September 24, 2014

As we confront our mortality at this time of year (the High Holidays), I would like to suggest a service you can perform that can alleviate suffering, prevent or ameliorate remorse and help prevent financial ruin.  I am talking about end-of-life documents — Durable Power of Attorney, Medical Power of Attorney, Directive to Physicians, and Do Not Resuscitate Orders.  I propose congregations make samples of these documents available on their websites and that rabbis discuss them from the bimah on Rosh Hashanah or Yom Kippur.

I cannot overemphasize the importance of these documents.  A Durable Power of Attorney along with a Medical Power of Attorney make it possible to avoid the necessity of a guardianship when a loved one becomes incompetent as a result of dementia or accident. This can save a family thousands of dollars and avert any humiliating court hearings that probe family dynamics as well as the proposed ward’s possibly bizarre behavior.

The Directive to Physicians will forestall any undesired “heroic measures” that can inflict horrible, unnecessary end-of-life treatments that not only subject an incompetent or unconscious patent to prolonged, useless and painful procedures, but also have been shown to leave surviving family members with PTSD because of feeling guilty for subjecting their loved one to unnecessary suffering.

The Medical Power of Attorney is also extremely important in addressing family issues.  Families are not always in agreement as to the level and extent of treatment that should be expended on a loved one.  The Medical Power of Attorney allows one person to “take charge,” and, referring to the Directive to Physicians, let everyone know that he or she will honor the patient’s desires.  This usually smooths relations and produces a modicum of harmony within the immediate family.

It should be noted that once someone turns 18, no one — not a parent, not a spouse, not a sibling — can make medical decisions on behalf of one, who because of accident or incompetence, can no longer speak for themselves.  With no Directive to Physicians and Medical Power of Attorney, the patient will be given every possible treatment to prolong life no matter the cost in suffering or money (or they will be subject to the dictates of a medical board that is alien to the family).  Remember the most likely event that will leave someone incompetent or unconscious between the age of 18 and 65 is an auto accident.  That cannot be planned for, but it can be addressed with end-of-life documents.

It should also be noted that people who have these documents tend to outlive similarly situated people who do not have them because they are subjected to fewer traumatic procedures and usually opt for palliative measures that actually improve the quality of life while extending it.

As for the Do Not Resuscitate Order, it is a document that should be considered as one ages or experiences diminished health. For young people and older people who are in good health, CPR and defibrillation can work wonders.  For the elderly or infirm they can be torture, pure and simple.  Unlike what you might glean from TV, they are not usually successful.  Only about 30% of elderly or infirm patients survive 30 days, and if they do they usually suffer severe mental deficits. Interestingly, while 85% of the general public say they would like to be resuscitated, 85% of emergency room doctors, knowing the probable outcomes, refuse the procedure for themselves. Moreover, the cost of treatment during those final days is exorbitant.

These documents allow each person to have control over the kind of treatment he or she will receive at the end of life, rather than being subject to the whims, wishes, hopes or dictates of others.  Unfortunately only about 23% of Americans have these documents.  As a result thousands of lives are subject to unnecessary and expensive treatments that only increase suffering and agony.

Rabbi Elliot Dorff has some excellent examples of Directives to Physicians that you could post on your websites.

Again, congregations and rabbis should consider using the “bully pulpit” of the bimah and get the word out to your congregants when you have the majority of them present. Help them to do themselves, and their loved ones, a favor, by taking steps now to prevent uncertainty and unnecessary angst in future. 

Fred A. Helms is a student in the Gamliel Institute. Fred has worked as an attorney for many years. He says: “I joined my congregation’s Chevra Kadisha as a way of repaying my community for the support and comfort they gave my wife and me after our son died in 2010.  In 2012, the chairman of the congregation’s cemetery committee and rosh of the men’s Chevrah Kadisha selected me as his assistant and successor.  He died in January 2014, and I decided to attend the Gamliel Institute’s annual conference in March to prepare me for my new duties.  I was so impressed with the conference, I enrolled in the Institute’s website educational program which has also proved invaluable in helping me help others.”


Editor's note: On behalf of Kavod v'Nichum, I wish all our readers a Shanah Tovah Umetukah, a good and sweet year. May it be a year of blessings for you and your loved ones.

To find a list of of other blogs we think you may find to be of  interest, click on “About” at the bottom right.

GAMLIEL INSTITUTE COURSE: Chevrah Kadisha – Origins & Evolution

We want to acquaint you with the work of the Gamliel Institute, if you are not already familiar with us, and to announce our next upcoming course.

The Gamliel Institute is the leadership-training arm established by Kavod v’Nichum (“Honor and Comfort”), the educational resource for Chevrah Kadisha groups throughout North America. Kavod v’Nichum provides a comprehensive website (www.jewish-funerals.org) on issues related to Jewish end-of-life practices, and offers community and synagogue trainings and educational programs. In addition, Kavod v’Nichum holds annual conferences that focus on issues and concerns dealing with the topics of Jewish death, mourning, burial, and remembrance, including the work of the Chevrah Kadisha and Jewish practices from serious illness to death and mourning, as well as Jewish cemetery operation and maintenance.

The Gamliel Institute offers a program of online, interactive classes at an advanced level. The Gamliel Institute will be offering Course 1: Chevrah Kadisha – Origins and Evolution – to begin October 14, 2014 (with an introductory logistics session on October 7). Course sessions will be on Tuesday evenings online (5 pm Pacific, 8 pm Eastern).

This course is an in-depth study of the origins and history of the Chevrah Kadisha, the Holy Society that deals with the sacred tasks surrounding practical and ritual preparations of the deceased person for a Jewish funeral. The course further examines how the institution and role of the Chevrah Kadisha has evolved over the centuries and in different localities into the modern day.

Are you interested in taking this course? If so, please be in touch with any of us with questions, or sign up for the course at Kavod v'Nichum Conference!

Join us for an unforgettable time in beautiful Austin, Texas, Feb 22-24, 2015 for the 13th N. American Chevra Kadisha and Jewish Cemetery Conference. Regiser now! Visit the web page to register, reserve a hotel room, and to make your plans! 

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