By Toby Ehrlich
STEIN HOSPICE: FULFILLING THE PROMISE TO CARE FOR PATIENTS WITH COMPASSION AND DIGNITY AT THE END OF LIFE
Somerset, NJ n Hospice is a program of palliative (rather than curative) care and supportive services that provide physical, psychological, social and spiritual care for the terminally ill person and their family. We bring our care to patients in their home, wherever they live, whether a private residence, assisted living or nursing home throughout Middlesex, Somerset, Union, Monmouth and parts of Hunterdon and Ocean counties. We affirm life but recognize dying as a normal process. We neither hasten nor postpone death.
Care is provided based on the wishes and desires of the patient and family. Stein Hospice strives to clarify the patient’s and family’s values without imposing a particular perspective. This may include choices such as whether to be cared for at home or in a facility, specific types of medical care, whether a patient takes suggested medication or not, what they choose to eat or drink, burial preparations, and many other personal life choice decisions.
A woman we cared for made a difficult medical choice that affected her end-of-life experience as well as her family and community; they needed support to accept her choices. Our team respects the choices of family and patient, wherever they are coming from, and we walk with them to the next place of understanding and acceptance. The entire staff worked to help this family, including a specially trained volunteer that stayed throughout the night in the long-term care facility with one of the family members to serve as a a calming therapeutic presence that was much needed as a part of this collective experience.
When a terminally-ill person becomes our patient, Stein Hospice’s interdisciplinary team (which consists of our medical director, clinical director, nurses, aides, social worker, rabbi/chaplain, therapists and trained volunteers) meets the family, the patient, and creates a plan of care with their input. If, initially, a patient requires daily physical care and pain or symptom management, our staff goes each day to ensure a smooth transition for everyone. If the patient needs or prefers fewer interactions with the staff, then we visit less often.
Members of the Stein Hospice are trained regarding Jewish culture and religious observances.
Using their expertise in recognizing pain and other discomforting stages in dying, our nurses are quick to provide physical relief to our patients. Our chaplain reaches out to the family clergy of all religious denominations to support the spiritual needs of the patients and their families. The social worker and nurses provide information about hospice and makes sure it is understood, as well as helping to make sense out of a seemingly senseless time in their lives. We offer creative solutions to the practical problems that might arise such as how to assist a bed-bound patient with oxygen to attend a holiday dinner with family.
Hospice considers the patient and family a unit of care. Family may include other persons the dying person identifies as having a significant role in providing support. Family members are caregivers who also need our care and support to ease their own stresses. When the Stein Hospice staff comes to care for a person on our service, we relieve the pressure and stress on the family members as well. We allow them to be daughter, son, husband, wife or friend again, and we stay with the patient and family through their fears, anger and sadness and a host of other emotions.
A single daughter caring for both parents at home needs care herself. Our social worker helps her to face the overwhelming choices and decisions, financially and emotionally. The nurse provides education about the physical needs of the daughter’s parent who is the hospice patient. The chaplain (rabbi) visits the patient helping him to connect with the religious life of his past, offering a different kind of hope and nurturing his spirit. The chaplain also tends to the family’s spiritual needs. Our staff joins the daughter in the caregiving, lifting some of the burden from her hands and heart.
Our team assists families and the dying to be free to attain a degree of mental, emotional and spiritual preparation for a death that is satisfactory to them.
Stein Hospice helps the family sort out the difficult medical decisions that they face. One family needed several group meetings to discuss the various medical, ethical and emotional issues they faced. Our rabbi, social worker, clinical director, nurse and medical director met with the family to help them come to terms with the impending loss of their mother and wife, the family matriarch.
At times it seems that patients are postponing their death or waiting for something before allowing themselves to let go. They want a resolution to some aspect of their lives, whether to see a particular person or to solve a particular problem. We try to help resolve unfinished emotional business and hope that the patient experiences successful closure. For example, the social worker has helped to find and contact an estranged son, thereby resolving a family conflict, and allowing the patient to die peacefully soon after seeing that grown child.
A Holocaust survivor spent her days angry at G-d, shunning company, alone in bed in her dark room. The rabbi, through gentle perseverance and short social interactions, helped her to resolve some of her anger and helped her to reconnect to her Judaism. She became more welcoming of social interaction and much less angry.
Stein Hospice strives to help maintain the dignity of the dying person to the end. We assist the patient and family in creating the best possible quality of life for the time the patient has left to live. This goal is evident throughout all of our care. You will find our staff reading to and singing with our patients (sometimes opera or prayers), playing Rummy or checkers (per the request of the patient), assisting to maintain the attire and grooming preferred by the patient (hair, makeup, jewelry, nails, shave and chosen clothes), and providing not only physical care but friendship. Throughout the day, while tending to the physical needs of the patients, our staff listens and talks, holds their hands and eases their concerns. We care for the body and spirit in a very holistic manner.
When the family feels their experience and the details are simply overwhelming to them, our team is there to provide both physical and emotional relief. For example, a young mother with an infant was caring for her dying father, and needed to focus on saying goodbye to her father at his time of death. Our aide took care of the crying baby without being asked instinctively knowing that the moment between daughter and father was invaluable to both of them.
For months after the patient has died our social worker, rabbi/chaplain and trained volunteers remain in contact with the family to offer bereavement support and grief counseling. Stein Hospice staff members often feel attached to the patient and family and will attend funerals, wakes, memorial services and make shiva calls. We are attuned to the fact that every family and family member grieves differently. We are here to support the family up to 13 months after the death of their loved one. There are some who continue to reach out to us long after the 13 months have passed.
A bereaved wife needed someone other than her family to talk to after the death of her husband, someone who could listen and validate all the feelings she had about her husband, her marriage and the difficulty of having him die at home. Our social worker visited and sat with her, offering the support she needed.
Hospice works to educate the community to help improve the quality of life for dying persons and their families. By talking to physicians, clergy, social workers as well as senior groups, synagogue members, retirement communities, and other organizations we offer people the opportunity to learn about hospice and health care proxies before they are needed. We strive to teach people that Hospice is part of living, not part of dying. That by choosing hospice services comfort, clarity and meaning can be found in last days when the diagnosis of a life limiting illness has been determined.
Various complementary therapies are offered through Stein Hospice to ensure the comfort of the patient and to emotionally support their family and caregivers. These include massage therapy, music therapy (including the soothing melodies of the harp), pet therapy, and The Chicken Soup Project. This alternative therapy program is made possible through generous funding from The Jacob and Hilda Blaustein Foundation, Inc. The Elizabeth and Arthur Roswell Foundation, the Jewish Federation of Somerset, Hunterdon and Warren, and The Foundation of the Oscar and Ella Wilf Campus.
As a Jewish hospice that understands the healing powers of chicken soup, the Chicken Soup project was developed as a community volunteer effort that provides homemade soup to patients and their families to help warm their souls during this difficult time. Stein Hospice understands that comfort and nourishment of the soul comes in many forms. And sometimes, that is a bowl of hot, steaming soup made with loving care and delivered with love to the doorstep of those in need.
For more information about Stein Hospice, or to participate in the Chicken Soup Project, contact us at (732) 227-1212 or hospice@wilfcampus.org. Visit us at www.SteinHospiceNJ.org
