End-of-Life Issues Get Full Hearing at Daylong Hospice Conference

"I think that most of us feel that our souls are shriveled up, emaciated, starving creatures," said Rabbi Naomi Levy. Then, the seven-year congregational rabbi from Venice Beach, Calif., went on to disagree with that statement, describing the soul as strong, beautiful and, most importantly, eternal. For the health-care professionals, caregivers and members of the religious community who were listening to her, the lesson might be a valuable one to remember in their work with the dying, the rabbi assured. It could be a valuable lesson for patients as well: "They need to hear it," she said.

Levy served as the keynote speaker for the Jewish Hospice Network of Philadelphia's recent event, "Finding the Words: Creating a Jewish Response at the End of Life," held on Dec. 6 at Gratz College in Elkins Park.

Sponsored by the Jewish Family and Children's Service of Greater Philadelphia, workshops at the conference included "Decision-Making and Self-Determination: Jewish Law and American Law," "When Death Comes Too Soon" and "At the Patient's Bedside."

Levy explained that "there is an enormous amount that Judaism teaches us about dying and the soul," but such resources tend to be contrasted by avoidance and denial concerning the subject of dying.

The rabbi also emphasized the need for patients to pray as they neared the end of their lives, and encouraged caregivers to assist in that process.

"Help them find their own prayers. Help them find their own connection to God."

Finding prayers is not unfamiliar territory for Levy; her 2003 book, Talking to God, features many prayers she herself wrote, some of which she shared during her speech.

She also addressed the idea of listening to the emotional needs of patients, and helping them address their anger and fear. She noted that many people think they're not being good Jews because they're afraid at the end of their lives, and so need the reassurance that such reactions remain completely natural.

Rabbi Dayle Friedman, who spent 12 years as a nursing-home chaplain, shared her expertise in the matters Levy first broached at a workshop titled "Coming to Terms: Meeting Jewish Patients' Spiritual Needs at the End of Life."

Friedman acknowledged that "anything I know about death and dying — and accompanying dying — I learned there. We are encountering people at a state of brokenness."

She emphasized that the job of the caregiver is to connect with the patient. "We don't need to prove how smart we are," she said. Sometimes, not talking is the most powerful way to connect: "It's not a volley," she said of having a conversation with a patient.

"Not finding the words may be the greatest thing we can do," she went on. She noted the power of connecting through silence — moving past that period of awkwardness and obligation to speak into a different place entirely.

"That's where the real stuff happens," she insisted.

The rabbi also advocated helping patients be part of Jewish practices, if they desire. "To the degree that we can help people mark time Jewishly, it can help texture time."

She explained that for many patients, the days can seem to run together, and so, bringing Shabbat candles can designate a special time for them.

The attendees at the conference took away various lessons about what they most often face in their day-to-day caregiving counsel. Paula Altszuler works at Einstein Hospice in Philadelphia, primarily with a lower-income, inner-city population that is mostly non-Jewish.

"Often, in their communities, they're very open about their faith," she said, but the few Jewish patients she sees are much more reluctant to open up about spiritual matters at the end of their lives.

"I came here to learn how to approach the subject with people of the Jewish faith," she said, which is her religion as well.

Altszuler added that her goal in such a situation is "to tap into their Jewish spirituality," and to understand what's meaningful for them.

'A Closeness to God'

Patricia Rich works at the Madlyn and Leonard Abramson Center for Jewish Life in Horsham, and so appreciated Levy's candor on end-of-life issues in the Jewish tradition.

"I rarely hear a voice in the liberal Jewish community that talks about the soul and the dying process," she said.

"It feels nice to enlarge the community of people who are around me," she said, referring to the interdisciplinary nature of hospice work, which involves doctors, nurses, rabbis and other caregivers.

For Harriet Paley, a volunteer at Keystone Hospice and a member of the chaplaincy training program at Jefferson Hospital, simply being with a person in hospice has a deeply spiritual significance. "There's a closeness to God when people are close to the end of life. Being able to be present for them is a gift."


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