At a point when aspects of their lives can spiral out of control, the frail elderly need the sense of comfort that comes from their spirituality, according to Rabbi Dayle A. Friedman, founding director of Hiddur: The Center for Aging and Judaism.

“On a spiritual plane, depression existentially comes from not having the opportunity to engage in meaning and not having the opportunity be meaningfully connected,” Friedman told NJ Jewish News during a break in her Dec. 15 workshop at the Leon & Toby Cooperman JCC, Ross Family Campus, West Orange.

“There’s Prozac, and then there’s spiritual life — and the two are not mutually exclusive, to be sure — but I do believe that isolation and being devalued and loss contribute to the immense incidence of depression in the elderly, and fostering spiritual well-being is a tremendous antidote.”

Friedman shared her perspective with more than 60 social workers, chaplains, nurses, activity and program directors, and others who work with the senior community. She offered the keynote address during Making Connections, a half-day conference hosted for the second year by MetroWest CARES, the Coalition Addressing Resources for Eldercare Services.

The founding director of chaplaincy services at the Philadelphia Geriatric Center, Friedman now leads Hiddur’s efforts in training rabbis in chaplaincy and creating “spiritual resources” — handbooks, rituals, and scholarship — for the Jewish elderly and their caregivers.

The goal, she said, is to understand the spiritual dimension of those who find themselves needing increasing care from others and whose sense of identity is further disrupted by moves from their homes to senior residences and nursing homes.

Most of all, she said, such people want to be listened to, to be able to express themselves without fear that they will be ignored or patronized. “They still want to change the world, too,” Friedman said.

According to the aptly named Ethics of Our Fathers, related Friedman, the world depends on three things: Torah, worship, and acts of loving-kindness. She urged agencies and professionals to use those pillars in their interaction with the Jewish elderly.

Applying Torah concepts, she said, means consideration of the fact that people are always looking to learn, to keeping their minds active, even if the focus is not necessarily Jewishly oriented.

When it comes to worship, however, she has found that the need for ritual and observance often becomes “incredibly powerful, even though they might not have been so earlier.” When one day becomes like the next — like a run-on sentence, she said — the elderly crave “markers,” such as Shabbat and holidays.

“In Jewish life, we have a completely different concept of time. It doesn’t look like the day before or the next day, especially in relationship to Shabbat,” she said.

Acts of loving-kindness can include simply listening to the elderly, Friedman said. Some topics, such as death, might not be pleasant, but she encouraged the audience not to discourage such conversation. Many older people start to talk of giving away their possessions in preparation for their deaths, and end up talking about the significance of such objects and the memories they conjure.

“When you’re going on a trip, don’t you make plans?” she asked. “Death is the most awesome journey.”

Karen Alexander, director of Eldercare Services for United Jewish Communities of MetroWest NJ and coordinator of MetroWest CARES, said that the disproportionate number of elderly in the area poses a challenge to agencies and resources.

Based on the Jewish population study that was done in the late 1990s, there are about 120,000 Jews in the MetroWest area, about 20,000 of them over the age of 65 — about 17 percent, compared with 14 percent for the general public.

“I’m delighted to see the energy in the room and to see the attention level of the participants…,” Alexander said. “They come from such different backgrounds professionally and organizationally, yet everyone seemed to be getting something out of it.”