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Jewish End of Life Care

Source Sheet by Chaplain Susan J Katz

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Created October 20, 2015 · 1023 Views · נוצר 20 October, 2015 · 1023 צפיות ·
  1. (ז) אוֹמְרִים לוֹ שֶׁיִּתֵּן דַּעְתּוֹ עַל עִנְיָנָיו, אִם הִלְוָה אוֹ הִפְקִיד אֵצֶל אֲחֵרִים, אוֹ אֲחֵרִים הִלְווּ אוֹ הִפְקִידוּ אֶצְלוֹ, וְאַל יִפְחַד מִפְּנֵי זֶה מֵהַמָּוֶת.

    (7) ...We tell the patient that he should attend to his affairs; if he owes or is owed money, but he should not take this inquiry as evidence that he is dying and become afraid.

  2. PENDING DEATH: GOSES

     

    • When death is imminent, a Rabbi, Jewish Chaplain, or other Jewish Clergy should be notified. They will be available to give moral support to the family and to the dying person by praying with them and offering practical counsel and assistance.
    • Prepare a list of persons to be notified after death occurs.
    • A person in his or her final moments of life is known as a goses, which means "dying", or "moribund." This word is derived from the sound heard coming from the throat as the chest cavity narrows. The Talmud teaches that the Shechinah (Divine Presence) stands at the head of the goses. This special status means that the dying individual should be treated as a living person in all respects and not as an object or as one to be avoided.
    • Everything possible to save a person's life is pursued even if it means transgressing Shabbat (Sabbath) or a Yom Tov (Jewish Holy Day). In the same vein, we do not take any action that would hasten a person's death.

    The presence of loved ones brings necessary and important psychological comfort to the goses, as well as meeting the emotional needs of those who love him/her. This final demonstration of love and concern provides all involved the assurance that they did all they could up to the very end. It also allows one to deal with grief directly and without the sense of guilt of not having done enough for the one who died.

    • If at all possible, the one who is dying should not be left alone. Try to limit conversations to those that meet the needs of the dying person.
    • One should leave the room to eat, drink, or discuss extraneous matters with another visitor.
    • Psalms and prayers may be recited to ease the loved-one's passing. Psalms 23, 91, 103, 121,130 and 139 are particularly appropriate. Singing, telling stories, background music may all be comforting.
    • The dying person traditionally recites the Vidui, a confessional prayer. If the dying person is unable to recite this confessional, a person in attendance may recite the Vidui on that person's behalf. Care should be taken that this does not distress the dying person. It should be explained that saying the Vidui does not mean that death is imminent. In fact, it may happen that a person says the Vidui and then recovers. The Vidui, followed by the recitation of the Sh'ma, in the last moments before death, help to affirm one's faith in God precisely when it is most challenged. 
  3. WHAT TO DO, WHOM TO CALL AFTER DEATH

     

    What to Do Immediately Upon Death:

    It is traditional for all those present to recite the words, Baruch Dayan Ha-Emet (Praised is the True Judge) immediately upon death (or, if not present, upon learning of the death). Mourners (the son, daughter, sister, brother, mother, father, or spouse of the deceased) also perform kri'a ("tearing" of a piece of clothing), though this may be done before the funeral or the burial.

     

    In addition, any of those present may assist with these steps:

    * Close the eyes and mouth of the deceased and straighten the limbs.

    * Cover the deceased with a sheet.

    Some Jews may also want to:

    * Open the windows in the room where the deceased is lying. (If weather is an issue, open a window, then close it as needed.)

    * Place a lighted candle near the head of the deceased (not done on Shabbat; on Yom Tov, kindle from a pre-existing flame).

    * Cover the mirrors in the room where the deceased is lying.

     

    Before the body is picked up, give time to companions to say goodbye to the deceased, hopefully not rushed.

     

    • The deceased should not be left unattended, so right after death, one begins sh'mira ("watching" of the body). 

     

    • If the deceased died in a hospital or other medical setting, medical personnel may remove tubes, needles, etc.

     

    WHOM TO CALL:

    * Contact the significant family members or companions of the deceased to inform them of the death.

    * If the family is affiliated with a synagogue, contact the Rabbi. 

    * If the family is not affiliated, contact a community Rabbi, Jewish Chaplain, or the Chevra Kadisha (Burial Society), the sacred burial team who prepares the body for burial. Spiritual Care and Multi-faith Services will have many of these phone numbers.

     

    For the situation of a Transgender/Transsexual Taharah and Burial, see http://www.najc.org/pdf/newsletters/dec2015.pdf

     

    Note: If this is not a natural death (such as a violent death), or if the deceased is an organ or tissue donor, the pattern may differ in some respects.

     

    Organ donation arrangements

    It's important to plan ahead and make your wishes known if you wish to donate your organs. All branches of Judaism allow organ donation, though procedures may vary.

  4. Adapted from: http://jewish-funerals.org/pending-just-and-after-death

  5. (א) הַגּוֹסֵס, הֲרֵי הוּא כְּחַי לְכָל דְּבָרָיו. אֵין קוֹשְׁרִין לְחָיָיו, וְאֵין סָכִין אוֹתוֹ, וְאֵין מְדִיחִין אוֹתוֹ, וְאֵין פּוֹקְקִין אֶת נְקָבָיו, וְאֵין שׁוֹמְטִין הַכַּר מִתַּחְתָּיו, וְאֵין נוֹתְנִין אוֹתוֹ עַל גַּבֵּי חוֹל, וְלֹא עַל גַּבֵּי חַרְסִית וְלֹא עַל גַּבֵּי אֲדָמָה, וְאֵין נוֹתְנִין עַל כְּרֵסוֹ, לֹא קְעָרָה, וְלֹא מַגְרֵפָה, וְלֹא צְלוֹחִית שֶׁל מַיִם, וְלֹא גַּרְגִּיר שֶׁל מֶלַח, וְאֵין מַשְׁמִיעִין עָלָיו עֲיָרוֹת, וְאֵין שׂוֹכְרִין חֲלִילִין וּמְקוֹנְנוֹת, וְאֵין מְעַמְּצִין עֵינָיו עַד שֶׁתֵּצֵא נַפְשׁוֹ. וְכָל הַמְּעַמֵּץ עִם יְצִיאַת הַנֶּפֶשׁ, הֲרֵי זֶה שׁוֹפֵךְ דָּמִים. וְאֵין קוֹרְעִין, וְלֹא חוֹלְצִין, וְלֹא מַסְפִּידִין עָלָיו, וְלֹא מַכְנִיסִין עִמּוֹ אָרוֹן לַבַּיִת, עַד שֶׁיָּמוּת. וְאֵין פּוֹתְחִין עָלָיו בְּצִדּוּק הדִּין, עַד שֶׁתֵּצֵא נַפְשׁוֹ. הַגָּה: וְיֵשׁ אוֹמְרִים דְּאֵין חוֹצְבִין לוֹ קֶבֶר אַף עַל פִּי שֶׁאֵינוֹ עִמּוֹ בַּבַּיִת, עַד אַחַר שֶׁיָּמוּת (ריב''ש סִימָן קי''ד). אָסוּר לַחֲצֹב שׁוּם קֶבֶר לִהְיוֹת פָּתוּחַ עַד לְמָחָר שֶׁלֹּא יִקְבְּרוּ בּוֹ הַמֵּת בְּאוֹתוֹ הַיּוֹם, וְיֵשׁ סַכָּנָה בַּדָּבָר (רַבֵּנוּ יְרוּחָם בְּשֵׁם הר''י הֶחָסִיד זַ''ל). וְכֵן אָסוּר לִגְרֹם לַמֵּת שֶׁיָּמוּת מְהֵרָה, כְּגוֹן מִי שֶׁהוּא גּוֹסֵס זְמַן אָרֹךְ וְלֹא יוּכַל לְהִפָּרֵד, אָסוּר לְהִשָּׁמֵט הַכַּר וְהַכֶּסֶת מִתַּחְתָּיו, מִכֹּחַ שֶׁאוֹמְרִין שֶׁיֵּשׁ נוֹצוֹת מִקְצָת עוֹפוֹת שֶׁגּוֹרְמִים זֶה וְכֵן לֹא יְזִיזֶנּוּ מִמְּקוֹמוֹ. וְכֵן אָסוּר לָשׂוּם מַפְתְּחוֹת ב''ה תַּחַת רֹאשׁוֹ, כְּדֵי שֶׁיִּפָּרֵד. אֲבָל אִם יֵשׁ שָׁם דָּבָר שֶׁגּוֹרֵם עִכּוּב יְצִיאַת הַנֶּפֶשׁ, כְּגוֹן שֶׁיֵּשׁ סָמוּךְ לְאוֹתוֹ בַּיִת קוֹל דּוֹפֵק, כְּגוֹן חוֹטֵב עֵצִים, אוֹ שֶׁיֵּשׁ מֶלַח עַל לְשׁוֹנוֹ וְאֵלּוּ מְעַכְּבִים יְצִיאַת הַנֶּפֶשׁ, מֻתָּר לַהֲסִירוֹ מִשָּׁם, דְּאֵין בָּזֶה מַעֲשֶׂה כְּלָל, אֶלָּא שֶׁמֵּסִיר הַמּוֹנֵעַ (הַכֹּל בְּהַגָּהַת אַלְפָסִי פֶּרֶק אֵלּוּ מְגַלְּחִין).

    (1) One who is dying is like a living person for all his affairs. They do not die his cheeks, and they do not annoint him, and they do not wash him, and they do not stuff up his orifices, and they do not remove the pillow from under him, and they do not place him on sand nor on clay nor on earth, and they do not place a pot or a trowel or a pitcher of water or a grain of salt on his stomach, and they do not announce about him to the cities, and they do not hire flautists and lamenters, and they do not close his eyes, until his soul departs. And anyone who closes with the departure of the soul, behold this one spills blood. And they do not tear over him and they do not remove their shoes and they do not eulogize over him and they do not bring a coffin into the house with him until he dies. And they do not open about him with [the post-death blessing of] justifying the judgment until his soul departs. Gloss: and some say that they do not dig a grave, even tough it is not with him in the house, until after he dies. (Rivash 114) It is forbidden to dig any grave to be open until the next day, that they not bury him in it on that day, and there is danger in the matter. (Rabbenu Yeruham in the name of R. Yehudah he-Hassid, ob"n) And so it is forbidden to cause the dead person to die quickly. Such as one who was dying for a long time and he could not separate, it is forbidden to remove the pillow or the mattress from underneath hum, because they say that there are feathers of some birds that cause this, and similarly they should not move him from his place. And similarly it is forbidden to place the keys of the synagogue under his head, in order that he take leave. But if there is something there that is causing delay in the departure of the soul, such as if there is a banging noise next to that house, such as a wood chopper, or there is salt on his tongue, and thes eare preventing the departure of the soul, it is permmitted to remove it from there, that in this there is no activity at all, rather he removes the barrier (it is all in the glosses of Alfasi in the chapter "these shave").

  6. (א) הַגּוֹסֵס, הֲרֵי הוּא כְּחַי לְכָל דְּבָרָיו. אֵין קוֹשְׁרִין לְחָיָיו, וְאֵין סָכִין אוֹתוֹ, וְאֵין מְדִיחִין אוֹתוֹ, וְאֵין פּוֹקְקִין אֶת נְקָבָיו, וְאֵין שׁוֹמְטִין הַכַּר מִתַּחְתָּיו, וְאֵין נוֹתְנִין אוֹתוֹ עַל גַּבֵּי חוֹל, וְלֹא עַל גַּבֵּי חַרְסִית וְלֹא עַל גַּבֵּי אֲדָמָה, וְאֵין נוֹתְנִין עַל כְּרֵסוֹ, לֹא קְעָרָה, וְלֹא מַגְרֵפָה, וְלֹא צְלוֹחִית שֶׁל מַיִם, וְלֹא גַּרְגִּיר שֶׁל מֶלַח, וְאֵין מַשְׁמִיעִין עָלָיו עֲיָרוֹת, וְאֵין שׂוֹכְרִין חֲלִילִין וּמְקוֹנְנוֹת, וְאֵין מְעַמְּצִין עֵינָיו עַד שֶׁתֵּצֵא נַפְשׁוֹ. וְכָל הַמְּעַמֵּץ עִם יְצִיאַת הַנֶּפֶשׁ, הֲרֵי זֶה שׁוֹפֵךְ דָּמִים. וְאֵין קוֹרְעִין, וְלֹא חוֹלְצִין, וְלֹא מַסְפִּידִין עָלָיו, וְלֹא מַכְנִיסִין עִמּוֹ אָרוֹן לַבַּיִת, עַד שֶׁיָּמוּת. וְאֵין פּוֹתְחִין עָלָיו בְּצִדּוּק הדִּין, עַד שֶׁתֵּצֵא נַפְשׁוֹ. הַגָּה: וְיֵשׁ אוֹמְרִים דְּאֵין חוֹצְבִין לוֹ קֶבֶר אַף עַל פִּי שֶׁאֵינוֹ עִמּוֹ בַּבַּיִת, עַד אַחַר שֶׁיָּמוּת (ריב''ש סִימָן קי''ד). אָסוּר לַחֲצֹב שׁוּם קֶבֶר לִהְיוֹת פָּתוּחַ עַד לְמָחָר שֶׁלֹּא יִקְבְּרוּ בּוֹ הַמֵּת בְּאוֹתוֹ הַיּוֹם, וְיֵשׁ סַכָּנָה בַּדָּבָר (רַבֵּנוּ יְרוּחָם בְּשֵׁם הר''י הֶחָסִיד זַ''ל). וְכֵן אָסוּר לִגְרֹם לַמֵּת שֶׁיָּמוּת מְהֵרָה, כְּגוֹן מִי שֶׁהוּא גּוֹסֵס זְמַן אָרֹךְ וְלֹא יוּכַל לְהִפָּרֵד, אָסוּר לְהִשָּׁמֵט הַכַּר וְהַכֶּסֶת מִתַּחְתָּיו, מִכֹּחַ שֶׁאוֹמְרִין שֶׁיֵּשׁ נוֹצוֹת מִקְצָת עוֹפוֹת שֶׁגּוֹרְמִים זֶה וְכֵן לֹא יְזִיזֶנּוּ מִמְּקוֹמוֹ. וְכֵן אָסוּר לָשׂוּם מַפְתְּחוֹת ב''ה תַּחַת רֹאשׁוֹ, כְּדֵי שֶׁיִּפָּרֵד. אֲבָל אִם יֵשׁ שָׁם דָּבָר שֶׁגּוֹרֵם עִכּוּב יְצִיאַת הַנֶּפֶשׁ, כְּגוֹן שֶׁיֵּשׁ סָמוּךְ לְאוֹתוֹ בַּיִת קוֹל דּוֹפֵק, כְּגוֹן חוֹטֵב עֵצִים, אוֹ שֶׁיֵּשׁ מֶלַח עַל לְשׁוֹנוֹ וְאֵלּוּ מְעַכְּבִים יְצִיאַת הַנֶּפֶשׁ, מֻתָּר לַהֲסִירוֹ מִשָּׁם, דְּאֵין בָּזֶה מַעֲשֶׂה כְּלָל, אֶלָּא שֶׁמֵּסִיר הַמּוֹנֵעַ (הַכֹּל בְּהַגָּהַת אַלְפָסִי פֶּרֶק אֵלּוּ מְגַלְּחִין).

    (1) One who is dying is like a living person for all his affairs. They do not die his cheeks, and they do not annoint him, and they do not wash him, and they do not stuff up his orifices, and they do not remove the pillow from under him, and they do not place him on sand nor on clay nor on earth, and they do not place a pot or a trowel or a pitcher of water or a grain of salt on his stomach, and they do not announce about him to the cities, and they do not hire flautists and lamenters, and they do not close his eyes, until his soul departs. And anyone who closes with the departuer of the soul, behold this one spills blood. And they do not tear over him and they do not remove their shoes and they do not eulogize over him and they do not bring a coffin into the house with him until he dies. And they do not open about him with [the post-death blessing of] justifying the judgment until his soul departs. Gloss: and some say that they do not dig a grave, even tough it is not with him in the house, until after he dies. (Rivash 114) It is forbidden to dig any grave to be open until the next day, that they not bury him in it on that day, and there is danger in the matter. (Rabbenu Yeruham in the name of R. Yehudah he-Hassid, ob"n) And so it is forbidden to cause the dead person to die quickly. Such as one who was dying for a long time and he could not separate, it is forbidden to remove the pillow or the mattress from underneath hum, because they say that there are feathers of some birds that cause this, and similarly they should not move him from his place. And similarly it is forbidden to place the keys of the synagogue under his head, in order that he take leave. But if there is something there that is causing delay in the departure of the soul, such as if there is a banging noise next to that house, such as a wood chopper, or there is salt on his tongue, and thes eare preventing the departure of the soul, it is permmitted to remove it from there, that in this there is no activity at all, rather he removes the barrier (it is all in the glosses of Alfasi in the chapter "these shave")....

  7. (ב) לְעוֹלָם יִרְאֶה אָדָם עַצְמוֹ כְּאִלּוּ הוּא נוֹטֶה לָמוּת וְשֶׁמָּא יָמוּת בִּשְׁעָתוֹ וְנִמְצָא עוֹמֵד בְּחֶטְאוֹ. לְפִיכָךְ יָשׁוּב מֵחֲטָאָיו מִיָּד וְלֹא יֵאָמֵר כְּשֶׁאַזְקִין אָשׁוּב שֶׁמָּא יָמוּת טֶרֶם שֶׁיַּזְקִין. הוּא שֶׁשְּׁלֹמֹה אָמַר בְּחָכְמָתוֹ (קהלת ט-ח) "בְּכָל עֵת יִהְיוּ בְגָדֶיךָ לְבָנִים":

    (2) A person should always view himself as if he is about to die, lest he die an untimely death and be established in his sins – therefore a person should do teshuvah from his sins immediately and not say, “When I grow old I will do teshuvah,” lest he die before he grows old. Thus Solomon said in his wisdom, Let your clothing be white in every moment (Ecclesiastes 9:8).

  8. (א) אֵי זוֹ הִיא תְּשׁוּבָה גְּמוּרָה. זֶה שֶׁבָּא לְיָדוֹ דָּבָר שֶׁעָבַר בּוֹ וְאֶפְשָׁר בְּיָדוֹ לַעֲשׂוֹתוֹ וּפֵרַשׁ וְלֹא עָשָׂה מִפְּנֵי הַתְּשׁוּבָה. לֹא מִיִּרְאָה וְלֹא מִכִּשְׁלוֹן כֹּחַ. כֵּיצַד. הֲרֵי שֶׁבָּא עַל אִשָּׁה בַּעֲבֵרָה וּלְאַחַר זְמַן נִתְיַחֵד עִמָּהּ וְהוּא עוֹמֵד בְּאַהֲבָתוֹ בָּהּ וּבְכֹחַ גּוּפוֹ וּבַמְּדִינָה שֶׁעָבַר בָּהּ וּפָרַשׁ וְלֹא עָבַר זֶהוּ בַּעַל תְּשׁוּבָה גְּמוּרָה. הוּא שֶׁשְּׁלֹמֹה אָמַר (קהלת יב-א) "וּזְכֹר אֶת בּוֹרְאֶיךָ בִּימֵי בְּחוּרֹתֶיךָ". וְאִם לֹא שָׁב אֶלָּא בִּימֵי זִקְנוּתוֹ וּבְעֵת שֶׁאִי אֶפְשָׁר לוֹ לַעֲשׂוֹת מַה שֶּׁהָיָה עוֹשֶׂה אַף עַל פִּי שֶׁאֵינָהּ תְּשׁוּבָה מְעֵלָּה מוֹעֶלֶת הִיא לוֹ וּבַעַל תְּשׁוּבָה הוּא. אֲפִלּוּ עָבַר כָּל יָמָיו וְעָשָׂה תְּשׁוּבָה בְּיוֹם מִיתָתוֹ וּמֵת בִּתְשׁוּבָתוֹ כָּל עֲוֹנוֹתָיו נִמְחָלִין שֶׁנֶּאֱמַר (קהלת יב-ב) "עַד אֲשֶׁר לֹא תֶחְשַׁךְ הַשֶּׁמֶשׁ וְהָאוֹר וְהַיָּרֵחַ וְהַכּוֹכָבִים וְשָׁבוּ הֶעָבִים אַחַר הַגֶּשֶׁם" שֶׁהוּא יוֹם הַמִּיתָה. מִכְּלָל שֶׁאִם זָכַר בּוֹרְאוֹ וְשָׁב קֹדֶם שֶׁיָּמוּת נִסְלַח לוֹ:

    (1) What is complete teshuvah? When a person has the opportunity to commit the same sin, and he possess the ability to do it, but he separates and does not do it because of teshuvah and not out of fear or lack of strength. What is an example? A person who had illicit sex with a woman, and after some time he is alone with her, and he still loves her and possesses his physical power and is in the same country where he committed the sin, but he separates and does not sin – that person is a complete ba’al teshuvah, about whom [King] Solomon said, Remember your Creator in the days of your youth (Ecclesiastes 12:1). And if a person only does teshuvah in the days of old age, when it is not possible to do what he once did, even though this is not the highest teshuvah, it is effective and that person is a ba’al teshuvah. Even if a person sinned all his days and did teshuvah on the day of his death and died in his teshuvah, all his sins are forgiven, as it says, Before the sun is darkened, and the light of the moon and the stars, and the clouds return after the rain (Ecclesiastes 12:2), which is the day of death. This implies that if he remembers his Creator and does teshuvah before he dies, he is forgiven.

  9. (ה) עושין כל צרכי המת, סכין ומדיחין אותו, ובלבד שלא יזיזו בו אבר. שומטין את הכר מתחתיו, ומטילין אותו על החול בשביל שימתין. קושרים את הלחי - לא שיעלה, אלא שלא יוסיף. וכן קורה שנשברה, סומכין אותה בספסל או בארכות המטה - לא שתעלה, אלא שלא תוסיף. אין מעמצין את המת בשבת, ולא בחל עם יציאת הנפש. והמעמץ עם יציאת נפש, הרי זה שופך דמים.

    (5) One may perform all the requirements for a corpse [on Shabbat]: [One may] anoint and wash him, provided one does not move a limb. One may move the pillow from under him to place him on the sand so that he will keep [from decomposing]. One may tie his jaw, not so that it rises but so it does not fall. And similarly, [if] a beam has broken one may support it with a bench or boards from a bed, not so that it rises but so it does not fall. One may not close the eyes of a corpse on Shabbat, nor [even] on a week-day while he is [still] expiring. [If] one closes the eyes of a dying person while he is [still] expiring he has shed blood.

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