Benefiting our Community

Benefiting our Community

The Jewish Home has a tradition of service to the community at large – to the frail, elderly, and under-served; to vulnerable populations; to intergenerational groups, interns and students.

This history of benefiting the community is fundamental to the Home’s initiatives and philosophy, and informs its membership in “Building a Healthier San Francisco” – a collaboration of San Francisco hospitals, Department of Public Health, United Way, human services’ providers, philanthropic foundations, and numerous community-based organizations.

The following gives an overview these community services. Download our most recent Community Benefit Report for a complete account.

INTRODUCTION

Founded in 1871, the Jewish Home of San Francisco is a private, not-for-profit geriatric center dedicated to the care and treatment of older adults who are typically over the age of 65 and who primarily reside in the greater Bay Area. In some instances, individuals are accepted from out of state. The Jewish Home has grown into a complex with five distinct buildings, serving more than 375 residents from different populations and with diverse care needs. Non-residential care is offered through the Home’s short-term and rehabilitation services unit (STARS) and acute psychiatric services.

The Home has a tradition of service to the community at large – to the frail, elderly, and underserved; to vulnerable populations; to intergenerational groups, interns, and students. This history of benefiting the community is fundamental to the Home’s initiatives and philosophy, and informs its membership in “Building a Healthier San Francisco” – a collaboration of San Francisco hospitals, Department of Public Health, United Way, human services’ providers, philanthropic foundations, and numerous community-based organizations.

We are pleased to share with you an overview of the Jewish Home’s community services from July 2008 to June 2009.

COORDINATED CARE

The Jewish Home is committed to the coordination of the scarce resources available to the expanding underserviced and elderly community throughout the Bay Area. The Home’s efforts are ongoing, as they have been for more than 138 years. In general, the Home serves the most medically/cognitively frail, who average 86 years of age. Its policy facilitates admission to the neediest, regardless of their ability to pay. Almost 86 percent of Jewish Home residents are indigent and/or Medi-Cal recipients who do not pay the full cost of care.

Through its coordinated care effort, the Home is integral in supporting seniors’ ability to live longer within the general community. The Home provides medical direction externally, and is an intrinsic part of a continuum of care throughout the Bay Area – from participation in the influenza prevention program, to the Home’s medical director serving as a consultant to staff of an assisted living community in Danville, Calif., and nurse practitioners and physician’s assistant coordinating care for residents of a subsidized housing community in San Francisco and the training of their staff in assessment.

PROVIDING CARE FOR ALZHEIMER’S DISEASE AND OTHER DEMENTIAS

An increasing number of beds at the Jewish Home are dedicated to residents suffering from Alzheimer’s disease and other dementias. The Alzheimer’s Garden Unit (dedicated by the Mark Ross Foundation) offers an enclosed garden accessible only to this living environment. In addition, the careful, selective use of the WanderGuard (a signaling device that alerts when a resident wearing one is about to exit the facility) enables the Home to care for many more individuals with Alzheimer’s, as they may then safely reside on other living environments located on the campus. This also affords these residents greater freedom to enjoy a variety of secure areas and outdoor spaces.

SHORT-TERM AND REHABILITATION SERVICES

STARS, the Jewish Home’s short-term and rehabilitation services program, is designed for those aged 65 or older who require temporary skilled oversight – including medical rehabilitation and management by on-site physicians, nursing care, and physical, occupational and speech therapies – usually following discharge from an acute hospital or an acute illness, with the goal of returning to the community. In response to the greater need for short-term and rehabilitation services, the Home has significantly expanded the number of beds initially allotted to this type of care.

ACUTE PSYCHIATRIC CARE SERVICES

As limited psychiatric resources exist for elders requiring hospitalization, the Jewish Home’s acute psychiatric unit is a major Bay Area resource, delivering both inpatient care and consultation to the general community. The Home specializes in meeting the psychiatric needs of seniors, offering individualized treatment for these individuals and support services for family members. Seniors with psychological concerns also benefit from the collaborative arrangement the Home maintains with Kaiser Permanente, where these seniors are referred by Kaiser to the Home for treatment.

When the Jewish Home’s renovated acute psychiatric wing opens, it will became the only psychiatric unit in the city dedicated to serving those aged 65 and older. With new licensing, permitting the Home to admit both voluntary and involuntary patients for acute, short-stay needs, the Home is filling a huge gap in medical care for elders.

COMMUNITY HEALTH EDUCATION AND PROMOTION

The Jewish Home aims to promote and protect the community’s health by advancing and sharing knowledge and understanding of the factors that affect health. The following are some of the numerous endeavors covering FYE 2009.

Associates of Jewish Homes & Services for the Aging invited the Jewish Home’s director of Corporate Planning & Communications to present the closing plenary session at their international conference in Mason, Ohio. Entitled It’s Not Your Bubbe’s (Grandmother’s) Nursing Home Anymore, the presentation addressed lessons learned from the history of the nursing home industry and its evolution, present-day realities and operating challenges, and future opportunities to make a positive impact in the provision of services for older adults.

From the more than 100 abstracts that were submitted to the American Medical Directors Association, Innovative Uses of Lighting in Long-Term Care, the abstract of the Jewish Home’s medical director, was accepted for oral presentation (educational segment) at AMDA’s 2009 Annual Symposium, held in Charlotte, N.C.

The Jewish Home’s director of Research is participating in an educational project funded by the John A. Hartford Foundation in collaboration with the American College of Cardiology and the Society of Geriatric Cardiology. This two-year project is designed to develop a modular, Internet-based educational tool for cardiology fellows to teach key concepts of caring for older adults with cardiovascular disorders, as well as improve knowledge, skills, and confidence in providing optimal care for older adults.

The Home’s director of Pharmacy was appointed to an interdisciplinary team advisory panel of the American Medical Directors Association. Participating on a national stage enhances what the Home’s Pharmacy director can do at the Home for both residents and members of the community.

In attendance at the American Society for Pain Management Nursing’s annual meeting in Tucson, Ariz., were two of the Home’s nursing unit managers and an assistant director of nursing. Ongoing Jewish Home staff in-services on the topic of pain management will include in-depth information from this meeting, ranging from new and established drugs applied differently to help reduce and alleviate pain; the use of new tools such as intrathecal therapy and patient-controlled analgesia; to a new reliance on complementary alternative medicines such as guided imagery, Healing Touch, music therapy, art, and acupuncture.

Director of the Home’s short-term and rehabilitation services unit, who is also a musicologist, addressed a gathering of dedicated Jewish Home supporters on Singing and Songwriting, Music and Memory at the Jewish Home. Among her findings: music programs keep the Home’s residents engaged in the community; music evokes memories; and even people with dementia can remember songs.

COMMUNITY ADULT EDUCATION

The Jewish Home recognizes that providing and collaborating in educational opportunities for adults foster personal and professional development, enhance a sense of community, and promote cross-cultural understanding, cooperation, and support. Below are some examples of the learning programs and information-sharing made available over the past year.

Over the past 35 years, the Jewish Home has partnered with San Francisco City College in offering several adult education classes to the general community. Approximately 20 to 25 students enroll each semester in the Creative Arts class. This all-day, once-a-week art class meets for nine months of the year. Tai-chi Chia® Mind/Body/Spirit/Health is another course provided through City College that meets weekly at the Home each semester. This is also open to the general community and has an enrollment of approximately 15 to 20 students. The Home receives no compensation for the space made available for these community classes.

The relationship that the Jewish Home’s rabbi has between his community teachings, his studies, and his work at the Jewish Home enhance one another. Examples of some of his endeavors during fiscal year 2009 typify this interrelatedness: He delivered the keynote address at a conference in Phoenix, Ariz. Entitled Doorways of Hope: How Jewish tradition can sustain us in the land of dementia, it covered dementia, spirituality, and the “creative outlook on life.” When Imagination is Kindled: Creativity in the Later Years of Life was the topic of his lecture in Lafayette, Calif. Largely inspired by his work at the Jewish Home, the rabbi also incorporated a screening of A ’Specially Wonderful Affair – the internationally acclaimed documentary that captures the Jewish Home residents’ production of and performance on their debut CD, Island on a Hill – in his lectures.

The Northern California Planned Giving Council’s annual conference attracts more than 300 fundraisers and charitable giving professionals from across the Bay Area. The Jewish Home’s planned giving officer sits on the board of the Silicon Valley Planned Giving Council, a cooperating organization for this event. He attended workshops covering major gifts from business owners, endowments, and how to work effectively with today’s sophisticated philanthropist. He followed this with a trip to Scottsdale, Ariz., for the 15th annual Summer Forum of the Planned Giving Roundtable of Arizona, when he delivered the keynote luncheon address and conducted a technical breakout session on planned giving vehicles.

SERVICES TO RUSSIAN EMIGRES

The influx of elderly Russian émigrés to the Bay Area community had a significant impact upon San Francisco’s Jewish community. The Jewish Home continues to address this population’s need for residential care, programs, and services. With the assistance of a Russian-speaking services coordinator, three translators, and a complement of full-time Russian-speaking staff in a range of disciplines and departments, the Home is able to offer a significant Russian services program. Approximately 160 Russian-speaking residents are served, which totals one-third of the Home’s population.

KOSHER NUTRITION PROJECT

Congregate and home-delivered meals for Jewish seniors

For a period of more than seven years, the Jewish Home has collaborated with Jewish Family and Children’s Services (JFCS) and the San Francisco Jewish Community Center (JCC) to provide hot, nutritious meals to Jewish seniors. The Home prepares up to 700 meals per month for JFCS, and approximately 1,500 meals per month for the JCC. During Passover, the Home provides a complete “Seder in a Box” to 100 homebound seniors, enabling them to celebrate this holiday with traditional food.

INFORMATION AND REFERRAL SERVICES

The Home’s Admissions department receives an average of 500 requests annually from the community for information about services for seniors in the Bay Area. Extensive outreach focuses on informing the community, older adults, and geriatric care professionals about the Home’s services.

The Pharmacy department continues to be an informational resource with respect to changes to the Medicare-sponsored prescription drug program. Medical and pharmacy staff collaborate to develop treatment guidelines in the areas of pain management, psychotropic drugs, and palliative care.

COMMUNITY SERVICE LEARNING

Encouraging social responsibility, providing access to information and ideas that help build and sustain an enlightened and involved community, and utilizing highly qualified staff, the community service learning opportunities offered by the Jewish Home continue to earn the respect, cooperation, and support of Bay Area organizations and institutions.

The Jewish Home partners with local high schools that aim to involve youth in their community; students volunteer within the Home, thus gaining valuable life experiences and acquiring volunteer time required for college admissions. Scholars from Archbishop Riordan High School, Mercy High School, Lowell High, and Saint Ignatius, among others, completed their community service requirements at the Home.

The Home also partners with local colleges to host service-learning programs, which combine experiential learning with community service. This past year, students from City College of San Francisco, San Francisco State University (SFSU), and California State University East Bay were placed at the Home.

The Jewish Home is considered one of the premier training sites for rabbinic interns specializing in geriatric work. It continues to provide training and supervision to rabbinic students from Reconstructionist Rabbinical College in Philadelphia; Hebrew Union College, Jewish Institute of Religion in Los Angeles (in cooperation with the Kalsman Institute on Judaism and Health); and Hebrew Union College, Jewish Institute of Religion in New York.

Six second-year medical students from the University of California, San Francisco (UCSF) are hosted by the Jewish Home’s rabbi every January as part of the students’ essential core curriculum. The program helps the medical students appreciate the challenges and rewards of working with patients and families during serious and terminal illness. Students observe the rabbi’s style of visitation with Jewish Home residents, study texts and poems with him, and reflect on ways in which pastoral care may be integrated into a physician’s practice.

Galileo Health Academy is a program that exposes students to the world of health care through paid and unpaid internships, college-level courses, field trips, and community service projects. Two paid interns explored health careers at the Jewish Home in July 2008.

Mayor’s Youth Employment and Education Program (MYEEP) is a city-wide program that provides after-school and summer employment to youth, with the goal of developing job skills, and offers work experience that increases career awareness and future employability. The Jewish Home is an approved work site for MYEEP students.

A year-round, four-year high school scholarship and enrichment program for underserved, low-income minority students, Project ACHIEVE opens a world of possibilities by providing students with access to quality education – including cultural, career, and community service experiences. Twenty-one ACHIEVE students from Archbishop Riordan High School and Mercy High School participated in an academic-year program at the Jewish Home, where they assisted residents of the Home with a variety of activities, ranging from post-Sabbath services to acting as companions.

Students from UCSF, Samuel Merritt College, Dominican University, San Jose State, and San Francisco State University (SFSU) continue to intern with the Jewish Home’s physical, occupational, and speech therapists. In this past fiscal year, five speech therapy students enrolled in SFSU’s Master of Science program (communication disorders) enhanced their academic learning with rotations at the Home.

The Jewish Home offers internship opportunities for recreation therapy students to take their academic knowledge and, under the supervision of state- and nationally-certified recreation therapists, apply it to gaining clinical experience. The intern attends interdisciplinary team meetings, plans and implements programs, does documentation and case studies, and completes a special project that will encourage their continued learning as well as positively impact the Home, specifically in the area of recreation and leisure.

The Home participates in joint educational programs with religious and non-religious youth groups. Teachers from synagogues often request visits to the Home when they wish to introduce their students to the wider Jewish community, educate them about the cycle of life, and respect for elders. Collaborators include Congregation Kol Shofar, Peninsula Beth El, Beth Sholom, Brandeis Hillel Day School, Temple Beth El, Congregation Emanu-El, Congregation Sherith Israel, National Federation of Temple Youth United Synagogue Youth, Beth Am, Bay Area Mitzvah Corps, Peninsula Jewish Community Center, Peninsula Temple Sholom, Mercy High School, and Belvedere Montessori pre-school.

PARTNERING FOR VULNERABLE POPULATIONS

Employment Plus, a non-profit agency, seeks paid and voluntary employment for adults with developmental disabilities, and provides on-the-job support through job coaching. The long-term goal of the program is to have individuals become fully-integrated, participatory, and contributing members of the community in which they work and live. The short-term goal is to maximize each individual’s self-reliance, independence, and productivity. The Home serves as a work site for four adult participants in this program who perform duties in the Home’s Environmental Services department one and a half hours per day, four days a week, accompanied by a job coach.

BENEFITS TO THE BROADER COMMUNITY

Social activities

Numerous social activities and events take place annually at the Jewish Home, which have the benefit of involving members of the greater community – either through their attendance as guests at these events, or through their direct participation. A broad range of programs are a regular feature at the Home, involving community groups who share their resources, talents, artistry, expertise, and skills for the enjoyment and instruction of the Home’s residents.

Employer

The Home is a mid-size employer in the city of San Francisco and provides employment to more than 700 individuals, ranging from skilled labor to executive level positions.

Donations to food bank

Staff of the Jewish Home supports the efforts of the San Francisco Food Bank by organizing and participating in an end-of-year food drive.

Neighborhood involvement

The Jewish Home successfully partners with local organizations, fostering dialogue, collaborations, and ongoing communications with its neighbors. Since the inception of the Excelsior Street Festival seven years ago, the Home has served as a major sponsor of this annual event.

HEALTH RESEARCH, EDUCATION AND TRAINING PROGRAMS

Research

The overall goal of research done at the Jewish Home is to improve the care and quality of life of older people, especially the frail elderly. Opportunities are provided for intellectual scholarship, clinically based research, and basic research into the mechanism of age-related processes, disability, and disease – making this cooperation of investigators, staff, study volunteers, and their families an investment in the future welfare of the community.

During 2008/2009, a number of research projects utilized the resources of the Jewish Home, while the Home served as a site for research trainees. The following is an example of the kind of work undertaken in this field: A Jewish Home physician and her research trainee were invited to present their results from the pilot phase of a longitudinal project at the Presidential poster session of the American Geriatrics Society’s annual scientific meeting held in April/May 2009 in Chicago, Ill. Entitled Creating and Maintaining Interpersonal Relationships in End-Stage Dementia, the pilot phase involved studying the caregiving relationships staff, volunteers, and family members have with end-stage dementia residents at the Home. The project’s results will provide a template for the development of testable models for relationship-centered care in end-stage dementia. Additionally, the significant information gained from learning how caregiving relationships work with end-stage dementia residents at the Home can be applied to improve care for similar individuals at other facilities.

In 2009, the Jewish Home entered into an affiliation agreement with the University of California, San Francisco, as a community partner, to promote efforts to translate research findings into clinical therapies.

Clinical training

In collaboration with the San Francisco-based American College of Traditional Chinese Medicine, the Home serves as a weekly on-site acupuncture clinic, assisting acupuncture students gain experience in treating elders, and providing residents who choose to manage their treatment through acupuncture with the opportunity to do so in a convenient setting and manner.

Geriatric fellows from the University of California, San Francisco (UCSF) receive training at the Home one to two days per week for five months each year. As part of their ICD 131 Foundations of Patient Care class, first- and second-year medical students from UCSF are in attendance at the Home approximately twice a month. Family Practice residents from San Francisco General Hospital program attend four days a month, while Internal Medicine residents from UCSF attend weekly.

Fourth-year pharmacy students from UCSF spend one eight-hour day a week, in 12-week rotations, in the Home’s Pharmacy department. Through its affiliation with the Home, six to seven Touro University School of Pharmacy students per academic year receive six-weeks’ training in long-term care pharmacy. They learn how the geriatric patient processes drugs differently from a younger population, are exposed to how drugs are dispensed and utilized, and gain an understanding of third-party payers.

Healing Touch

As a complement to traditional medical care, training in Healing Touch is given to an interdisciplinary group that includes nurses, social workers, recreation staff, administrative personnel, volunteer services staff, and volunteers from the Home’s end-of-life care program. A therapeutic approach that uses gentle, non-invasive hands-on touch and energy techniques, it is proving to be a particularly good tool for decreasing agitation in residents with dementia or Alzheimer’s. This award-winning program has been enthusiastically embraced by the Home’s culture, by the medical community, and beyond.

End-of-Life and hospice care

At the initiative of the Jewish Home’s rabbi and director of Jewish Life, the Home implemented Kol Haneshama: Jewish End-of-Life/Hospice Volunteer Program – a program of volunteer and staff training the Home co-sponsors with the Bay Area Jewish Healing Center. The Home and the Healing Center have worked in close partnership with the Zen Hospice Project, an innovator in the training of volunteers for end-of-life care. Now an award-winning, nationally recognized program, Kol Haneshama not only promotes inter-agency cooperation, but family and community members benefit from knowing their loved ones formed a close relationship as they approached the end of their life.

CONCLUSION

Continuing its history of service is fundamental to the Jewish Home’s organizational philosophy and strategic planning initiatives. This objective informed the role the Home played in the development of the Taube Koret Campus for Jewish Life in Palo Alto, Calif., providing independent and assisted living services to older adults in the South Peninsula, and it will inform future initiatives, such as increased fundraising to ensure the continued ability to serve the frail and indigent elderly in the future, and a Jewish Home site re-master planning project, with the goal of better serving existing residents and ensuring the future relevancy and financial viability/sustainability of the Home’s campus.

The Jewish Home’s board of trustees is committed to this tradition of service to the entire community and, in particular, the underserved. It will continue to identify and plan for needs as the ages and demographics of both members of the community and the Home’s residents undergo change.