Understanding identity is key to supporting the Jewish community

Culturally appropriate care should be part of personalised care planning, but it isn't always the case. Natalie Valios talks to Jewish Care about the charity's role in making it happen

Photo: Dmitry Pistrov/Fotolia

Stepping out at Brent Cross tube station, you don’t need to walk far to notice that you are in the heart of north London’s Jewish community. Kosher shops abound and many of the men in the local area are dressed in variations of the traditional Charedi dress – high-crowned black hats, ringlets and frock coats.

Just round the corner is charity Jewish Care’s Michael Sobell Jewish Community Centre. It is part of the impressive Maurice and Vivienne Wohl Campus on Golders Green Road which, as well as the community centre, consists of:

  • Otto Schiff, a 42-bedroom specialist care home for older Jews with dementia.
  • Selig Court, purpose-built independent living apartments for rent with one or two bedrooms and access to round-the-clock support if needed. Priority is given to Holocaust survivors and refugees from Nazi persecution.
  • Facilities including: Booba Brenner’s shop (booba is Yiddish for grandmother and the shop is named in memory of the original Booba Brenner shop in Stamford Hill) which sells a variety of kosher food, gifts and cards; a café and restaurant; a hairdressing and beauty salon; a library; an arts, craft and pottery studio complete with kiln; a varied entertainment programme (while I’m there the weekly current affairs discussion group is in full swing); book and film clubs; access to a chiropodist, and hearing and optical clinics; and communal celebrations of Jewish festivals.

Jewish Care supports about 7,000 people every year across London and south east England and as many as 1,000 make use of its six community centres each week for a nominal membership fee of £30 per year.

As you enter the centre’s lobby there is huge mural covering one wall depicting images from the Old Testament with Hebrew language that members will recognise and instantly feel connected to. Black and white photos of streets and Jewish people in London’s East End during the early 1900s hang along the corridor walls.

Photo: Natalie Valios

Photo: Natalie Valios

Walking through the centre’s café and lounge area, the atmosphere is friendly and relaxed; groups play rummicub, bridge and cards, others chat over tea, coffee and cake, or read the papers by themselves.

Playing rummicub. Photo: Natalie Valios

Playing rummicub. Photo: Natalie Valios

Comfort of community

Taking an individual’s ethnic and cultural background into account should be an integral part of personalised care planning. But sometimes, providers and commissioners think it enough just to provide a kosher meal in an otherwise non-Jewish residential home with no thought for any of the other considerations which make up that person’s identity. This is why so many Jews turn to Jewish Care, and consequently why it is the largest provider of health and social care services to the Jewish community in the UK.

There are obvious reasons why Jewish people look to culturally appropriate care as they age. Firstly, there are the religious laws and rituals, which commonly become more important in later life even if the person hasn’t particularly adhered to them during their life. But, says Neil Taylor, the charity’s director of care and community services, the second part is about identity, “the far more implicit nature of the community, its history, its connection and its culture which is far less easy to describe and is nuanced”.

The comfort of community and understanding cannot be underestimated, he says. “My grandfather had a fierce Jewish identity but didn’t attend synagogue or eat kosher food, but there was only one choice he was going to make when going into a care home and that was that it would be a Jewish one. People would understand him and it’s that sense of belonging – you don’t have to explain your history because it is shared.”

Language is another shared identity. So while Yiddish isn’t strongly used in non-Orthodox communities, for many Jews Yiddish words are nevertheless interspersed in conversation and they are also a throwback to their childhood.

Many older Jewish people return to their faith in the latter years of life, even if they haven’t lived according to Jewish law until then. It’s not unusual for them to want to be buried in a Jewish cemetery according to Jewish laws and practices whereby burial takes place as soon as possible after death, usually within a day or two. The burial is followed by a week-long mourning period known as a Shiva. During Shiva, mourners remain at home and the Jewish community comes and offers comfort to them, joining them for daily prayer.

Discrimination and prejudice

Even in a home care situation, where you might question the importance of culturally appropriate care when someone is coming into your own home for minutes at a time, an understanding of the person’s faith is key to good care, says Taylor.

“When our staff go into someone’s home they understand the significance of two lit candlesticks on a Friday [to mark the beginning of Sabbath]; the significance of a memorial candle that could be alight in the home, or the eight-branch candelabra – known as the menorah – being lit on the festival of Chanukah; as well as the kosher dietary law that prescribes keeping meat and dairy products separate when preparing, cooking and eating food, as well as the cutlery and crockery used to eat them.”

Dining at the Michael Sobell Jewish Community Centre. Photo: Natalie Valios

Dining at the Michael Sobell Jewish Community Centre. Photo: Jewish Care

The Sabbath is a very strong element of the Jewish faith and this is reflected at Jewish Care in that it’s a rest day; the offices aren’t open on a Saturday, and care home managers are asked not to send emails.

The rhythm of their care homes changes at Sabbath and during festivals. For example, TVs are not switched on in communal areas although individuals can choose to watch programmes in their own room. This practice has its limits though.

“If there is a risk of serious harm we can break our rules, the sanctity of life is the most important thing and it overrides everything,” says Taylor.

For Jewish people, arguably more than most, their identity is born out of a common experience of discrimination, prejudice and anxieties around anti-Semitism.

It would be difficult for a non-Jewish organisation to truly respond to the needs of Holocaust survivors and refugees. Those who grew up in the east end of London through Moseley and the Second World War, the people we care for, have a great deal of past experiences and trauma,” says Taylor.

As an example he cites an outbreak of lice in beds at one of the charity’s independent living facilities. Across the flats this triggered a memory of being in death camps for many residents. “It generated a great deal of anxiety and our staff’s ability to understand that and respond with sensitivity and compassion was significant. Staff went into counselling mode in a way that others might not have done,” he explains.

Paula Plaskow, north west community support and social work team manager, recounts a story of a Jewish woman who was sectioned because she hoarded food, particularly lumps of bread. “She had been in a concentration camp, so when the approach to deal with her was changed to allow her to hoard food, she calmed down. It’s about understanding why.”

Working with synagogues

As a rule, Jewish people turn to their own for help and generally won’t approach social services. Jewish Care’s helpline is often their first port of call. Each year the helpline receives over 15,000 inquiries. The confidential helpline is run by a small team of advisers providing support and information on a range of issues. Three-quarters of calls are answered directly by the helpline advisers, with the remaining 25% referred on to the organisation’s social work team.

The helpline team carry their own cases in situations where social work input is either not needed, because the person just needs some basic information or signposting elsewhere, or where the person calling doesn’t want to be referred. When a person would benefit from a referral but declines this service, the advisers will sometimes make follow-up calls in the hope that the person may come to trust them and change their mind.

The charity’s community support and social work (CSSW) team has 12 social workers and nine community support workers covering London and the South East. The majority of their caseload supports members of the Jewish community living at home. They are also involved in admissions to Jewish Care’s care homes.

Additionally, the CSSW team is split into branches in different areas and each branch links with the synagogues in their locality – through the synagogues’ welfare coordinators – to offer advice and information, which often generates new referrals.

Plaskow works in Barnet, Brent and Ealing. “Welfare coordinators are approached by members of the synagogue if they are struggling with health or social care issues but they don’t want to go to the local authority for fear of stigma and not wanting others to know they have issues.

“To start with they often don’t want to go straight to Jewish Care either because they don’t feel confident, so they go to the welfare co-ordinator who speaks to the social worker. So there is strong collaboration and then eventually you will get a referral. It could happen quickly, or it could take a few months.”

Jewish Care sees working with synagogues as community social work at its best. When assessing clients, social workers ask questions to try to understand the individual’s personal journey and background in order to deliver personalised care – for example, where they were born; where they grew up; when they arrived in the UK; whether they have siblings, a partner or children; and whether they belong to a synagogue.

Art room at the Michael Sobell Jewish Community Centre. Photo: Jewish Care

Art room at the Michael Sobell Jewish Community Centre. Photo: Jewish Care

They find out whether they have a community they can work with to help support them or whether they are isolated, and ask where they feel most comfortable and understood by those around them – this can be a vital part of establishing whether they have an existing support system.

They also look at whether aspects of culture, foods and sounds – such as traditional prayers or songs in Hebrew; songs connected to ritual and festivals like prayers over wine on the Sabbath; those sung together from a young age while lighting the candles on the festival of Chanukah, or around a festive meal at Passover – remind them of their younger days that could be revisited.

Almost two-thirds of residents in Jewish Care’s care homes are local authority funded. The charity’s social workers provide an advocacy role on their behalf, as well as for self-funders, to ensure they receive the culturally appropriate outcomes they are seeking.

The team has information on and contacts with a range of local services both within and outside the Jewish community. If there is no availability at Jewish Care’s homes or from its services, its social work team refers to other Jewish homes and domiciliary care services.

“Our social workers are at the heart of what we do,” says Taylor. “They understand what’s on offer and what someone is looking for when they need support.”

Training

Jewish Care’s services

The charity is the largest health and social care provider for Jewish people in the UK, working across London and south east England, touching the lives of 10,000 people each week. It has 1,500 staff and 3,000 volunteers.

It provides:

  • nine care homes for older Jewish people, the majority of which support people with dementia;
  • one residential home for Jewish adults aged 18-65 with physical or sensory disabilities;
  • two residential homes for Jewish adults with mental health support needs, one for young adults and the other for those over 50;
  • two sets of independent living apartments with 24-hour support available.
  • three day centres for people with dementia;
  • a Holocaust Survivors’ Centre;
  • six community centres;
  • a home care service;
  • respite care at several of its care homes;
  • four Memory Way cafés; and
  • a helpline: 020 8922 2222 or email helpline@jcare.organd Jewish Care Interact, an online service for the Jewish community jewishcareinteract.org

Dementia care

Case study

Hannah and David (not their real names) have always been heavily involved in their north London Jewish community; Hannah was a yoga teacher and David was involved with their synagogue’s community work.

David came across Jewish Care about 30 years ago when he went to his great uncle’s 100th birthday party at the charity’s residential care home Rubens House in Finchley. Later, one of his aunts and Hannah’s mother went to live in another of the charity’s homes.

“When I retired, Hannah thought she would do some community work and I thought about Jewish Care and Rubens House which wasn’t far from where we live. Hannah started teaching yoga with residents sitting on chairs and in wheelchairs. I used to take her and when staff found out my profession – a tailor – they asked me to do various jobs like alter clothes. And while I was there I’d always play dominoes with residents, that was my job!”

After Hannah had a couple of falls she could no longer teach yoga and then in 2012 she was diagnosed with dementia and David found himself in the new role of carer. Rather than volunteering for Jewish Care and supporting others, now it was their turn to seek help and because they had a long-established connection with the charity it felt like a natural progression.

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