Mah tovu . . . ohalecha Ya’akov . . . mishk’notecha Yisrael, “How pleasant are your tents, O Jacob, your dwellings, O Israel” (Numbers 24:5). This biblical verse – among the first words of prayer every child learns in the Jewish liturgy – is a call to worship indelibly ingrained in our musical memory. In a very special community “call to worship” this year, the Dorothy and Peter Brown Jewish Community Adult Day Program (Brown Program), will host its first-ever “dementia-friendly” service for Yom Kippur on Sunday, September 24, at 11 a.m. at Congregation Shaarey Zedek, 27375 Bell Road, Southfield, Michigan.
“Studies show that memories of prayer, music and worship are fixed so deeply in the brain, they are some of the last things to slip away,” explains Debra Yamstein, Director of the Brown Program. “I had the idea for a dementia-friendly Yom Kippur service while sitting in shul for High Holiday services last year with my children. When the congregation started to sing Avinu Malkeinu, there were my children – just 4 and 7 years old – singing right along. And it occurred to me how early and deeply we learn those melodies. And when I looked around the congregation, I thought about the people we serve at the Brown Center, and realized that most of them were not able to attend High Holiday services and their caregivers weren’t either. I know for myself, going to shul on Yom Kippur is a special time. But for those with dementia, attending services with their families can be overwhelming.”
It didn’t take long for Debra to put forth her plan to provide a community service accessible to families caring for a loved one with dementia.The Michigan Board of Rabbis heartily endorsed the idea, and agreed to support the rotation of the service at different congregations each year. This year, the service will be led by Rabbi Aaron Starr and Hazzan David Propis of Congregation Shaarey Zedek. “There’s no cost to attend – but we are looking for a family or foundation to endow future services,” says Debra.“The format will be 45-minutes – an abbreviated service that will feature the highlights – including Kol Nidre, Avinu Malkeinu, and the sounds of the Shofar. This year, we plan to start small with an intimate gathering in the chapel. Our hope is to expand the offering next year. Ultimately, we envision a dementia-friendly Shabbat service once a month.”
Embracing dementia, A walk through the Brown Center with Debra Yamstein
A joint program of JVS and Jewish Senior Life, the Brown Program operates in two locations: on the Eugene and Marcia Applebaum Jewish Community Campus at 6720 W. Maple in West Bloomfield and at the JVS Rose and Sidney Diem Building at 29699 Southfield Road in Southfield. Currently, the Program serves approximately 100 participants, ranging in age from 53 to 98. With a minimum participation requirement of two days a week, three hours a day, most of the participants in the Program attend an average of 17.5 hours a week. While participants enjoy a full schedule of music, art, gardening, pet therapy and other stimulating activities including outings into the community, caregivers also benefit from respite, support services and referrals to community resources to help them care for their family members and for themselves.
“As a society, we know how to embrace families dealing with cancer and chronic illness, but we still don’t know how to embrace those families dealing with dementia,” Debra observes. “For many, there’s still a stigma associated with dementia, and it’s kept as a family secret. Everything we do in the Brown Program is focused on inclusion, maintaining the dignity of each individual and easing the difficult journey that we know families are on.”
In a walk around the Brown Center in West Bloomfield, Debra describes a typical day. “Routine is very important in dementia care,” she begins.“We start in the lobby, where our staff greets our participants in the same manner every day. The simple routine of escorting them into the Brown Center, hanging up each person’s coat on a hanger labeled with their name, maintaining a bin with a change of clothing – builds a level of confidence and comfort. Even as their dementia progresses and they forget where they are or why they are here, they know they are safe in our care.”
“People tend to have this image of dementia as sitting around at home in front of a TV all day. Or they think of the concept of an adult day center as a sad place or sign of defeat for the family. We are the opposite of that,” Debra affirms. “Several times a day I come out of my office, just to see what everybody is laughing about. The Brown Centers are places of warmth and joy.”
Debra continues: “The big difference between home care and the Brown Center is that family members have a history. They have memories, habits and expectations with their loved ones that we don’t have here. Our goal is to meet everyone every day where they are, and to seize the day and to enjoy it with them. If they say its 1939, then it’s 1939 and we’re going to celebrate that and do the Lindy Hop or whatever they were doing back then.”
Staffing has everything to do with the success and longevity of the Brown Program, now in its 17th year of service in the community. “Our staff have been employed here an average of eight years, which is unheard of in terms of direct care staff,” says Debra. “When we speak to other people in this industry, they can’t believe it. But our people stay on staff with us because they feel valued here. And we are particular about who we hire and the culture of our workplace, to ensure that the people who work here have a passion for what they do.”
It feels like beshert – what’s meant to be
With a Master’s Degree in social work, a background in foster care and adoption, Debra, 44, shares that she’s always had a passion for caring for vulnerable populations. When the position at the Brown Center opened two years ago, colleagues recognized that Debra’s professional skills were easily transferable to running the Brown Program.
Commenting on her personal experience, she shares, “My grandfather had dementia and lived with my family for the last ten years of his life. Back then, we said he was getting senile and left it at that, but I clearly recall my parents calling the rabbi and asking what to do. I remember the frustration and stress my grandfather’s illness caused in their lives. And there were no resources in the community to help them cope. Between that scenario and today, I feel it’s beshert that I am at the Brown Center, working to make a difference every day.”
So, what’s on the wish list? What would Debra Yamstein do with more funding for the Brown Center? “My dream is to increase awareness of our services in the community, to enhance our support groups and to hire a full-time staff member to offer even more support, education and resources for our caregivers. Caring for someone with dementia 24/7 is not an easy job. Our goal is to shed light and normalize dementia as an aging process, to reduce the shame and confusion attached to the condition and to help reduce the burden of those who struggle to care for loved ones in their home day-in and day-out with no relief.”
And on the agenda today? Debra is thrilled that the Brown Program will be part of a documentary focused on Alzheimer’s and dementia. The first in a proposed 12-part series, On the Front Lines of Alzheimer’s and Dementia, is being launched by Michigan filmmaker Keith Famie. The project will take Famie around the world and approximately two years to complete. Filming has begun in Michigan with support from the Alzheimer’s Association, Henry Ford Health System, the University of Michigan Alzheimer’s Disease Center, the Wayne State University Institute of Gerontology, Central Michigan University and the McKnight Brain Institute at the University of Florida.
For more information on the Brown Center – the Program and its services, please visit online (link http://www.jslmi.org/services/brown-day-care-program/) or www.jvsdet.org/seniors or email Debra Yamstein, firstname.lastname@example.org
To register or for more information about the Yom Kippur service, please call (248) 661-6390. Individuals are encouraged to pre-register by September 19th with the understanding that last-minute difficulties may prevent them from attending.