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You could easily discern the pain in Harav Shloime Mandel’s voice. “There have been times I have literally cried in anguish over this issue” said the Rosh Hayeshiva, Yeshiva and Mesivta D’Brooklyn. He was speaking at the “caring for our elders” lecture series hosted by Scharf’s Ateret Avot in Flatbush, and his emotion illustrated the complexity of the issue at hand. He shared the story of a woman who took in her elderly mother, who in turn subjected the children to verbal abuse so severe, that some drifted away from yidishkeit as a direct result. Rabbi Mandel arranged for her to meet with a prominent Godol in his home and it was determined the mother had to move out. “I pained for the woman, I pained for the children, and yes, I pained for the mother” Said Rabbi Mandel. We say- al tashlichaini  l’ais zikna. We are not davening to not get old. We are davening not to be forsaken!” On the other hand, he continued, how many homes have been torn apart because of issues with one spouses parents? How does one reconcile a difficult and burdensome parent with kibud av v’eim? What guidelines are there in halach and hashkafa regarding what our obligations and outlook should be as caregivers?
To offer some perspective, Rabbi Mandel talked about his personal life experience. “I never had the opportunity for kibud aim; my mother died when I was a baby”. He shared how he would have loved to have that nisayon and more importantly the tremendous zechus rewarded to one who affords the proper kavod to a parent. But the fact that caring for one’s parents can be overwhelmingly stressful is undeniable. How does one react when it becomes too much to bear?
Rabbi Mandel quoted the Rambam in the case of a man who had a completely senile father:
“He may not do anything to embarrass his father; rather he must remain completely silent for fear of the melech malchei hamilochim, who commanded him in this mitzvah .For if a mortal king were to decree on him something which caused even more pain, he would not be able to utter a word, how much more so for the one who created the world.”
The Rambam does not use that term anywhere else, Rabbi Mandel points out.  Truly caring and affording respect to a parent, is a mitzvah that at times can so defy logic, our only recourse is to not question the One who commanded it.  How fitting it therefore is that the mitzvah of kibud av was given the same time as para adumah. After learning this Rambam, it is a tossup which is more logical.
We do know however, that the reward for being mikayim this mitzvah is so great, that Yaakov was scared eisav would be successful in killing him because he was mikayim kibud av better. So too, one can be assured that by persevering in caring for their parents they will receive tremendous schar and arichas yomim.
Before ending, Rabbi Mandel posed a few questions to illustrate issues that arise which require halachic guidance:
•    Can you restrain a parent that is a danger to them self to a bed or chair?
•    Can you administer injections?
•    Can you stop them from eating foods prohibited to them by a doctor?
•    For a non-frum parent, may you break his razor blade?
•    Can you lie to a parent about the amount of rent paid from their money, in order for them to agree to better living conditions?
•    Wake up a parent for minyan or bentching?
•    Take a parent to a simcha when they say they have no koach? (You say it’s good for them but is that really the reason?)
•    Tell a parent their true medical situation?
•    Tell other people to daven?

The lecture at Ateret Avot, part one of two in a series on the same subject, was organized in conjunction with L’Orech Yomim, headed by Rabbi Reuven Becker, and sponsored by New Century Home Care . The theme was “maintaining safety and independence at home” and Rabbi Mandel was followed by Mr. Chaskel Bennett an EMT and dispatcher for Hatzoloh of Flatbush as well as Evelyn Baron, PT, MPA Rehabilitation Manager, Revival Home Health Care.
Mr. Bennet presented “Case Studies: Lessons from the Field.” He spoke about common situations that Hatzolah members encounter, and practical steps people can take to prepare for and avoid them.
He explained that people panic in an emergency, forgetting numbers and important information and therefore the key is to prepare. Some basic steps that one must takes are:
•    Hatzolah stickers are the easiest say to remember the number. They should be placed anywhere and everywhere
•    Do not block your caller id if at all possible- it can be the difference between life and death
•    Keep emergency contact numbers near the phone for when Hatzolah comes
•    All the information one would think a responder needs to know should be inscribed on a paper near the phone i.e. medications, history, doctors, etc.
•    Illuminate the house address- not being able to find the address is the single most frustrating thing for Hatzoloh
Mr. Bennett also put special emphasis on preventing slips and falls saying how much havoc they create for the elderly person because the recovery and pain are so overwhelmingly difficult. Some common causes of falls are loss of balance, slippery surfaces, cords, unsteady carpet, etc.
Most falls happen in the bathroom as a wet and slippery surface poses disastrous consequences. Mr. Bennett advocated the use of floor mats, shower chairs, and wall mounted bars wherever possible. Bars, he added, are also vital at the bottom top of steps, helping seniors to mount them.
Other necessary steps for safety include carbon monoxide detectors, and a lifeline pendant. People fall in their apartment and may not be missed for many days only to be discovered literally wasting away. He said “I have personally seen it save lives many times.”
Ms. Baron presented “Common Problems and Preventions”, and stressed that by properly protecting our parents, we are also preparing for ourselves. She discussed the pressing issue of falls as well and enumerated several additional causes to be aware of. These included medications, change in blood pressure, and dizziness caused by a change in position.
She explained the need to look around to determine what can be made safer, and presented some common hazards as well as prevention tips:
•    Wet floors
•    Wet leaves on the street
•    Cords  (should be taped)
•    Rugs (try to secure e.g. double side tape)
•    Fire detectors and carbon monoxide detectors- make sure they are working!
•    Lighting can affect how you perceive things. There should be a maximum amount of light
•    Climbing on a step stool to reach things
•    Cluttered areas
•    Leaning over a stove flames with long sleeves
•    Bathrooms should have ultra secure towel racks and toilet roll holders
•    Leaning on unsecure sinks
•    Scalding water- lean toward more tepid showers
•    Clumsy shoes can cause you to trip
•    Socks on a polished floor cause slipping
•    If you have eyeglasses wear them
•    Wear your hearing aid
•    Door saddles and thresholds are major causes of falling. cover them with bright colored tape
•    The same goes for the bottom step
•    If changing position, don’t  go quickly from low to high
•    Buy a picker upper. It eliminates bending, extending and step stools
•    You can convince your parents to take step for safety by asking them to do it for you.
She ended with the message that it may be difficult to balance protecting our parents and being michabid them but it comes to a point where you have to decide the best method of approach and take action.
The second lecture featured Rabbi Yisroel Belsky, Gordon Ravis, and Dr. Harold Flamer, who discussed safety and independence, as well as medical issues from the perspective of a geriatrician respectively.

Here is a short clip from the event: