End of Life: A Jewish Perspective
וַיִּקְרְבוּ יְמֵי יִשְֹרָאֵל לָמוּת
And the days drew near that Israel must die.
Genesis 47:29
Engaging hospice or palliative care services is often in line with Jewish values, regardless of how you identify along the continuum of religious observance.
Beliefs and Practices
Jewish end-of-life care programs are expert at caring for Jewish patients while acknowledging each person’s cultural beliefs and religious values. In a Jewish hospice program, such as MJHS Hospice, rabbis are available to provide counseling and caring conversations and to address end-of-life issues. A well-developed Jewish hospice program employs staff members who are sensitive to Jewish religious and cultural preferences. Your family’s religious observances will be respected. Your dietary preferences and your kitchen’s integrity will be maintained. Funeral planning can involve the Chevra Kadisha (Jewish communal burial society) and can also facilitate burial on a short timeline – often within 24 hours of the patient’s passing.
If your family system includes Holocaust survivors, look for a provider who will ensure that your family will receive gentle, loving and peaceful care from staff members who are sensitive to their past experiences. This community has extraordinarily unique needs due to the emotional, social and psychological pain experienced during the war years; these traumas often resurface during the end of life. You will want to find an educated and sensitized team of clinicians and professional caregivers who are attentive to the survivors’ past traumas, are committed to caring for Holocaust survivors with respect and compassion, and will extend this care to second and third generation survivors who have their own set of needs as caregivers.
A valuable resource for caregivers:
Jewish Hospice – For Torah/Halachah-Observant Jews
Jewish hospice providers may also provide care to other unique Jewish communities. Certain hospice providers have special programs for Jewish families observing halachah (traditional Jewish law). These programs, such as the MJHS Hospice “Halachic Pathway,” assure patients and their families that a chosen posek (rabbinic advisor) is included in the medical decision-making process. Experts in hospice understand the importance of facilitating these conversations appropriate to a person’s religious beliefs. This enables patients and their families to receive end-of-life care that adheres to their personal religious practice and to Jewish law.
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What is Jewish Hospice?
Hospice is a benefit which offers services of a physician, registered nurse and home health aide designed to help patients with advanced disease live as comfortably and productively for as long as possible. If and when the physician says that cure or treatment are no longer possible and the patient/family is interested in being cared for in accordance with his/her own religious values, it is time to identify what benefits you are entitled to.
A Jewish hospice program, such as MJHS Hospice’s Jewish program, offers the core hospice services and much more. Jewish hospice professionals are experts in pain and symptom management but also offer special consideration and attention to the patient’s emotional and spiritual well-being, shaped by the patient’s individual religious practice and observance.
Hospice is a specialized program of care and services for you or someone you love who has a life-limiting or advanced illness. Hospice focuses on providing comfort, rather than on trying to cure a condition. Hospice services aggressively treat and manage pain and other symptoms such as nausea and shortness of breath. Hospice services are usually provided in the patient’s home, but also are available in hospitals, nursing homes, in special hospice residences and in inpatient hospice units (IPU).
Five Core Jewish Values of a culturally-sensitive Jewish Hospice program:
- Dignity and Respect – All people, created in the image of God, deserve dignity and respect – particularly when confronting advanced illness. Our patients and their families are emotionally, spiritually and physically supported with the sensitivity to their thoughts, feelings, moods, culture, values and beliefs.
- Choices – Clinicians, as members of a coordinated, interdisciplinary care team, present options to the patients in a balanced manner and help families identify their goals of care in accordance with their values and desires. Our approach enables patient-autonomy and empowers families to share the values and wishes of the patient wherever the journey may lead.
- Self-Determination –It is patients’ goals and values that guide the care and decision-making, when clinically appropriate. Care choices are the patients’ and, if requested, may also be informed by their families, caregivers, spiritual guides and healthcare agents
- Hope – Each individual is entitled to live with hope. For some it is the hope to have a pain-free day for others it may be the hope to reconnect with a loved one. Hospice clinicians help patients identify their individual hopes and help nurture hopes and dreams as much as possible.
- Compassion – Perhaps the consummate Jewish value, a Jewish hospice program values providing all of our care, particularly to those with advanced illness, with compassion and respect. As did our ancestor Abraham, we strive to provide rest and refuge to those weary travelers along the journey of life before we escort them back along their way.
Services of a Jewish Hospice program:
- Involvement of the designated spiritual or religious leader is encouraged and respected
- Artificial hydration and nutrition, medication and oxygen are continued as per the family’s or rabbi’s instructions and in consultation with a physician
- DNR/DNI is not a requirement for enrollment
- Choosing to revoke the Hospice benefit remains an individual choice in order to pursue treatments not covered and the patient may elect to access the benefit and be re-admitted at a later date.
- Staff is educated to be sensitive to the family’s values and culture
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Jewish Hospice – For Torah-Observant Jews
Jewish hospice providers may also provide care to other unique Jewish communities. Certain hospice providers have special programs for Jewish families observing halachah (traditional Jewish law). These programs, such as the MJHS Hospice “Halachic Pathway,” assure patients and their families that a chosen posek (rabbinic advisor) is included in the medical decision-making process. Experts in hospice understand the importance of facilitating these conversations appropriate to a person’s religious beliefs. This enables patients and their families to receive end-of-life care that adheres to their personal religious practice and to Jewish law.
Chayim Aruchim – Center for Culturally Sensitive Health Advocacy and Counseling
Many care programs for those in the Jewish community with advanced illness are guided by Chayim Aruchim, established by Agudath Israel of America to help Jewish patients make health care decisions according to Halacha.
With the team of halachic authorities, legal experts, patient and pastoral care professionals and high-level government policy advocates, Chayim Aruchim endeavors to serve as a vital resource in championing, promoting and ensuring the implementation of preferences of Torah observant patients care decisions in accordance with Halacha.
