Clutching a thick photo album containing a century of family history, Isadore “Izzy” Kranzel, 81, practically bounces from one side of the lunchroom table to the other.
Seated in one wheelchair is his 102-year-old mother, Sonia Kranzel. Across the table, also wheelchair-bound, sits his 91-year-old aunt, Freda Rosenzweig. He’s been serenading both with a Gershwin tune, the notes echoing through the institutional hallway.
Sonia Kranzel has lived at the Madlyn and Leonard Abramson Center for Jewish Life in North Wales for nearly six years. Rosenzweig moved in to the long-term care facility a few months ago, after her husband died. Both sisters suffer from dementia.
But Izzy Kranzel, a retired administrative law judge and onetime assistant city solicitor, is nothing if not determined to retain a connection to the women, even if the sparks of recognition are fleeting, focused more on the past than the present.
Every Friday afternoon, Kranzel and his wife, Myra, make the 45-minute drive from their Center City apartment to Abramson. (And every three weeks, they drive to Bethlehem to visit Myra’s mother, who’s 97, and also in a care facility.)
At Abramson, they are almost always joined by Izzy’s younger sister, Fran Chelder, and her husband, Larry. The Chelders live in Elkins Park and are active volunteers at Abramson.
Abramson currently has 18 residents who are 100 or will turn 100 this year: The oldest is 104. A number of them don’t have living adult children who check on them regularly, according to staff at the facility, so the center doesn’t have many octogenarians like Izzy Kranzel visiting centenarian parents.
For those parent-child seniors, this extended relationship can be a mixed blessing — a heavy responsibility but also a time to cherish.
“It is stressful to be 75 and dealing with your own issues around aging, and then to have a parent to worry about,” according to Joy Shore, of Abramson Care Management Programs.
Shore, 49, can relate beyond her professional capacity. Her grandmother, Sylva Naden, is one of Abramson’s centenarians. Her 74-year-old mother, Barbara Beller, is also a regular visitor.
“We have been going through having my grandmother age for a quarter of a century,” said Shore, who, as part of her responsibilities, meets with family members of prospective residents. Shore’s mother “made the flip in her head a long time ago that she was the parent” to her own mother.
Regardless of whether someone is 70 or 90 or 102, if they suffer from Alzheimer’s or another form of dementia, families often confront the same questions.
How can a connection be maintained? How can a son or daughter have a meaningful relationship with a person who bears so little resemblance to the one they knew?
According to Sarah Humes, director of therapeutic recreation at Abramson, staff members often have a much easier time interacting with residents than family members, because professionals come to the person without much knowledge of their prior lives.
Despite all the research in brain science, there’s little if any knowledge about how to reverse the tide of dementia, said Humes. But researchers have learned a great deal about how to engage such patients and how to improve their quality of life while limiting moments of disorientation and distress.
Staff members try to learn as much as possible about what’s important to the person and find ways to use that knowledge, said Humes. For instance, for someone who was an avid tennis player, a staffer might bring in a can of tennis balls, a racquet or a book with photos from tennis history, and try to enage with the resident. Ideally, she said, family members could be doing the same kinds of things.
With every patient it’s different, she said. “Your goal may be to get them to have a great day. It might be that they have a positive five minutes.”
Izzy Kranzel alternated between his mother and aunt as he showed them images of family members, both immediate and distant. The pictures tell the story of one family’s experience. They were taken in Russia, in the hardscrabble neighborhood of Kensington in the 1930s and ’40s, at a vacation bungalow in Neshaminy Falls, in front of the family home in Mount Airy and at a massive 1982 family reunion held at Germantown Jewish Centre.
“Now, see if you can tell me who that is?” he asked his mom.
After a moment, she replied quietly, “Freda.”
“That’s right, Mom. That’s your sister,” he said, the excitement evident in his voice. No matter how many times he’s done this, he said, he’s amazed that she recognizes the woman in a 50-year-old photograph, but doesn’t appear to know the same person sitting just a few feet from her.
“We don’t know an awful lot about how connections are made by people who have dementia,” Kranzel said. “Where are the connections in their brains that cause them to remember certain things and not others?”
Humes said that Kranzel is, if not unique, exceptional in his approach. Unlike many visitors, he doesn’t appear to expect his mother and aunt to get better.
“He may have the exact same experience on his end, but to her, it is new every time,” she said. “He doesn’t need her to say, ‘Oh Izzy, I’m so glad you are here to look through the photo album like we did last time.’ ”
A body of research exists on reminiscence therapy and how to use oral histories and visual cues to benefit an older person’s mental health. But Humes noted that Izzy Kranzel came up with the whole routine on his own.
“It helps me and her. Using that method increases her sense of family,” he said.
But 10 minutes after he leaves, Kranzel added, “She can’t tell you I was there.”
In contrast, Kranzel, co-president of the Philadelphia Jewish Archives at Temple University, seems to have the past on a recall button. Ask him where his mother was born — Novoukrainka in what was then Russian territory and what is today part of western Ukraine — and you’ll get a 10-minute lecture about the history of Eastern Europe until the Russian Revolution.
When more than 200 family members attended that 1982 reunion at the Germantown Jewish Centre, Kranzel compiled a 20-page booklet that contained families trees and individual histories and gave copies to everyone present. And he’s written a play and several short stories — all unpublished — based on his mother, the person he says he admires more than any other.
For Kranzel, keeping track of this history and spending hours with his mother and aunt are not burdensome.
“I do not find it painful at all. I find it rewarding. I’m doing what I’m supposed to do,” he said. “Our daughter finds it hard to visit her grandmother. She is too fixated on what her grandmother was once like. My son is better, he’s more stoic, he accepts it more easily. They were both very close to her.”
About 15 years after she left Mount Airy and moved into the same Center City building where her son and daughter-in-law live, Sonia Kranzel started to forget things. In 2007, she moved in with her daughter and son-in-law in Elkins Park, but they had trouble caring for her. After six months, she moved into the Abramson Center.
But Kranzel doesn’t fret over the possibility that his mother could live another five years or worry about any potential toll the traveling back and forth could have on himself, his wife or his sister. This time together, he said, is truly blessed.
Through it all, his mother, who will be 103 next month, remains upbeat, he said. Despite all she’s been through, he’s convinced she’s glad to be alive. “And that is a great comfort.”