Facing Death, Facing Life

This summer was one of the most challenging of my entire life. I knew it would be. In fact, I signed up for it. Toward the end of last school year as my classmates were firming up their fellowships for the summer, I made the very challenging decision to work as the rabbinic fellow at Cedar Village Retirement Community. This is very difficult to say, but I have always had a hard time developing relationships with older adults. They immediately remind me of my grandparents. It has always been so sad to imagine a world without my grandparents, and I have always had a hard time accepting that the reality of aging leads to death. There is the added layer that there are younger residents at Cedar Village, many of whom are hospice patients. I knew because of this that hospice would present an added challenge. I also knew that I needed to become comfortable with this demographic. Because the Jewish population continues to age and medical advances allow people live longer and longer, it is crucial to include and care for this population. Older adults are part of our community; they built the foundation on which we stand. It is my responsibility as a leader of the community to make sure these people are not neglected.

I had three goals as I walked into Cedar Village, all of which stemmed from my need to get comfortable with the aging population. I wanted to explore the connection between music and memory, work with individuals who have dementia, and understand hospice.

Exploring the connection between music and memory was the easiest of these three goals to tackle. There is an incredible organization called Music & Memory that started in New York. Their mission is as follows:

Music & Memory is a non-profit organization that brings personalized music into the lives of the elderly or infirm through digital music technology, vastly improving quality of life. [They] train nursing home staff and other elder care professionals, as well as family caregivers, how to create and provide personalized playlists using iPods and related digital audio systems that enable those struggling with Alzheimer’s, dementia and other cognitive and physical challenges to reconnect with the world through music-triggered memories. By providing access and education, and by creating a network of Music & Memory Certified organizations, [they] aim to make this form of personalized therapeutic music a standard of care throughout the health care industry.

I spent a lot of time this summer making personal playlists for residents using information we gathered from their families and friends. I uploaded these playlists to iPods and distributed them to the residents. It was so rewarding to see people change when the music started. Some were nonverbal, and the music allowed them to have conversations. One man spoke Russian and communicated only sporadically. When we started playing his playlist, he began telling me in full English sentences about his time in the Russian army during World War II. The music gave me a way to connect with residents I would otherwise have had trouble approaching, because I did not always know how to start a conversation. The music opened doors and created relationships between the residents and their caretakers that could have taken much longer to develop. If you are interested in learning more about this incredible program, please visit Music & Memory’s website. They produced a documentary called Alive Inside about people with dementia. Watch this unbelievable clip from the movie to really understand how music can make an amazing difference in the lives of older adults with memory issues.

The next goal on my list was to work with individuals who have dementia, a goal which really intimidated me. I was really unsure how to interact with people who were stuck inside themselves. Luckily, as I spent more time with these individuals and got to know them, I felt more and more comfortable. The staff who work with these individuals helped me so much, giving me lots of training and support as I continued to grow within my relationships. Of course, my work with Music & Memory also allowed me to have a way in with individuals with dementia. I felt useful, like I was improving their quality of life dramatically.

By far the most challenging of my goals this summer was understanding hospice. I thought of hospice as just the step before death. But it is so much more than that. In my first week, I made nine clergy visits to individuals in hospice. These people ranged dramatically in age and ability. Some were in their 40s and some in their 90s. Some had been in hospice for years and some just for a few weeks. Hospice means that all major treatment has stopped. Pain is managed as it comes up. Putting a loved one in hospice care requires an acknowledgement that death is part of our lives and that our loved ones don’t last forever. Hospice care also involves dealing with family and friends as they come to the realization that their loved one is passing on. I had lots of exposure to these people as they experienced their last moments. I watched the hospice nurses and aids lovingly care for people as they withered away. They are so strong and were so helpful to me as I experienced death for the first time as a rabbinic figure. I slowly adjusted and became more comfortable with the reality that death is a natural part of life.

Doing this work with individuals in hospice was emotionally draining and required a steep learning curve. But I would not have traded the experience for anything, especially because, on July 20, my own dear aunt went into hospice care at her home. Cedar Village was so supportive. They told me to go be with my family and not to worry about anything there. So I jumped in my car and drove to St. Louis. I was able to support my family members through the most challenging time in their lives because I had the experience from Cedar Village. I wasn’t surprised about how she deteriorated and what the signs from her body were. I was sad, of course — and she was so young — but I was the rabbinic presence my family needed. This could never have happened before my time at Cedar Village. I wasn’t ready or able to face death or comfort families or even talk about the aging process.

When I started at Cedar Village, I expected that would be the most challenging part of my summer. It was difficult, but it prepared me for an even more trying experience with my own family. It seems that my choice of fellowship was not an accident. I am so grateful to have learned the skills that I needed to be present for my family and that I will carry with me into my rabbinate as I continue on this path.

Alicia Harris was a third-year fellow over the summer at Cedar Village. Currently she is serving as the student rabbi at Temple Beth El in Muncie, Indiana.

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