Diyar is a consortium of Lutheran based, ecumenically oriented institutions serving the whole Palestinian community from “the womb to the tomb”, with an emphasis on children, youth, women & the elderly through community building, development and outreach in the areas of civic, culture, psycho-social, health, educational and spiritual programs that are contextual & holistic in nature

Vision

“That We Might Have Life

and Have It Abundantly”

AJYAL Faith Community Nursing

in Bethlehem

Bringing hope and healing

to a suffering community

Dar Al-Kalima Health and Wellness Center

Elderly in Palestine

• Percentage of the population is 3% at mid 2006 The number is 117,000

– 49,800 Men – 67,200 Women

• The number is increasing despite that the percentage remains the same because of the high fertility rate which increase the percentage of youngsters in the society (47% under 15 years)

• Elderly spend on average more than 17 hours/day at home. 14 hours of which are spent on personal care and maintenance.

Elderly in Palestine

• No special healthcare services • No specialization in elderly health issues ( we

only know of 1 gerontologist in Jerusalem and it’s very expensive to contract him to offer services.

• No social security programs / no pension • Income for elderly is either from personal

savings or from their children or from random gifts from the Ministry of Social Affairs which are very inadequate.

Elderly within their Families

• Families are extended • Usually the elder stays in the family house with the older

son or with unmarried daughter/s • If he/she stays with the married son, the daughter in law

takes care of them (which makes it hard for them to really ask for assistance in many issues)

• Sometimes the elderly begin to feel that they are a burden to their families who have to care for them.

• At the same time, it is expected socially for children to care for their elderly and not to send them to shelters or nursing homes. This is socially NOT acceptable. Therefore , we can say that there are No nursing homes here. ( 1-2 with a capacity of 50 elderly)

Elderly and their families

There seems to be a paradox in the issue of elderly care

• At one hand , family members are expected to care for their elderly, but on the other hand, they have their busy lives to lead that it becomes a burden to care for their elders.

• The elders at the end feel that they are overburdening their children and therefore try to avoid asking for assistance or money or companionship.

Elderly living on their own

• Some elderly live on their own with family members checking up on them once a week or maybe a month or maybe never.

• Neighbors help one another as part of the culture

• Some elderly prefer to stay alone because they do not want to burden their children even though their home may not be suitable for their special health needs

Elderly in Bethlehem

• Immigration among youngsters is high within the district of Bethlehem.

Reasons: • Political unrest affects the socioeconomic status of the residents • Many families in Bethlehem already have members who have left

the country a long time ago and have established lives in the US or Europe or Latin America

• Youngsters feel desperate due the lack of jobs, lack of opportunities and therefore tend to seek alternatives outside. They go to live with their family members abroad leaving behind their parents and elders.

• Older generations tend to be very connected to their homeland and cultures. They refuse to leave even if they are offered a chance to do so. They go for visits but not to leave for good.

Health Issues of the Elderly

• Similar to Elderly Issues all over the world – Physical Frailty and osteoporosis particularly

in women which may result in falls and fractures.

– Chronic diseases (Diabetes /Heart Disease / Hypertension for women in particular) and related complications

– Dementia – Hearing loss / vision loss

AJYAL – Why?

• Responds to the growing need to care for the elderly especially living on their own

• Based on the Faith Community Nursing framework which offers a holistic perspective to health, healing and personal wellbeing.

• Explores the potential of its members to be active and engaged in their communities in addition to receiving services.

• Considers and responds to the special needs identified for each of its members

Logo – Arabic Calligraphy of the word Ajyal

Designed by one of our members

AJYAL

• A comprehensive Faith community nursing program for Bethlehem.

• Offers:– Home and hospital visits for basic care and

companionship – Social and recreational events and activities – Health education activities – Spiritual activities where members explore a

different aspect to health and wellbeing.

Types of Activities we hold • 3-5 joint activities each month including:

– Joint meal with recreational program (9)

Home and hospital visits to offer basic care/ companionship/ prayer and support On average 20/month

Health Education activities including lectures and screening activities.(11) 7 – health education 4- screenings

Recreational outing events /trips to various localities

Spiritual activity: Inviting a clergyperson from different churches

Light exercise including Yoga and meditation

Special occasions such as Christmas, Easter, Mother’s Day and Elderly Day

group birthday/anniversary celebrations

Heritage Book

A product of our members displaying our Palestinian

culture

(currently being developed)

Vision for the future

• Empowerment for Elderly –Courses: Arts, Computer, English

Language, ceramics

–Income generating Opportunities

–Displays of Ajyal member Products

Impact of the Program

• Members are more involved and active in the community. The program offered a chance for the elderly involved to go beyond their homes.

• Many have developed a “new hope” in life as they actively participate in the various activities

• Members acquire knowledge about their health and how to look after themselves

• Members feel less lonely and loved and cared for. • Members developed new friendships and

relationships by meeting other elderly through this program

Testimonials from our members

“You have colored our lives”

“You have given us new hope in life”

“ We never thought that there’s such a beautiful life after 65”

AJYAL – Stage 2

• Acquired fund from USAID through CARE to expand to rural Bethlehem

• We now have about 600 elderly that we visit on a regular basis

Ajyal 2 - Activities

• Training of community nurses • Home visits for basic care and screenings • Joint health events including lectures and

screening • Joint meals or meal distribution “meals on

wheels” • Referrals• Responding to special needs such as elderly

diapers and assistive devices • Booklet “Family Guide for Elderly Care” • Documentary film about the elderly

Growing Needs • Increasing number of members increases the

need for a bigger budget to cover the expenses of the various activities and the need to develop the program and grow.

• Increasing number calls for having a special relatively large place to hold meetings and activities on a more frequent basis

• Need to have elderly specific health services such as a gerontology clinic even for once a week or once every two weeks.

Growing Needs

• Need to have a means of transportation (minibus/van) for our members who have mobility problems.

• Need to have a special budget to cover healthcare expenses for elderly who cannot afford to pay

• Need Elderly sponsoring for those who are underprivileged

Thank You