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Training Paraprofessionals: Both In Residential Facilities and In the Community


Sarah Abrams, MSG
Educator, Holocaust Community Services
Council for Jewish Elderly
Chicago, Illinois
773-508-1701
hcs@cje.net


Our Program:
Holocaust Community Services is a collaborative effort of Council for Jewish Elderly, HIAS Chicago, Jewish Community Relations Council and Jewish Family and Community Service, in partnership with Jewish Federation of Metropolitan Chicago. The program provides a wide-array of programming for survivors in the greater Chicago Metropolitan area. These services include: weekly drop-in groups, personal care and housekeeping, adult day services, home-delivered meals, transportation, counseling, care management services, emergency financial assistance, Holocaust assets and reparations information, and community programming.


Training Professionals and Paraprofessionals:
In addition, we provide workshops to sensitize professionals and paraprofessionals to the needs of the survivor community. Our workshops are tailored to the specific audience that attends. Previous workshops include those for administrators, social workers, nurses, nursing assistants, chaplains, and students. Although in many facilities, there may be only a few survivors out of their total population, awareness of the particular issues faced by aging survivors and their families helps them to be more sensitive to their needs and provide improved care.


Training Specific Groups: Nursing Assistants and In-Home Workers
Training is particularly important for nursing assistants and in-home workers who work hands-on with survivors. Below, I will describe the general workshop that we have conducted focusing on this group of workers. The workshops have three components to them. First, we show the video, "Painful Memories: Understanding the Special Needs of Aging Holocaust Survivors," produced by Menorah Park Center for the Aging in Cleveland, Ohio. This video provides a history of the Holocaust, narrated by Congressman Louis Stokes of Ohio and also includes several survivors' narratives. It also includes a section addressing some specific fears of survivors and appropriate interventions. Second, we provide an interactive discussion delving further into the issues brought out in the video. Third, participants walk away with a packet of valuable information on working with survivors. The packet provides both additional information that time did not permit us to address as well as a written form of many of the discussed topics that participants can go back to for reference.


Introductions:
We begin the program through introductions. We ask all participants their names along with their specific positions. This provides a warm atmosphere as well as gives us an opportunity to know in what capacity each worker works with survivors. This allows for further customization of the workshop.

We also introduce the workshop by acknowledging that there may be survivors or children/ relatives of survivors in the room and while today's presentation is likely to trigger reactions in all of us, it may be more difficult for those who have a personal connection. In order to be effective providers, it is important to take care of ourselves, so if the video or discussion becomes too painful, it is important to attend to yourself in any way necessary.

Participants are asked to share any experiences they have had through work or personal experiences. At a training for nursing assistants, since most of the participants are doing similar jobs, by each person giving their own examples, it is more compelling for the participants to learn from each other's experiences working with survivors.

In order to further illustrate what the workshop will be teaching, we tell a few vignettes as examples to some of the behaviors specific to Holocaust survivors. For example:

Following the introduction, we watch the video "Painful Memories." 


The Video:
The video is an effective training tool that allows the participants to follow up with the interactive portion of the workshop.


Interactive Discussion:
The movie prompts a discussion. While we are prepared with certain topics that we want to cover, the discussion takes the form of a free-flowing conversation. We often open up this portion with questions such as," Does anyone have any thought, comments, or reactions to the film?" The most common responses are expressing sadness, anger, and recognizing some of the behaviors in the film. The other topic that is often brought up is the similarities between the African-American experience in slavery in the United States and the experiences of the Jews during the Holocaust. This is a heated topic among many of our African-American staff. We bring to their attention that we are not here to compare suffering and that hopefully by understanding our own people's suffering we are able to empathize with the suffering of another people.

Following this open topic, we talk about the many triggers that are introduced through the video. Especially important to the nursing assistants and in-home workers are those triggers that relate to hands-on triggers. Some examples of this are the hiding or hoarding of food, fear of taking showers, or darkness. Often the participants will think of triggers that are job specific that could bring about reactions among survivors. For instance, in a different field, at a workshop at a rehabilitation facility, a physical therapist thought of himself coaching a client to work harder by saying, "1,2,3, push harder", etc. He realized during the workshop that this could bring back memories of slave labor for a survivor.

At each session the topic of countertransference is discussed. Whereas social workers are used to speaking about countertransference, this is a new idea for nursing assistants. While the language we use is less clinical, we talk about how working with Holocaust survivors makes each of us feel and the importance of being aware of our feelings so that we do not let it interfere with the work we are doing. Probably at every workshop that we have provided, at least one participant relates their own family's Holocaust history or their own story of racial or religious discrimination. It is very clear that both the workshop and working with survivors brings up strong emotions.

Other issues that are discussed are the impact of surviving on the second and third generations and the impact of aging and illness on survivors.


The Training Packet:
The final piece of the training is the training packet that is handed out at the end of the workshop. In addition to providing some extra information, it also provides in writing much of what was discussed during the program. This allows the participant to process the information at their own pace and have a resource to go back to at any given time that they need the information. While the packets are customized for the audience, the general packet for this audience includes the following pages:

  • "Serving Elderly Holocaust Survivors in the Community" -- a 2 page sheet giving an overview of the Holocaust, who are survivors, some of the different reactions that one may see in residents/ clients who are survivors, and how to respond to survivors.
  • "Survivors as Patients: The Impact of Early Life Trauma on Present Health, Triggers, Reasons, and Interventions" -- This is an adapted version of the list of triggers that the Menorah Park Center for Aging wrote in "Painful Memories: Understanding the Special Needs of Aging Holocaust Survivors."
  • A time-line of the Holocaust
  • A visual time-line showing the various components of a person when we see them once they are aging. For example, individual personality, cultural/ religious identity, surviving the war, immigration, aging, etc.
  • Internet Sites about the Holocaust and Holocaust Assets


Conclusion:
Through training professionals and paraprofessionals within the greater community we are able to further our reach of improving the quality of care given to Holocaust survivors. We hope that the workshop is only part of our relationship with each agency we train and that they will continue to call upon us both for consultation with specific cases and for use of the many services we provide for survivors.