Los Angeles Jewish Home

After 15 years as CEO-President of the Jewish Home, Molly Forrest reflects on the Home's achievements, financial challenges, and future.


Looking back, what stands out as the most notable achievements for the Home?
The expansion of the Home's capacity to help more seniors — both in-residence and through our community-based services — has been a significant accomplishment.

In 2002, we opened our award-winning Goldenberg•Ziman Special Care Center, to treat seniors with dementia. In 2007, the Joyce Eisenberg-Keefer Medical Center opened, offering a 10-bed acute geriatric psychiatric hospital and 239 skilled nursing beds. Last years, Fountainview at Eisenberg Village, featuring luxury living for independent seniors, opened.

The Home also developed a number of community-based programs. These include Skirball Hospice, the Jewish Home Center for Palliative Medicine and short-term rehabilitative care for seniors. In total, last year the Jewish Home helped over 2,300 seniors, either on our campuses or in their own homes.

Opened in 2007, the Annenberg School of Nursing has prepared almost 60 vocational nursing students to start new nursing careers.

What have been your greatest challenges as you led the Home to expand services and build new facilities?
With a population of 600,000, the Los Angeles Jewish community has the smallest capacity for seniors of any Jewish Home in the nation on a per-capita basis. The senior population grows daily, with Baby Boomers swelling the numbers. And, thanks to benefits of modern medicine, we enjoy longer life spans and have more "super elderly" (85+), many with complicated medical or social needs.

Adequate funding to maintain our quality programs and services has been, and remains, a challenge. 70% of our residents are on government assistance or welfare. The proposed Federal and State cutbacks in Medicare and Medi-Cal will impact us. In particular, the recently passed California budget will reduce our welfare payments by about $3-3.5 million.

Our "greatest challenge" becomes how we can expand responsibly, and serve more seniors with less reliance upon governmental support for long-term care?

How is the Home responding to these financial pressures?
Our mission — to provide excellence in senior healthcare reflective of Jewish values — is our cornerstone.

The cutbacks and limitations in benefits for seniors have hurt. We have implemented difficult changes. We re-assigned staff, reconfigured positions and, unfortunately, laid off about 20 from the 1,100 staff we employ. We also renegotiated contracts and continue to spend money prudently.

With careful planning and support from our wonderful board and valued friends, we continue providing exceptional senior care and have grown to serve more, while reducing reliance on governmental funding.

What does the future hold for the Jewish Home?
Next year, as we celebrate our Centennial, we will open the first site for the Brandman Centers for Senior Care (BCSC). This is a new program that combines Medicare and Medi-Cal benefits to assure needy seniors can live safely at home with coordinated, quality healthcare and services.

We have plans for the Gonda Health Aging Westside campus, as well as new projects for the Grancell Village and Hirsch Family campuses in the Valley. We are also planning for an in-home concierge program focused on helping seniors live in their own homes.

Once all our plans are completed, our Home will serve 5,000 seniors every day! It is up to us to meet the needs of an aging population with careful foresight, management and, yes, the ongoing generosity of hands, hearts, and dollars.

Labels: Achievements, Funding, Future, Jewish Home News, Los Angeles Jewish Home, Molly Forrest, Palliative Medicine, Q and A, Seniors, Super Elderly

During the month leading up to Rosh Hashanah, I am going to be making a lot of noise here at the Jewish Home’s Grancell Village.

At lunch time every weekday, I will be visiting 18 dining rooms and blowing four powerful blasts of the shofar in each one. The residents and staff love these moments, and so do I. But they are intended to be more than mere fun.

The shofar, of course, is the herald of the New Year. It is also a call to prepare ourselves for Rosh Hashanah and Yom Kippur — the “Days of Awe.” So what kinds of preparation are appropriate?

We are all familiar with the “outer” preparations for family gatherings at the New Year. There are the dinners we will share; the clothes we will wear in synagogue in honor of the occasion; the beautification of the synagogue itself, the flowers and the white coverings for the Torah scrolls.

But when we look beneath the surface, and let the sound of the shofar touch our hearts, we hear the call for another kind of preparation — the beautification of our selves, deep down inside. The way we do this is through personal reflection. This is the true call of the shofar, and the grandest task in Elul, the month before Rosh Hashanah.

In preparation for the New Year, I find it helpful to ask ourselves a few important questions, such as:

• Of all the things I have accomplished in the past year, what pleases me most or makes me most proud? In what ways did I live up to my highest standards?


• How have I let myself down by failing to live up to these standards, or being less of a mensch than I could have been?


• Have I apologized to people I’ve wronged? Can I find the courage to do that?


• What can I do that will make my life and the lives of others a little better in the coming year?


• What can I do next year that will make me more proud of who I am?

On Rosh Hashanah and Yom Kippur, we commune with a compassionate and forgiving G-d, and realize that it is also time to forgive ourselves. It is important to understand that acknowledging the ways we have fallen short does not mean we should beat ourselves up. Far from it!

Our goal should be to come out of Yom Kippur free from sense of guilt or failure, and inspired to improve ourselves in the coming year. That is why the end of Yom Kippur is such a joyful time.

At the New Year, we will share apples and honey with families and friends, and wish each other a happy and sweet new year. We will ask to be written into the Book of Life for a good year ahead.

Our preparation in the coming weeks enables us to come confidently before G-d to make that plea. May the sweetness of the New Year arise from your true striving to become the best person you can be.

I wish you and your family a Happy, Healthy, and, yes, a Sweet New Year.

Labels: Days of Awe, Elman, Feature Articles, For the Spirit, New Year, Preparation, Rosh Hashanah, Shofar, Yom Kippur

It’s 2:15 a.m. Out of a deep sleep, you awaken to clanging noises in your kitchen. Not long ago, you would have thought someone was attempting to get into the house. But with everything that’s gone on lately, you realize it is actually someone trying to get out. It’s your mom. She’s ‘wandering’ again.

Recently, you’ve noticed she is having memory problems. It’s been harder for her to recall what was just said. Now she’s forgetting the day, the date and other little features of daily life. Learning new things seems especially challenging for her, and she is starting to make up details to fill in the parts of stories she’s forgotten.

At first, it was possible to chalk it all up to getting older. After all, there are many challenges to deal with as the years advance. But things have really begun to change for the worse.

Mom can’t sleep through the night. She wakes up disoriented and confused. During the day, she believes she has appointments that have never been made. She talks about going to see friends or family who have long ago passed away or moved. She gets mad and lashes out when she is prevented from doing things you know she can no longer do.

Sometimes Mom seems depressed. It is harder and harder to take care of her personal needs, and she doesn’t seem to understand why you want her to take a shower. Sometimes she even forgets who you are.

It seems that her symptoms are coming on faster and faster, and, since she took that fall last week, things have gotten so much worse. Her doctor prescribed some medication, but it really isn’t helping.

You get out of bed and go downstairs to try to help Mom back to bed. She isn’t settled until 4 a.m. You don’t know what you’re going to do. One of these days you might not be able to get to her in time.

Mom has dementia, and now you’re worried about her safety. You need someone to help you figure out what to do next.

The preceding scenario is a composite of several we’ve heard from families caring for loved ones with various forms of age-related dementia.

At the Jewish Home’s acclaimed Auerbach Geriatric Psychiatry Unit (AGPU), we counsel families on mental health services for their senior loved ones, and provide short-term (acute) intensive treatment for seniors experiencing stressful mental or emotional challenges.

More than 50% of patients treated are suffering from acute dementia. The goal of our small, specialized hospital unit is to help restore seniors to an optimal level of functioning so they may safely return to their home or residential setting.

While most people do not need to be admitted, the staff at the Auerbach Geriatric Psychiatry Unit can help you sort through your options, gain new insights on dealing with dementia, and where to go for additional help.

If you have a loved one who is experiencing acute mental health challenges, please call the Jewish Home’s Auerbach Geriatric Psychiatry Unit at (818) 758-5042. A helpful staff member will either talk with you immediately or get back to you promptly.

Labels: Aging, Alzheimer's, Auerbach Geriatric Psychiatry Unit, Dementia, Feature Articles, For the Mind, Luke Jackson, Memory, Parents, Wandering

For a senior, a hip fracture can be as life-threatening as heart disease or cancer. Sadly, nearly one in four older women who fracture a hip will die within a year. For men, the odds are even worse. A year after a hip fracture, one-third will not survive. Of those who do, many will not be able to walk without a cane or walker.

The reasons for such poor outcomes after hip fractures are not clear, however loss of mobility and independence play an important role. Immobility also leads to depression, a loss of motivation, and, in many cases, even the will to thrive and live.

Since we don’t want one, let’s look at ways to prevent these potentially devastating accidents.

Fall Proofing Your Home

Most falls occur in the homes, that were built without the needs of senior residents in mind. Many contain slippery floors and poorly-lit hallways, and stairs.

To fall-proof your home, start with your kitchen and your bathroom, the two most common sites for falls. Grab rails are a must in the shower and next to the shower, bathtub and sink. They don’t have to look industrial. There are nice designer shapes and colors from which to choose.

If you use throw rugs in the bathroom or kitchen, make sure they are fixed to the floor. Re-organize your kitchen to ensure that commonly-used items can be easily reached. And don’t store anything so high that you need to stand on a chair or stool to reach it.

Be sure hallways and staircases are well-lit and clutter-free. For more information on how to make your home safer, visit www.homemods.org.

Change Those Shoes

High heels and smooth-soled shoes must go. Personally, I prefer the security of shoes with non-skid bottoms. If you encounter a wet or slippery surface, your shoes can make the difference.

While you’re at it, retire those running shoes with lots of elevation. They simply put too much space between the soles of your feet and the surface on which you’re walking.

Improve Your Balance

There are several ways to improve your balance and thereby prevent falls. Perhaps the best method was devised by the Chinese, and is called T’ai Chi. The gentle motions of T’ai Chi have been shown in clinical trials to reduce falls and their resultant hip fractures in seniors.

If T’ai Chi is not for you, there are other balance exercises that a physical therapist can show you. Your physical therapist or physician can also coach you on how to avoid landing on your hip if you do take a fall.

Strengthen Your Bones

We all lose bone mass after the age of 40 or so. For women, this process accelerates after menopause due to a loss of estrogen. What can we do to slow down and even reverse this process so that we’re not at risk for fractures?

Surprisingly, the best way to strengthen bone is through exercise, both the aerobic and strength-training types. Just 30 minutes of walking at two to three miles per hour will build bone mass. Light weight training will strengthen your bones as well as improve your balance.

Get Sufficient Vitamin D

Another way to prevent fractures is by getting enough vitamin D, which has been shown to prevent falls. Your skin manufactures vitamin D after exposure to the UV rays in sunlight.

Unless you get out in the sun for a considerable amount of time each day, it is unlikely that you are getting enough vitamin D, and you will need to take a supplement of 1,000 IU a day.

Have a Bone Scan

If you are over age 50, you should have a DEXA scan. This x-ray of your hip and spine will determine if you have osteoporosis (severe loss of bone matrix) or osteopenia (moderate loss of bone matrix). If you do have these conditions, you are at greater risk for hip fracture.

There are several options for treating osteopenia and osteoporosis. Consult with your physician to see if estrogen, etidrionates such as Fosamax, SERMs such as Rolaxifene, calcitonin, or parathyroid hormone, are right for you.

Reducing the risk of a hip fracture and its consequences is something you can start working on today. By taking the steps outlined above, you should be able to protect yourself from this potentially devastating injury.

Labels: Aging, Bones, Falling, Feature Articles, For the Body, Hip Fracture, Schneider

Sandra Hoban, Executive Editor at Long Term Living Magazine, wrote this wonderful piece in their blog yesterday, entitled Residents reconnect with the soil at LA Jewish Home. We wanted to share an excerpt of it with you.


It's always nice to be recognized for one of the amazing services we provide our seniors. We'd like to thank Long Term Living Magazine and Sandra for writing such an amazing piece. Click the link above to read the entire blog.

Also, take a look at the article we wrote in our News and Updates page about Susan Leitch and the G•Z community garden.

Labels: Alzheimer's, Cognitive Exercise, Cross Post, Garden, Long Term Living, Molly Forrest, Nadine Roisman, Shoban, Susan Leitch

Earlier this week, we posted on our Facebook fan page and Twitter account an article from the Los Angeles Times about how a new study confirms that even a little exercise helps prevent heart disease. The study is gaining some pretty significant traction in the medical community. We found this article by Dr. Howard LeWine of Harvard Medical School in response to all the media buzz, and thought we'd share.

News Review From Harvard Medical School -- Study: Any Exercise Helps the Heart


Even small amounts of daily exercise help to reduce the risk of heart disease. That's the conclusion of a new review of research on the topic. Some benefit was seen with as little as 10 to 15 minutes of exercise a day. The review combined the results of 9 previous studies. All of them included information on exercise habits. Researchers looked at people who did moderate-intensity exercise (such as walking) for a least 150 minutes a week. That is the current recommended minimum. People in this group had a 14% lower rate of heart disease than those who did no exercise. Benefits of exercise were strongest among women. The study appeared in the journal Circulation. USA Today wrote about it August 2.

By Howard LeWine, M.D.
Harvard Medical School


What is the Doctor's Reaction?
Yes, we all know that exercise is good for you. But does more exercise actually prevent coronary heart disease? Not everyone has been convinced of the direct link.

People who exercise tend to be more conscious of what they eat. They are less likely to smoke. They also pay more attention to their health. Maybe that's why they are healthier.

This very comprehensive study gives us a definitive answer. It found that any amount of exercise decreases your risk of chest pain, heart attack and death from heart disease. In fact, people who don't exercise at all can decrease their risk of heart disease with as little as 10 to 15 minutes of exercise per day.

The researchers set out to define how much exercise it takes to decrease your risk of heart disease. Their benchmark was the recommended minimum of 150 minutes of moderate-intensity exercise per week. This is exercise that a person performs during non-work hours. It is often called leisure-time physical activity.

According to this study, people who get an average of 150 minutes per week of exercise reduce their risk of coronary heart disease by 14%. For people who average 300 minutes per week, the risk reduction improves to 20%.

Women appear to benefit more than men. The researchers found that women had a greater reduction in heart disease from similar amounts and intensity of exercise. This was unexpected. Other studies have not shown a sex difference. Also there is not a good biological explanation to account for this.

What Changes Can I Make Now?


Do you engage in any leisure-time physical activity that raises your heart rate and makes you sweat a little? If you don't, get started. Take a short walk every day, mow the lawn or plant a garden. Do something every day, even if it is only for a few minutes.

Your next goal is 150 minutes of moderate-intensity physical activity per week. That is less than 2% of the total minutes in a week! (There are 10,080 minutes per week.)

Moderate-intensity exercise can be determined by heart rate or METs. MET stands for metabolic equivalent. One MET is the amount of energy you burn when you are sitting quietly.

Heart rate -- Moderate-intensity exercise raises your heart rate to 60% to 75% of your maximum heart rate. The simplest formula for maximum heart rate is 220 minute your age.

METs -- Moderate-intensity exercise means 3 to 5.9 METs. Examples of activities that increase your metabolic rate to this level include:

• Walking at 3 to 3.4 miles per hour
• Riding a stationary bike with light effort
• Riding an outdoor bicycle at 7 to 10 miles per hour

Labels: Circulation, Cross Post, Exercise, For the Body, Harvard Medical School, heart disease, Heart Rate, Howard LeWine, Leisure-Time Physical Activity, METs, moderate-intensity, Physical Activity, Staff

Last month, Jeanna Bryner, Managing Editor of LiveScience, published a list of 5 reasons why aging is awesome. It was so good we wanted to share it with you.

Intro
The saggy, wrinkly view of aging may have a much more positive, and real, conterpart: Getting older has its perks, lots of them, from needing less sleep to having better sex. Here's a look at why the crowded candles on your birthday cake, as you enter middle age and beyond, are just plain awesome. (photo credit: stock.xchng)


More Awake Time
That's right, more time to enjoy life. Seniors need about 1.5 hours less sleep on average than their younger counterparts, according to one study.

In another study of 110 healthy adults who were allowed eight hours of bed time, the oldest group (ages 66 to 83) snoozed about 20 minutes less than the middle-agers (ages 40-55), who in turn slept about 23 minutes less than the youngest group (ages 20 to 30). The simplest explanation for the fewer shut-eye minutes: Older adults need less sleep.

Another explanation, and one supported by research: Older adults just can't get the sleep they need, taking longer to nod off, spending less time in deep sleep, and having more trouble staying asleep. In fact, more than half of men and women over the age of 65 say they suffer from at least one sleep problem, with many experiencing insomnia, according to WebMD. (photo credit: © Rozenn Leard | Dreamstime.com)


Wearing Rose-Colored Glasses
Being happy may come down to attitude, studies have shown. That's great news for older adults, whose brains seem to be wired to remember the good times. A brain-scanning study published in 2010 in the journal Cortex revealed that older adults' rose-colored glasses may be linked to the way the brain processes emotional contents.

The researchers scanned the brains of participants — young adults (ages 19-31) and older adults (ages 61-80) — as they viewed a series of photographs with positive and negative connections between the brain regions that process emotions and those known to be important to the successful formation of memories, particularly when processing positive information. The same strong connections weren't found for the younger participants.

Aging adults don't just recall blissful moments of the past in vivid colors. It's also becoming apparent to researchers that being old could lend itself to optimism. In one recent study, both old and young participants where shown virtual faces portraying sadness, anger, fear and happiness. Eye-tracking technology revealed the older participants, ages 18 to 21, focused on fearful faces, while those ages 57 to 84 zeroed in on the happy faces, avoiding the angry ones. The researchers, who detailed their study in 2006 in the journal Psychology and Aging, think that as a person's life expectancy decreases, they might focus on what makes them feel good now rather than focusing on the negative. (photo credit: Dreamstime)


Being Grandparents
No diapers. No temper tantrums. No fevers and ear infections. Aging means you get to enjoy grandkids, as if they were your own, but without any of the frustrations. Pop-pop and G'ma can do no wrong in the eyes of grandkids. Research has suggested grandparents can increase the chances of a child surviving during the high-risk period of infancy and childhood in traditional societies. The same link may hold true in Western societies, according to David A. Coall of Edith Cowan University. "We felt if such an association existed in Western societies, where the fertility and childhood mortality rates are much lower, grandparents could make a substantial public health contribution to our society," Coall said in a statement.

And you're good at it, too. A study published in the November 2008 issue of the journal Pediatrics, by scientists at the Johns Hopkins Bloomberg School of Public Health, showed that kids cared for by a grandmother were 50-percent less likely to get injured than children cared for by daycare workers, other relatives, or even the child's own mother. (photo credit: © Monkey Business Images | Dreamstime.com)


More Wisdom
Like a fine wine, older adults have been aged to perfection it seems, at least when it comes to wisdom. As you age, you may have a tougher time tuning out irrelevant information, but this lack of focus can actually boost memory, according to research published in 2010 in the journal Psychological Science. More specifically, seniors have the unique ability to "hyper-bind" the irrelevant information, essentially tying it to other information that is appearing at the same time. This type of memory could help older adults with decision-making and problem-solving, the researchers suspect. For instance, if a manager wants to promote an employee, it might be helpful to recall not just that employee's work performance, but also his interaction with other employees. (photo credit: © Denis Raev | Dreamstime.com)


Rewarding Sex Life
Sex drive seems to stay strong as you age. One 2007 study published in the New England Journal of Medicine surveyed adults ages 57 to 85, finding more than half of 75- to 85-year-olds reported a roll in the hay at least two to three times a month, and 23 percent reported having sex at least once a week. oral sex appeared to be less "ageless." nearly 60 percent of the participants under 65 years old said they had engaged in oral sex in the previous 12 months, compared with 31 percent for the over-75s. (photo credit: © Alexander Raths | Dreamstime.com)

What else do you think makes aging awesome? Leave a comment!

Labels: Aging, Cross Post, Elderly, For the Body, For the Mind, For the Spirit, Grandma, Grandpa, Grandparents, Healthy Aging, Jeanna Bryner, LiveScience, Optimism, Seniors, Sexuality, Sleep, Staff, Wisdom