Where every day counts: A closer look at end-of-life care

Yaffi Spodek

Issue of June 26, 2009 / 4 Tammuz 5769

Rabbi Binyamin Mayefsky of Far Rockaway could not have predicted where life would take him once he graduated from Yeshiva University,

but the father of two is happy to have found his calling as a chaplain for the Hospice Care Network.

“As a chaplain, I go see Jewish patients and their families all over Queens, Nassau and Suffolk, usually in their own homes,” said Rabbi Mayefsky, 31, explaining his role. “I visit them, I talk to them about their spiritual journeys, I say prayers with them, and I talk about

how they’re doing with their illness, and how it relates to them from

a spiritual perspective.”

The Hospice Care Network (HCN), which began in 1988, is a non-profit

organization that services patients and their families by addressing

their physical, emotional and spiritual needs during the end stages of

life. The staff includes an interdisciplinary team of doctors, nurses,

social workers, dieticians, pastoral care providers, bereavement

counselors and trained volunteers. Three years ago, HCN began an

Interfaith Outreach program that trains people to become advocates for

their congregation. Recognizing that hospice can be a sensitive

subject, HCN believes that by creating personal connections within

religious organizations, they can better reach out to people.

After finishing his rabbinical courses at YU’s Rabbi Isaac Elchanan

Theological Seminary, Mayefsky attended the Healthcare Chaplaincy, an

organization in New York City that trains people of different faiths

to become chaplains. Following that, he studied Clinical Pastoral

Education for several years and later secured his current job at HCN,

where has worked since September 2007. As the only rabbi on staff at

HCN, Mayefsky is automatically assigned to all Jewish patients, but he

visits people of different faiths as well.

“So many of their experiences are similar, as far as talking to them

about their illness, whether they’re religious or not,” he observed.

However, “I find that with Jewish patients who are religious like I

am, I’m able to make a connection with them based on that,” he said.

Another part of Rabbi Mayefsky’s job is centered on outreach to the

rest of the Jewish community, where many are unaware of the services

provided by HCN. “I go to different shuls and talk to rabbis and

people in the community about what hospice does,” he explained.

But it is not only the Jewish community that is largely unfamiliar

with the concept of hospice care.

“My program began because we found that people came very late to

hospice, from lack of knowledge about our services or because of the

misconception about what it really is,” said Angela Cesa, the

Interfaith Outreach Coordinator for HCN. “It is not meant to be given

in the last week of life. The criteria is that a person has a terminal

illness that the doctor believes that, if it progresses the way it

normally does, the person’s life expectancy is six months or less.

That’s the time that a person could enter a hospice.”

The Interfaith Outreach program aims to help people in those earlier

stages, rather than in their last few weeks of life. “We had the idea

that when people are struggling with terminal illness, they turn to

their faith community,” explained Cesa, an interfaith minister. “If

there are key people who know about hospice and can give that

information, we have a better chance of having those people enter

hospice at a more appropriate time... We try to reach out to different

churches, synagogues, mosques, temples of any kind and we have

representatives in almost all of the faith communities now.”

Cesa also clarified that hospice is not a place, but a way of caring

for people. While 90 percent of patients receive hospice care in their

own homes, there are freestanding hospice facilities available, as

well as treatment in nursing homes and hospitals for those who may not

have family or others to care for them in their final days.

Since The Interfaith Outreach program began in 2007, 50 lay people

have been trained to become advocates for their congregations. Each is

required to have the approval of the leader of their religious

community, and to pledge confidentiality. Following that, they

participate in a five-hour training course given by Cesa or by one of

the chaplains on staff.

“The advocate is like a familiar presence, someone you can talk to

who will hold your confidence,” Cesa said. “You are more likely to

turn to someone you know. It’s very low-key. For example, if an

advocate knew someone in their congregation dealing with a terminal

illness, they could very gently advocate for that congregation, hoping

to get the dialogue going with families that might need it.”

Close to 20 years ago, Barbara Prins, a HCN-trained advocate, began

working as a client visitor, providing respite assistance to people

who were caring for sick relatives in their homes.

“I have always been in favor of it, because my father was involved in

it in Florida, so I know firsthand how they can be of help,” said

Prins, a member of the Central Synagogue of Nassau County, a Reform

congregation in Rockville Centre. “If people bring it up, I am happy

to tell them what I know. More and more people are living longer and

need help, and since I maintained contact with hospices for a few

years and I saw that Reverend Cesa was part of it, I was glad to come

for a refresher course in the training.”

“I don’t get paid, but I accept people’s gratitude,” Prins added. “It’s my privilege to help them in any way I can because it’s the Jewish way and I like to... As much as the doctors can do, sometimes patients need hospice care more.”

The religious component of hospice care is an integral part of HCN’s

work. “When people die in other places, they don’t often have the

benefit of the intense spiritual connections that we can give them,”

explained Cesa. “We can facilitate their own spiritual leaders coming

to visit them. Rabbi Mayefsky is available around the clock to speak

to them.”

For more information on HCN and to learn how you can become an

advocate for your congregation, visit www.hospice-care-network.org.