MetroWest pioneers a community-based nursing service, but the concept has been slow to catch on in the Jewish world

 

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 said, to caring for her elderly Jewish patients, body and soul.

“I visit one old man with dementia,” she said. “When he sees me he cries out ‘Misheberach,’” — the Jewish blessing for restored health — “and I sing him the Debbie Friedman song of that name. I hold his hand and he weeps.”

Frank is a congregational nurse for five synagogues in the MetroWest area. She works one day a week at Temple B’nai Abraham in Livingston and Congregation Agudath Israel of West Essex in Caldwell, and on a regular but less frequent basis at Temple Ner Tamid in Bloomfield, Morristown Jewish Center Beit Yisrael, and Temple Shalom in Succasunna.

She also puts in time at the MetroWest Jewish Health and Healing Center, a joint program of the Leon & Toby Cooperman JCC, Ross Family Campus, West Orange, and Jewish Family Service of MetroWest. There she provides 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 2000-01 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 mitzva of bikur holim, or visiting the ill, to the growing popularity of Jewish healing centers like the one Frank serves.

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 longstanding 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 one who works at the job full-time.

Why is that? Part of it might be cultural, suggested Wendy Bocarsky, founder and chair of the Reform Jewish Nurses Network, a three-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 said. “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 added, chuckling, “a pain in the butt.”

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 half a 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 said, 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,” said congregant Sandy Krebs, a chaplain at a local hospital who spearheaded the program.

Krebs noted 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., said 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 said. “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 said, “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 said. Some think creatively and get together across institutional and denominational lines. 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 Reform and Conservative synagogues and JCC MetroWest, each of which gets her services a certain number of days per month.

‘Hope and courage’

In Springfield, Reform, Conservative, and Orthodox congregations split the costs for nurse Jackie Herzlinger, a member of one of the sponsoring congregations who now works as a community nurse for all three. Herzlinger initiated the program with a group of people at Sha’arey Shalom, a Reform congregation, and — with initial funding from the Healthcare Foundation of New Jersey and the Wallerstein Foundation — expanded the program — now called Three Congregations Nursing Program — to the other two synagogues.

“This program is about taking care of our own, our Jewish own,” said Rabbi Chaim Marcus of Congregation Israel of Springfield. “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 asked. “Mental health is where it’s at: We can’t cure everything, but we can give people hope and courage.”

In her five years as congregational nurse, 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 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 said. “She felt God had abandoned her. We fashioned prayers together, prayers like, ‘God, why have you left me? I feel so lonely.’”

Frank said 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 told 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,” said 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.”