jerusalem | The photos in the brochures and on Web sites are all different yet somehow similar: A group or a pair of smiling, elegantly dressed older men and women, their graying hair carefully coiffed, their teeth white and perfect, pose against a backdrop of flowers or greenery.
They live in retirement homes or, as many prefer to call them, senior citizens’ residences. There — at least according to the pictures — happy seniors live out their autumn years playing bridge, strolling through gardens and sipping coffee in the company of vivacious friends.
Although old-age homes have long existed in Israel for those who cannot care for themselves, only in recent years has the American idea of retiring to a comfortable community of seniors really taken off. Over the past 20 years, retirement homes have sprung up all over, and each seems to be trying to outdo the next in the level of luxury, services and amenities offered.
“There are now more people over 65 in Israel than there are under 25,” says David Ditch, CEO of the Ad 120 chain. “The population is getting older, but physically they’re still young because medicine has advanced so much. The standard of living has gone up, and the elderly population has a lot of free time and is looking for ways to fill it.”
According to Israel’s Central Bureau of Statistics, there were 670,000 people aged 65 or over in Israel in 2003, comprising almost 10 percent of the population. This proportion is expected to reach 12.7 percent, or 1.2 million people, by 2025. Life expectancy in Israel has risen to 77.5 for men and 81.5 for women.
But with longer lives come other challenges. Fully 25 percent of Israel’s elderly live alone, and while their health may be good, loneliness and boredom can eat away at their days. Retirement homes promise a range of social and cultural activities in a supervised setting.
But before rushing out to book a place, there are some factors to consider.
“When someone comes to us and says they want to put Dad in a home, the first question we ask is ‘Why?’ and the first thing we do is meet the person to see what they want,” says David Danhai, who heads Yad Lakashish, a free advisory service for the elderly. “If the children say ‘Dad is lonely,’ we look at why he’s lonely. He may already live in an apartment but shut himself off from his neighbors because that’s his personality. A closed-off person will be just as closed off living in a home.
“Or he may be lonely because he doesn’t know where to go to find activities and meet people his own age. We show such people how to use the resources they already have in their area, such as the local day center for the elderly, golden-age club or public gardens. It is no small matter for an elderly person to move out of the home where he has lived for most of his life. It’s traumatic and drastic, and a step that shouldn’t be taken lightly.”
There are two types of retirement housing in Israel, with significant differences between them.
First are old-age homes, which are licensed and supervised by the Ministry of Social Affairs. While many people think these are only for the feeble and bedridden, in fact many of them are designed for the independent senior who wants to be taken care of. Ministry conditions dictate that these homes must provide three meals a day (and two snacks) in a dining room, have a certain ratio of staff to residents, clean residents’ rooms daily, and keep strict hygiene in the home’s laundry, among other stipulations. Activities may be offered, and medical supervision is ever-present.
Residents generally live in apartments that may have an electric kettle, but no cooking or laundry facilities. All apartments have emergency call buttons, and staff checks in on residents if they do not show up for a meal. Residents pay an entry fee of $30,000 to $50,000, plus monthly maintenance fees of $1,200 to $1,750. This entry fee depreciates to nothing within three to five years.
The Ministry’s Web site (www.molsa.gov.il/) lists some 190 licensed old-age homes across Israel.
Then there’s sheltered housing, which is unlicensed and unregulated, but often luxurious, like Ad 120. This type of residence has grown dramatically over the past two decades.
Sheltered housing buildings are essentially private apartment buildings for seniors, with extras. Residents live in apartments equipped with a kitchenette and cooking facilities, and sometimes even a washing machine. Apartments are cleaned weekly and have emergency call buttons, but daily check-ups on residents are not necessarily made. Complexes usually have swimming pools, gymnasiums, game rooms and libraries, with a wide variety of activities.
Residents pay a deposit of $120,000 to $450,000 for their apartments, plus a monthly maintenance fee that can range from $700 to $1,000. The deposit depreciates by 2 to 4 percent annually for 10 to 12 years, and what is left is given to the residents’ heirs.
Each sheltered housing or old-age facility has a separately run Ministry of Health licensed nursing division for residents who need chronic care.
Ad 120 in Hod Hasharon features a dramatic, glass-roofed lobby with greenery hanging from the balconies and thoughtful design touches throughout.
Few residents are seen in the public areas, reflecting the fact that people are out and about keeping busy, according to staff.
Says Ditch, “The whole concept of private senior citizens’ residences came from the United States about 20 years ago. In the beginning [marketing] was very difficult because nobody knew what it was and what the customers wanted, or even who the customers were. We started 15 years ago and were one of the first. We had to make a market for the product, which took a few years. Today, it’s thriving.”
Hod Hasharon, which opened six years ago, was the company’s second home. A third, even more luxurious building, is under construction in Ramat Hahayal, north of Tel Aviv. Ditch says they plan to build or to buy and renovate three more buildings within the next five years.
In Herzliya, the sheltered housing project Beth Protea is Israel’s only English-speaking retirement home. “Ours is a real family home, small and intimate,” says director Lynn Lochoff, a former social worker. “The idea is that people can live out their advanced years in dignity. You don’t feel that you are in a facility for the aged.”
In Kfar Saba, Hamavri is similar to Beth Protea in the standard of furnishings, but its status as a licensed old-age home means its emphasis is somewhat different. Riva Shtreifler, a qualified nurse who has run Hamavri for 15 years, says, “We check on residents if they don’t come to the dining room for a meal, and we pay attention to what each one eats … Our residents who need regular medication are given it by a nurse.”
While Hamavri offers some activities, many people can be found in the lobby, sipping tea or coffee, or reading. Which is good, says, Shtreifler.
“Elderly people don’t always want to be doing so many things. Sometimes they just want to sit and think. They don’t necessarily want to be rushing around all the time feeling they must do something.”
Danhai, who recently set up a Web site (www.yad-lakashish.co.il/) for Yad Lakashish, chooses his words carefully in distinguishing the two housing groups.
“I would say that sheltered housing suits the ‘young elderly.’ That is, people who are under 75 or 80, in good health, and looking for things to do, probably after losing their spouse. They want to move away from their old home and all the memories, and make a fresh start in a nice place.
“But the sad truth is that most people don’t stay healthy forever, and if their health starts to deteriorate and they start to need some help with things like washing or dressing, there is no one who can look after them in sheltered housing, until they become so frail that they have to go into the nursing unit.”
Elderly people living at home also have the option to hire a caregiver, he notes, and financial help for this is available from the government.
“My position is first and foremost to investigate all the options an elderly person has at home,” he says. “Then, if staying at home is not an option, we can think about what is the best option. People often think that if they pay more they will get more. But that’s not always the case.