09 Aug THE ART OF BEING A CARETAKER PART 2

 In the mishebeirach we say by the Torah for one who is ill, we ask Hashem that they should be granted a refuas hanefesh and a refuas haguf, a healing for their soul and for their body. It is enormously important to note that we request first a refuas hanefesh, the healing of the soul. A caretaker must pay special attention to the mental state of the one they are caring for. With this in mind, I believe fervently that one should make an initial assessment whether the patient needs to know their specific diagnosis. If the one who is ill is not actively quarterbacking their own medical affairs, it is often a great kindness to spare them of the grim finality of their medical predicament. Sometimes with the assistance of the medical team, a slight adjustment to their diagnosis can make the difference between having hope and living with crushing despair. For example, my father, Aron Tzvi ben R’ Meir, took ill with pancreatic cancer. With the agreement of his doctors, I told my father that he had pancreatitis, a condition that mirrors most of the symptoms of pancreatic cancer. Until two weeks before he passed away, he lived with hope and not with the fear of imminent death.

This course of action is not for everyone. There are many who want to know every detail of their situation. Some people want to know how much time they have left. They want to make videos for their family, write ethical wills, and grab every available moment to do what they think is most important. This issue is so important that it behooves the caretaker to take counsel with a knowledgeable Rav, on whether to share a frightening diagnosis with the patient.

As much as possible, it is also important to give the patient as much hope as you can. When caring for someone with a specific disease, try to find someone who battled it successfully and let them visit your patient and give them encouragement. When choosing a doctor, since we believe that refuas hanefesh, the mental health of a person is of paramount importance, make sure you find a doctor who has good bedside manners, is optimistic, and doesn’t alarm a patient unnecessarily. This choice can make the different between life and death. It is also important when choosing a doctor to check out how available she or he is. The fact that a doctor is from the top twenty-five in the world will be of little benefit if you can’t call him or her when there is a sudden pain or fear of new development.

Here’s another important piece of advice for those caring for a patient with cancer. Besides finding a qualified, warm and sensitive oncologist, it’s of great importance to have a very good internist as well. Often, a person fighting cancer does not suffer from their immediate cancer. Rather, the cancer and its associated treatments unfortunately breaks down the body and other parts of the body are affected. Treating this is not the specific knowledge of the specialized oncologist. Thus, a skilled internist will know better how to deal with the constipation that is a side effect or the heartburn and joint pains.

One of the ways of helping the patient’s mental well being is to discover how, in the choleh’s incapacitated state, they can still have pleasure. For some, it is to surround them with happy music. Others who are more delicate and cannot tolerate noise find aromatherapy to be uplifting. Remember, the sense of the soul is smell. That’s why we make a bracha on the besamim right after Shabbos, to console us for the loss of the neshama yeseira, the extra Shabbos soul. Yet others are uplifted by massages. Then, there are those who are uplifted by listening to Torah lectures. Perhaps a big screen with Torah Anytime will give them a sense of meaning and value, even when they are trapped in their sick bed.

Orchestrate paced visits from loving relatives and good friends. Remember that as a caretaker, it is your responsibility to be a traffic cop when it comes to visitors. Stagger the visits. Often, everyone comes Shabbos afternoon when it’s convenient for them. The living room becomes full and everyone ends up talking to one another, to the patient’s frustrations. Furthermore, during the rest of the week no one comes to visit. So, the first rule of thumb is make a schedule and limit the number of people at each specific time. Also, especially if the patient is unaware of the diagnosis, caution everyone before they come into the house.

Familiarize yourself with who is a healing visitor and who aggravates or irritates the patient. The art of bikur cholim, visiting the sick is not for everyone. I’ll give you a simple example. When the sick person asks, “Do they miss me at work?” the uninitiated will answer, “Don’t worry. Everything is fine.” Actually, that’s the worst thing to say. The sick person sinks deeper into the bed thinking, “They don’t even miss me.” The intelligent visitor will proclaim, “We are barely surviving without you. We can’t wait to have you back.” Discourage visits from people who make comments like, “For someone with your sickness, you don’t look to bad,” or “Baruch Hashem, you can catch up on your reading.” It’s amazing what can come out of the mouths of mindless visitors. Someone can come into the house and tell the suffering person, “Don’t worry! If something happens to you, I’ll be there for you and your family.” Also, know how to keep away the know-it-alls or alternative medicine cultists who want to tell you all the things you should be doing. They want to push their own agendas and tell you not to go to doctors anymore. Surround the patient with optimistic people who are not there for themselves, but who come to put a smile and to enrich the life of the one who is suffering.

(to be contimued)