The Challenge of Optimal Aging in Israel: An In-Depth Look at the Demographic and Social Future

The Challenge of Optimal Aging in Israel: An In-Depth Look at the Demographic and Social Future

Israel, like many countries worldwide, faces a significant challenge: the aging of its population. Those challenge of optimal aging in Israel, are not just a demographic issue, but also a social, economic, and health challenge of the highest order. In 2021, the Israeli government made an important decision (Government Decision 127) outlining the way to address this challenge, with an emphasis on optimal aging. This article will review the current situation, the challenges we face, and the strategies Israel is adopting to ensure a better future for its elderly citizens.

Current Situation

Demographic Overview According to current data, the elderly population in the world currently constitutes about 10% of the total world population. However, projections indicate that by 2050, the proportion of those aged 65 and over will rise to about 17% of the world’s population. In Israel, the picture is even more dramatic: within 50 years, the elderly population is expected to grow from about one million to about three million.

Characteristics of Optimal Aging in Israel

Studies show that about 80% of the elderly in Israel function at a high level, while 17% are in significant functional decline. Another interesting statistic is that 98% of the elderly live in the community, and only 2% in institutions.

The Health and Functioning Challenge

One of the central challenges in population aging is maintaining health and function. While life expectancy in Israel is among the highest in the world, the gap between life expectancy and healthy life years is growing.

Basic Assumptions for Addressing the Aging Challenge

To address the aging challenge, Israel has adopted several basic assumptions, including a holistic view, shared responsibility between the individual and the state, a common language, and an emphasis on prevention.

National Metrics Map for Optimal Aging

One of the central tools developed to deal with the aging challenge is the National Metrics Map for Optimal Aging. This map includes metrics in various areas such as quality of life and loneliness, healthy life years, functioning, economic resilience, health management, healthy lifestyle, active lifestyle, and digital literacy.

Government Decision 127

A Significant Step Forward In 2021, the Israeli government adopted Decision 127, which marks a significant milestone in dealing with the aging challenge. The decision includes several key components, including adopting the National Metrics Map for Optimal Aging and publishing a national report on the state of optimal aging in Israel every two years.

Strategies for Dealing with the Aging Challenge

Based on the data and insights that emerge from the metrics map and the national report, Israel is developing several central strategies to deal with the aging challenge. These include focusing on prevention, promoting a healthy lifestyle, strengthening social connections, economic preparation for old age, integrating technology, adapting the health system, and age-friendly urban planning.

The Budgetary Challenge

One of the significant challenges in dealing with population aging is the budgetary challenge. However, studies show that investing in prevention and early intervention programs can save many resources in the long run.

Inter-sectoral Collaboration

Dealing with the aging challenge requires cooperation between different sectors of society, including government ministries, local authorities, civil society organizations, the business sector, and academia.

Unique Challenges in Israel

While the aging challenge is global, Israel faces several unique challenges, including cultural diversity, geographical gaps, immigration, and security issues.

Innovation and Technology

Israel, known as the “Start-up Nation,” is also leveraging its technological capabilities in the field of aging. Innovative technological developments include home monitoring systems, adapted social platforms, technologies for cognitive improvement, and assistive robotics.

Preparing for the Future

One of the central issues in the concept of optimal aging is preparing for the future. This includes financial planning, career planning, healthy lifestyle, and housing planning.

Summary and Future Outlook

The challenge of optimal aging in Israel is complex and multidimensional. It requires rethinking the concept of old age, the place of the elderly in society, and the shared responsibility of the individual and society in ensuring a good quality of life in old age. The success in dealing with this challenge will be measured not only in numbers and statistics but also – and perhaps mainly – in the quality of life of the elderly in Israel, their integration into society, and their sense of value and meaning.

Happy Seniors Services

Happy Seniors offers a wide range of services to help elderly people living at home and their families. The services include assistance in finding suitable nursing caregivers, managing medical monitoring and personal care, and supporting daily challenges. The company also offers technological solutions that allow the elderly to stay connected with their families and enjoy community support, all with the goal of improving their quality of life and allowing them to age in a familiar and comfortable environment. Happy Seniors helps the elderly enjoy maximum support and advanced technology, thereby significantly improving their quality of life.

Technological innovations in the treatment of Alzheimer’s

Technological innovations in the treatment of Alzheimer’s

Alzheimer’s – one of the most common diseases in the world, and still incurable. Despite the emergence of new technologies in a wide range of medical fields; We are far from finding the solution that can detect Alzheimer’s in the pre-clinical stage or get rid of the disease. But, there is a wide variety of technological innovations in the treatment of Alzheimer’s;

Innovations that help patients and make their lives easier. This time we will talk about the most useful innovations that can help your loved ones live a better life.

1. Photo phone – one of the simplest, but most exciting innovations in Alzheimer’s treatment.

Alzheimer’s patients face memory loss that increases over time; Phone numbers are among the first things that become confusing for them. A photo phone, like the one in the Alzheimer’s store can be very helpful in these situations.

This useful technology is like the smartphone version of Alzheimer’s patients. Many of the models include the option to save a large number of dialing numbers for emergency services and the numbers of loved ones.

In the case of the phone the memory photos; The numbers have been replaced by large buttons where you can save small pictures of the nearest contacts. The patient can easily make a phone call to the desired number with one click on the picture of the person with whom they want to communicate.

חידושים טכנולוגיים בטיפול באלצהיימר

2. Devices for detecting wandering

Alzheimer’s patients develop a tendency to wander in public places; There is a danger that they will get lost if they are not looked after properly.

Devices like Jiobit can be a real help when you need to locate your loved ones; To the extent that they forget their surroundings and get lost. Jiobit is a secure clip device with Bluetooth, GPS and WIFI connection that allows you to keep your loved one at home and outside the home.

This device also allows you to set a geographic limit (GEOFENCE) around a certain location so that you will receive an alert if the wearer of the device crosses this area. Jiobit also remembers the patient’s movement patterns and alerts when there is a change in them.

3. The Alzheimer Master – one of the social innovations for the treatment of Alzheimer’s.

Alzheimer’s Master is actually an application with the help of which you can record the voice of a familiar and loved person.

By recording your voice you can create a reminder to take medicine, drink water, eat, etc. You can also use these recordings as an alarm clock, so you will prevent your loved ones from a lot of anxiety that can be caused by a normal alarm sound. Hearing the voice of a familiar person can be much more soothing than the sound of an alarm.

Furthermore, the application can record the user’s responses so that you can understand how he is doing by examining the data. Alzheimer’s Master is available for all Android devices at a cost of $10 for full use. You can also download for a free trial period.

4. Amazon’s Alexa (voice activated assistant)

Alzheimer’s patients may reach a point where they feel like a burden on their caregiver or family. Sometimes even simple things like today’s date or time can be regularly forgotten. Dealing with this forgetfulness can create a stressful situation for both the patient and the caregiver.

A voice-activated assistant like Amazon’s Alexa can be very helpful in this regard. A voice-activated assistant can be used for alerts and reminders, playing music, telling jokes and just having an interactive conversation with the patient.

These devices can answer questions non-stop and the questions can be repeated as many times as the patient wants. These advanced technologies can help Alzheimer’s patients feel less alone, and experience more control over their condition.

They can also be used to control things like the temperature in the room and the intensity of the light according to the needs of the patient.

5. Silver Mother (The Silver Mother) – an innovative home sensor for treating Alzheimer’s.

when one of the family members is diagnosed with Alzheimer’s disease; These are the loved ones who find themselves on the standard of caregivers. They soon discover that caring for an Alzheimer’s patient is a full-time job.

You have to monitor the patient’s activity, keep them busy, take care of their safety, make sure they have taken their medication, help them with their daily chores and many other things besides these. The therapist can’t always keep track of everything; This is exactly the point where Silver Mother comes into action.

This device includes several sensors that can help monitor sleep patterns, medication alerts, activities, etc. of the Alzheimer’s patient. The sensors are small and simple and can be used to recognize the patient’s normal behavior patterns, and to receive an alert when there is abnormal activity.

All the sensors are connected to each other through a mother hub connected to the router.

6. Calendar apps

These apps are intended for caregivers; Apps like Google Calendar can be used to keep track of all the tasks the caregiver needs to complete.

The calendar can create automatic reminders for monitoring one’s medication intake; important visits and doctor appointments; And many things besides. Caregivers can also collaborate using the calendar and share tasks with each other; This way, several people can keep track of the appointments and reminders.

7. Improving the quality of life – Spark Memories Radio

– Music has been proven to calm and relieve anxiety and to help improve the mood of people suffering from Alzheimer’s and dementia.

Spark Memory Radio is actually an application that includes a collection of thousands of old songs. Tunes that take us back to the thirties and allow caregivers to schedule a playlist for their loved ones at the push of a button. The app is available for Android and Apple devices and costs $9.99 per month.

We probably have a long time to wait until the day when we wake up to hear about the first cured Alzheimer’s patient. But despite this, with the help of the appropriate technological innovations, we have the ability to make patients’ lives happier, less stressful and as comfortable as possible.

How to deal with a dementia patient, who repeats the same questions?

How to deal with a dementia patient, who repeats the same questions?

Introduction-

One of the most disturbing symptoms of dementia is: the person suffering from dementia repeats the same questions over and over. I will present you 6 ways that will help you maintain your peace in your communication with the patient. In addition, dementia patients will be helped to regulate stress and anxiety.

Why do dementia patients ask repetitive questions?

Most often, the dementia patient repeats the same questions, for two main reasons: a. He just forgot what he asked before. B. He feels anxiety, insecurity and tension which make him ask the same questions to calm the anxiety he is in.

For example: the day before Mom’s doctor’s appointment, Mom asked several times – whose appointment is and when is the appointment? On the day of the appointment itself, she asked the same repeated questions every 20 minutes. Also, a few hours before the actual appointment, she asked every 5 minutes, the same questions over and over again. This is because she became more nervous as the doctor’s appointment approached.

6 tips on how to deal with a dementia patient who repeats the same questions?

1. Live their current reality-

A very common and completely natural mistake is to correct the dementia patient. Also, to remind him that the reality that he forms as correct, is actually not correct.

Below is an example case: Shoshana (pseudonym), lived with her family in Haifa, in 2012, when her room was in the attic. Today, in 2019, her family moved to Nahariya, in an apartment without an attic. Shoshana, now with advanced dementia and asks repeated questions every day about the time when she still lived with her family in an apartment with an attic in Haifa, in 2012.

For example, questions like: “When will Bugs the dog come downstairs to my room?” or “When will you fix the banister on the stairs to my room?”

In the above case, Shoshana got stuck on certain significant events from her past, which causes her to remember them over and over again and therefore she repeats and asks about the same events over and over again.

The response that can be more helpful is to participate in her experience, for example: when she asks questions of the above type, you should respond as if we were still living in 2012 in an apartment with an attic in Haifa.

For example: “The dog is currently on a walk outside with one of the children.” Or one of the children will bring the dog to the attic, to keep you company.”

There can be situations in which the person with dementia will recognize where he is and what year he is living in, and there will be situations where he will not.

Below are interesting books on the subject of dementia:

2. Use white “lies”-

It is recommended to use them, especially in cases where the dementia patients wish to perform tasks that may endanger their lives. For example – let’s take the same lady Shoshana, if she insists on driving a car, because she is sure that she drives well. It is absolutely permissible, in order not to hurt her feelings, to tell her that the vehicle is now in the garage and cannot be used. It is better to give space to their feelings, than to try to explain things to them that they will not understand or remember anyway.

Another reason why you should use a white lie is to prevent them from pain or grief. For example: explaining to Shoshana that her sister has passed away may cause her pain and sadness, which the family members taking care of her will have to deal with. Instead, it’s better to tell her that her sister is out shopping now. Which will cause Shoshana, most likely about 20 minutes later, to forget that this fact has already been told to her and she will ask the same question again.

Using white lies, for the demented person, is a better way than telling him the truth that could hurt him and make him in a bad mood. Especially, when there is a reasonable chance that that person will forget the truth that was told to them about 20 minutes later.

You are invited to join our WhatsApp group – on old age diseases:

3. Distract them-

Dementia patients sometimes have a question stuck in their head and they can’t find ways to get rid of it. The way of action that helps them in these situations is to distract them with an action or a task that needs to be done. For example, let’s take Shoshana’s family, if Shoshana asks the same question over and over again, it is very useful to distract her with a sentence like: “Let’s make the sandwich together”. Or “come fold the clothes with me now” etc.

4. Prepare a white memory board for them –

It is very advisable to prepare a small white board for them, on which they will have a list of what tasks they need to perform during the day. When the tasks are written on the board, the demented person does not need to ask the same questions over and over again, because everything is written in front of his eyes. Even if he asks the same question again, just show him the white board with his tasks for the day and it can calm him down for the next few minutes.

What are the stages of dementia?

What are the stages of dementia?

Introduction-

The onset of dementia is not the same in all patients, nevertheless, doctors have managed to divide the typical course of the disease into seven main stages. The duration of the disease ranges from 3-20 years, with the average period of time being 4-6 years from the diagnosis of Alzheimer’s (dementia)Alzheimer’s (dementia) until the patient’s death.

In the first stages, it is very difficult to notice the existence of dementia. After that, the patient begins to forget small things, such as people’s names, the location of objects that have always been placed in a fixed place. After that, he forgets what he wants to say. Reads a story chapter and forgets that he read the chapter at all. Later, he forgets what he ate for breakfast. Begins to lose interest in hobbies that he used to engage in enthusiastically. Also, also loses interest in the environment in general. Does not recognize people in his immediate vicinity and from here the situation only gets worse.

In this article, the 7 stages of dementia will be detailed for you, so that you can identify which stage of the disease your family member/patient is in. This is in order to make a diagnosis and start treatment on time and also to know how to prepare for each stage.

Sad dementia patient.

Stage 1 of dementia – before the disease –

At this stage, there are no noticeable symptoms of the disease. The patient looks and sounds perfectly healthy. The disease cannot yet be diagnosed at this stage. After that, small symptoms, begin to give their signals. However, these symptoms still seem relatively normal and cannot be associated with dementia.

Also, some symptoms may develop gradually and go undetected for a long time.

Stage 2 – mild forgetfulness that is still associated with age and not dementia.

A slight forgetfulness begins, which does not yet cause the environment to suspect that it is dementia. The patient forgets things such as: forgetting where objects are, locking the door. At this point, it is still difficult for a geriatrician to diagnose dementia.

Stage 3 – mild cognitive impairment that begins to hint at dementia.

The environment begins to notice that a mild cognitive disorder begins, the cases of forgetfulness become more frequent. For example: forgetting where the keys are, finding them and after a few minutes forgetting where they are again. Placing objects in inappropriate places. For example, putting a garment in the kitchen cupboard. The patient tends to forget names, fails to learn new names, has difficulty functioning in society or at work, has difficulty reading and generally has difficulty organizing and planning in advance. This stage lasts between two and seven years.

Stage 4 of the dementia disease – stage of moderate dementia –

A stage where the patient begins to lose orientation in time and space. This is the stage where the geriatrician must give a diagnosis, because the symptoms start to become clear to the environment. Examples of this stage: forgetting what the patient saw and heard on the news. Forgetting what he ate for breakfast that day. Inability to concentrate on one thing for a long time. Losing interest in activities that the patient previously liked to do.

Damage to the ability to think abstractly in complex tasks, damage to the ability to plan activities or perform complex cognitive operations (such as managing a bank account). Also, difficulty remembering personal events from the past, and physical weakness.

Stage 5 of dementia – noticeable cognitive decline that requires getting help.

At this stage the patient suffers from a noticeable cognitive decline, which requires getting help. For example: forget what the address is. Forgetting exactly where the patient is and whether it is morning, noon or evening.


The patient is confused, his ability to perform complex actions deteriorates. In addition, his ability to decide and adapt his behaviour to social norms and rules is impaired.

Nearly 50 million people were diagnosed with dementia in 2017, worldwide. Most of them live in developing countries. The number is expected to double in 20 years.

Stage 6 of dementia – severe cognitive decline.

This is a stage where it is already very difficult for the patient’s family to take care of the sick person alone and in need of help. The signs are: forgetting the identity of his relatives and the people closest to him. Completely forget how to perform daily activities.

At this stage, the patient has difficulty sleeping, begins to lose control over the sphincters, becomes more suspicious, suffers from false thoughts, hallucinations and compulsive behaviors. Also, at this stage, many of the patients tend to go wandering, when they very quickly forget the purpose of going out and may get lost and endanger themselves.

Stage 7 of dementia – most severe cognitive decline –

The patient at this stage loses his ability to communicate and speak. He needs daily help with very simple tasks. He needs help with everything because his muscles and reflexes become inflexible – he cannot get to the bathroom in time, has difficulty walking, sitting and even holding his head and swallowing. This condition usually lasts a few months, but sometimes also long years of inability to function and the need for constant nursing.

In conclusion-

There is an estimate that 75 million people may suffer from dementia by 2030 and 131.5 million in 2050. In any case, only 20-50% of cases in developed countries are identified in statistics. In developing countries the situation is much worse, with the majority of the population remaining undiagnosed during their lifetime. Spreading awareness of the disease and its various stages can significantly reduce the pain and costs required to treat the disease. It’s all up to you, share the important information in the article and spread awareness of the disease today!

The new reform in nursing

The new reform in nursing

Introduction:

From November 2018, the new reform in nursing, shared with the Ministry of Health, the National Insurance and the Ministry of Welfare, was launched. This article comes to explain the new situation in accordance with the reform and to give tools for choosing between the various options. And:

Chapter I- Basic definitions:

When we come to examine what are the main changes in the new reform in nursing, we must define a number of main issues on which it is based.

1. Nursing allowance-

An allowance provided by the National Insurance Institute. Until October 2018, it was possible to receive the benefit in one of the following 2 ways:

A. Employers of Israeli workers – through a nursing company or directly to the bank account (this if the recipient of the benefit has the opportunity to prove that he receives the service of an Israeli nanny for 6 days a week and 12 hours a day).

B. Employers of foreign workers – through a nursing company (see my previous article), or with a direct benefit to the beneficiary’s bank account.

2. A.D.L. test

This is the functional test performed by the National Insurance through nurses coming to the home of the benefit recipient. The test consists of 6 main tests:

A. Getting up and lying down.

B. Mobility.

C. Bathing

D. Dressed.

3. Eligibility levels – 6 established levels:

A. Level 1 – between 5.2 and 3 points

B. Level 2 – between 5.3 and 5.4 points

C. Level 3 – between 5 and 6 points

D. Level 4 – between 5.6 and 5.7 points

E. Level 5 – between 5.7 and 9 points

F. Level 6 – from 5.9 points and above.

Chapter II – The main changes in the reform:

There are 2 main changes in the nursing reform

1. Change in nursing hours according to each level:

Until October 2018, there were 3 levels in receiving the nursing allowance.

Level A- It provided its recipients with 9.75 hours of nursing per week.

Level B- Granted its recipients 19 nursing hours per week when employing an Israeli caregiver and 16 nursing hours for employers of foreign workers.

Level C-Granted its recipients 22 nursing hours per week when employing an Israeli caregiver and 19 nursing hours for employers of foreign workers.

As of November, there are 6 levels for the benefit as written above. (In the rest of the article, the levels will be detailed according to the services that can be received in each of them).

2. Payment amounts when receiving the benefit or a portion of it directly, the amount of money paid to those entitled to the nursing benefit at each level has increased significantly.

Additional nursing services:

  • Laundry (0.25 hours per week for 5 kg),
  • club (2 weekly sessions per day),
  • Emergency button (0.25 hours per week)
  • Absorption products
Level B:
  • hours or a caregiver from a nursing company for 10 hours or a caregiver through a nursing company for 6 hours in combination with a financial allowance of NIS 820 per month.

Level C:
  • A caregiver through a nursing company for 15 hours or a caregiver from a nursing company for 11 hours in combination with a financial allowance of NIS 820 per month.
  • Exceptionally and according to the decision of a social worker referred by the National Insurance Institute, it will be possible to get a caregiver from a nursing company for 10 hours in combination with a financial benefit of 1025 NIS per month.

Additional nursing services:

  • club (2 weekly hours per day),
  • emergency button (0.25 hours per week),
  • Laundry (0.25 hours per week for 5 kg),
  • Absorption products
Level D:

Caregiver through a nursing company for 19 hours. or a nanny from a nursing company for 15 hours combined with a financial benefit of 820 NIS per month, exceptionally and based on the decision of a social worker referred by the National Insurance Institute, it will be possible to receive a nanny from a nursing company for 12.5 hours combined with a financial benefit of NIS 1300 per month. Additional nursing services:

• Laundry (0.25 hours per week for 5 kg),

• Club (2.75 NIS per day)

• Emergency button (0.25 hours per week)

• Absorption prod

Level E:

Caregiver through a nursing company for 23 hours. Or a caregiver from a nursing company for 19 hours combined with a financial allowance of NIS 820 per month. Exceptionally and according to the decision of a social worker referred by the National Insurance Institute, it will be possible to get a caregiver from a nursing company for 15.5 hours combined with a financial benefit of NIS 1570 per month. Additional nursing services:

• Laundry (0.25 hours per week for 5 kg),

• Club (2.75 per week per day),

• Emergency button (0.25 hours per week)

• Absorption products.

Level 6:

Caregiver through a nursing company for 28 hours. Or a caregiver from a nursing company for 24 hours combined with a financial benefit of NIS 820 per month. Exceptionally and according to the decision of a social worker referred by the National Insurance Institute, it will be possible to get a caregiver from a nursing company for 18.5 hours, combined with a financial benefit of 1910 NIS per month.

Additional nursing services:

  • Laundry (0.25 hours per week for 5 kg),
  • Club (2.75 per week per day),
  • Emergency button (0.25 hours per week)
  • Absorption products.

Chapter 3 – The services that can be received at each of the levels for benefit recipients who need 24-hour supervision.

Benefit recipients who employ foreign workers (and/or benefit recipients who employ Israeli workers for 6 days a week, for 12 hours a day), can choose whether to receive the money through a nursing company or through a direct benefit. In my previous article on this matter, I showed that there is a gap expressed in thousands of shekels per year between the employers who choose to receive the benefit directly, and those who receive the benefit through the nursing companies, therefore, we will not focus on that in this article. However, it is important to note the amounts of money paid by the National Insurance Institute to direct benefit recipients as follows:

Chapter 4 – Holocaust survivors 9 nursing hours

Holocaust survivors recognized by the Authority for the Rights of Holocaust Survivors and/or the Claims Conference are entitled to an additional 9 hours of nursing care per week beyond the nursing benefit provided by the National Insurance.

Eligibility for receiving these 9 hours is meeting a rating of 6 ADL points (level 3 as above) in the dependency test and in addition, in that the nursing allowance is not reduced due to income.

According to the new reform, those Holocaust survivors, who are entitled to this supplement, can receive this benefit financially directly to their bank account, which will add 1842 NIS to them every month.

The option to choose a direct benefit is only given to those who employ a 24-hour caregiver.

Chapter 5 – Considerations for receiving compensation in money or directly:

When it comes to receiving part or all of the benefit directly, we must take into account a number of factors that influence the decision:

1. Bureaucracy-

The nursing companies claim more than once that a benefit recipient is directly “alone” with the employees he employs. This assumption is devoid of any foundation since the corporations and private bureaus are responsible for the employment of the foreign workers. The nursing company has no responsibility towards the foreign worker. With the exception of the payment of the salary, she has no connection with him, even though she is considered his employer, the recipient of benefits and the holder of the license is the main employer. Therefore, he must manage the employment of the caregiver regardless of the nursing company.

In fact, the nursing company is a body that stands in the way between the recipient of the benefit and the employee, thus hindering the transaction. Therefore, the recipient of the benefit must know that, in any situation in which he employs a caregiver, he must treat it as a full employer and, therefore, must manage the employment as required by law. The nursing company will not give him the help he needs once the employee ends the employment. On the contrary, in most cases the recipient of the benefit learns that the nursing company did not give him the information he required as an employer and he is left alone in front of the workers’ organizations, led by “Ko Le Oved”.

2. Sharing family members-

As a result of the fact that the employment of a 24-hour caregiver requires the benefit recipient to manage the employment, it is very important for the family members to participate in this employment. This sharing can often be the difference between a successful deal and a failed deal. The family member managing the employment will be the one who deals with all bureaucratic matters in front of the employee and the various authorities. Any problem of the employee will be directed directly to the family member and the patient will be able to be the one who receives the service without disputes or conflicts regarding wages, conditions, vacations, etc.

3. The ability to use the payment received directly to finance nursing care-

According to the new reform, those Holocaust survivors who are entitled to this supplement can receive this benefit in monetary form directly to the bank account, which will add 1842 NIS to them every month.

The option to choose a direct benefit is only given to those who employ a 24-hour caregiver.

Unfortunately, many elderly people in the country do not “finish the month”. In such a situation, every amount of money, even the smallest, that goes directly to the bank account of the benefit recipient, is used for day-to-day financing and not for nursing care. Be and the family members are involved in the administration of the benefit, after all, they must act wisely and not use the money to buy products from the grocery store.

It must be taken into account that when the benefit recipient reaches a nursing situation, in most cases the situation is not reversible but only worsens and as a result, the nursing expenses increase. Various devices, medicines, hiring a 24-hour employee, receiving a private consultation from a specialist doctor, etc. cost a lot of money. Therefore, the more the family members involved save the money received directly and save it for the day they need it, the better off they will be.

A number of examples are given:

per month, the cost of employing a foreign worker is currently around NIS 9,000 per month. A private home visit by a specialist doctor (NIS 1,000-1,500 and double that in some areas). A wheelchair privately, 5000-3000 NIS. A benefit recipient who receives care from a nursing company and combines with the care a monetary benefit and saves the amount he receives directly actually prepares the ground for a better future for him.

Chapter 6 – Summary:

The new nursing reform gives the recipients of the nursing allowance many new options. There is no doubt that much thought was put into the reform in order to give more to the recipients of the nursing allowance. The change in treatment levels and the increase of hours at each level allow the recipient of the benefit to calculate and plan his steps forward – which was not part of the options until today. Correct planning and making the appropriate personal decision for each benefit recipient are a cornerstone in reaching the third age or a nursing situation. It is possible to ask whether the new reform is sufficient and the answer is likely to be no and there are many other things that need to be done, but there is no doubt that the new reform is an important first step in creating a comprehensive solution for seniors who are in nursing care.

The post was written by: Mordechai Seig, CEO of the SLA company – Aid, counseling and guidance for the elderly.

The six functional states in the adult community.

The six functional states in the adult community.

Different functional states in a person are determined in relation to his ability to perform basic actions called day-to-day actions. These actions are: dressing, eating, controlling braces, bathing, moving around and making transitions between positions (for example from lying down to sitting) independently at home.

These actions that seem “basic” to us begin to take on a different meaning when we reach old age. Also, with the elderly I take care of, they are not basic at all.

There are six functional states in the elderly based on the definitions and laws in the State of Israel. These definitions will determine which of the authorities is responsible for financing the out-of-home living arrangement of your parent or relative. In other words, according to the functional status, it is possible to determine where the person will live and what the conditions of his care will be.

Therefore, the importance of understanding these functional situations is very great.

מצבים תפקודיים בקהילת המבוגרים.

1. Functional modes: independent-

Self-employed is someone who does not need help at all in day-to-day activities. Those who function on their own in an optimal way in each and every one of the activities. Therefore, he does not need the help of a person or a device (such as a walker, etc.) to maintain his lifestyle. Independent people, live without difficulty among the community in which they live, or if they chose to do so within the framework of sheltered housing.

If the older family member who is independent, feels lonely and is interested in a nursing home suitable for the independent. However, he does not have the financial ability to pay for the institutional housing, he must contact the office responsible for the elderly at the bureau of social services in his city.

He must ask her to help him begin the process of financing his stay in the institutional housing where he wishes to live.

To start the process, you will need to bring documents detailing the income of the older family member and his children. If the older family member owns an apartment, the cost of renting it will be taken into account. The welfare services usually transfer all the income of the older family member to them by standing order.

So he has about NIS 500 left in his account for monthly pocket money during his stay in the nursing home. The children will also be charged a participation amount based on the calculation of their income scale. It is important to know: there are nursing homes under the supervision of the Ministry of Welfare today that accept elderly people at the request of the Ministry of Welfare.

2. Functional conditions: exhaustion or body exhaustion-

When the level of functioning decreases and the ability to function independently in day-to-day activities is impaired, the elderly person moves to a new functional state called exhaustion, or body exhaustion. In this situation, the elderly no longer function completely independently, sometimes needing the assistance of a walker for mobility, help with bathing, etc.

How will we recognize that an elderly person has gone from a state of independence to exhaustion or physical exhaustion? When he needed help with 2-3 ADL activities (daily). For example – needs a walker and supervision in the bath. If your family member who is defined as debilitated or physically debilitated, is interested in a nursing home for the debilitated. In addition, he needs financing for his stay in a nursing home for the elderly, the process for receiving the financing is exactly similar to the process that takes place with an independent elderly person

3. Functional situations: nursing-

Only when the elderly is unable to function and needs full help in most ADL activities (activities of daily living) is he defined as nursing. That is, when he is confined to a wheelchair, does not control the braces, needs full help in bathing and dressing, he is defined by the authorities as nursing.

It is important to note that there is no connection between the physical state and the mental-cognitive state and an elderly person can be nursing and also completely lucid. In order to get help and make it easier for the elderly, long-term care health insurance should be taken out so that the expenses are reduced and the help is greater.

In addition, if the nursing family member needs help financing his stay in a nursing home, it is necessary to contact the website of the Ministry of Health. Forms must be downloaded from this website in order to obtain the Ministry of Health code. In addition, there is a list on the website of all the forms required to obtain the code for the Ministry of Health.

Collect all the required documents and submit them to the Ministry of Health as soon as possible. The process usually takes about two months until you can get the hospitalization code. If there is no choice and the family member must be rushed to a long-term nursing home, there are nursing homes that provide the option of pre-cod. That is, a partial payment given to the nursing facility for two months until the code is received from the Ministry of Health.

4. Functional situations: temporary nursing – a person in a rehabilitation situation –

Sometimes when an elderly person becomes nursing due to medical activity (for example surgery) but has rehabilitative abilities. For example, after the medical activity and with the help of proper guidance and training in a rehabilitation institution – he may return to a higher level of functioning. The definition of this functional state is temporary nursing.

In order to receive funding for a rehabilitation institution, it is necessary to contact the health insurance office in the area of ​​residence or the office at the hospital where the elderly is hospitalized. The social security office will help in finding a rehabilitation institution according to the area of ​​residence and the health fund of the elderly.

5. Complex nursing-

Patients who are nursing based on their function and in addition to that, special medical treatment is necessary for them. Below are some examples of medical conditions that may lead to hospitalization in a complex nursing setting:

1. Pressure sores of severity level 3-4.

2. Need for fluid infusion and/or intravenous drug therapy for an extended period of time.

3. Respiratory problems that require respiration, inhalations or inhalations more than once a day.

4. Dialysis or hemodialysis, a person suffering from a malignant disease and needs close medical monitoring and/or pain management.

If you wish to go to a complex nursing department in a nursing home, permission is required from the geriatrician responsible for this issue at the health fund. The referral to the geriatrician is made through the family doctor for the person living in the community or through the social service of the hospital if the person is hospitalized.

6. Exhaustion-

The definition of mental exhaustion does not concern the physical condition of the elderly at all, but the degree of his clarity. A person is diagnosed with dementia, when his level of dementia increases and his orientation in time, space and person decreases. The decrease in orientation levels is such that he needed constant supervision.

It is important to note that a debilitated person is not a mentally ill person but someone whose cognitive level is impaired due to diseases related to old age (Alzheimer’s for example). Although various tests to check the soundness of an elderly person (mini mental tests for example) are conducted by various parties, a qualified diagnosis accepted by the authorities is given by a psychiatrist who specialized in geriatrics only.

If the elderly person lives in the community, his family members should contact the family doctor in order to receive a referral to a psychogeriatrician. Also, if the elderly is hospitalized, a psychogeriatrician at the hospital performs a diagnosis in order to determine the functioning of the family member as a mental retardation.

After determining that the elderly person is mentally ill, the family must contact the health insurance office if the elderly person lives at home, or the hospital office. This is in order to help find a suitable institution for the mentally ill and to help start the process of receiving a hospitalization code from the Ministry of Health. The body that finances institutional arrangements for the mentally ill is the Ministry of Health, below is the link to the website of the Ministry of Health

In conclusion-


The different functional situations require different preparation of the elderly and his family members in order to continue the routine of life as much as possible. This, in order to enable the best and most appropriate care for each elderly person.

Article: Irit Rabinowitz, attorney M.A. degree in health and rehabilitation.

ששת המצבים תפקודיים בקהילת המבוגרים.
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