A family dilemma
Sharing the Burden
“I felt like I just couldn’t do it anymore. The strain of all my many responsibilities nearly crippled me. How could one woman, who also has fifteen children and ten grandchildren and works full-time outside of her home, also take care of her elderly parents in such an intense way, and also serve as a full-time nurse, a 24-7 social worker, and full time aid?!”
(Yehudit, a mother and grandmother in her early fifties)
Rabbi David Levine, director of the social services department at Mayanei Hayeshua Medical Centre in Bnei Brak, is well familiar with the situation and distress which Yehudit expresses. “Many ‘children,’ some of whom have great-grandchildren themselves, are torn between their own homes and caring for their parents, when there really is no other alternative.”
Although patients generally stay in the hospital for a relatively short period of time, Rabbi Levine, like many of his colleagues, has seen family dilemmas cropping up at the hospital – where the question of how to divide the burden between family members nearly always comes up.
“It’s easy for me as an outsider to notice family dynamics. Many times, the need to start caring for an elderly or unwell parent causes a rift between the children, or between some of the children and their spouses. This happens when most of the burden falls on one child with the others doing a far smaller share of the work. Sometimes the spouse might openly oppose it, but other times the opposition is covert.
“I think that not always is there a connection between what people say and the real reason for the rift. It’s not easy to take care of aging parents, but if the children never got along with each other thirty years ago, what would you expect now?
“A hospitalisation might bring old rivalry to the surface, or new dilemmas that arise due to the recent deterioration; especially if the elderly patient’s spouse remains at home and also needs assistance, and the children are dividing their energies between the parents. But not always is this situation really the main reason [for the rift].”
As these family dynamics are exposed and stress levels rise, the hospital’s social services team tries to refer the family to a rabbi to advise them on how to best share the burden. Sometimes, it may actually be the son or daughter who has taken on most of the responsibility who needs to let go somewhat, and when that is not possible, a resolution might be reached in which they may cut the number of visits or take additional household help to assist with the physical labor and ease some of the burden.
“We encourage the family members to talk, and then suddenly the dam bursts,” says Rabbi Levine. “Many times, the fact that we are listening is enough to relieve the pressure; just the simple act of sharing helps ease things. But many times we can also advise the family on how to maximise the assistance they can get from the government, the elderly parents’ rights, the benefits of keeping the father or mother in their own home with a full-time aide versus sending them to a nursing home, and so on.
“Of course, we leave it up to the family to make the final decision, but when you explain the options clearly it makes things much clearer.”
The opposite situation can occur as well – the ignoring, quarreling, or petty children who prefer to continue the same old fight and reject those people who should be dearest to them.
“First of all, despite what we might like to think or believe, there are cases of neglect even in frum society,” notes Rabbi Levine. “We’re not talking only about lonely people who have no family, but even about parents in normal families, who for some reason are abandoned by their children.
“We usually discover this accidently, when an elderly patient is brought to the hospital and we notice that there are no children coming to visit or see how he’s doing, or if we see them only rarely. Then we discover that this disconnect is actually part of a much older rift, which can be due to financial issues, unjustified feelings of one of the children, sibling rivalry, or a thousand other reasons.
“To us, it certainly makes no difference when the fight began or why. What we are concerned with is the aging father or mother who has reached the stage in which they need their children, but their children are turning their backs on them.”
What do you do in such cases? Are you allowed to intervene?
“Many times, the medical team will notice that the elderly patient has no visitors, and when they try to ask the patient for his children’s numbers and actually call them, they become aware of the painful truth – that there is raw pain here that affects the current relationship between the parents and their children. But many times it is the elderly patients themselves who alert the attending staff to the problem.
“An integral part of our work at the hospital is to give the elderly patients emotional support. We try to help, and can sometimes offer to have a rabbinical or public figure serve as an arbitrator. Some people are thrilled with the opportunity to have us help them end the fighting, but when we encounter a hostile response of ‘It’s not your business’ we back off.”
To illustrate, Rabbi Levine describes a certain old, Russian man who lay in the hospital for a long time without any visitors coming to see him. The hospital’s social workers contacted the family and found out that the man had two children, both of whom were uninterested in a relationship with their father.
“The old man’s condition did not allow for him to be sent back home, but the children refused to hear about caring for him. After many conversations, we found that the daughter was willing to have him move to a nursing home near her home. At the same time, we contacted the government social services and the Health Ministry to arrange for a nursing home in the daughter’s vicinity.
“It is important to realise that even when children refuse to lend a hand, there is no reason for the elderly patient to suffer. There is always the option of the government appointing an independent guardian. Sometimes it’s enough to simply raise this option as a threat, and the children are willing to do everything to avoid that, because they know that no obligations means that there are no inheritance rights either.”
In the last week of November 2019, Professor Rael Strous, the South African-born medical director of Mayanei Hayeshua’s Mental Health Centre, and professor of psychiatry at Tel Aviv University’s Faculty of Medicine, was in London for a busy round of meetings and events organised by the British Friends of Mayanei Hayeshua.