Rabbi Becker, please tell us about your professional background in the field of elder care.
I have been involved with elder care since 1972, when I was recruited to join the administrative team of a 527 bed geriatric Center. Equipped with an MBA, MS and Rabbinic ordination, I became the point person for addressing and resolving family complaints and concerns regarding all aspects of service delivery.
At this and subsequent appointments I was responsible for organizational management, development, state surveys, regulatory compliance, and the clinical programs. ?A veteran caregiver ? I served as the primary family caregiver for each of my parents over a period of twelve years ? ?my background includes the design and development of Jewish hospice programming, quality assurance of long-term care services, graduate student training in geriatrics and research presentations in the field of gerontology at national professional scientific conferences.
In 1999 I founded L?Orech Yomim/Center for Healthy Living, Inc. to service the needs of the Orthodox Jewish Community. Its landmark ?Caring for Our Elders? seminar series, integrating rabbinic and professional expertise has earned a reputation for excellence. Our first program was entitled ?Choosing a Nursing Home: Cultural Competence, Halachic Issues and Practical Considerations.?? I can recall the expressions of amazement among rabbis, professionals and all attendees that evening, as we looked around the hall and saw the standing room only crowd. We knew something of significance was transpiring.? The model has been replicated nationally
What led you to write this book?
I wrote the book because of a longstanding commitment to mitzvas kibud av v?eim and elder care. This in fact, is my second volume on the subject.? It was spurred by my professional background, the positive feedback from the original work, my personal experiences while caring for my parents, the subsequent availus periods? as well presentations at L?Orech Yomim?s ?Caring for Our Elders? seminar series.
I had experienced all the life cycle events identified in the book, visiting the sick, care management, mourning and the emptiness after a loss, and then.? if only I knew, I would have done it differently?
Just as I had struggled, I knew that the community was struggling with the challenges of fulfilling the mitzvah. I also found that there were deep rooted traditions and practices that were not common knowledge. I was eager to learn their rationale. Learning about them after the fact, when they can longer be performed was disappointing and frustrating.
This book is a collection of hashkafa, kabala, halacha, minhag ? philosophical, theological, and religious practice ? ?which is not typically taught in yeshiva, seminary, or secondary school.
Ultimately, if we know we are ?doing the right thing,? it can be a source of personal strength, satisfaction, growth, and consolation. The objective of this volume is to help foster such feelings.
Who ought to read this book?
I mentioned the title to a friend who told me ?This book is not for me ? I don?t have parents, they are no longer living.?
I would like to think that anyone who has ever had a parent, will benefit from this book. One of the underpinnings of the work is to advance the teachings of our Sages that the mitzvah of kibud av v?eim is very much applicable after a parent?s demise. Indeed, some suggest that it is even greater after death than when they were living. In this regard, I have incorporated primary text from these Masters representing a broad spectrum of tradition, Chasidic, litvish, and musar schools. The original language is accompanied by a translation.
Scholars and laypeople will find the information meaningful. I made special effort to make the presentation clear, simple, and reader friendly. Every point is supported by a primary source. Sources are available on the side margins so that readers do not need to flip pages unnecessarily. Extensive documentation and notes are also provided to allow for additional independent research and study.
How is your book different than other Jewish books that deal with similar issues?
I don?t think anyone has tackled the scope of this subject matter in one volume.
If a reader has a local Rabbi that they consult with ? is it still relevant to read this book?
This is certainly laudable yet the input of scholars familiar with elder care and end of life issues are often still required. Moreover,? ?the value of early selection of and regular consultation with a Rabbi ? one that all family members respect ? cannot be sufficiently underscored. In addition to practical Halachic guidance, it will reduce the risk of family conflict that almost inevitably ensues in the tense and demanding circumstance of caring for a frail parent. Further, your rabbi may not be available at the very moment you need his guidance. It is also very important to learn what the issues are so you will know when it is necessary to call the Rabbi.
What surprised you as you wrote this book? ?
The impact mitzvas kibud av ?v?eim has on family relations in general, eg, child rearing, was not that surprising. Much of the research was also expansive and enjoyable. The one finding that was startling was the Sefer HaChinuch?s explanation of Mitzvas Yibum. It is awesome. The torah encourages a union that heretofore is an erva, forbidden, one may not normally marry a brother?s wife, to facilitate a subsequent progeny who would fulfill the mitzvah of kibud av, for the father that had passed away. This is unquestionably a powerful demonstration of the significance the Torah attributes to kibud av v?eim after a parent?s demise.
It is unclear how the mitzvah of Yibum is connected to kibud av v?eim. Can you clarify?
Gladly. One of the messages the book conveys is that fulfilling the mitzva of kibud av veim after a parent?s death is a fundamental tenet of our tradition. This concept is enveloped in the phrase bera mezake aba- the behavior of children benefit their parents. A number of chapters in the book are dedicated to this theme. With regard to yibum, When the brother is living the tora firmly states, ervas aishes achicho lo segale, Vayikra 18:16. It is prohibited to expose any nakedness of your brother?s wife. However, should a brother die childless, the Torah directs the surviving brother to marry his widow. it becomes a mandate, even a mitzva to do so (Devorim 25:5). The Sefer Hachinuch, known to be a pure ?halachaist? a la the Rambam, not prone to homoletic interpretations, provides the rationale for this change in direction. He states that the very objective of mitzvas yibum is to give the deceased brother the benefit of bera mezake aba. When the children of the new union perform mitzvos, they are not only fulfilling kibud av for the surviving brother, but to an even greater degree they are benefiting the neshama of their mother?s first husband. Perhaps this point can be clarified further by a recent comment made to me. A noted, very well educated rebbitzen,in the midst of reading the book. She expressed great appreciation for the comfort the book was giving her as she had recently lost her mother and was in the twelve months of mourning. She said she had read all books on the topic, but really appreciated the depth of halacha and hadracha she was gaining from it. One example she mentioned was the citation of Harav Chaim Kianovsky who states that every mitzvah a son performs, even if it is not his intention to do so, elevates his parent?s soul.
What are 3 things people can do right now to prepare for dealing with elderly parents?
I would encourage the following three things:
- Have a Halachic Advance Directive document completed. This is very important and it is given prominence in the Fundamentals section of the book.
- Do not go it alone.? Develop a relationship with a professional, who can be a friend, a volunteer and with a Rabbi for guidance and support. Complications typically occur without much advance notice. It does not have to be formal. So long as you have numbers to call for help when needed.
- ?Become familiar with the directive of Rav Moshe Feinstein, z?tl in his Responsa regarding care management of the terminal frail elder patient. It is not that well known, but nonetheless critical. ?I entitle it ?The Overall Guideline,? p33:
?Decisions made at this time will truly determine whether?a patient will indeed live or die.It is therefore imperative to gather and connect with every tolmid chochum feasible and every medical specialist knowledgeable [for input in the decision making process].?
I would add another. 4. Read this book
We recently conducted a national study of Orthodox Jewish caregiving. We found that Orthodox Jewish caregivers felt a greater degree of burden in the role as compared to the general population. While we do our best to encourage caregivers to seek out support and respite to avoid burnout, sometimes they are paralyzed ? feeling entrapped, uncomfortable ? or too busy in their very role for this to occur. It is up to community leadership, rabbis, professionals, friends and neighbors to be proactive and reach out to anyone they know caring for an elder. A Rabbi, Bikur Cholim volunteers, home care agency and nursing home administrators are aware of caregivers in the community who are struggling with the challenges of fulfilling the mitzvah of kibud Av v?eim and other family expectations. Outreach to the unaffiliated has become a popular programming model and outreach to the caregiver is deserving of community attention as well.
Do you think the issues you talk about in your book are more important now than in the past? if so, why? How?
The Holocaust actually has a big impact today on these issues.? One of the tragedies of the Holocaust is the break in the chain of transmission of customs. Many of us, the second generation, did not have the merit to learn these mitzvos from our parents because we did not experience having grandparents.
For example, we, never observed a parent practice the 12 month mourning ritual for their parent. My book is an attempt to research such practices from primary sources and understand their rationale.
End of life care may span a few months, hours, days, or many years. Today, due to advances in medical intervention and to the very existence of a generation of family elders unknown to adult children of the Holocaust, the book?s contents has a broader application than it would have just a few years ago. As we engage in conversations with friends and associates, we learn that the incidence of attending to the needs of a frail parent is no longer an uncommon occurrence.
Another factor that impacts on elder care today, more so than in the past is the likelihood that both husband and wife are working. With work demands greater, there is less time for family in general, let alone for an ailing parent. Such pressures impact on natural human tendencies to want to do good and be helpful. At the same time the halacha requires certain behavior in these circumstances. As Torah observant Jews it is important to learn what is expected of us in these intense times. The book offers such guidance.
The book has writing from a number of prominent Rabbonim ? can you tell us a little about this?
Foremost, it is important to point out that an internationally recognized posek, HaRav HaGaon Noach Isaac Oelbaum shlita, accepted the task of reviewing the halachic content of the book. In fulfilling the objectives of this work, Rabbi Shlomo Brevda, Rabbi Yechezkel Rubin (The Tomashover Rav), Rabbi Yisroel Reisman, Rabbi Noach Isaac Oelbaum, and Rabbi Avraham Schorr contributed essays to provide support, solace and guidance to individuals facing life?s challenges. Rabbi Mordechai Willig provides an understanding of Halachic issues in estate planning and Rabbi Maurice Lamm offers a beautiful description of what it truly means to say kaddish. Both the messages and the messengers are significant. The eminent Rabonim teach us important lessons. Their voices generate substance. Their willingness to contribute to this work in of itself carries a statement. I am honored to serve as a conduit for bringing their messages to the general public. The book includes selections from the Responsa of ?HaGaon HoRav Moshe Sternbuch,shlita, seminal TshuvosV?Hanhogos to strengthen an understanding of the perspectives of our Sages in addressing the challenges of fulfilling the mitzva of kibud av v?aim and elder care.
You added a number of inserts to the book which readers can actually use ? ?what are these?
Every estate planning attorney will include these two documents when advising their clients: The Advance Directive and The Last Will and Testament. The standard forms do not satisfy Halachic guidelines. Because it is so vital to have these forms executed correctly, we have provided acceptable versions to facilitate their use.
Let me end with this anecdote which just happened before this interview:
Just a few hours ago I met with someone who had read the book during shiva and commented to me something I know too well ?I found it very useful. I just wish I had read it earlier when I was caring for my father?.
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joshua komisarjevsky barney frank barney frank rob gronkowski kim richards robert hegyes mary louise parker
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