To meet the growing need, a number of innovative programs have been introduced into some of the country's 125 day-care centers. Run by government ministries and ESHEL (the branch of the American Joint Distribution Committee that aids seniors), many facilities are modeled after Melabev — a Hebrew acronym for Community Clubs for the Mentally Impaired.

Melabev is a leader in developing day care for the mentally frail elderly. The prevailing tendency in Israel is for the elderly to remain at home.

"Only 4.5 percent of the elderly in Israel are institutionalized, compared to 6 percent in the United States, 7 percent in Canada and 10 percent in Holland," says Mark Clarfield of the Ministry of Health. For this reason, multiservice day-care centers are a prevalent form of assistance provided by Israel's innovative nursing law. The National Insurance Institute initiated this benefit for frail and impaired elderly seven years ago, which makes available not only day-care, but also professional caregivers, laundry services, beepers and hot lunches.

With its offices at Jerusalem's Shaare Zedek hospital, 15-year-old Melabev — in English, the name means "heart-warming" — operates five day-care centers in Jerusalem.

"Once, patients released from hospital confinement who were mentally frail and elderly returned to a community that offered limited resources for them or their families," says Leah Abramowitz, a geriatric social worker at Shaare Zedek and co-founder of Melabev.

"Melabev's day-care centers were founded to provide a therapeutic and social framework and to enhance the quality of life of those afflicted with Alzheimer's disease or similar disorders."

This enables family members to continue their daily activities, knowing that their relatives are receiving excellent care in a supportive environment while enjoying stimulating activities like physiotherapy, occupational therapy, art, music, movement and dance therapies, and cooking.

Nathan Richman was formerly a prominent Boston lawyer but is now in an advanced stage of Alzheimer's disease. He was brought to a Melabev program by his wife, who investigated a number of senior citizens' facilities and decided she wanted to keep her husband at home in their Jerusalem apartment and care for him herself.

Like some Alzheimer's patients, Richman is very quiet and withdrawn. But he will often respond when addressed directly by the Melabev staff. His wife ensures that he arrives each morning dressed as impeccably as he did when he showed up at his Boston office.

"For the caregivers of people with Alzheimer's disease," Richman's wife says, "the benefits of having Melabev cannot be overstated. Nathan is in a warm, caring center, which, in my opinion, represents the best example of chesed [charity]."

An innovative computer program helps activate patients and stimulate cognitive functions.

This project, now undergoing trials in Melabev's Shaare Zedek center, was developed by Elimelech Lange, a computer programmer, and his wife, Yehudit, a Melabev social worker. They began with two programs, one using arithmetic computations and one based on geometric shapes and colors.

Via the computer, the patients work on basic skills such as addition, subtraction and identifying shapes and colors that they may not have been called upon to use since the early stages of their illness. Not only do they seem to retain the knowledge from session to session, but they are also learning something new and modern — the use of a computer.

Another recent development is intergenerational programming: Although bringing children together with the elderly in day-care centers has been part of Melabev activities for some time, last year a shiduch (match) was organized between a Jerusalem elementary school in the Old City, the state religious school HaRovah and the San Simone Melabev center. "The elderly enjoy the company of the young," says Leah Abramowitz.

Eleven-year-old Tali Gillis agrees, but she feels the benefits are mutual: "I really enjoy it there because I can see that [the Alzheimer's patients] enjoy it too, even those who can't speak. You always know what they're trying to say. It gives me a good feeling that they know I'm trying to help them. I've been going for a year now and some of them actually know my name."