The Three Musketeers of Los Angeles Jewish Health
When Talat Barahmand, Iran Diansedgh, and Zaghi Kohan Ghadosh moved into Los Angeles Jewish Health, they expected to find vital assistance in meeting their daily critical care needs. What they did not expect was to find fast friendships that would ease their transition to a new living situation and fill their days with joy. The three women arrived at Los Angles Jewish Health not knowing one another: Iran about six years ago, Talat around five years ago, and Zaghi, most recently, approximately, three years ago. Sharing a common background (all are originally from Iran) and a common language (Farsi), they quickly connected and have been inseparable ever since. Iran and Zaghi are roommates in the Mark Taper building; Talat lives across the hall. Rabbi Karen Bender, chief mission officer at LA Jewish Health, refers to the friends as "the Three Musketeers." "They spend as much time together as possible, and it's just amazing," she says. "What a gift they have received and given to each other by finding best friends at this stage of life!" Iran, 100, is a native of Teheran; she and her husband fled after the Islamic Revolution. They landed in Dallas, Texas, where they had a daughter, son-in-law, and grandchildren, and spent roughly 15 years living there before making their way to Southern California, home to their other two children. Her husband passed away in 2007, and she lived on her own until her health and advancing age made independent living impossible. As Iran tells it, her experience at Los Angeles Jewish Health has been excellent – the people and the service have all been wonderful. She is especially grateful to be able to spend her days alongside Zaghi and Talat. "We do everything together: playing bingo, attending Shabbat services, listening to music," she says. "We're all really happy." Of course, there are occasional disagreements; all three women prefer to see themselves as being in the right. "We may argue, but there are no actual fights!" Iran laughs. Zaghi, 90, has been in the United States for two decades. She came from the Iranian city of Shiraz, which she fled because of the increasing intolerance of the authoritarian government. In Iran, Zaghi's family was quite wealthy, but during the revolution they lost everything: their home, the two cinemas they owned, and extensive property holdings. Los Angeles made sense as a destination because two of her five children lived here. It was difficult to adapt to an unknown environment, but with her family's support she built a new life. "I miss Iran, but I like California," she says. When mobility issues made it clear she could no longer live without assistance, she moved into Los Angeles Jewish Health and was thrilled to meet people with similar backgrounds. "My friends are the best, and I love talking with them," she says. "We chat, we watch Persian TV, and sometimes, as Iran pointed out, we argue. But we always stay close." At 86, Talat is the youngest of the group. She and her husband, along with one of their three daughters, emigrated from Iran in 1996 as a result of religious persecution, making their way to Los Angeles, where their other daughters and their son already lived. It was a difficult move, but they were thrilled to be reunited with family and away from a repressive regime. After Talat's husband died in 2011, her deteriorating vision made living alone a health hazard, and she chose to take up residence at Los Angeles Jewish Health. The decision, she says, was a good one. "I love it here. They take such good care of me, and everyone is very friendly." Talat is extremely outgoing, and having her friends as a social outlet has been a godsend. "Zaghi, Iran, and I all help each other. We're all Jewish, and it's so nice to be able to speak Farsi and to have people I get along with so well." Rabbi Bender says the Three Musketeers' friendship is as special as the women themselves. "When I greet them 'Shabbat Shalom,' they will often respond not only by saying, 'Shabbat Shalom,' but also by giving me a blessing. It's truly an honor to have three such wonderful women living here with us." Seeing Zaghi, Talat, and Iran interact every day has led Rabbi Bender to marvel at how fortunate they are to have formed such a tight-knit bond. "If I spoke Farsi, I would petition to become their Fourth Musketeer!" she says.
When It Comes to Serving Seniors, Los Angeles Jewish Health Keeps Up the PACE
Life expectancy in the United States is on the rise. As Americans live longer, older adults are increasingly searching for ways to age in place—and to remain in their own homes for as many years as they can. Enter the Brandman Centers for Senior Care (BCSC), a Program of All-inclusive Care for the Elderly (PACE). Launched by Los Angeles Jewish Health and generously funded by Joyce and Saul (of blessed memory) Brandman, BCSC immediately distinguished itself as the San Fernando Valley's first PACE program. Today they serve 320 senior participants, providing them a one-stop shop for meeting their comprehensive health needs. The Brandman Center's primary objective is to help seniors remain as independent as possible, living safely in their homes and communities. It works to achieve this goal through the provision of well-coordinated, highly-personalized, quality care, with a broad range of services that promotes seniors' health and fills their days with meaning and joy. "Our offering truly is all-inclusive, covering everything from medical care, specialty services, and rehabilitative care, to nutritional counseling, nursing and preventive services, medications, medical supplies, and more," says Susie Fishenfeld, BCSC executive director. "One of the best parts is that participants never get a bill; as long as they use our providers, we handle everything." With an interdisciplinary staff that includes a primary care physician; medical specialists; a nurse; social worker; occupational, speech, and physical therapists; personal care attendants; and a dietician, BCSC is open five days each week, year-round (excluding holidays) from 8:30 am to 5 pm. Seniors become eligible when they are age 55 or older, live in the BCSC service area, and have been deemed by the team at BCSC and the California Department of Health Care Services to require nursing home-level of care. Unlike with regular health insurance, such as Medicare or MediCal, there is no specific enrollment period for BCSC's PACE program; seniors can sign up at any time. There are other key differences, as well. "We provide more than just what people typically think of as 'healthcare,' like doctor appointments and prescriptions," Susie notes. "So often, seniors are just sitting home, watching TV all day; we actually get them out and bring them to our center, where there are all kinds of wonderful activities for them. To see how they thrive when they get here is really quite amazing." Evelyn Frenkel, BCSC's director of marketing, agrees that, when it comes to BCSC, seeing really is believing. "We just had a large holiday gathering, with music and dancing," she says. "As people arrived, you could tell they were just lighting up inside. It was wonderful." Part of what makes BCSC so dynamic is its diversity. "We have so many languages and cultures represented, and all religions," Susie says. "Forty percent of our participants are Hispanic. And the diversity goes beyond background: Some participants work; some drive. Everyone is at a different stage in life, yet they all come together to create this beautiful community." The census at BCSC, which continues to grow, is now the highest since the program started in 2013—and talking to participants, it's easy to see why. "I love all of the activities, I love the dancing and the music. I just love it all," says Rose Robinett, who has been coming to BCSC since 2016. One of BCSC's most ardent fans was William Kreiling, a devoted participant who has since passed away. His expert summary of the prevailing sentiment about BCSC: "If you look all over LA, you are not going to find a better organization than this one."
A Life of Resilience—An Inspiration for All
Katherina "Katy" Schaffer knows what it means to face extraordinary odds. But she has also experienced, first-hand, the triumph of perseverance. Over the course of her 97 years, Katy has faced unimaginable challenges, including time spent in three Nazi concentration camps. Through them all, she has proven time and again she has the strength of spirit to carry on—and, above all else, that she is a true survivor. A resident of Los Angeles Jewish Health's Grancell Village for the past year, Katy's story starts in 1925, in pre-war Czechoslovakia. One of six siblings, at the age of 19 she traveled to a neighboring town to become an apprentice seamstress. As Europe fell under the cloud of Nazi threat, her parents sent word that she should return home. On her way back, at a train station in the company of her older sister, Katy was abducted by the Germans. So began an odyssey that would subject her to the unimaginable horrors of the Holocaust and leave her at death's door. "When my mom was liberated, in 1945, she remembers airplanes dropping little bags of cheese and bread. Some people she knew in the camps, who were on the brink of starvation, ate so much that they died—their systems couldn't handle all that sustenance at once," says Katy's daughter, Erit Siegal. "Fortunately, she restrained herself, and she eventually made it to a hospital, where she recuperated for a long time." After she was liberated, Katy traveled to her native Czechoslovakia, only to find that, aside from two sisters and a brother, her entire family had perished in the Holocaust. She and her siblings eventually emigrated to Israel, where she met her husband Otto and gave birth to Erit. By then, one sister had moved again—this time, to Los Angeles—and Katy and Otto decided to join her. Katy and her family—which soon expanded to include a son, George—thrived in Southern California. Otto worked in the garment industry; Katy was a homemaker who cooked, sewed clothing, and provided a warm and loving environment for her children in the house they purchased in the San Fernando Valley in 1963. Despite the hardships she had endured, she found fulfillment and success. "I always tell people to learn from their parents and neighbors, to follow Jewish values, to help the poor, and to be a mensch," she says. Husband Otto passed away in 2011; Katy stayed in their home for another decade or so. Among the hobbies she took up during this period was volunteering for seven years at Los Angeles Jewish Health (LAJH), in the Arts and Crafts Room on the Eisenberg Village campus. "I've always felt that, wherever I can help, I help," she says. "Giving back to LAJH was a way for me to contribute." Katy came to Los Angeles Jewish Health as a resident via our short-term rehabilitation program after falling and fracturing her spine. While in rehab, the vascular disease she had in her leg progressed, ultimately resulting in the amputation of her leg. She moved into Los Angeles Jewish Home full-time just over 12 months ago. "Mom has always been incredibly active, and losing her leg was so traumatic," Erit recalls. "But it's kind of miraculous how she's adapted and adjusted. I think her experience in the war contributed to her being able to deal with her current situation—these survivors have something special in them that has enabled them to carry on." Today, Katy keeps her mind and body active and agile through knitting, doing word searches, and reading. Already during her brief tenure at LAJH, she has developed a reputation for her trademark resilience and positive energy. "Katy is an extraordinary person, and it's an honor to have her residing here at Los Angeles Jewish Health," says Rabbi Karen Bender, LAJH's chief mission officer. "She never allowed the atrocities she witnessed and experienced during the Shoah to interfere with her ability to embrace life, and it's no wonder all of the staff adore her. I personally love spending time with Katy. Her smile inspires me!" For her part, Katy is grateful for the blessings of family and the benefits of living at Los Angeles Jewish Health. "My children and four grandchildren keep me going," she says. "And I appreciate LAJH: I like the kosher food, I've made friends with my roommate, and Dr. Marco and my nurses are right here to help take care of me. I love it here—other places are just not the same!"
Celebrating the Wonder and the Miracle of Chanukah
To borrow from Adam Sandler, "Chanukah is the Festival of Lights. Instead of one day of presents, we have eight crazy nights". From those words of wisdom, we get the questions to address. What is this Festival of Lights? Why eight nights? In addition, while sufganiyot (jelly doughnuts) and latkes (potato pancakes) are awesomely delicious, why are they associated with Chanukah? In the larger universe of Jewish holidays, Chanukah is known to be a minor observance. It certainly is not a holiday or observance on the level of Passover or Sukkot, let alone Rosh Hashanah. Even as we know Chanukah is a minor festival, Chanukah is beloved and its existence is widely known, if not understood. Here in America, Chanukah gets extra exposure because of the proximity to the Christmas holiday. Christmas is always December 25 but Chanukah follows the Jewish-Lunar calendar and can occur as early as Thanksgiving or fall in the later part of December. In that range of dates, Chanukah falls during what is commonly called the Holiday Season and becomes incorporated into it. That takes us to a uniquely American ideal about the make-up of our nation. We inscribe on the coins of our currency E Pluribus Unum- or in the English "Out of many one". In America, we celebrate being united; additionally we treasure what makes each part of the American mosaic unique. As the majority of Americans observe one holiday, Americans of the Jewish faith observe Chanukah. At its core, Chanukah is the celebration of maintaining that uniqueness. In the days following the breakup of the empire of Alexander the Great, the dominant culture in the Mediterranean world was the Greek culture. It would have been easy and made their lives simpler for the Jews of those times to be swallowed by that Greek culture. Yet, they refused, they rebelled against assimilation and they elected to fight to maintain the faith and identity they inherited from their ancestors. At the conclusion of this struggle to remain unique in a larger culture, it was time to dedicate the great Temple in Jerusalem. Part of the dedication or Chanukah was lighting the menorah. On hand was only enough oil to last 1 day. It would take several days for more oil to be procured. Rabbinic legend is that the oil that should have lasted for 1 day actually lasted eight. For that reason, we light candles in ascending numbers each night, to remember this miracle of the oil lasting. In observing Chanukah, we celebrate our unique identity in a larger world. Jews chose to retain the faith of those who came before us and treasure that faith and uniqueness in a diverse world. Finally and very importantly, why the latkes and sufganiyot? They are both linked to the miracle of the oil, as they both are fried foods. When I was a student in Israel, I marveled at the wide variety of sufganiyot-doughnuts on sale in every store and bakery. Naturally, I had to sample a cross section. My favorite? The chocolate frosted-halvah filled doughnut was the winner. Latkes are potato pancakes of course. There are many different recipes for them. You can use potatoes, sweet potatoes or even zucchini. Among the many toppings can be applesauce, sugar or what I recommend, sour cream. All are wonderful, all tasty without a doubt. Nevertheless, what is valued is to pause, gather together to bless and light the candles, sing the traditional songs and celebrate the wonder and miracle of Jewish identity in our day and time.
So Very Much to Be Grateful For This Season
Andrew Berman, Chair, and Dale Surowitz, President & CEO As we enter the month of November, known for giving and giving thanks, we would like to take this opportunity to reach out and share our heartfelt thanks and gratitude for all of the support provided to the seniors of Los Angeles Jewish Health. Once again, your donations, coupled with the outstanding work of our Los Angeles Jewish Health teams, meant our High Holidays were moving and meaningful for all who participated. Our outstanding rabbinical leaders were joined by dozens of additional staff from across departments including Dietary, Housekeeping, Activities, Information Systems, Maintenance and many others, who came together to produce special events and programming that resonated with all who participated. We are also grateful that, this year, we were able to open our campuses to a modest number of family members to join with their loved ones in person for services, even as we continued to follow all ongoing health regulations still in place due to COVID-19. May next year bring even bigger services, gatherings and celebrations! For everyone who has supported the work of Los Angeles Jewish Health this year, as we care for nearly 4,000 older adults, nearly 80% of whom are at or near national poverty levels, you have our collective thanks and deep appreciation. With the coming of Giving Tuesday on November 29, and as you make your year-end gifts; please consider contributing to Los Angeles Jewish Health. As our senior population continues to grow exponentially now and into the future, we are proud and privileged to be available to serve them. Without your support, we could not provide these outstanding services and programs or the award-winning care our seniors so richly deserve. Warmest regards and best wishes for the holiday season. Andrew Berman Dale Surowitz Chair, Board of Directors Chief Executive Officer & President
Los Angeles Jewish Health A Leader in Telehealth for Seniors
Identifying impactful ways to optimize the well-being of older adults is a central focus of our work at Los Angeles Jewish Health (LAJHealth). We are constantly seeking innovative approaches to raising the bar on clinical care, and our telehealth program is a case in point, leveraging leading-edge technology to ensure our seniors can thrive. Launched with funding from the Federal Communications Commission (FCC), which selected LAJHealth as the lead grantee in California to pilot a telehealth program, our organization's initiative deploys state-of-the-art mobile carts—each equipped with a tablet computer, digital stethoscope and otoscope, a camera, speaker/microphone system and WIFI— throughout Los Angeles Jewish Health campuses, enabling physicians to care for patients, from a distance, in an individualized and caring way. Whether for routine visits or to assess changes in medical condition, telehealth appointments offer patients, families and physicians a wide range of critical advantages. "In any discussion of the telehealth program, it's first important to stress that this is not just doctors seeing residents over Zoom or FaceTime," notes Noah Marco, MD, chief medical officer with Los Angeles Jewish Health. "These are highly sophisticated, patient-centered encounters through which we are actually able to hear and evaluate heart and lung sounds, look inside patients' ears and mouths, and see their tiniest skin lesions." "Our experience has been that, once patients and their loved ones become comfortable with the technology involved, the benefits of telehealth are immediately apparent to them," he says. Patient convenience is one of the major benefits. "For many of our residents, travel to and from physicians' offices can be challenging at best, causing them to disrupt their routines to do what's convenient for their doctor," Dr. Marco says. "Telehealth alleviates this burden, allowing them to check in with their doctors and share any concerns from the comfort of their own rooms." Anton Domingo, a registered nurse and LAJ Health's telehealth program manager and quality analyst, says the telehealth consults are particularly helpful when a resident is experiencing a change in condition. "In more urgent situations, when we need to determine whether a resident may need to be transferred to the hospital, a telehealth appointment gets the doctors' eyes on the patient almost immediately, allowing the provider to see the patient and correlate the data provided with the patient's status in real time," Anton says. "This translates to better, more informed decision-making about the necessity of hospital transfers, which ultimately means less strain on—and less cost for—our residents." In fact, according to data gathered by LAJHealth as part of this pilot program, telehealth visits lessened the need for nearly 20 percent of transfers to acute care facilities. The pandemic has further highlighted the wisdom of including telehealth options in patient care. "For instance, say a patient needs to be in isolated care due to a transmittable disease, we can dedicate a telehealth cart to that area, making sure the resident has easy and timely access to the provider he or she needs for their care," Anton says. The telehealth program also lets residents' families play a more active role as a member of their comprehensive care team. "When the patient, the provider and a family member come together, we get more and better information, and the quality of the care inevitably improves," Dr. Marco says. "Family members really benefit from hearing from their loved ones' physicians directly because it puts everyone on the same page and ensures we answer everybody's questions in a comprehensive way." Erit Siegal and her mother Katherina Schaffer That was the case for Erit Siegal, whose mother, 97-year-old Los Angeles Jewish Health resident Katherina Schaffer, signed up to participate in the telehealth program. "My mom, who is originally from Czechoslovakia and survived three different concentration camps, is miraculously healthy and 100 percent cognitively fine. She's one tough cookie," Erit says. "She moved to LAJHealth about a year ago. When she needed some routine care, she saw Dr. Marco via telehealth, and I was on the call, as well." "It was a good experience," she continues. "Dr. Marco asked questions, my mom answered, and I was there, watching and listening the whole time. It was super convenient, especially during COVID, because we got the attention we needed while minimizing interruption to my mom's day and limiting the exposure she (and other residents) would have had if I had needed to come to campus for the appointment." LAJHealth currently has 25 telehealth carts; 12 of them are deployed across four different facilities, resulting in more than 40 virtual visits so far this year. It's a promising start, and plans are for the program to expand. That expansion – and the program itself—are the result of generous support not just from the FCC, but also from numerous individuals and foundations. "We've seen telehealth add real value for so many of our residents, and we look forward to making the program even more accessible going forward," Dr. Marco says. "At Los Angeles Jewish Health, we work to give each of our seniors every health advantage possible."
At Los Angeles Jewish Health, High Holy Days Bring Blessing of Community
Los Angeles Jewish Health residents always approach the High Holy Days with a sense of deep appreciation for having reached the start of another New Year. This year, our seniors have found even more reason to be grateful: the loosening of COVID restrictions to allow residents to celebrate the holidays with their loved ones. "It's hard to put into words how exciting it is that, this year during the High Holy Days, we've finally been able to invite a small number of family members back onto our campuses," says Rabbi Karen Bender, Los Angeles Jewish Health's chief mission officer. "Over the past several years, in order to keep residents as safe as possible, we were mandated to hold off on inviting visitors to campus, so these High Holy Days have really signaled a dramatic, welcome change." Rabbi Bender says services have been packed and that events leading up to Rosh Hashanah and Yom Kippur were equally well attended. "We held an apple and honey tasting across multiple campuses, which was really wonderful," she says. "Taste and smell are two of the most powerful ways to conjure up memories that can engage our residents and inspire them to share their thoughts, feelings and life experiences." According to Rabbi Bender, the apples and honey gatherings were significant for another reason, as well. "I like to point out to our residents that we don't hand people apples already dipped in honey; we give them the apples, and they dip them on their own," she says. "It's a symbol that every individual has the ability to influence the sweetness in his or her own life. We're more empowered than we think, and I believe that's a critical message for our incredible population of seniors." The run-up to the holidays also included a special mitzvah project: Residents gathered together to assemble fully-stocked backpacks for students in need. Sponsored by generous Los Angeles Jewish Health donor Bill Prady, co-creator of the Emmy Award-winning television sitcom "The Big Bang Theory," the project allowed residents to partner with School on Wheels, a nonprofit organization that fields approximately 4,000 requests each year for backpacks from students experiencing homelessness. Los Angeles Jewish Health participants worked a fun assembly line-style to fill the backpacks with school supplies such as paper, pencils and folders, as well as special items such as puzzles, books and science kits. "Jewish tradition teaches that we are inscribed in the Book of Life at Rosh Hashanah, and that the book is sealed at Yom Kippur," Rabbi Bender says. "One of our goals with the backpack project was to fulfill the commandment of the High Holy Days machzor (prayer book), which encourages us to focus these Days of Awe on tefilah (prayer), tzedakah (charity) and t'shuvah (repentance). This project enabled seniors to perform an act of tzedakah, and they were so happy to be a part of it." Their enthusiasm, Rabbi Bender notes, was beautiful to see. "A significant percentage of our residents are recipients of other people's good deeds, whether it's our donors, our volunteers or members of the larger community. It's challenging for them to find opportunities to give back and make a difference the way they used to, when they were more independent," she says. "Through this project, they were able to realize they can still do things to help other people. It was truly thrilling to watch and was easily one of the most moving things I've done in my time here." As they were filling backpacks, dipping apples in honey and singing at in-person holiday services, our residents enjoyed the benefits of built-in community that living at Los Angeles Jewish Health makes possible. "How many people in their 90s get to be with their peers at holiday time?" Rabbi Bender asks. "Not many, which is why our events this year have been so meaningful. It's such a blessing and a privilege to belong to this community."
Comedy and Camaraderie at Los Angeles Jewish Health
Michael Preminger is always quick to find the joke. It's a quality the veteran stand-up comedian, who has been performing on some of the nation's most prestigious stages for decades, brings with him as a dedicated volunteer at Los Angeles Jewish Health (LAJH). "The residents at Los Angeles Jewish Health are hilarious and such a joy to be around," Michael says. "When I first started volunteering, I asked a lady named Edna, who was 104, whether she would ever consider dating younger men. Without missing a beat, she looked at me and said, 'Are there any other kind?'" That camaraderie and humor have been bringing Michael back to LAJHealth as a volunteer for more than 10 years. Career success was professionally satisfying (his many television appearances have included The Tonight Show, The Merv Griffin Show, The Dinah Shore Show, and more. He also co-wrote the critical and commercial hit Nothing in Common starring Tom Hanks and Jackie Gleason), but it is his weekly visits to LAJHealth that give him rich personal rewards. "I've learned so much from the residents and have gained a lot of wisdom. I remember one woman named Rita who would say in Yiddish, 'Vos geven iz geven'—essentially, 'What was, was.' I think it's a very profound way of looking at the world, essentially acknowledging that we can't recapture the past, we can only look ahead," Michael says. One of the things he loves most about volunteering at LAJHealth is hearing residents' stories. "One person told me she went dancing with the Dodgers when they were still in Brooklyn!" he exclaims. "These folks have done such incredible things, and through their stories, I feel I've been all over with them, from Brooklyn to Buenos Aires." Michael himself has New York roots: Born in the Bronx, he headed to Los Angeles in 1975 to pursue his passion for showbusiness. He raised a son and a daughter while climbing the rungs of comedy stardom. Now a grandfather, his touring days have slowed down, and he is able to enjoy other pursuits like giving back to Los Angeles Jewish Health. "I mainly do trivia with the residents, quizzing them on old movies, TV shows, and music," he says. "Some of them really know their stuff, and the questions lead to super interesting conversations about their lives." As a veteran of the entertainment industry, Michael would like to see more of his colleagues doing their part to uplift older adults at LAJHealth. "Especially in this town, where you have thousands of actors and comedians just sitting around all day waiting for their agents to call, I'm astounded by how few people make it a priority to volunteer," he muses. "They have the time; they should come join us!" Michael arrives at LAJHealth every Tuesday and Thursday like clockwork, and he says it's consistently the highlight of his week. "Volunteering here is one of the best things I've ever done in my life; it's so fulfilling, and I get such a high from it," he says. "The hours between Tuesday and Thursday always feel too long—I just can't wait to come back!" Los Angeles Jewish Health is currently recruiting volunteers of all ages (18 and up) – from individual adults to school groups and synagogue youth groups. Contact Stacy Orbach, director of volunteer services, for more information: (818) 774-3219 or firstname.lastname@example.org.
Understanding Skirball Hospice: A Q&A with Dr. Noah Marco
Among Los Angeles Jewish Health's many exceptional programs and services, Skirball Hospice stands out. Our skilled, compassionate end-of-life care provides patients and their families with critical support during one of life's most challenging times. We are proud to be a nurturing, collaborative partner in helping to meet their needs. It can be confusing to understand the difference between hospice care and palliative care. Below, Los Angeles Jewish Health's chief medical officer, Noah Marco, MD, sheds light on what distinguishes each and offers an introduction to what makes Los Angeles Jewish Health the right choice for these services. Question: What is hospice, and when should someone consider it? Answer: Hospice services should be considered by an individual whose doctor believes his or her life expectancy may be less than six months. The decision to enroll in hospice is usually made when a life-limiting condition is believed to be advancing, when medical intervention has reached its maximum benefit, and when a patient or their representative decides to focus on maintaining comfort and symptom management at home rather than in a hospital setting. Hospice is a federal benefit that provides additional services not usually covered by other insurance plans. Q: What is the difference between hospice and palliative care? A: Palliative care helps optimize quality of life by anticipating (or preventing) any form of pain and suffering rather than treating an underlying disease. Qualifying individuals do not have to meet the strict criteria requirements of hospice to receive this care. The focus of palliative treatment is both on meeting the patients' physical needs with regard to symptom management and the psychological, spiritual, and social challenges diseases create. Many individuals start in palliative care until they meet the care criteria for hospice. Palliative care can be provided in a hospital, cancer center, nursing home, outpatient clinic, hospices, or in the patient's home. Q: Where does Skirball Hospice care take place? A: Hospice services are offered wherever the person is residing. Currently, 30% of Skirball Hospice patients are residents of Los Angeles Jewish Health, and 70% are community residents in the San Fernando Valley, West Los Angeles, and surrounding cities. The very first visit can even occur in the hospital. One of the advantages of Skirball Hospice is that our clinicians go to people's homes rather than requiring patients to find transportation to a clinic or doctor's office. Q: What differentiates Skirball Hospice among other, similar hospice services? A: Founded in 2002, Skirball Hospice is the only Jewish-sponsored nonprofit hospice in the greater Los Angeles area. It has a well-deserved reputation for high quality, caring service. Though our program has its roots in Jewish values, we proudly serve people of all faiths and backgrounds. We work with a variety of payors including Medicare, Medi-Cal, and most private insurances, and because we are a not-for-profit agency, no one is ever denied service because of inability to pay. Q: What type of support does Skirball Hospice provide family members, both during hospice and after the passing of a loved one? A: Whereas routine medical care can often focus on the individual patient, providing little or no support to family and friends who may also be impacted by the burdens of disease, the dedicated staff members at Skirball Hospice offer families compassionate assistance from the very first contact. Our response team is available to meet in the home or at a hospital or care facility. Our bereavement staff is trained and experienced in the areas of counseling, chaplaincy, spirituality, end-of-life, grief, and loss. Bereavement support at Skirball Hospice includes ongoing planned contact with the family through visits, telephone calls, letters, an annual memorial service, and referrals to community resources such as support groups. All participants in the bereavement program receive a comprehensive series of mailings on a monthly basis to help reflect on their loss and assist with the grief and recovery process. Our support continues for 13 months, covering an entire cycle of holidays, birthdays, and anniversaries and helping family members maintain or regain their level of well-being. For more information, call Skirball Hospice at (877) 774-3040.