Stephen Horenstein
Music, Arts and Society

Smoke kills!


Of late, I have been visiting nursing homes throughout Jerusalem as part of a research project I am directing.  By chance, I visited one in the neighborhood of Kiryat HaYovel and upon entering, was accosted by a waft of smoke coming from the entryway and parts of the lobby.  I tried to be inconspicuous, wandering toward the cafeteria where the odor was faint but still present.  I decided to speak to one of the residents and asked about the smoke.  He replied, “yes, it’s a serious problem here.  We have approached many people, including the head nurse, and her response was that there was nothing to do about it.”  Rumor has it that even the facility’s director smokes and sometimes in his office, albeit with the window open.   The kind resident said, and “You should smell the first floor which is like a hospital; smoke is everywhere!”

I said to myself, if this is happening in one place it must be happening in others.  So I moved along with my journey to the Baka-Talpiot area.  One older state-sponsored home was quite crowded and cramped.  The entryway was on the ground floor but immediately led to stairs (that is, there was low lobby).  Still, I smelled the faint waft of nicotine.

Such phenomena occurred in other facilities.  For now, I am not mentioning names or places.  I do not want to incriminate people without giving them a chance to respond, nor do I want to endanger residents who speak their mind.  I believe that elderly residents need to be given more authority and control of their lives: how they choose to live, especially when their health is at stake.  Many of them do not have the strength or tenacity to speak up.

For me, this issue has become a campaign I want to “champion”.  There are clear health laws.  They are enforced (sometimes strictly) in even the shoddiest of bars.  Likewise in restaurants.  So why do our elderly have to suffer?

In one smoke-filled home for the aged, one resident came up to me.  “I have cancer.  This place cannot be helping me.  In fact, I feel sicker here lately, and suspect it is the smoke.  I have tried to tell people, but it didn’t help.”

His words saddened me.  I have always thought that a civilization’s strength was measured in how much they valued their elderly, the wellsprings of wisdom and experience.  I for one have decided to do something about, “loud and clear”.  Anyone want to join me.

To all those who smoke among defenseless elderly: G’mar Hatima Tova!

Appendix, for more information:

In one article entitled “How Smoking Can Effect the Elderly” the author explained what many of us know as common knowledge:

“Cigarettes and other smoked tobacco products have a range of chemicals meant to keep you addicted to the product. At the same time, these products can slowly kill you, and the issues stemming from smoking can creep up quickly on an elderly person.

“There are thousands of chemicals in these products, and they do viciously harmful things to your body, especially as you age…

  • Nicotine: The highly addictive chemical present in tobacco plants. It’s allegedly as difficult to quit as heroin.
  • Lead: This is not a chemical you want to introduce any more of into your body than is already naturally present.
  • Carbon monoxide: This is poisonous.
  • Formaldehyde: It’s a toxic chemical used to treat wood and carpeting.

“Smoking also causes an overall weakening to your immune system due to the high potency of chemicals and sludge in the inner workings of your body. This makes it more difficult for your body to heal when severe and potentially fatal diseases and illness onset in your elderly life.   (It may bring on Diabetes, Cardiovascular Disease, High Blood Pressure, Cancer, COPD (chronic obstructive pulmonary disease), Osteoporosis, Eye Damage, and other illnesses)..”

Things are equally dangerous for those elderly exposed to second-hand smoke

“When caring for the elderly, exposing them to second-hand smoke is out of the question. Even if a caregiver is smoking outside, he or she should take special care to ensure elderly residents aren’t exposed.

Working as a caregiver for the elderly is challenging, tiring but very rewarding. Elderly patients in care homes often require round-the-clock care, and as well as providing company for them, people working in elderly care need to ensure their medical and other needs are met. The elderly residents in an elderly care home are likely to be in a more fragile state of health than other adults or even other senior citizens, and as such, the risks of exposure to cigarette smoke are even more serious in these individuals. This puts an extra requirement on anybody working as a caregiver in a care home: to protect residents from exposure to second-hand smoke.

The Risks of Second-Hand Smoke for the Elderly

“Second-hand smoke causes a wide range of health conditions, ordinarily the same ones as active smoking causes. For example, people exposed to second-hand smoke are more likely to develop lung cancer or have heart problems as a result. It also adversely affects lung functioning, and can cause adult-onset asthma.

“The risks of second-hand smoke are serious for everybody, but especially so for the elderly. Since older people are more likely to have heart problems, and many will have problems with their breathing, adding the risks of second-hand smoke into the mix is particularly dangerous. Additionally, many of the elderly residents may have a history of smoking or exposure to second-hand smoke, so continuing this exposure in old age is particularly risky.

The homes I visited treated smoking quite casually. The smoke traveled into the common areas, both for residents and workers.  There are solutions:

“Reducing Exposure to Second-Hand Smoke in the Elderly

“Thankfully, care homes for the elderly usually don’t allow smoking, so the risk of exposure for elderly residents is inherently limited. However, it is possible that outdoor smoking areas for staff members and residents will be close to areas where non-smoking residents and staff members will congregate, and in these cases there would be a risk of exposure to smoke. The best solution for this is to ensure that any outdoor smoking areas are far away from any areas non-smokers and residents will congregate, but if not, you need to be careful to ensure that you don’t smoke when non-smokers are nearby….

About the Author
Stephen Horenstein is a composer, researcher and educator. His repertoire of musical works has been performed and recorded worldwide. He has been a recipient of the Israel Prime Minister's Prize for Composers and the National Endowment of the Arts (USA) and recently a Mifhal HaPais prize to produce a new album “Sounds of Siday: Side B” (orchestra).. Horenstein's teaching has included Bennington College, Brandeis University, Tel Aviv University, Jerusalem Academy of Music and Dance; residencies at Stanford University, York University, California Institute of the Arts, and others. He is Founder and Director of the Jerusalem Institute of Contemporary Music, established in 1988 to bring the music of our time to a wider audience.
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