WEST ORANGE, N.J. (Dec. 28)
When home-care nurse Karen Frank makes a house call, she brings a Book of Psalms along with her stethoscope and blood-pressure monitor. All three are essential tools, she says, to help care for her elderly Jewish patients, body and soul.
“I visit one old man with dementia,” she says. “When he sees me he cries out ‘misheberach,’ ” the Jewish blessing for restored health, “and I sing him the Debbie Friedman song. I hold his hand and he weeps.”
Frank is a congregational nurse, hired by five synagogues and the MetroWest Jewish Health and Healing Center, a joint program of her local Jewish Community Center and Jewish Family Services, to provide physical and spiritual care to elderly Jews in the community.
There’s a tremendous need for nurses like Frank as the American Jewish population ages rapidly. According to the 2000-2001 National Jewish Population Survey, one-quarter of America’s 5.2 million Jews are 60 or older, and those 75 and older are the fastest growing segment.
Taking care of the sick always has been an integral part of Judaism, from the mitzvah of bikur holim, or visiting the ill, to the growing popularity of Jewish healing centers such as the one that sponsors Frank.
But the Jewish community has been slow to embrace the concept of congregational or parish nursing, which views nursing as a service that a congregation should provide to its members. Parish nursing is a long-standing tradition in the Christian world, dating back to the Middle Ages.
There are more than 8,000 Christian parish nurses in this country, but fewer than 10 Jewish congregational nurses. Frank is the only full-time one.
Why is that? Part of it might be cultural, suggests Wendy Bocarsky, founder and chairwoman of the Reform Jewish Nurses Network, a 3-year-old Los Angeles-based group that tries to bring together nursing and Jewish text skills.
“Jews tend to be very educated health-wise,” she says. “Even if there’s a nurse on staff in a congregation, people are going to call their doctor directly. In churches, people have a different relationship with their doctor; they tend to be more trusting. Jewish patients are,” she adds, chuckling, “a pain in the butt.”
Half of Frank’s budget comes from the Healthcare Foundation of New Jersey, which seeded the project five years ago. The rest is shared between the synagogues and the JCC, each of which gets her services a certain number of days per month.
In her five years in the role, Frank has seen 1,170 patients. Her current caseload is several hundred people.
She recently hired a part-time nurse out of her grant money, with extra funding from the Grotta Foundation for Senior Care, to serve three neighboring congregations.
“We go into the home as representatives of the synagogue,” Frank said last August in Seattle at the national convention of the Coalition for the Advancement of Jewish Education. “We are not from MediCare or the hospital, we are Jewish nurses from their community. We check if they’re eating, if they’re clean, can they get to the bathroom, as well as being a professional Jew who can read psalms and discuss God with them.”
One former client was depressed following a series of debilitating health problems.
“We talked about God a lot,” Frank says. “She felt God had abandoned her. We fashioned prayers together, prayers like, ‘God, why have you left me? I feel so lonely.’ “
Without such care, that loneliness could be filled by Christian missionaries, says Judith Berland of Springfield, Va.
“Jews for Jesus are going into the nursing homes and talking to the people we have forgotten,” she says.
Rabbi Richard Address, director of the department of Jewish family concerns of the Union for Reform Judaism, is an active proponent of community-based nursing, but he knows of fewer than a half-dozen congregations that have bought into the idea.
When Bocarsky ran a training program for prospective congregational nurses last year at Hebrew Union College’s Los Angeles campus, Address notes, just a few students signed up.
B’nai Jehoshua Beth Elohim in Glenview, Ill., hired a congregational nurse five years ago, using a $25,000 gift from a congregant. When the gift ran out it was promised again, but the synagogue board didn’t renew the program.
“I wasn’t able to convince them,” says congregant Sandy Krebs, a chaplain at a local hospital who spearheaded the program.
Krebs notes that two other nearby synagogues hired congregational nurses: One lasted a year, one for two years. When the initial grants ran out, neither congregation continued funding the positions.
Bocarsky, who volunteered as her congregational nurse for 14 years at Temple Beth Sholom in Santa Ana, Calif., says the Jewish community needs to recognize that health-care delivery has changed, and that the most vulnerable people are falling through the cracks.
“People are discharged too early from hospitals, and they’re still sick when they get home,” she says. “The synagogue needs to pick up the slack.”
Some people say other health-care methods are better. Sharona Silverman is director of the Deutsch Family Shalom Center, a Jewish healing center at Temple Chai, a 1,100-member congregation in Phoenix. The center provides healthcare resources, hosts lectures and support groups, houses the congregation’s bikur holim committee and runs what Silverman calls “services of peace and comfort.”
They hired a community nurse for a few months nine years ago, she says, “but it wasn’t necessary, this takes care of our needs.”
Very few Jewish institutions are prepared to cough up $20,000 for even a part-time nurse, Address notes, but some think creatively and get together across institutional and denominational lines. Frank is sponsored by Reform and Conservative shuls, as well as the JCC.
In Springfield, N.J., Reform, Conservative and Orthodox congregations split the costs for Jackie Herzlinger, a member of one of the sponsoring congregations who now works as a community nurse for all three.
“This program is about taking care of our own, our Jewish own,” says Rabbi Chaim Marcus of Congregation Israel, Springfield’s Orthodox synagogue. “It’s not about denominations.”
Three years ago Herzlinger secured a grant, and was able to hire two part-time nurses to help her.
“Why shouldn’t we be helping our people feel good?” she asks. “Mental health is where it’s at: We can’t cure everything, but we can give people hope and courage.”
Frank says her home visits are a way for synagogues to “reach out into people’s homes when people are no longer able to access the synagogue.”
Frank tells of her first trip to see one 97-year-old woman. When she introduced herself as the congregational nurse, the woman said sharply, “it’s about time the congregation realized I’m still a member.”
“Karen has always been there to listen, advise and comfort me when I needed someone to talk to,” says Claire Bornstein, a woman in her 80s whom Frank visits regularly. “At this point in my life I am very much alone, and she has filled my life with encouragement and kindness.”