Three years ago, Rivka, 72, was hit by a motorcycle while she was walking in Jerusalem. The accident changed her life dramatically. Formerly an active and mobile senior, Rivka was unexpectedly thrust into an unfamiliar world, one initially dominated by hospitals and medical staff, and then, after a long and continuing recuperation, a bureaucratic landscape whose contours were defined by piles of paperwork, often obstinate insurance companies and the rigors of 24 hour care.
Among the systems that Rivka needed to put in place was finding someone (as is often the case, a foreign worker) to be with her at all times. While there are many agencies in Israel that provide this service, once the caregiver is set up, there is a hidden layer of bureaucracy that Rivka, already burdened by her physical changes, found increasingly overwhelming.
For example, she needed to pay Bituach Leumi (Israel’s social security) on behalf of her caregiver on a quarterly basis and visas and work permits had to be renewed on time. The agency sent the forms direct to Rivka’s caregiver, but they were long and complex and, moreover, in Hebrew, a language the caregiver didn’t speak and Rivka, as an immigrant from North America, had a hard time with.
Meanwhile, Rivka was struggling to keep up with the documentation required by medical insurances she held in two countries, Israel and the U.S., some of which had to be completed weekly and mailed in almost as frequently.
These are just some of the problems that seniors in life-changing circumstances can face, explains Jody Blum, who heads up Service for Seniors Israel, a Jerusalem-based organization that serves as an intermediary between senior clients and the indifferent institutions with which they must deal.
Blum, who has an M.S.W. from the University of California at Berkeley, with a specialization in geriatrics, says that in cases like Rivka’s, hiring a knowledgeable and sympathetic assistant can make an enormous difference in quality of life. And it’s not just for seniors who are on their own. “Adult children, even if they live nearby, don’t want to spend all of the time they have with their parents dealing with these bureaucratic issues.” When Blum enters the process, valuable free time can be freed up. “It can really improve the dynamics in a family under sudden stress. The question really is: who’s going to handle all of the things that the senior can’t and the family doesn’t want to. Sometimes it’s better to hire someone.”
Rivka’s story demonstrates a growing need for such “organizational intermediaries.” Blum says she also works with seniors suffering from a different type of elderly incapacitation: memory loss and dementia. The problem is similar: dealing with the bureaucracy of banks, health funds and preparing materials for tax professionals – all of which is convoluted even when clear headed – can be near impossible when the mind begins to deteriorate.
Take reconciling credit card statements with bills. Without someone to essentially “manage” that process, a senior can easily slip into overdraft. “One of the first things I do with a client, at whatever stage they’re in, is get them online with their banks, so they don’t have to run out every month to ask for paper print outs,” Blum says. “Some of my clients check their statements online themselves; for others I do it for them. For one client I have with dementia, I let the bank know when she needs to transfer money over from her savings to checking accounts or bring in dollars. It’s critical to build a trusting relationship. Money is such an intimate topic!”
Sometimes a senior may be sharp as a tack but is thrown into uncharted waters by the death of a spouse who formerly handled all the financial issues. This can result in unnecessary or inadvertent overspending.
Blum gives an example that will be immediately familiar – even to non-seniors. “Phone bills are deliberately tricky and hard to read,” she explains. “One of my clients was paying for a 500 minute a month package, but when we looked at her calling habits, we discovered she was making less than 200 minutes a month of calls. Another client had canceled one of her cell phone plans but she was still getting billed NIS 160 a month. This had been going on for years. It added up to almost NIS 2,000 a year! We found the mistake and requested a refund retroactively. We got it and the client saved many thousands of shekels.”
Another situation where Blum saved a client a bundle: “Three years ago, one of my clients received an email from an organization she had worked for offering long term nursing insurance. It was all in Hebrew and she didn’t understand it, but I signed her up at only NIS 100/month. After a year of paying in, she qualified and now receives benefits of more than NIS 4,000 every month.” These are the types of everyday matters that can slip through the cracks without a professional involved.
Setting up a filing and tracking system, one that a senior can actually use, takes place in both the real world and in the virtual. Despite the increasing use of social media and email by seniors, computers can be intimidating even when they’re working well. So when the system goes down – as it inevitably will – Blum will stay on the line with the technician in a senior’s home until the problem is fixed. “My clients think I’m some kind of computer genius,” she laughs.
Seniors with means can benefit from creating a system to track what they’re giving to charity. Such a system should indicate how much the senior has given, to whom and when, so that when the senior receives a call from a charity, he or she can easily reference past history with that group or similar ones. “Very often, people wind up giving twice to the same charity without knowing,” Blum adds.
In addition to the “usual” challenges for seniors, immigrants who move to Israel late in life face the trial of managing an alien bureaucracy in a language they may not understand fully. A useful trick in this case is to schedule appointments with service providers during the time the senior is already meeting with someone like Blum. That way, someone will be there who understands the situation better, can speak Hebrew to the provider, and can advocate on the senior’s behalf.
Blum isn’t the only game in town. “There are groups that help with specific issues, like getting out of overdraft or setting up appointments with doctors and the like. What I offer is different,” she says. “It’s comprehensive, including the organizational, financial and – most important – emotional/personal element. Someone else can certainly go through all your files, but ultimately you want to work with someone you trust, to whom you can open up your heart; someone who really cares and loves you.”
And if that love can also save some money while freeing more quality time with the family, it seems like an eminently solid investment.