As an elder care lawyer for almost 19 years, I have learned the importance of studying health care delivery systems, specifically related to the delivery of services to seniors. There is no doubt the U.S. health care system can and should improve the health care services provided for an increasingly aging population.
In November 2016, I had the privilege of traveling to the Netherlands as a member of the National Academy of Elder Law Attorneys (NAELA) delegation. The delegation’s goal was to learn about how health care and legal services are provided to seniors in the Netherlands compared to the U.S. model. As an outcome of the trip, our office has scheduled Eloy van Hal, the co-founder of Hogeweyk, the world renowned Dementia Village outside Amsterdam, to travel to New Jersey in April 2018 to speak about the Dutch model for treating individuals with dementia.
Given the enlightening experience studying the Dutch long-term care system, I wanted to experience more. From February 16-26, 2018, I was part of a group of 18 professionals from the U.S. who traveled to Israel to focus on aging in Israel. Among tour participants were chaplains, clergy, rabbis, a doctor, and a geriatric care manager.
The Israel tour was significantly different than the Netherlands tour for several reasons. First, I was the only attorney on the tour. In the Netherlands, we were all attorneys, and therefore we tended to ask similar questions and analyze the issues in similar patterns. The Israel tour, in contrast, was comprised mainly of chaplains who concentrated on end of life issues with an emphasis on spirituality. As a result, I obtained a greater appreciation of the value of spirituality at the end of life that I intend to apply to my elder care law practice in the future.
Additionally, unlike the Netherlands, in which I had no previous connection to the country, the Israel tour became highly personal. While I was on a journey about aging, the trip soon became an exploration into myself. In addition to exploring at least a dozen different aging services in Israel for both Jews and Arabs, I had the opportunity to meet many of my distant cousins, had dinner with a childhood friend in Tel Aviv, and had a chance meeting with a gentleman in a coffee shop who I believe was placed there by a higher being at that exact time for me to meet.
I met Jay Pollack at a coffee shop in Jerusalem. Jay was originally from Philadelphia who moved to Israel in 1967. As it turned out, he knew my great-grandfather, Pinchas Rothkoff, who died before I was born. He remembered Pinchas having a tailor shop on South 4th Street in South Philadelphia. As a 10-year old, Jay remembered him to be the leader of Sabbath Saturday morning services in South Philadelphia in the late 1940s. He recalled Pinchas as always bossing people around during the service which intimidated Jay. Jay’s father told him that my great-grandfather would receive complaints from women every day of the working week that their dresses were too tight or didn’t fit well. Therefore on the Jewish Sabbath, Pinchas deserved to be king. Sometimes people are put in certain places for a reason.
The substantive tour itself taught me that regardless of the country, the work across different societies responds to the different needs in every place and time, but the principles are the same. I had a precious opportunity to see how government and society in Israel interact in conducting the fight to ensure a life with dignity for elders. I witnessed how some problems are being solved and how many problems still remain. Israel’s problems are certainly different from our problems in the United States—it is a much younger society, divided between Jews and Arabs, and with modern and very conservative actors of society living side by side, not always in peace. The responses in Israel are sometimes different from those in the U.S., but surprisingly they are many times the same as here. We have so much to learn from them and they have so much to learn from us. Ultimately, we fight this fight together wherever we are.
What seems to me to be a major difference is the effort in Israel to pay specific attention to personalizing individualized care and management as much as possible. I also learned that excellent caregiving across the continuum can occur in physically substandard buildings if there are really good caregivers.
My journey ended on a highly spiritual note at Ben Gurion airport outside Tel Aviv. After passing through security, as I walked to the airport gate for my return flight to Newark, I noticed a man outside an airport gift shop putting gift packages on a table. Being a curious individual, I stopped to inquire what the packages were for. He proceeded to explain in English with an Israeli accent that the gift packages were Shalach Manos, gifts of food that are sent to family, friends and others on the Jewish holiday of Purim. I assumed there was a charge, but he said they were free, so I graciously took a gift bag (forgetting of course that I should not accept packages from anyone prior to boarding a plane). The very nice gentleman went on to explain that he was distributing the free gifts to give to someone you love to tell them the story of Purim, the triumph of good against evil. The Shalach Manos Purim gifts were sponsored by the families of three Israeli teen boys, Gil-Ad Shaer, Eyal Yifrah, and Naftali Fraenkel, kidnapped and murdered by terrorists while coming home from school in 2014. The gentleman who handed me the gift bag was Ofir Shaer, the father of Gil-Ad Shaer, who was 16 when he was murdered. I was stunned and speechless. I gave him a hug and walked to my gate. I sat down in the airport terminal and began to cry. My spiritual journey had come to an end and another was just beginning.