Although old-age homes have always existed in Israel for those who cannot care for themselves, it is only in recent years that the American idea of retiring to a comfortable community of seniors has taken off here. Over the past 20 years, retirement homes have sprung up all over Israel, and each seems to be trying to outdo the next in the level of luxury, services and amenities offered.
"There are now more people over 65 in Israel than there are under 25," said David Ditch, CEO of the Ad 120 chain. "The population is getting older, but physically they're still young because medicine has advanced so much. The standard of living has gone up, and the elderly population has a lot of free time and is looking for ways to fill it."
Official government figures bear this out. According to Israel's Central Bureau of Statistics, there were 670,000 people age 65 or over in Israel in 2003, comprising almost 10 percent of the population. This proportion was more than double the 4.8 percent in 1955 and is expected to reach 12.7 percent, or 1.2 million people, by 2025. Life expectancy in Israel has risen to 77.5 for men and 81.5 for women, more than five years higher than it was in 1980.
But with increasingly long lives come other challenges. Fully 25 percent of Israel's elderly live alone, and while their health may be good, loneliness and boredom can eat away at their days. Retirement homes promise a range of social and cultural activities in a supervised setting. But before rushing out to book a place for grandma, there are some factors to take into consideration.
"When someone comes to us and says they want to put dad in a home, the first question we ask is, 'Why?' and the first thing we do is meet the person to see what they want," said David Danhai, who set up and runs Yad Lakashish, a free advisory service for the elderly. "If the children say dad is lonely, we look at why he's lonely. He may already live in an apartment but shut himself off from his neighbors because that's his personality. A closed-off person will be just as closed off living in a home. Or he may be lonely because he doesn't know where to go to find activities and meet people his own age. We show such people how to use the resources they already have in their area, such as the local day center for the elderly, golden-age club or public gardens. It is no small matter for an elderly person to move out of the home where he has lived for most of his life. It's traumatic and drastic, and a step that shouldn't be taken lightly."
There are two types of retirement housing in Israel, and the differences between them are significant. First are old-age homes (batei avot), which are licensed and supervised by the Ministry of Social Affairs. While many people think these are only for the feeble and bed-ridden, in fact many of them are designed for the independent senior who wants to be taken care of.
Ministry conditions dictate that these homes must provide three meals a day (and two snacks) in a dining room, have a certain ratio of staff to residents, clean residents' rooms daily, keep strict hygiene in the home's laundry, among other stipulations. An old-age home might have a greater or lesser range of activities for residents, and medical supervision is ever-present. Residents generally live in one- or two-room apartments, which may have an electric kettle but no cooking or laundry facilities. All apartments have emergency call buttons, and staff check in on residents if they do not show up for a meal.
Residents pay an entry fee of NIS 130,000 to NIS 220,000 (approximately $31,160-$52,745), as well as monthly maintenance fees of NIS 5,000 to NIS 7,500 (about $1,200-$1,800). This entry fee depreciates to nothing within three to five years. The ministry's Web site (www.molsa.gov.il) lists some 190 licensed old-age homes across Israel.
The second type of retirement housing is sheltered housing (diur mugan). This category is unlicensed and unregulated, but that does not mean it falls short. On the contrary, it is into this category that luxurious retirement residences such as Ad 120 fall. And it is this category that has grown so dramatically over the past two decades.
Sheltered housing buildings are essentially private apartment buildings for seniors with some -- or a lot of -- extras. Residents live in one-, two- or three-room apartments which, unlike old-age homes, have a kitchenette and cooking facilities and in some cases space for a washing machine. Apartments are cleaned weekly and have emergency call buttons, but daily checkups on residents are not necessarily made. Sheltered housing buildings usually have swimming pools, gymnasiums, game rooms and libraries and offer a wide variety of activities, including arts and crafts, exercise classes, concerts and lectures. In some homes, lunch in the dining room is included; in others it is extra. Some add coffee and cake in the afternoon.
Residents pay a deposit of NIS 530,000 to NIS 1.8 million (around $127,000-$431,000) for their apartments, as well as a monthly maintenance fee that can range from NIS 3,000 to NIS 5,000 (approximately $720-$1,200). The deposit depreciates by 2 percent to 4 percent annually for 10 to 12 years, and what is left is given to the residents' heirs. Each sheltered housing or old-age facility has a separately run Ministry of Health licensed nursing division for residents who need chronic care.
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