Department of Jewish Family Concerns for the Union for Reform Judaism

At the Edge of an Abyss? Part 2

A baby boomer tsunami on the way.

By Rabbi Richard F. Address, DMin

A few weeks ago the “call” came. From the assisted living facility to me: I needed to run home from New York and get to the hospital. My 95-year-old mom was being taken there.

Thus began a journey not unfamiliar to so many. As I alluded to last time, the abyss of reality caused by dementia is very real.

It is a truth that impacts increasing numbers of people and will become a major issue (if it hasn’t already) for boomers. For, not only are our parents “enjoying” longevity, but we are expected to as well.

Here is an astounding statistic. Beginning on January 1, 2011, baby boomers will start turning 65 at a rate of one every eight seconds. This fact was recently published in a short, but powerful, op-ed piece titled “The Age of Alzheimer’s” (New York Times, October 28, 2010). It was co-written by Sandra Day O’Connor (the first woman justice to be appointed to the Supreme Court), Stanley Prusiner (a Nobel Prize winner and expert in neurological issues), and Ken Dychwald (an expert on issues of aging and baby boomers).

One of the main issues in this piece is the lack of concentrated funding for research: “The National Institutes of Health still spend about $3 billion a year on AIDS research, while Alzheimer’s, with five times as many victims, receives a mere $469 million.”

This is not to pit one disease against another; instead, it is to indicate that as the numbers of older adults continue to rise, we need to realize that the cost of caring for patients with dementia and Alzheimer’s will skyrocket. As the article noted: “The United States spends $172 billion a year to care for people with Alzheimer’s. By 2020 the cumulative price tag, in current dollars, will be $2 trillion and by 2050, $20 trillion.”

Clearly, we are at the beginning of a major wave. The blessing of longevity can also, for some, become a curse. As many of you know, the impact on families—emotionally, spiritually and financially—can be overwhelming. There are many resources from many organizations that deal with issues of dementia and Alzheimer’s. May I suggest that the time may be right for your social group, church, synagogue, mosque, community center, etc., to develop some educational programming that can provide information and support not only for families and individuals who are dealing with this long good-bye, but also for those who will face it in the future.

Shalom.

At the Edge of an Abyss? Part 1

Beginning the last chapter.

By Rabbi Richard F. Address, DMin

Longevity has many blessings. It has given us the gift of time, and if we are blessed, that time provides millions of people with untold opportunities for new experiences.

Longevity has its challenges as well. I have written in this space about new life stages that our longer life spans have created. I have written on the life stage of caregiver, which can last for years.

It now seems that I have encountered another aspect of that caregiver stage. My mom, who is in her mid-90s, is now dealing with an accelerating case of dementia. It had, in the past few months, begun to take away her ability to function. It has landed her in the hospital and confronted us with new choices and new realities, among them being the fact that we have begun the last chapter.

As many of you know, it is easier to teach the “art” of caregiving to a class than it is to live it. As many of us learn, it is easier to speak about working with a parent than it is to try to make sense of the illogic of a moment with a mom or dad who may still see you as her or his child. Standing in a hospital corridor, it is daunting to be faced with the need to understand, within just a few moments, the complexities of negotiating the Medicare-Medicaid health systems. But many of us do.

I keep trying to remember that this will all work out and that it is important to take care of the “me” that can so easily be lost. A doctor I spoke with kept reminding me to remember to eat right, exercise, and take time each day to try to renew the soul. Certainly there is enough literature on this to support the fact that the health of a caregiver is of primary concern given the stresses that must be endured. Yet, as many of you know, it is easier said than done!

So, we have entered a new stage of this long caregiving journey. Longevity is a blessing—for some. But for others? We value and praise the value of life. Every religious tradition does, and no one argues or finds fault with that. A challenge, however, for an increasing number, will be to remember the gift and beauty of life in circumstances that challenge that gift. An underlying value still is “dignity and sanctity.” At the edge of an abyss of unknown proportion, it is a calling to remember that dignity and sanctity, and safety and security, are still present and powerful aspects of life, even as that life begins to make its final turn.

Shalom.

When Is It Okay to Take the Car Keys Away?

Having “the conversation” with your senior parent

By Rabbi Richard F. Address

Eventually, in every caregiving workshop, comes the question of when it’s okay to take the car keys from an aging parent. To this I often remark that if you are ever bored and want to engage in a “fun” conversation, float that trial balloon. One can accept a walker or cane, a hearing aid, and/or bifocal or trifocal eyeglasses, but take the car away? Here is the bottom line: there is no right way, just right times. And you, as a caregiver, will have to try to finesse this as much as possible, unless circumstances dictate otherwise.

I started having this conversation with my mom several years ago. I was usually met with icy silence, as if I had brought news of earth’s imminent demise. Independence, or the fantasy of same, is an American “right,” and nothing in our culture says independence better than our car. Just ask any teenager! So, until last May, my mom ignored her gradual loss of directional sense, the rare TIAs (transient ischemic attacks), and a host of other issues. It seems that she got lost returning home—lost enough for her to panic.

One day we were discussing another list of “issues,” when she turned to me and handed over her car insurance bill. “Do I really need this now? After all, I live in an assisted living facility. Someone will always be around to drive me where I wish to go, and this way I can save all this money for something I do not use that much.”

There it was, the opening. The pretext was money saved; the subtext, her reaction to being lost, forgetting where she lived, and her ensuing panic. Long story short, Mom agreed with me when I suggested that her idea to save all that money was a good one. We let the insurance lapse and sold the car the next week.

That process took about two and a half years from first conversation until final resolution. Time and circumstances allowed this to occur, and, thank God, she was not in any accidents. Not all are so lucky.

Again, there is no correct way to resolve the driving issue. I have heard of adult children allowing the car to remain unrepaired after an accident or “forgetting” to pay license renewals. Others are proactive and just take the car away. This is a life-transition moment of major importance in our culture. Just think about how you would feel if you were unable to drive and were dependent on others for everything from going to the store or the movies to just out for fun.

So here is a hint. This is not a conversation to be taken lightly. It is one that, in most circumstances, must be planned with the knowledge that the entire process may take some time. Good luck.

Shalom.

The Long and Winding Road?

Increased longevity raises important public policy questions

By Rabbi Richard F. Address

We are often at a party or in a conversation when the age issue comes up, either jokingly or in some serious context, and someone opines that after all, age is just a number!

Well, as you know, there is some truth in that (except maybe early in the morning or in the middle of the night). Attitude, it has been said, is a major factor in how we see our own aging.

Another factor emerging in our so-called developed world is literally reshaping cultures before our eyes. We are just plain living longer. Not only in the United States, but also in many countries in the world, and this longevity reality is now beginning to impact entitlement programs, the perception of work, and the value of retirement. These economic, social, and personal realities present us with some amazing choices and challenges.

I was flying to vacation last month when I came across an article in Foreign Policy magazine that discussed this fact. It referenced a piece in the Lancet that reported more than half the babies born since 2000 in France, Germany, Italy, Britain, Canada, Japan, and the United States will live past 100. “By mid century”, said the article, “there will be nearly 6 million people over the age of 100 in the world, compared with just 340,000 today, according to the US National Institute of Aging.” (Foreign Policy, May/June 2010, p28). One can only feel sorry for Willard Scott!

We can immediately jump to questions of who is going to pay for this extended life span as well as who is to say that the added years will equal added mobility and cognition. Here is where the spiritual and religious questions arise. Just because we “can” do something doesn’t mean we should. Of course, all of us want to feel that we will be able to live longer, better, healthier lives. God willing, that will be so. But what of the people who do not, or cannot, or the people who simply outlive their financial resources?

This longevity challenge raises important public policy questions about work and leisure, retirement, and relationships. We already spend most of our lives without children. Why fix a date for retirement? Why not extend the entry age for Social Security? Medicare? What happens to younger workers when we keep on working, either out of desire or necessity (or both)? And, if we can take a page from so much of the contemporary political discussions, are our children prepared to pay increased taxes to fund entitlement programs that will allow us to enjoy these added years?

These are very real and pressing questions. Sadly, it does not seem as if many leaders have begun to consider the implications of these challenges. We ignore them at our peril. Perhaps it is time, during the coming program year, for our churches, synagogues, and mosques to create discussions around these issues, discussions framed from a perspective of faith and not politics.

Just a random thought as the summer season begins. Enjoy!

Take a Deep Breath

Technology has given us more blessings than curses, but…

By Rabbi Richard F. Address, DMin

We have turned another corner in our relentless pursuit of technology. In mid-May, the New York Times trumpeted the headline “Synthetic Bacterial Genome Takes Over a Cell.”

This was heralded as a “philosophical advance as much as a technical advance,” and the article noted that the synthetic cell “raised new questions about the nature of life.” OY! I am having enough trouble dealing with the old questions about the nature of life!

But, technology will be served (just ask the millions who lined up for an iPad), and, in truth, technology has given us more blessings than curses. Ask the many friends and family who are walking around with new hips, knees, hearts, kidneys, etc., and you get the message. No, technology marches on to create artificial life, while most of us just try to get through the day in “real” life. And even a casual glance at a news show or newspaper will tell you that this is getting harder.

I am convinced that one of the great challenges of life now is that of trying to take a “time out.” The challenge of trying to step back from life and take a deep breath, to collect our thoughts and recharge an ever-depleted source of personal energy. It is tough.

I recently called a cruise line to speak about an upcoming reservation and noticed (while on hold) the brochure, which gleefully proclaimed that I could bring my laptop so I could be 100% connected with my world. WHY? Isn’t the point of getting away to get away?!

Enough research now supports the fact that constant work and the associated stress is, on a very basic health level, not good. Every person and thing needs some rest. That is why mankind created the concept of a sabbath, and it is why religious traditions celebrate this concept as a way of sustaining oneself. Religions couch this in terms of one’s relationship with the Sacred and the need to find spiritual refreshment and energy. They are right. Each of us needs to find a way to “escape,” even if it is for a few hours. Those of you who are caregivers (or who have been) know how true this is. How many the times have I spoken to caregivers who see those few hours away on their own as a true sabbath of the soul!

The idea of taking that deep breath is really, I think, reflective of the beginnings of the Bible. Creation in Genesis begins with the ruach, or spirit, being manifest over the earth. Ruach can mean spirit as well as have the connotation of breath. Indeed, in some commentaries, it is God’s breath of life that gives the spark of creation its initial charge.

We come to times in our lives when it is important to be able to recognize the need to step back and take that deep breath, a deep breath of life that will allow us to recharge our own souls, gain clarity of purpose, and focus on what may be next. It is not the creation of a new world that these relaxing breaths allow—it’s the re-creation of ourselves. That is real, not artificial. This is the life we live every day.

For many, June is a time that the rush of the “program” year begins to ebb. For many, we will try and take a few days here and there or, if possible, actually plan a vacation. For some, such luxury will not be possible. However, for everyone, there is the possibility, and in truth, the necessity, of needing some time for yourself. So, remember that idea of the sabbath, the time to step back, take that deep breath, and tune out. You owe it to yourself. And don’t worry: I have it on good authority that those problems and issues that haunt us will still be there when you get back. So, take that breath and enjoy some real life!

Shalom.

Truths from Tradition

“A joyful heart makes for good health; despondency dries up the bones”

By Rabbi Richard F. Address

One of the least examined books of the Bible is the Book of Proverbs. I decided to look at this book for a mini class I am teaching this month in suburban Philadelphia.

Proverbs is part of a small collection of books referred to as “Wisdom literature.” The book offers observations on life, not from a lofty stance, but rather from the point of view of most of us who have to get through the day making a series of choices for our families and ourselves. Often, wisdom (chochmah in Hebrew) is personified and speaks as a wise sage. There are collections of maxims on a variety of topics. Some deal with issues related to health and healing and provide us with some very sound and common sense advice. In fact, the book really contains a lot of just plain old common sense advice.

For example: A joyful heart makes for good health; despondency dries up the bones (17:22). We all have heard the adage that attitude is everything. Well, here it is from a text about 3,000 years old! Indeed, study after study in our times has concluded that how you choose to respond to the challenges of life really does impact how you live your life and how your health reacts. In other words, Proverbs suggests that seeing that glass as half full actually has health benefits and makes life better. This is echoed a chapter later, where the book says: A man’s spirit can sustain him through illness; but low spirits—who can bear them? (18:14).

Here is another example of the common sense contained in the book. Many of us, as we grew up, heard from our elders advice on when it is appropriate to speak and how to speak. Likewise, we echoed these sentiments as we ourselves parented our children. The reality that words have power and sometimes it is better to stay silent is a reality that we all can identify with. So, it is no wonder that Proverbs says: Pleasant words are like a honeycomb, sweet to the palate and a cure for the body (16:24).

Jewish tradition teaches that words, when wrongly used, can have the power to kill. The concept of lashon ha’ rah (evil speech or gossip) is a very strong part of our teachings. Indeed, it is included in the interpretation of the commandment against murder, as commentators knew that words, spoken in anger or with malice, can have the impact of “killing” another person. What we say can and does make a difference, so Proverbs reminds us that A healing tongue is a tree of life, but a devious one makes for a broken spirit (15:4).

Much of the text contains advice in the form of a parent talking to a child. It is often cast in the language of Wisdom speaking to the author and symbolizes a host of things (e.g., parent to child, God to humanity). However, if you examine many of the proverbs, you will probably smile and think and remember when you may have said something quite similar to your own children as they grew up, or to grandchildren now.

In the beginning of the book are several texts that remind the reader to listen to the instructions of parents, simply because they are your parents! In other words, life experience, honor, and respect count for a lot. In the end, that honor and respect is linked to long life and a peaceful soul. As the text says in one cogent verse from chapter three: My son, do not forget my teaching, but let your mind retain my commandments; for they will bestow upon you length of days, years of life and well being (3:1-3).

Take a look at this most interesting book. I think you will find some very meaningful insights.

Shalom.

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