ABSTRACT
The aging process is accompanied by many changes, such as physical, functional and mental diffi culties. At some point, these changes may lead to diffi culties in the elderly person’s ability to continue living independently, and the person may be confronted with the decision regarding whether or not to enter a nursing home. The decision to enter a nursing home has been reported to be accompanied by feelings of anxiety, uncertainty and tension (Biederharn, Bastlin, & Normoyle, 1991; Lowenstein & Yacovitz, 1995). This decision might be especially diffi cult for Holocaust survivors who were exposed to prolonged situations of extreme helplessness, deprivation of freedom and individuality, and loss of all support groups such as family and friends (Safford, 1995). Intense traumatic situations, as the Holocaust survivors experienced, leave long-term effects, even decades after the events (Lomranz, 1995). The term “institutional arrangement” may activate suppressed feelings related to the loss of autonomy and independence in the Holocaust. Although entering a nursing home is accompanied by adaptation diffi culties for most of the elderly (Lowenstein, 1998), clinical studies show that Holocaust survivors, living in nursing homes, suffer special adjustment problems. These diffi culties are mainly caused by coping with authority and structured timetables, as they remind survivors of the discipline of the camps or their hiding places (Betts, Adams, Steinberg, Mann, Weintraub, Prigal, Fein, Souders, Sookman, & Gerber, 1994).
