Three old Holocaust survivors are sitting around playing cards, chatting about various things. Dave says, “You know, I’m getting really forgetful. This morning, I was standing at the top of the stairs, and I couldn’t remember whether I had just come up or was about to go down.” Sarah says, “You think that’s bad? The other day I was sitting on the edge of my bed, and I couldn’t remember whether I was going to bed or had just woken up!” And Goldie smiles smugly. “Well, my memory’s just as good as it’s always been, knock wood.” She raps the table. With a startled look on her face, she asks, “Who’s there?” Aging Holocaust survivors may forget whether they’re going up or down the stairs or whether they’re going to sleep or waking up, but what is most striking to their family members is that their traumatic experiences in the Holocaust are even more memorable in their old age than they were seventy-two years ago. Sons and daughters of survivors are often caught off-guard when a parent becomes clinically depressed after retiring or losing a spouse, other relatives, or friends. Their families do not understand that when an aging survivor experiences a current loss, their grief encompasses not only the immediate death, but the murder of family members which they were unable to mourn at the time. A present loss in a survivor’s life acts as a trigger to vivid death imagery they witnessed of prolonged, or abrupt killings, of loved ones and strangers, and their own near-death encounter. In older Holocaust survivors, the elements of natural aging are unconsciously or consciously perceived through a different lens. Survivors relive the loss of control over their own destiny more intensely. Erik Erickson’s adult ego development of integration versus despair is another trigger to mourn aspirations never reached and survivor guilt. Survivor guilt at times can be mediated with seriously focusing on Erickson’s concept of generativity, imparting values to future generations. The aging Holocaust survivor is often not conscious of the connection between the horrific past and his or her current emotional state, especially if he or she is surrounded by beauty, love, and financial security. Despite these commonalities among aging Holocaust survivors, their descendants do not experience a monolithic group. This presentation will delineate four types of families which are not mutually exclusive and which have implications for different experiences by the children and grandchildren of survivors. The types are the “independent aging Holocaust survivor family,” the “bearing witness family,” the “dependent aging Holocaust survivor family,” and the “aging isolated Holocaust survivor.” Let us begin with the “independent aging Holocaust survivor family.” Here, the survivors are working, semi-retired, or retired and still living an active lifestyle. Very often, this is a family that has sufficient financial resources to live comfortably. Members of the family may or may not be active community members, they are generally involved with their extended families, and their lives are not necessarily focused on Holocaust remembrance or commemoration. Their identity encompasses their profession, their hobbies, their role in the family, or their Jewish or ideological identity. The life they lived during the years of the Third Reich or the German occupation does not necessarily constitute a major part of their identity. It might be the family that says “what does the Holocaust have to do with me?”—almost like the wicked son at the Passover Seder. Or it might be a family whose primary identity is that of being immersed in a religious community, e.g. very active Orthodox or Chassidic Jews, or Bundists, or Yiddishists. In rare cases, these might even be families that denied their Jewish identity and their persecution as Jews during the Holocaust. In these families, the burden of maintaining the family secret continues. The independent aging Holocaust survivor requires minimal care from their children or outside social service agencies. Because they are not financially needy, they do not seek out Holocaust survivor support organizations. Often, their only link to Holocaust related institutions is their monthly reparations check. However, this independent aging Holocaust survivor is not immune from becoming another of the types listed below, should he or she incur a death of a loved one, or has lost the capacity to be an active professional or community member. It is at that point that a family member who is witnessing a vibrant parent become clinically depressed feels helpless and will seek out psychological help for a magical cure to get back the old parent. The most commonly used clinical intervention is psychopharmacological medication. In severe cases, psychiatrists have all too often resorted to ECT (Electric Convulsive Therapy). While these alternatives may have an immediate effect to jolt an individual out of severe depressive symptoms, such as unwillingness to get up or engage in activities of daily living (bathing, eating, etc.), these treatments are not permanent solutions because they do not satisfy the patient’s unconscious need to mourn. Survivors need a listening ear. Parenthetically, when Prozac was in vogue, doctors were giving it out like candy. Some survivors had suicidal ideations, which of course panicked the children. Others became enraged at loved ones for not meeting their needs. One example I would like to share with you is of Joseph whose father was a successful scientist, a devoted husband and father. After he retired he became very depressed. He had been a very busy professional, which did not leave much time for hobbies or hanging around. The Prozac he was given made him very angry at his wife who he felt did not want him to talk about his Holocaust years. She had been a loving wife who got him and the family to be Yankees. His son tried to keep his father busy by giving him some tasks in his business. He bought him a computer and gave him tutorials. All this did not bring back his productive successful father who soon started to deteriorate physically as well. The role of the offspring of survivors to make the survivor happy is intensified during this period. However, it is important to know your limitations. Yes, children of survivors must make themselves available, but at the same time others need to be to engaged in order to create a social support system: A few volunteers in the community who visit once a week, other family members who can be in touch regularly, a survivor social gathering, other community events, and maybe a mental-health professional. This rude awakening of the vulnerability of the survivor, may motivate the second and third generation family member to want to do a long postponed oral history or to fill in the gaps. It is best not to be too eager to ask about the survivor’s experiences during the Holocaust, and to begin with the present, and then early childhood before delving into the traumatic events. If there are any photos, begin by identifying family members, or to take a map and start with locations. These are a few non-threatening devises to begin a long-awaited conversation. While the second-generation family member is often engaged in the physical care taking of the survivor, the third-generation child is there to bring levity and joy. The second type of Holocaust survivor family is the one I call the “bearing witness” type. In these families, the Holocaust survivor or possibly one or more of their children or grandchildren are involved in Holocaust education and commemoration. This can take all kinds of forms, including public speaking, memoir writing, political activities, or Holocaust, Jewish, or other types of activism, such as human rights, advocacy for other oppressed groups, volunteerism and participation in the helping professions. The dynamics in the “bearing witness family” vary. At times, one person takes the lead, and the other family members are supportive, while in other instances, family members have mixed reactions to the active witness. The active witness can be a member of the first generation or the second or third. Holocaust survivors who have spearheaded Holocaust museums or commemorations, written memoirs, or participated in Holocaust education feel emotionally validated when other family members want to join them in their mission. This is an opportunity for collaborative effort when different family members with various talents have a common goal to make a difference in the world. The burden of remembrance becomes a creative endeavor that emotionally energizes rather than depletes the participants. An active witness survivor may be very proud of a son or daughter who has written a play, is working for a human rights organization, is teaching a Holocaust course, is speaking at a Holocaust commemoration, or who has otherwise embraced their family history. Often, a survivor will write and publish a story based on their experiences with the help of one of their children, who are sometimes professional writers. A project such as this could not have been done by most survivors without the help of their children because of educational or language barriers. This experience of writing together has often brought the survivor and their child closer together. One problem that emerges with the “bearing witness” survivor is when he or she becomes too weak, or ill, to continue to do the work of “bearing witness.” At this point, to give up the role of “bearing witness” would not only cause a loss of identity, but the loss of a supportive environment in which bearing witness is conducted. Isolation and despair can follow such a transition. It is a double-edged sword for children, a spouse, or other relatives to tell a survivor to quit their “bearing witness” work. On the one hand, they do not want to take away what is most meaningful to them, on the other hand, family members have a responsibility to become protectors of their aging survivors and prevent them from losing face. Anger often intensifies with aging survivors as they confront their own imminent end. Out of control public displays of this anger in public speeches or in the media embarrasses and shames their offspring. Again, an awkward position of a child of survivors to tell a survivor not to be so angry, when in reality, they have so much to be angry about. Child survivors and second and third generation are taking over the telling of their family story for their parents and grandparents. Some survivors are using their last energies to continue to tell their stories in public or to try to write them down. This group requires support for the emotional strain their activities cause and validation for making a difference. At times these families need assistance with intergenerational communication and understanding. There is a difference between being supported by the external world for participating in Holocaust education and commemoration and life-affirming activities, and a resistance and negative reaction from family members for wanting to make a difference through these positive projects. The third type of family is the “dependent aging Holocaust survivor family,” in which a survivor has experienced a loss of motivation or ability to care for themselves caused by the death of a spouse or physical illness. If the deteriorating physical condition of a spouse becomes too overwhelming for the elderly partner to cope with, it is one of the children or grandchildren who is called upon to help. Often in these cases, one child sacrifices himself or herself for the care of a surviving or ill parent, thus establishing a dysfunctional family structure. If siblings have to coordinate their efforts to care for an ill parent, or one who is suffering a complicated grief reaction, the prior dynamics among them come to the fore. If relations were healthy, the elder becomes the primary focus. However, if the relations were replete with conflicts the interaction between the siblings takes center stage, rather than focusing on the best interests of the aging parent. This dynamic, of course, can also happen in families that do not have a Holocaust family history. What makes a Holocaust survivor family different in this stage is its increased distrust for individuals outside the immediate family, or institutions. Aging survivors who are feeling vulnerable may become even more suspicious of outsiders when they are ill, or lost a spouse, or most of their friends. The role of the next generation as protector from the outside world or interpreter of the external surroundings is even more pronounced in a “dependent aging Holocaust survivor family.” Social service providers become part of the outside world that is not to be trusted. Under these circumstances, the job of mental-health providers is challenging. Often the second and third-generation members of these families are caught in the middle between the survivor and the social service providers. A survivor who only wants a family member to care for them ignores the suggestions of social workers who may suggest that it is time to get outside help at home, or to move to an assisted-living or nursing home environment. No matter what outsiders say, a spouse, child or grandchild may feel disloyal to a survivor who is emotionally or physically incapacitated if he or she does not personally care for the elder who has suffered so much in their life. Disloyalty brings up survivor guilt feelings in second and third generation. In order to avoid such feelings, a second or third generation member may attempt to do the impossible in caring for the elderly parent, such as moving the survivor into an already-cramped apartment, leaving one’s spouse and children to live at a survivor’s home for an extended period, or otherwise sacrificing themselves. The “dependent Holocaust survivor family” can get into this state overnight or over an extended period of time. In families where the Holocaust survivor was perceived as the strong one, the “fighter” as opposed to the “victim,” the transition to becoming caretakers rather than being taken care of comes as a shock, and causes what Robert Jay Lifton calls a “disequilibrium.” At other times, family members enter a state of denial in the face of the worsening physical or psychological condition of the survivor. A second-generation family member or an American spouse who at times feels their own survivor guilt, can have these emotions surface when the survivor becomes physically and psychologically needy. These feelings may influence family members to sacrifice themselves more than is appropriate or realistic under the circumstances. When second generation members make unrealistic choices, friction with other family members, spouses, or children may result. In a “dependent survivor family”, one of the most difficult choices a child of survivors may have to make is to put a parent in a nursing home. When placed in an institution, such as a hospital or nursing home, the loss of control, uniforms, regimented schedule to get up, go to sleep, triggers being incarcerated and post-traumatic stress symptoms erupt. When it is impossible to avoid such institutions, the offspring of survivors has to sensitize the staff to the emotional needs of their parent, and has to take on an ongoing role of advocate for the parent. PTSD symptoms can too easily be interpreted as psychotic and a survivor may be given the wrong medication. The fourth type of family is the “aging isolated Holocaust survivor,” which is an individual who is left all alone with no immediate family, is alienated from their family, or whose descendants are abusive. This isolated survivor is dependent on social service organizations, volunteers, friends, and strangers for coping and daily needs. In the mind of the isolated Holocaust survivor, Hitler’s plan to annihilate the Jews succeeded. This survivor cannot stop obsessing about what he or she did to deserve such a fate, and can be beleaguered with survivor guilt. The question often asked is, “Why did I survive to suffer like this?” I mention this type of Holocaust survivor family because often the volunteers are children or grandchildren of survivors who lost their parents or grandparents, or descendants of survivors who work in social service or medical agencies. The despair experienced by some Holocaust survivors is exacerbated by the fact that they did not have children, or had problematic children. Not having children can happen to anyone, but for survivors, and particularly for women incarcerated in concentration camps, this circumstance has special significance, and a different level of responsibility is therefore felt by the survivor. There are survivor mothers who fear that their incarceration or persecution was responsible for their child’s infirmities. A few blame their lack of conception on experiments performed on them during their years in concentration camps. There are those who chose not to have children because the trauma of witnessing what happened to youngsters during the years of German-occupation. Thus, the despair is compounded by survivor guilt, which is relentless in some aging Holocaust survivors. Survivors in their final developmental stage, which Erik Erikson characterizes as “integrity versus despair,” must assume responsibility for their own lives and accept significant others—including family members—into their lives. When a survivor does not have “significant others,” despair sets in because there is no one for the survivor to guide, and their need to bear witness is not validated by people who matter to them. Volunteers who befriend isolated aging Holocaust survivors, listen to their stories, show them that they have something worthwhile to impart to the next generation, give isolated survivors the will to live. Despite the fact that the legacy is a mixed blessing, it does have integrity, and that integrity is imparted to others. The role of a volunteer, social service agency and mental-health or medical provider is, with these families, emotionally intense. As outsiders, their first task is to gain the trust of these survivors who distrust them or suspect they have ulterior motives. These survivors are sometimes forced to rely principally on social service agencies or strangers for their needs because their children or grandchildren have given up trying to care for them. The second or third generation in this scenario may resent the survivor because they are demanding or entitled, paranoid about outsiders, or irrational about giving up control over some aspect of their lives, typically finances. In any of these family types, family secrets are often revealed during this late stage of life. Children or grandchildren may be shocked to learn that a survivor was married before the war or had a previous family, or that a spouse survived the war and the survivor knowingly or unknowingly committed bigamy. Of course, learning that one’s parent is Jewish, though rare, is another secret that subsequent generations have had to face. As the memory of the past is sharpened for aging Holocaust survivors, a certain kind of earworm attacks them. It is not jingles that they cannot get out of their head, but rather, the last words they heard from a parent, or child or sibling. Or, their own voice saying, “I should have gone to the left with my daughter and not given her to my mother.” Family members have to assuage their irrational survivor guilt so that they can go to their resting place in peace. Finally, let’s return to Dave, the survivor, I introduced you to at the beginning. Dave was at death’s door, and the family was gathered all around him. “Sarah, my wife, are you here at the bedside?” “Yes, Dave, of course I’m here.” “And Bernie, my oldest son, are you here?” “Yes, dad.” “And Rachel, my daughter, are you here?” “Yes, Father, at the foot of the bed.” “And Sam, my youngest, are you here too?” “Right here, Pop.” “Well, then,” said Dave, “if all of you are here, who’s minding the store?” Holocaust survivors across the board wish for their descendants to mind the store after they are gone. And by that, I mean that it is their wish that their descendants as well as all Jews be in charge of their legacy, of their memories, of who they were and what they accomplished during their time on earth. While wishing one’s legacy to continue is inherently human, with Holocaust survivors, it is profoundly urgent, that future generations bear witness when the survivors no longer can.