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Hospice care: What and when

Fundamental to Judaism is the belief in the infinite value of human life and the obligation of each person to protect and preserve it. Life is viewed as a gift from God to be safeguarded and maintained. There is an obligation, as well, to alleviate pain and suffering. At the same time, Judaism recognizes the inevitability of death. Thus, end of life care is a reality that most families will eventually have to deal with.

Hospice care is an approach to end of life care that many are unaware of. It is an alternative to acute hospital care, which may not always be the best choice. There are times when the care that a hospital can provide is of limited or no benefit, and may do little to alleviate a patient’s suffering while holding out no hope for improvement.

What is hospice care? Hospice care is, in a word, comfort care. It is not curative. It is not designed to cure any underlying medical condition such as heart failure or COPD. The goal of the hospice program is to keep the individual at the end of life as comfortable and pain free as possible while preserving his/her dignity, as the terminal illness progresses and follows its natural course to conclusion. This is accomplished by providing all medical interventions necessary to effectively manage whatever symptoms exist, be they pain, respiratory distress, agitation, nausea and vomiting, etc. Support is provided to the family and caregiver(s) of the patient, as well. A multidisciplinary hospice team that includes medical personnel, home health aides, social workers, and spiritual counselors manages care. Hospice professionals function as partners with patients, their loved ones, and caregivers.

Hospice care can be provided at home, in a nursing or assisted living setting, or in an inpatient hospice facility. In the inpatient environment, families are welcomed and encouraged to keep their loved ones company and even adorn their rooms in a manner which will make them feel as much at home as possible. Whatever the venue, care is managed by the same interdisciplinary team.

When is hospice care appropriate under Jewish law? As in all areas of halacha, there is more than one opinion. In general, I believe it can be said that when a person’s condition is terminal and irreversible, when there is no hope for recovery and further treatment is futile, when there is severe pain and suffering, then hospice care may be an appropriate halachic alternative. While there is an obligation to prolong life, there is also the recognition that life may become unbearably difficult and painful. There are circumstances, therefore, under which the withholding of life-sustaining or aggressive medical treatment is permissible, and palliative or comfort care is appropriate. Since each person’s circumstance is unique, each situation has to be judged on its own merits. But hospice presents an alternative to continued intense suffering and an opportunity to live out your remaining days in peace, and perhaps even prepare spiritually for what is to come.

The decision to elect hospice care is a very difficult and painful one for both the patient and the family, and should be made in close consultation with medical experts and your own rabbi or religious/spiritual guide. Life and health being as precious as they are, the decision naturally should be made with great care and with the best information and advice available.

My experience as a hospice chaplain at Villa Marie Claire, Holy Name Medical Center’s residential hospice center in Saddle River, and in the community has taught me that hospice care providers are exceptionally compassionate and caring, and hence very successful at providing incomparable end of life care to patients and their families. Families regularly offer thanks and praise to hospice staff for the excellent care provided their loved one. And at the Villa, “We wish we had known about this place sooner,” is a comment we often hear.

Rabbi Joseph Siev
Spiritual Counselor
Villa Marie Clair
Saddle River

He’s for Trump

I was very surprised in a negative manner when I read the letter penned by Dr. Greene, (“Trump and the big lie,” Letters, September 30). I thought that he was above trying to play the Hitler card in a Jewish or any other publication. His equation of a candidate using the “big lie” fits more with Clinton than it does Trump. Which candidate was referred to as lying many times by the director of the FBI before a House Committee?

“Nes ipsa loquitor”? Which candidate has been able to isolate herself from the actions taken by allies and subordinates to provide for deniability when called to task for actions taken? Just because Trump has been “called a racist, nativist, a misogynist and worse” does not make these accusations true, especially when the quotes used are distorted. The latest accusation to help prove he is a “misogynist” as of this writing, was to call the winner of a Miss Universe Pageant “piggy.” It was reported he called her that after she gained 40-50 pounds after winning the title. Would it have been better, to instead of trying to embarrass her into losing weight and then paying for her going to a health club to assist her in doing so, he just had her fired for breach of contract?

When one looks at many of the ad hominem attacks on Trump they rely on the lack of knowledge of the listener or reader. Two are; Trump’s calls to halt the entry of Muslims into the U.S. until they are properly vetted has been distorted into a blanket ban. He is not alone with this demand, many in the intelligence and security communities agree and have spoken out concerning this failing. A second was his call for a judge with Mexican ancestry to be recused from adjudicating at a trial he was involved with that he based on the alleged membership of the judge in the organization called La Raza.

After the first debate, light was made of Trump’s claim that he had a faulty mic causing him to sound as if he had sniffles. He was portrayed as just making it up as an excuse because he did not sound well. In an attempt to further demonize Trump, Howard Dean, former governor and head of the Democratic National Committee, had the nerve to make the almost libelous accusation, “Notice Trump sniffing all the time. Coke user?” An accusation like that should have been more widely condemned and a loud, widely disseminated apology made. All I heard up until today was that Trump was making it up. There was nothing wrong with the mic we were told by all, until the Commission on Presidential Debate admitted that he was correct, the mic amplified the sounds of his breathing.

The Jewish Standard should not print articles, letters or quotes that equate actions or words by any candidate with Nazis or Hitler. I would hope that your readers are smart enough to understand what is being done.

I hope that in the next Town Hall type forum, the questions from the audience are chosen to provide information to the viewer and not to embarrass a candidate.

Howard J. Cohn
New Milford

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