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Strategies for Successful Bikur Cholim Visits

 

  1. CHECK WITH THE PATIENT AND/OR FAMILY FIRST

Don’t assume that because you are the congregational rabbi, your visit is automatically expected and welcome. Often, patients are uncomfortable, and don’t want to receive  any  visitors for  a  period of time. We must always respect their wishes because, ultimately, the purpose of our visits is for the

patient’s sake, not to satisfy our sense of professional duty or to fulfill our mitzvah. So, always call before planning a visit. Sometimes, too, you may have a cold and it’s not a mitzvah to visit and

spread your germs to an already sick patient (a  possible exception  might be  where you  are  needed to do vidui, in which case you should request a mask). In general, if you’re unable to visit for whatever reason, write a personal note that he/ she is in your prayers and extend warm wishes for a  refuah shleima. Patients cherish these heartfelt letters from their Rabbi and often display them in their room.

 

Additionally, in keeping with the Shulchan Aruch’s directives ( Yoreh Deah 335: 4)  to see patients at the times of the day which are most conducive to successful visits, we should check in advance to

determine the best time to visit. And, then, when actually visiting, remember to always knock on the door of the patient’s room before entering and ask if it’s convenient to stop in now, or wait a few

minutes. In fact, in a hospital setting, if you find the door to the patient’s room closed, check with a nurse to see when you may enter. If a physician enters the room, while you’re visiting, offer to step outside, as typically, the patient really awaits this visit, unless, of course, the patient gives you

permission to stay. Finally, always respect the patient’s confidentiality: don’t discuss your visit with

anyone. In fact, according to federal HIPAA regulations, one may not even  disclose that a  patient is in  the hospital, unless the patient gives consent to do so.

 

  1. YOUR ROLE IN THE VISIT — EMPATHETIC LISTENER AND SPIRITUAL PRESENCE

As rabbis, we feel the need to somehow make things better by being “fixers,”  offering reassurances that somehow things will get better (even when we know that the patient is end-stage terminal and will die with a diminished quality of life). We want to put a positive spin on a difficult situation however and wherever possible. We are uncomfortable with the chilling reality that this situation is hopeless and we, as spiritual leaders, are helpless.

 

As rabbis, too, we are always talking — learning, teaching, sermonizing and counseling.  We’re  simply not used to listening. We are uncomfortable with silence and we’re not trained in carefully and

empathetically listening to what is being said (and to what is not being said). We’d all do well to remember the very first Bikur Cholim visit when Hashem visited Avraham. What does the Midrash teach us about what Hashem said to Avraham at that momentous visit? Absolutely nothing — for indeed there is no record of Hashem saying anything to Avraham! It was  simply Hashem’s  presence that made all the difference. In the world of chaplaincy, we refer to this clergy-congregant encounter as “the ministry of presence.” Just being there as a spiritual leader, representing Hashem  who truly cares for each of His flock, is what’s essential. We must then take our cues from what the patient is

saying, and not enter his room with our own pre-existing agenda. And, if the patient doesn’t  want to  talk about “it,” neither should we!

 

…more

 

  1. DON’T OFFER UNSOLICITED ADVICE OR THEOLOGICAL BROMIDES

How do we respond to the age-old queries of terminal and dying patients:

 

“Rabbi, what did I do to deserve this? I’ve always been a good person, never done anything to hurt others!”… or… “Rabbi, why doesn’t God just take me already? I’ve lived long enough and can’t go on like this!”

 

In reality, these questions are rhetorical. As wise as you  may be,  this is  not an invitation or occasion  for you to launch into theological discussions of why  bad things happen to good people ( tzadik v’ra  lo), or suggest zol zein a kapparah (yissurin m’markin avon) or “God gives no man or woman a

burden greater that he or she can bear.”  This is  not what they  want  to  hear!  What they patients would like to hear is that though you don’t know the answers, God does, and that though these trials seem unfair and make no sense to us, after the proverbial 120, He will reveal the rhyme and reason

for our suffering. More importantly, they must know that God still loves them and has not abandoned them. The 23rd Psalm doesn’t declare: “I fear no evil, for Thou will heal me,” but rather, “for Thou

are with me!” God  doesn’t  promise healing or salvation, but that He  will  be there with  us and for  us to the very end and beyond. And  we,  in  the ministry of God’s  presence,  must be  there to care,  as well!

 

  1. RECOGNIZE YOUR EMOTIONAL BAGGAGE WHEN MAKING VISITS TO THE DYING AND THEIR FAMILIES

Remember, each of us brings to these visits our personal baggage: how have we responded to the

losses of our loved ones? How have our personal tragedies affected our understanding of  death  and dying and their impact on  our families?  Did  we  require  and receive  bereavement counseling?   Were we left with unresolved issues? Are we fearful or overwhelmed by  the high-tech  equipment in  ICUs? Are we able to recite vidui in these cold, clinical settings?… How do all of our personal issues make it difficult for us to meet and offer support to congregants and others?  Feel free  to  discuss your issues with your chaverim , particularly, health-care chaplains who are knowledgeable and sensitive to these concerns. Also, to demystify the clinical, high-tech environment… learn! Don’t be embarrassed to

ask medical / nursing staff to explain to you the purpose and function of various pieces of equipment.

 

  1. THE ESSENCE OF BIKUR CHOLIM – PRAYER!

Nothing is more reassuring to patients/ congregants in a time of  need then  a  m’sheberach offered  by their personal Rav.  Before  we leave the patient’s bedside,  we should ask  whether he or she would like  us to recite a m’sheberach. Almost invariably, they smile and ask us to do so. We might remind them beforehand that the very Shechinah is present at the head of their bed and is very close to our prayers; indeed, God seeks the prayers of the sick more than the prayers  of others on their behalf.  So,  (unlike  other religions), if they know how to daven, they should pray with us for a refuah shleima b’toch sh’ar cholei Yisrael!

 

 

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