Elder care in Israel: behind the scenes with a geriatric care manager
- Jul 8
- 7 min read
By Sharon Beth-Halachmy, Founder and CEO at B'Lev Shalem
There is a moment that comes in almost every initial meeting with a new family.
Someone exhales. Sometimes it is visible — a breath released, shoulders dropping an inch. Sometimes it is something more subtle. A shift in tone.
It rarely happens at the beginning of the conversation. It comes twenty or thirty minutes in, after they have had a chance to tell their story.
Until that point, they have been carrying the weight of it alone. They have been trying to piece together information from doctors, hospitals, social workers, government offices, friends, and the internet. They are worried about a parent, overwhelmed by unfamiliar systems, and unsure what to do next.
The change is simple but profound: they realize that someone is actually listening. That they are being heard. Someone understands not only the immediate problem that prompted the call, but the bigger picture surrounding it.
Then comes the real shift.
They realize they do not need to solve every problem on their own. They have found a trusted guide — someone who knows how to navigate the Israeli healthcare system, Bituach Leumi, foreign caregivers, hospital discharges, assisted living facilities, family communication, and everything else that comes with aging in Israel. Someone who knows the answers not only to today’s problem, but to the many questions they haven’t thought of or didn’t know to ask.
The relief is almost tangible.
Not because every problem has already been solved. It hasn't.
But because, for the first time in a long time, they know they no longer have to navigate it alone.
A day in the life of a geriatric care manager in Israel
As soon as a care manager’s day is planned, it is inevitably revised. It is not a complaint. It is just the nature of caring for people — people whose needs do not arrange themselves according to a calendar.
A typical day might include three home visits.
The first visit of the day might be a routine check-in. This is not, as it sounds, a formality. A care manager walks into a home and notices things that even the most devoted family member may miss from afar. She sees if the refrigerator is empty. She notices if the house is too warm or too cold. She observes whether the caregiver seems content or stretched to her limit. She sits down, has a coffee, looks at the photographs on the wall, and listens.
She checks the client’s medications. If a prescription was filled three months ago and there are still three boxes on the shelf, that is information. If there is only one box left and no refill request has been made, that is urgent. She notes how the client is walking. Whether she is steady. Whether that has changed.
She has a side conversation with the foreign caregiver, knowing that she may be nervous about raising a concern with a family member, but will share it with someone else she can trust.
She says her goodbyes and heads to her second home visit. In the car she calls Maccabi to try to move up an MRI appointment that has been scheduled six weeks out. Parked in front of her client’s home, she puts in an order for a prescription and sends a WhatsApp to the office to ask for a follow-up on an application for long-term care hours from Bituach Leumi (Israel’s national insurance institute) that has been pending longer than it should.
This second home visit is anything but routine. A live-in caregiver is moving into her client’s home today. This is one of the most delicate moments in the arc of elder care: a stranger is entering a private space, taking up residence alongside a person who may be confused or frightened or simply private. The care manager is there to ease the transition, diffuse tensions, align expectations, smooth out the wrinkles, and lay the foundation for a successful long-term relationship.
On her way to her third visit, she makes a quick stop at Yad Sara — Israel’s national organization for medical equipment loans — to pick up a shower chair that the family has not managed to order. She does not flag this as an extra. It simply gets done.
The third visit begins at home before the care manager and her client head together to an important doctor’s appointment. She accompanies her into the appointment, listening carefully, prompting forgotten questions, and writing down the answers to make sure everyone leaves with a clear plan. On the way out, she stops to confirm that the next appointment has been scheduled.
The family experience
For families navigating elder care in Israel, the challenge is rarely a single medical issue. It is coordinating dozens of moving parts—medical care, home care, government benefits, family communication, and the countless practical details that keep an older adult safe and well.
A family calls us in a state of genuine distress. They have a parent who needs more support than they can provide. They live far away. They do not know the system. They do not speak the language. They have received conflicting advice, and none of it seems to fit together.
We get to work, and a few weeks later, their parent is enjoying the care and company of a compatible caregiver. The paperwork for Bituach Leumi has been submitted, benefits have been approved, and additional support is in place. Appointments have been scheduled, and medications have been organized. The late-night phone calls have stopped.
“You’re a miracle worker,” they say.
It’s not a miracle. It’s the result of years of experience, thoughtful advocacy, and genuine compassion.
In all likelihood, they have no idea how much unwavering effort—and occasionally, a little Israeli chutzpah—went into it. The dozens of interviews with caregiver candidates, the repeated conversations with the family doctor to obtain good supporting documents, the endless follow-ups with Bituach Leumi, or the number of calls to imaging centers all over the country to schedule a critical MRI appointment from 3 months away to next week.
And they don’t need to. Because for the families we work with, it’s the outcome that matters. Their parent is safer. They have a plan. They know someone is looking ahead, anticipating problems before they become crises, and advocating for them every step of the way.
Our job is to make complexity disappear — to transform what feels overwhelming into something manageable, coordinated, and clear.
Behind the scenes
Some aspects of care management are visible: the home visits, the doctor appointments, the conversations around the kitchen table, and the reassuring presence of a trusted professional.
And then there is everything else.
Long after the home visits are over, the work continues. A care manager writes up her notes, coordinates follow-up appointments, orders equipment, communicates with doctors, and ensures that every loose end has been tied up. She reminds one client to fast before tomorrow's procedure, confirms another family's hospital arrival time, follows up on pathology results that still haven't arrived, and notices that a prescription renewal is due before the weekend. She is constantly anticipating what will be needed next.
Then there is everyone else.
Care management at B’Lev Shalem is never the work of one person alone. Behind every care manager in the field is an entire team. An administrative team that is on the phone with hospitals, tracking down test results, processing benefits claims, and expertly navigating a dozen systems from Kupot Cholim and Bituach Leumi, to specialist referrals, assisted living communities, and private insurance. Alongside them is a clinical team with years of collective experience navigating aging in Israel, providing a sounding board for complex situations, brainstorming solutions, and sharing knowledge.
Working as a team means no one is expected to have every answer alone. Our clients benefit not only from the care manager they know personally, but from the collective knowledge and expertise of the entire B'Lev Shalem team.
Our guiding principle is simple: if something matters to a client, it matters to us. Sometimes that means coordinating a complex hospital discharge. Sometimes it means helping a family navigate Bituach Leumi or finding the right caregiver. Sometimes it means finding a groomer for someone's beloved dog. Not because it appears in a care plan, but because quality of life is made up of countless small details, and caring for the whole person means paying attention to all of them.
Care management is much more than coordination
People sometimes arrive expecting a medical care coordinator, or a social worker, or someone to help with logistics. A care manager is all of these things. But she is much more.
Care management isn't defined by any one task. It's about seeing the whole picture and bringing together all the moving pieces of aging—medical, legal, financial, emotional, social, and practical. She is the person who holds the whole picture, so that no one else has to hold all of it alone.
Over time, she builds an ongoing relationship with both the older adult and their family. She knows that updates should be sent in writing to a client’s daughter in London, while her son in Jerusalem prefers a phone call.
If you have a parent in Israel and you are trying to figure out how to make this work — from abroad, from another city, or simply while juggling the demands of your own life — this is what we are here to do.
We take care of the complexity behind the scenes, so you can spend less time navigating systems— and more time being a son, a daughter, a spouse, or the family you want to be.
B'Lev Shalem provides comprehensive care management for aging adults in Israel, bringing peace of mind to their families around the world. Whether you are coordinating care from abroad, supporting a parent locally, or navigating the complexities of the Israeli system, we are your partners in making it work.