Hela Fisk hides bread in cubbyholes in her bedroom. She becomes frightened if nurses mention the word “shower.” At 89 and stricken with Alzheimer’s disease, the petite grandmother of five relives the horror of the Holocaust as though it were happening now.
Fisk and thousands of Chicago-area Jews who endured the Nazi purges have entered their 80s and 90s, and many now find themselves in health care facilities, struggling each day with age-related dementia. Their minds can no longer keep buried the tortured memories of concentration camps, gas chambers and loved ones killed before their eyes.
Compounding the problem, many of the things that spark vivid flashbacks are found in hospitals and nursing homes: white lab coats, restraints and locked doors, antiseptic smells, people yelling in pain. In addition, many Holocaust survivors underwent excruciating experiments at the hands of German doctors.
So for the last four years, a group of Chicago-area social workers has been training nursing home employees–some of whom know little about the Holocaust–to understand what the survivors are going through and offer tips on how to avoid triggering bad memories and violent reactions.
Though the needs of aging Holocaust survivors have sparked discussions among geriatrics researchers and care providers around the world, this systematic approach is fairly recent. David Bier of the Council for Jewish Elderly said health care professionals in the Chicago area began to notice symptoms particular to Holocaust survivors in the early 1990s.
As the problem grew, the council and other Jewish agencies decided four years ago to create the Holocaust Community Services program, which visits dozens of nursing homes in Chicago and the suburbs, giving history lessons and sensitivity seminars to everyone from nurse’s aides to cooks and dishwashers.
“All it takes is something little to provoke a flashback,” Bier said. “It might be the sight of a military uniform. Or it might be a loud, confrontational voice.”
At one retirement home a few years ago, a young nurse started putting patients’ wheelchairs in a row and telling them they were being lined up for the showers, Bier said. One woman, a Holocaust survivor, became combative and tried to flee, though the aide had no idea why.
“For a person during the Holocaust, going to the shower meant going to the gas chambers. The memories are so traumatic, many can’t even bear to hear the word,” Bier said.
Many nursing homes now give them baths, and others decorate shower stalls with flower and cartoon decals.
Another common occurrence is the hoarding of food in pockets and drawers and under mattresses, as if hiding it from soldiers, Bier said. If a worker tries to take the food away from them, they often lash out.
“We tell the employees to just give them some space, let them keep the food,” Bier said. “For perishables like fruit or bread, you can quietly replace them with canned goods. They just want the safety of having it there.”
Dr. Michael Gordon, the head of geriatrics and internal medicine at Baycrest Centre for Geriatric Care in Toronto, said he has treated hundreds of such cases among Holocaust survivors and sees more each day.
“During Alzheimer’s you revisit the past, and Holocaust survivors have a pretty awful past,” Gordon said. “They may have tried to compartmentalize it or forget it, but with age that coping mechanism begins to fail.”
`Horrors never leave you’
Rabbi Marvin Hier, dean of the Simon Wiesenthal Center in Los Angeles, a Jewish human rights organization, said it is simply a different version of what many survivors have lived with for decades.
“Even 50, 60 years later, those horrors never leave you, they’re always fresh. The majority of survivors suffer nightmares even when completely healthy,” Hier said. “So as they get older and more medically vulnerable, reigniting those memories gets even easier.”
At the Gidwitz Place nursing home in Deerfield this month, about 50 employees gathered around a big-screen TV to watch black-and-white footage of mass graves, death marches and Jewish prisoners gaunt with starvation. Bier then led them in discussion for more than an hour.
For many, it was their first glimpse of the Holocaust. Immigrants from Haiti, China, the Philippines and Mexico, they were never exposed to it in school.
“Just a little education is all you need,” said Ann Hartman Luban, director of Holocaust Community Services. “Once they see these images, they understand.”
Darius Brauel, 36, has been an orderly at Gidwitz Place for three years. He said he has to be especially careful because he has a German accent.
“At first I just couldn’t figure out why this person was so frightened of me,” he said. “But then I found out she survived the Holocaust. It was my accent. Now I just try to speak softly, give the person a chance to calm down. Being nice will always win them over.”
At Lieberman Geriatric Health Centre in Skokie, employees have taken part in the training since its launch in 1998. Social service director Jo Hammerman keeps plastic dolls on hand for women who might have lost children in the concentration camps. One nurse climbs into bed with a patient and hugs her to get her out of bed in the morning, she said.
“When Alzheimer’s takes away their short-term memory, they live through World War II all over again, worrying about their families, crying for their babies,” Hammerman said. “The nurses know not to argue. Instead, we get into their reality, try to make them feel better. It’s called therapeutic fibbing.”
A daughter’s concern
Rose Sharon, 48, goes to Lieberman every day to visit her mother, Hela Fisk, who has flashbacks so intense she trembles, shouts and sometimes begins swinging at people around her.
Fisk spent years in a Jewish ghetto in Poland. When her family was found hiding, her husband and 5-year-old son were killed by Nazi soldiers, and she was shipped to a forced labor camp.
“She never spoke about that camp. It was just too painful,” Sharon said.
Fisk immigrated to New York after the war and married another Holocaust survivor, Stephen Fisk. In the 1960s he developed a brain tumor related to his war injuries, and his mind became trapped in the Holocaust, Sharon said. He sometimes confused his young children for children he had lost in the war; he would make the family stow away food and force the children to hide beneath their beds. He eventually had to be hospitalized.
“My mom went through so much. She kept it all inside. Then her mind started to go a few years ago and things just started rushing to the surface,” said Sharon, who moved her mother here from Manhattan in 1998. “She was hoarding piles of food in her apartment. She was getting afraid of other people.”
Fisk’s nurses and aides try to give her time to herself when the flashbacks hit, rather than struggling to stop them, avoiding confrontations that could further provoke her. Most of the time, they say, she is in great humor.
“You just have to treat her right. Give her time to cool off,” said nurse’s aide Gloria Ortiz, 45. “The smell of coffee brings her out of it or talking about fashion and dresses. Little by little, she gets back to her old self. She starts smiling again.”
Sharon said she made a great choice in sending her mother to Lieberman Centre and appreciates the employees’ Holocaust training.
“It’s just wonderful to know that they understand my mother,” she said. “I really worry about her, and the care she gets here helps me sleep at night.”
