of purpose. They learn more about their inner strength and gain a purpose in life by the act of helping. They can help pull family and friends together, but there will be changes in family dynamics and relationships. At times, the recipients of care may be resentful at their loss of independence and privacy.

There is an emotional impact on the caregiver in that they may worry about not being strong enough to carry the load. At the same time, they may avoid asking for help, and this could lead to burnout, Shook warned. There are a number of warning signs to watch for, such as a loss of energy, the neglect of personal needs, trouble relaxing, irritability with the senior and isolation. To avoid burnout, he advised caregivers to learn about the disease or condition plaguing the senior and take any help that is offered for that condition. Know your limits and specify them to others, i.e. family and friends, sharing the burden with them. Make sure to have regular breaks, and talk with others about your feelings.

Communication is very important, he said. Keep up to date on information from the health team. Let the recipient of the care lead, try to be a good listener and maintain eye contact. Always remember that the person has changed, so avoid giving advice or quarreling over minor issues. Do not say, “I know how you are feeling,” but instead say, “How do you feel?” Have a consent form so you can accompany the recipient to the doctor and have questions ready and take notes. There are three major areas of decision-making that need to be arranged with the recipient and not for them, said Shook. These are medical, the need for a representation agreement; legal, power of attorney; and financial, also covered by power of attorney.

Always remember to take care of yourself by accessing, for example, adult day care for respite, home help and community support groups. There is no such thing as a perfect caregiver. Always remember to respond to the present situation and not to the person you once knew. If you don’t care for yourself, you can’t care for others, he said.

After Shook completed his presentation, Eireann O’Dea introduced Deslauriers, who, prior to joining L’Chaim five years ago, was the coordinator of the seniors program at the Jewish Community Centre of Greater Vancouver. She has also been active in seniors housing issues and is a family caregiver for her parents.

L’Chaim is one of 12 adult day centres in the region funded by Vancouver Coastal Health. Referrals are made by a caseworker at the health unit and the programs provide stimulation for the recipients and respite for the caregivers.

At L’Chaim, clients arrive about 10 a.m. and have a light breakfast after which the programs begin. The morning may consist of word games, followed by news and a discussion. A full lunch is served during which socialization is encouraged. The afternoon consists of a guest speaker and/or a musical program. Clients are usually picked up about 3 p.m. Any pertinent information is passed on to the caregivers.

L’Chaim is similar to other centres but it is culturally Jewish. It is funded for 13 clients/day, three days/week and costs $10/day. More information is available at lchaim.ca.

A list of resources for caregivers will be made available on the JSA website, jsalliance.org. Also watch the website for information on the next Empowerment program, April 26, in co-sponsorship with Jewish Family Services, and the Spring Forum on May 15.

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

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.

Sharing her inspiration

On Oct. 8, nonagenarian Gloria Levi was the featured speaker at the JSA Snider Foundation Virtual Empowerment Series session co-sponsored by Jewish Seniors Alliance and the Peretz Centre for Secular Jewish Culture. The topic was What Inspires Me at 90.

Gyda Chud, co-president of JSA and president of the Peretz Centre, welcomed the approximately 70 attendees and shared the background of JSA’s Empowerment series.

Fran Goldberg introduced Levi as a feminist, an activist, a COVID survivor, a gerontologist, a therapist, a social worker and a woman of tremendous confidence, who finds joy in even the darkest of moments.

From her talk, it seems that Levi does indeed find inspiration in everything around her, from rustling breezes and glistening sunsets to soulful self-discovery. She finds meaning in both everyday happenings and the larger matters of the heart and social justice. If we were to sum up Levi’s nuanced and profound wisdom in a word, it would be wholeness. She elevates the whole person with all their perfect imperfections.

To Levi, self-discovery and self-knowledge are paramount values. She illustrated the importance of being true to oneself with the charming story of Rabbi Zusia, who lamented to God, bemoaning his not being like Moses and Abraham. God advised him to be exactly who he is – Zusia. The goal in life is not to strive for perfection but to be authentically oneself.

Through Levi’s lens of wholeness, even a global disaster like COVID-19 has vital lessons. A COVID-19 survivor, Levi refers to the virus as the 11th plague, but also is passionate about the important issues that the pandemic has brought to light. For example, it revealed the discrepancy between the haves and the have nots: the ones who support our daily life – the grocery store clerks, hospital employees, delivery drivers and food workers, among others – in stark contrast with the wealthy. The pandemic has yielded an awakening, a heightened awareness that things need to change on numerous levels, both environmentally and socially, said Levi.

Along with her commitment to social justice, Levi draws connections and inspiration from Jewish sources; for example, she refers to Leviticus, in which God tells Moses to instruct the Israelites to give the land a rest. During the sabbath year, the land is to lie fallow and to be “released” from cultivation, she explained. Weaving rest and restoration into our physical and spiritual worlds is a much-needed change, she said.

In conclusion, Levi quoted Ecclesiastes and reminded us that “vanity of vanities; all is vanity.” Her advice: embrace life, enjoy meaningful relationships and small kindnesses – and find inspiration all around us.

Tamara Frankel is a member of the board of Jewish Seniors Alliance and of the editorial committee of Senior Line magazine. She is also a board member of the Jewish Community Centre of Greater Vancouver.

Election amid chaggim

Much has been made of the challenges facing Canadians as the country engages in its 44th federal general election while still in the grips of a pandemic. For Jewish voters, the succession of holidays in the weeks leading up to the Sept. 20 election makes scheduling events like community forums with candidates extra confounding.

Nevertheless, the Centre for Israel and Jewish Affairs (CIJA), along with partner agencies, will present a number of events across the country. Here in Metro Vancouver, there will be a virtual town hall on Sept. 14, 4 p.m., co-presented, as is tradition, with SUCCESS, the United Chinese Community Enrichment Services Society. Topics addressed will include racism and hate crimes; seniors’ care; post-pandemic economic recovery; immigrants and refugees; safe and healthy communities; and the sustainability of charitable and nonprofit organizations.

Two days earlier, on Sept. 12, a Richmond-focused virtual town hall will take place at 5 p.m., co-presented by CIJA and the Kehila Society of Richmond.

Tucked in between, on Sept. 13, is a national town hall, presented virtually from Toronto, again hosted by CIJA, this time in partnership with The CJN. All events are accessible from the website cija.ca/election.

Locally on Sept. 13, there is an all-candidates meeting on seniors issues for the ridings of Vancouver Granville and Vancouver South, co-hosted by Jewish Seniors Alliance. To register for it, visit jsalliance.org.

CIJA also has released a federal issues guide, outlining what it considers to be priorities on matters of domestic and foreign policy.

Among the recommendations is a request to supplement the Security Infrastructure Program, which provides funds to enhance security at institutions such as synagogues and community centres, with a program modeled after the Community Security Trust in the United Kingdom, which trains volunteers to provide patrols, situational awareness and threat prevention.

The guide urges amending the criminal code to make Holocaust denial an indictable offence and developing a standardized national social studies curriculum on antisemitism and the Holocaust.

The document, which is downloadable from the CIJA website, calls on the next government to address online hate through education and enforcement, including a social literacy campaign to “sensitize Canadians to the potent role social media plays in bullying, harassment, intimidation, dissemination of hate, and threats.” It calls for reestablishing provisions in the Canadian Human Rights Act to combat hate speech and strengthening Canadian tax laws to prohibit charities from promoting or inciting antisemitism or violent extremism.

The foreign affairs section calls on the government to ensure that Canadian humanitarian aid to Palestinians “goes where it is intended” and to oppose one-sided United Nations resolutions singling out Israel. It also calls on the government to demand that the Palestinian Authority stop the “paid to slay” program that rewards terrorism. It also calls for putting pressure on Iran until it “demonstrates meaningful improvements in comes into full compliance with its international obligations.”

Other CIJA recommendations include:

Implementing the United Nations Declaration on the Rights of Indigenous Peoples “as an important step toward truth and reconciliation.”
Putting pressure on Eastern European countries “that have evaded their responsibility to pass meaningful restitution laws” for Holocaust survivors and their descendants.
Strengthening immigration and refugee policies particularly to support those targeted for their identity, such as Christians and Yazidis in Iraq, LGBTQ2+ people in Chechnya and Iran, and Rohingyas in Myanmar.
Reintroducing the question about religion in the census “to prevent continued underreporting of Jewish Canadians.”
Ending the three-month celibacy requirement for LGBTQ2+ blood donors.

The full document is downloadable at cija.ca/election.

The Canadian Jewish Political Affairs Committee (CJPAC) is also busy during the campaign.

CJPAC engages “Jewish and pro-Israel Canadians in the democratic process” and helps community members build relationships within the Canadian political arena. Their website, cjpac.ca, has links to all major political parties, as well as links to volunteering and getting involved in campaigns. There is a final volunteer training webinar available at noon Pacific time on Sept. 13.

For information on your riding, where to vote and a list of candidates, go to the Elections Canada website at elections.ca.

Libby Yu plays music for soul

Libby Yu performed A Concert for the Soul on June 28, hosted by Jewish Seniors Alliance and the Kehila Society of Richmond. (screenshot)

On June 28, Jewish Seniors Alliance and the Kehila Society of Richmond presented classical pianist Libby Yu in performance via Zoom. A Concert for the Soul was the last session of the 2020-21 JSA Snider Foundation Empowerment Series.

Toby Rubin, coordinator of Kehila Society, welcomed everyone to the concert and introduced Yu, who was born and grew up in Richmond. An accomplished performer, collaborator, teacher and adjudicator, Yu has graced international stages and has appeared as soloist with major symphony orchestras. She brings her passion for music to audiences of all ages and venues. She is an artist for the Health Arts Society’s Concerts in Care, which allows her to share her music in residential care homes and hospitals. Rubin encouraged us all to watch Yu’s fingers as they moved on the keyboard.

Yu greeted everyone from her home, saying how much she enjoys performing for JSA and Kehila and that she looks forward to playing for us in person in the future. She told us that she would be playing Ludwig van Beethoven, Franz Schubert and Frédéric Chopin.

The first piece was Beethoven’s Moonlight in three movements. The first was slow, the second light and happy, while the third was dramatic with many runs and chords.

The next piece was Schubert’s Impromptu, 4th Opus in A Flat Major. This piece is full of cascades, arpeggios, with a beautiful melody. It is in the ABA format, where the third movement returns to the melody of the first.

This was followed by two of Chopin’s Etudes, the first in F minor and the second his well-known revolutionary étude that reflects his turmoil over the instability of his native Poland.

Yu ended her performance with a Chopin Ballade, in G minor. The main theme is a quiet, still melody that builds in virtuosity and then flourishes to huge dramatic chords. The coda is fast and exciting.

It is indeed a pleasure to watch Yu in her intensity and concentration. After her performance, she thanked us and said she hoped the music brought us all joy.

Gyda Chud, co-president of JSA, thanked Yu for the program. She reminded everyone that, in the past, events with Kehila have included lunch and, hopefully, we will all be able to enjoy both lunch and a performance in person soon.

Chud again thanked Yu, saying the concert was not only an inspiration for the soul, but also for the heart and mind.

The Empowerment Series will continue with the theme “Be Inspired” for the 2021-22 season.

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

The power of breath

Yoga therapist and teacher Tianne Allan (photo from yogatianne.com)

Don’t hold your breath. Breath is life, and each breath we take optimizes our health. This is what I learned at Jewish Seniors Alliance’s third empowerment session – Discover the Power of Your Breath – which was held on May 4.

Gyda Chud, co-president of JSA, welcomed the 75 Zoom participants, explaining that the overarching theme for the empowerment series is “Be Inspired.”

Fran Goldberg introduced the speaker – yoga therapist and teacher Tianne Allan, who was involved for two decades in the world of aquatics and high-performance athletics. After a car accident, her yoga practice became her pathway to healing, both physically and emotionally. She now specializes in pain care and in the treatment of anxiety and insomnia.

Allan guided the group in movement – breathing while opening the arms and bringing them back to the chest. She explained that the foundation of our breath is comprised of three steps:

1. Sit up straight and breathe through your nose.
2. Low and slow, take a breath down into your belly.
3. Smooth and steady, inhale and exhale.

Other types of breathing are the relaxation breath, where you sit back, relax and exhale with a sound; and the humming breath, to relieve anxiety, where you inhale through the nose and exhale through a hum.

Correct breathing can also help ease pain, Allan explained. And it can help us sleep better. The sleep exercise involved imagining ourselves looking through the ceiling to the blue sky and letting the sun fill our bodies with warmth. This exercise actually lulled some of us to sleep.

Shanie Levin thanked Allan for getting us involved in using our bodies and minds, and reminded the audience of the JSA’s next Empowerment Series session, on June 28, featuring Libby Yu, a classical pianist.

For more information on Allan, see yogatianne.com.

Peer service reinvented

To say that COVID-19 has wreaked havoc on British Columbians would be an understatement. The virus has disrupted anything that we would call the normal activities of daily life. Most of us have had to make major compromises: where we go, what we do and how we can avoid getting the terrible virus. These adjustments have had a major impact on Jewish Seniors Alliance clients, who are already compromised by loneliness and isolation.

How we serve our clients and how we support our volunteers has undergone major changes – let’s give it the label “reinventing peer services.” In order to better understand what has taken place, I interviewed Charles Leibovitch, JSA senior peer support services coordinator, and Grace Hann, JSA trainer of volunteers of senior support services.

In the beginning

By mid-March 2020, the first sign of COVID-19 began to show its ugly head. The lockdown left clients and volunteers absolutely unprepared. Persons who were already isolated and lonely found themselves even more isolated and lonelier. As time progressed, clients were cut off from family members who might have supported their relatives through personal contact and social events. This was especially devastating for persons without family.

In many situations, volunteers were their primary contact; their lifeline! Being alone undermines one’s mental health. Being alone exaggerates one’s fear of COVID-19. Most of the clients were cut off from community programs, like adult day care. Spouses who usually spent time with their spouse in a long-term care facility were also cut off. Simple activities like going for a walk and sitting on a bench were curtailed. Elders had depended on having that human connection – having that human touch makes us feel needed and whole.

Volunteers meet challenge

The changing scene called for quick action, initiated by Grace and Charles. Instead of personal visits, the telephone would become the prime instrument of contact between volunteers and their clients. It was necessary to contact the volunteers quickly. Support for the volunteers would be provided by Zoom. This necessitated a steep learning curve for volunteer and client. After all, making and keeping the connection was critical. The three services – peer support, friendly visits and friendly phone calls – had to be reassessed in terms of the neediest clients. Each of the three services’ volunteers had different levels of training by Grace.

In some situations, a certified peer support volunteer was assigned to a person who ordinarily would have had contact with a friendly visitor or a friendly phone caller. Moving from in-person contact to impersonal contact was a major transition – almost like reinventing how support was to be provided. The JSA volunteers made the transition like veterans, with the extraordinary help of Grace and Charles. There was an increase in the contacts between volunteers and clients and an increase in Zoom online meetings to support the very special work being carried out by the volunteers.

Supporting the volunteers

Grace and Charles organized many activities, including outdoor picnics, weekly webinar seminars, a Chanukah party with a singalong and group support meetings every three weeks. The spirit and esprit de corps by the volunteers has been amazing. Volunteers will send cards to their clients as an additional way to keep in contact. Who doesn’t like to receive mail?

Next steps

Challenging times require challenging solutions. Charles and Grace rose to the challenge and proved that, with dedication, imagination and determination, obstacles can be overcome. When the COVID-19 vaccine has been fully distributed, we will establish a “new normal.” This will present JSA, Grace, Charles and the volunteers with a new set of issues and situations. And, as the song goes, “we shall overcome” – they will face these challenges with creativity, empathy and caring.

Ken 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. A version of this article originally appeared in the March 2021 issue of Senior Line.

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