Interview with Cathy Byrne, Associate Executive Director at the Marion and Aaron Gural JCC

1) What is the L’Chaim program, and what was the impetus behind creating the program?

Our L’Chaim Montessori model social day program is for Holocaust survivors with cognitive impairments. Innovative sensory skills help participants connect with positive emotions and joyful, meaningful experiences. L’Chaim engages all the senses in order to help those with Alzheimer’s and other dementias rediscover the world around them.

The program serves a growing cohort who can no longer be helped by our existing programming and need specialized care. It enables us to meet the critical needs of our survivor population and allow them to age in place, avoid institutional care, and die with dignity. Addressing the ever-changing needs of Holocaust survivors is a critical component of our mission to help improve the lives of this fragile population and mainstream these individuals back into the Jewish community.

2) Can you tell us more about the Montessori model, and how it is utilized to help this particular population?

Montessori activities are simple, modified, and focus on cognitive and life skills, movement, sensory stimuli, music, art, and socialization.

The Montessori model places an emphasis on independence, freedom within limits, and respect for a person’s psychological, physical, and social development. The positive attitudes and personal touch that are the hallmarks of the Montessori model help caregivers enhance their loved ones’ opportunities to reconnect with happy events and re-experience the accompanying joyful emotions. This approach helps survivors function at their maximum level using creative arts, music, cooking, aroma therapy, and tactile experiences. Survivors no longer feel alienated in their final chapter, and through innovative activities experience joy, community engagement, and a renewed sense of meaning.

3) How does treating survivors with dementia differ from treating other older adults with dementia?

Care for Holocaust survivors with dementia is complicated. The survivors’ early life history of trauma, deprivation, confinement, and displacement can make it difficult for them to trust care companions with whom they do not have familiarity. Adapting to new circumstances that are meant to preserve their independence but require them to depend on others is a challenge made worse by the impairments in learning, planning, and memory that result from the dementia. Survivors’ family members, who are certainly impacted by the trauma of their loved ones, can find it difficult to assume more responsibility to counter the deficits caused by the dementia. They’re often wary to potentially take away a degree of control from someone whose sense of control was achieved at such a high cost.

4) Understanding that treating survivors is unique, given their history, what approach do you take when helping them heal from trauma?

That Holocaust survivors have experienced significant trauma is undebatable, so helping survivors with cognitive impairment heal from trauma requires a high level of skill. Trauma treatment, as part of a person-centered trauma-informed care (PCTI) approach to service delivery, is built on the commitment to avoid re-traumatization. The L’Chaim client population is safeguarded from re-traumatization as special attention is given to the nature of their traumatic experiences. More specifically, L’Chaim clients are viewed through the lens of developmental trauma and the symptomatic manifestation of PTSD rooted in childhood experience. As survivors experience cognitive impairment the neurobiological shift allows for traumatic memories to surface, specifically those which were repressed by childhood developmental trauma.
PCTI methods of care improve the quality of life for our L’Chaim participants. Person-Centered approaches take into account the individuals experiences, needs, strengths, preferences, and goals. They are rooted in the core principles that people are the expert in their own lives, everyone can express the preferences and desires that describe the life they want to live, everyone can live a full life in their own community, and communities and families have an impact on the well-being of all their members.

5) Can you tell us about a L’Chaim client and how the program has helped him/her?

Rachel was born Czechoslovakia in 1923. In 1939, the Nazis sent her brother to the labor brigade. She and the rest of her family were forced into a cattle car and deported to Auschwitz. Rachel, along with 500 other young women, escaped death by the gas chamber only because the gas chamber they were placed in malfunctioned. Rachel, her father, sister, and older brothers ultimately survived. She never saw her mother or her three little brothers again.
Rachel has been attending programs for Holocaust survivors for many years and spoke at local yeshivas and public schools about her history and the importance of tolerance. She was featured in the famous Paper Clips film.
The staff at Gural were concerned when they started to notice a decline in Rachel’s cognitive function. Rachel lives alone, so the staff encouraged her children to hire a home health attendant during the day to assist Rachel. The staff also suggested that the L’Chaim Group for Holocaust survivors with memory loss would benefit their mother.

Rachel willingly comes to the program each week and warmly greets the staff and her peers as she arrives. The Montessori approach and our person-centered trauma-informed care allows staff to directly meet her unique needs. When presented with a choice of art therapy or the game/iPad table, Rachel always gravitates to art. She is deeply focused and engaged in the project and has been able to express herself through her art. She enjoys the music therapy, as it connects her with joyous past memories with her favorite Yiddish songs.
Rachel thrives on the individualized attention she is given, and the staff has watched her flourish in the group. Her resilience, strength, and ability to see the good in people makes her an asset to the program.

6) What are some successes of the program so far? What do you see as its future?

This program benefits clients and their families — and our staff — in so many ways. Persons with Alzheimer’s disease or dementia don’t often get to make their own decisions, but at L’Chaim each member is given a choice of activities. Our communal meals allow our members to connect with each other and socialize, positively affecting their well-being. Although our members have memory loss, the Yiddish music brings a smile to their faces as they joyfully sing along. Our once-homebound survivors are often mainstreamed back into the Jewish community. L’Chaim is a lifeline and has dramatically added years to life and life to years.

The needs of this population will only continue to escalate, and more families will be turning to us in need of assistance. We anticipate we will need to open another program like L’Chaim, where survivors can age in place and die in dignity. It’s incumbent on all of us to help ease the burden of those survivors who survived the full horror of death camps. We must continue to honor the pillars of our Jewish community.