Survivors of the Holocaust pose special challenges for caregivers at the end of life

By JANE GROSS

“And Then There Were None.’’

The title of Agatha Christie’s 1939 mystery, her masterpiece, spooled through my mind on a recent visit to the Hebrew Home at Riverdale, where my mother died 11 years ago.

Out on the patio, one man sat in the sunshine with his visiting children and grandchildren. On his left forearm was the telltale tattoo of time spent in Auschwitz, marking him a survivor of the death camp where one million Jews lost their lives.

The string of letters and numbers, vivid more than 70 years later, is a ghastly sight no matter how many times you’ve seen one. But each year, at an accelerating pace, there are fewer survivors left to remind us of the last century’s atrocities.

The number varies in different accounts, but Vice President Joseph R. Biden Jr. recently told the Senate’s Special Committee on Aging that 140,000 survivors remain in the United States. A decade ago at the Hebrew Home, there seemed to be hundreds. Now there are 40, among a total of 800 residents.

They are cared for as the deaths they once barely escaped are bearing down again. Some have always lived in a fog of fear. Others are grateful to be alive, to the point of exuberance, and still others are guilty to have survived for no reason other than luck. None are like the other aged residents here, facing death in its expected time. They have spent too long already staring into the abyss.

Rabbi Simon Hirschhorn, himself the son and grandson of Holocaust survivors, said that his multigenerational work with these families is the most satisfying and important work he does. As a nursing home clergyman, he is always guiding parents and their adult children through what is arguably the most difficult transition of their lives.

Some of the elderly survivors cry inconsolably but wordlessly, incapable or unwilling to articulate anything about the past. Others, often dry-eyed, incessantly discuss the terrible things they saw and had to do to save their lives.

And they often flip, all but overnight, from one way of coping to the other as the end of life approaches.

Their adult children, Rabbi Hirschhorn continued, struggle more than others with the guilt of placing a parent in an institutional setting — particularly one that may evoke memories of confinement.

Those who wound up in one of the camps with gas chambers, the rabbi said, are often traumatized by the congregate showers in some nursing homes. How could they not be? At Auschwitz and Treblinka, internees were given shards of soap and towels and told the showers were for the purpose of delousing them. Then deadly hydrogen cyanide spewed from the shower heads.

Survivors’ children “grow up, from the time they are little, with the unconscious wish to make it better, to take away the pain,’’ said Rabbi Hirschhorn, who is also an analyst in private practice.

Charlotte Dell, the head social worker at the Hebrew Home and also the child of Holocaust survivors, said, “I remember from the moment I could understand things that I couldn’t understand this. Isn’t it beyond comprehension that something so atrocious could happen?”

She “read everything’’ about the horrors her parents lived through and carried a “feeling of inadequacy, of not doing enough.’’ There has always been, for her, “an overwhelming feeling of responsibility that there is no additional suffering.’’

By contrast, she said without judgment, her sister, six years younger, “does not want to hear, to know, to talk. It’s just too painful, and that’s her way of coping.”

Ms. Dell’s late father wouldn’t speak of the Holocaust through most of his life; by the time he wanted to, Alzheimer’s disease had muddled his ability to open up.

Growing up, Ms. Dell’s mother “bombarded’’ her daughters with information about that time. She “speaks less of it’’ now, Ms. Dell said, speculating that advanced age and Parkinson’s disease have made her too vulnerable, too focused on surviving in the most immediate sense of the word.

Surviving in the camps and long afterward in the company of others like themselves has been a solitary ordeal. She and the rabbi had hoped that support groups for the resident survivors would help them “be present’’ for one another. Instead, the groups degenerated into a nasty competition. Suffering at Auschwitz trumped suffering at Dachau. Tattoos became perverse status symbols.

Recently, the rabbi looked west from the patio, where the sky was turning pink.

“All of these people will have to be said goodbye to, and soon,” he said. “Then we have to shift from witness to memory.’’ (NY Times)