They were there for us.  We will, in turn, be there for them:  For our parents, for our partner, or for our beloved grandparents.  We would like to see them age with dignity, to guarantee that their last years will be happy and dignified.  We hope to be treated similarly down the road, when we will need care.

One of every four elderly Israelis needs assisted care so as to perform activities of daily living.  When the need arises, family members discover that the National Insurance Institute (Bituach Leumi) funds only a small portion of a caregiver’s cost and insurance companies barely help.  If, for instance, an elderly parent needs long term hospitalization, the cost is not covered by national health insurance, and out of pocket costs are very high.

The Ministry of Health is well aware of the situation.  In 2011 Minister of Health Yakov Litzman attempted to enact reforms to address some of the problems, but faced many obstacles.  Public pressure is the only way we can achieve change.  Join our campaign.

Why and What We Are Fighting For

One of every four elderly Israelis experiences difficulties of some level in daily functioning, and needs constant care from a relative or professional caregiver, at home or in a nursing home.  The need for a caregiver increases significantly as one gets older.

Without appropriate care, an elder’s health will rapidly decline, an elder’s life will be in danger, and his or her dignity will be trampled upon.  Elder care and hospitalization thus exemplify the State’s duty to guarantee the right to health and the right to live in dignity.    But despite the importance of those rights, they are not guaranteed to the elderly in Israel.

Elder care and hospitalization in Israel currently suffer from many systemic failures.  Most elderly Israelis who need assistance with activities of daily living remain at home.  National Insurance dues collected by the State from all residents includes a portion designated for elder care; this funds the cost of a home-based caregiver, but only for very few weekly hours, far fewer than are needed by elders who depend on assistance with daily living activities.  In order to provide proper care, a family member usually devotes time to care for an aging parent or grandparent, risking potential job loss and struggling to continue to earn a living.  Many family members also incur high costs to pay for caregivers out of pocket, at the expense of other basic needs.

Furthermore, for all but the most impoverished Israelis, long term hospitalization or hospice care is not fully covered by the public healthcare basket.  Rather, the elderly and their families are charged a deductible amounting to thousands of New Israeli Shekels each month.  Others, using private institutions due to shortage of options in the public system, are forced to incur the full cost of hospitalization, which can amount to twice the average salary.

As if those hardships did not suffice, responsibility for elder care is divided among multiple authorities, creating a tangled bureaucratic maze with which elders and their families must cope, and making it difficult to obtain continuity of care.

Many elders in Israel therefore do not receive the care needed to maintain their health and their dignity in their later years.  Only public pressure can bring about change.

What Are We Suggesting?

We are proposing reform with three main components:

• Providing elders with a real choice to remain in their homes and communities, by providing a universal, comprehensive, and publicly funded set of services, without an income qualification test and significantly increasing the number of caregiver hours funded;
• Anchoring in law the universal right to long term geriatric hospitalization for elders unable to remain in their homes, by including long term hospitalization in the basic services provided by HMOs (Kupot Cholim) and eliminating deductible costs charged to elders' families;
• Establishing an umbrella-agency responsible for all elder care – both in the community and in institutions – and simplifying the procedures elders and their families must undergo in order to realize their rights.

My Dear Mother? And What About Dear Father?

Our father, grandfather, partner, best friend – are all beloved and important, and we wish to ensure for all of them the right to age with dignity and care.  Nonetheless, we have emphasized the gender aspect, as Elder Care Has Direct Impact on Women’s Rights.

First, a majority of those who need elder care are women, as women have longer life expectancy than men, and often outlive their spouse.  In 2014, 70% of those eligible to receive elder care allowance were women, a far higher percentage than their share of the population.  Additionally, 60% of women over age 65 live without a partner, whereas only 22% of men over age 65 live without a partner.  Thus, when an elderly woman needs assistance with daily living activities, she usually already lives alone, while a man in the same situation usually still lives with his wife who take care of him.  The absence of quality affordable elder care affects men and women, but affects women much more.

Second, there persists an expectation that the wife or daughter, rather than the son, of an elderly in need of care, would bear the lion’s share of the burden of caring for an elderly parent, and would give up her career and forego her personal aspirations in order to do so.  The responsibility of caring for an elderly parent or spouse is grave.  It is difficult work that takes a physical and emotional toll on the caretaker.  One study indicates that 70% of primary caretakers caring for elderly are at risk for depression.  Significant expansion of State funding for skilled caregivers would ease the burden on female family members, who bear the brunt of the care for their elders.

Third, the majority of those employed as professional caregivers are women.  Caregiving is a predominantly female profession.  In 2014, most Israeli caregivers working in elder care were women, and over half of them were women over the age of 50.  Women also constitute a majority of caregivers who are migrant workers – particularly among migrant workers from relatively poor countries such as the Philippines, Nepal and India.  According to Kav LaOved (Workers’ Hotline), over 80% of the approximately 60,000 migrant workers employed currently in Israel as caregivers to the elderly are women.  As caregiving is a predominantly female profession, one consisting of women with low status in the workforce (foreigners, older), there is a tendency to violate the rights of workers in this arena.  The current elder care system’s inadequacies and reliance upon high costs incurred by family members creates pressure on employers to deny women employed as caregivers their rights – for instance, to deny them a day off so as to avoid extra expenses, or to deny them the employers’ share of their pension plan payment.

Therefore, we believe that our proposed reforms of the elder care system would significantly advance the rights of women in Israel, along with advancing the right to healthcare and the right to live in dignity.