Conversations On The Final Chapter: The Holiness Of Caregiving

In the course of less than a decade, my mother went from independent living to assisted living and, following one quick event, to a skilled nursing facility that specialized in dementia. Her path from enjoying her evening cocktail to having to be fed by family and aides is a path now shared by many of our loved ones. We take that journey with them, juggling work, our own families, and our own lives.

And, in quiet moments, we often find our souls asking, “Where is God in this?”

We echo God’s call to Adam and Eve in Eden; ayecha (where are you?) takes on a deeper texture as we hold the hand of the one who held ours and feed the person who fed us. These are acts of devotion, motivated by deep love, which keep our obligation to honor and respect our parent.

You escort your mother to a doctor’s appointment, placing your arm around her shoulder to help. And in a flash, you realize that those arms that once held you now reach out to you for caring, support and guidance.

These are profoundly spiritual moments. Even in the midst of sadness, fear or frustration, it is a time to thank God for the fact that we have been given the opportunity to be present in this transitional and revelatory experience.

Judaism has always supported the notion that a connection exists between caregiving and maintaining loving, personal relationships. As members of the family of Jewish people we are part of a living, organic, spiritual community. We are responsible for each other’s well being and responsible for providing love and support when caregiving is required.

In these cases, we are fulfilling our responsibility to not allow our parents to be alone. We are responding to the internal fears of our own frailty: “Will this be me in years to come?” “Who will care for me if and when I am in a similar situation?”

Issues of competing values often arise within the caregiving continuum. How do we live so we do not lose our own “self” as we try to honor and respect our parents? We want to do what is right, but at times things just spiral down in such a way that it becomes too burdensome, especially if we are juggling work, children, and spousal responsibilities. Is there ever a time when it is permissible to turn care and control over to a third party?

As important as being a caregiver is, equally as important is offering emotional, psychological and spiritual support for the caregiver and the caregiver’s family. If we do not “honor and respect” the life of the caregiver, then the person needing care will also suffer.

As early as the 12th century, Maimonides argued in his Mishneh Torah that when it becomes too difficult, when the status quo may actually cause potential harm to the person being cared for and negatively impact the stability of the family system, it is permissible to cede control to the community or a third party. The “right” thing to do is to bring in someone else to handle the caregiving responsibilities.

Engaging caregiving professionals is fully appropriate under Jewish law when the child’s attempts to provide care will result only in a deterioration of the relationship, causing the child to manifest a lack of honor or reverence to the parent. As we journey with another person toward the end of life, we are often reminded of the richness of our faith and its values, rituals and traditions. As we seek to make decisions that respect dignity and magnify sanctity, we may grow in our appreciation of our             role as God’s holy partners.

While the amount of life that is granted to us may be out of our control, what we do with that life — its quality or meaning — rests squarely within our hands. In caring for another we invite in the presence of God. n

Rabbi Richard F. Address, senior rabbi of Congregation M’kor Shalom, in Cherry Hill, N.J., wrote this article for the Center for Jewish End of Life Care (centerforjewishendoflifecare.org), a collaboration between MJHS (www.mjhs.org) and UJA-Federation of New York (www.ujafedny.org).