Where Do I Go To Mourn?

Ariele Mortkowitz

[T]he Jewish tradition is rich with mourning rituals. We’ve done it as a nation for millennia; mourning the loss of Jerusalem, lamenting the Holocaust, remembering the long lost days of the Holy Temple. As individuals, we do it with bagels and covered mirrors and week-long shiva visits. We can say Kaddish (the mourner’s prayer) for a year. There is plenty of space and opportunity to grieve.

And it’s a good thing. A great thing even. It’s supportive. It’s community showing up at times when someone might be at their lowest low. It’s not leaving people to manage their grief alone. It’s a built-in system of shoulders to cry on, arms to lean on, caretakers, yentas – all of them creating a space for you to mourn and pause before gathering strength to move forward.

But while we offer so much to mourn those who have passed, there is nothing available to support those mourning pregnancy loss. There are no rituals. No one brings bagels. No one even talks about it. Some rabbis will tell you that you are not even permitted to say Kaddish after a stillbirth. It’s like it never happened.

And there’s a logical reason for that. In times long ago, pregnancy loss was incredibly common. It was also often very public. It was rare to find a family that had not lost a child or infant in the course of their family-building. In fact, many parents lost more than one in their lifetimes. So if the custom would have been to stop everything to mourn, people would have been in states of mourning constantly. And one could say that therapeutic value of shiva/mourning rituals would be diluted. The rabbis, in their wisdom, thought it better to not make such a big deal of pregnancy loss – precisely because it was so common.

But what about today? 2017. When pregnancy loss is not something that happens as often in each family? And certainly not in the same public way it did in olden times? What do we do with these feelings of loss that can be so devastating – particularly in the midst of communities that value children so highly?

Where should a couple take their grief when they learn that they will not be able to be parents? How should a mother-to-be mourn the loss of a life that she cherished? What prayer should she say? There is no ritual. No one talks about it openly because of the attached shame and disappointment of not being a “fruit bearer.”

It’s rough. It’s lonely. And it is incredibly sad.

It is ironic that a faith community that is normally so very good at supporting individuals laden with grief, can fail so terribly at addressing this common and natural loss.

I know of more than a few synagogue regulars who stopped attending services and recuse themselves from the ebb and flow of Jewish communal life after a miscarriage or when they continue to fail to conceive. With no “official” way to mourn a pregnancy loss or a fertility struggle, it can be incredibly isolating and “othering” for couples — often pushing people away from their communities during the very time they need support most. They feel not understood, invalidated, wrong for being so heartbroken. The absence of ritual or commemoration of pregnancy loss sends a message loud and clear: “Your loss is not a real loss. It is not worthy of the community’s attention or caring.”


So we wanted to do something about that. We wanted these important community members to feel held and supported and we wanted to validate their loss and let them know that they are not alone in their grief.

This month, we participated in Yesh Tikva/The Red Stone’s “Infertility Awareness Shabbat” in an unusual way. Our goal was to create a space for empathy and understanding about infertility in the very tight-knit, family-focused Jewish community. But, rather than ask our clergy to talk about infertility or pregnancy loss in a sermon as has been traditional, we decided to do something new.

On the Sabbath before Passover, the Agam Center at Ohev Sholom invited the entire community to “Light A Candle For Your Loss.” We circulated an anonymous form and asked our community members to indicate the number of memorial candles they would like illuminated on their behalf and gave them the option to have their candles dedicated or labeled in the manner of their choosing.

The response from the community was overwhelming. We lit forty-seven candles, submitted anonymously by thirty individuals – just from our 300 family congregation alone. We displayed these candles publicly, at the entrance to our sanctuary, in our light-filled atrium. Every community member passed by the memorial display on their way into services, and our clergy, Maharat Ruth Balinsky Friedman, invited the community to pay their respects and honor the (often silent) loss felt deeply among our grieving community members.

The responses from the community came pouring in.

“Thank you for doing this. Don’t really have words right now. Just gratitude to have the opportunity to mark my little boy’s birth, especially so close to the actual date.”

“This is absolutely beautiful. Thank you for giving a voice to so many who are on this journey. All my love and support for your amazing, very necessary work.”

“I thought I’d fill out the form because it was a lovely idea – and then found myself in tears, making a small space for something I mostly push aside. Kudos to you for creating the holy opportunity. Really proud to be a part of this community.”

As far as I know, our decision to publicly anonymously recognize pregnancy loss in the synagogue community is a unique endeavor to validate this loss and create a space for a life-experience that can be so isolating and stigmatized and reframe it as an opportunity for communal support.

As we filed into the sanctuary for Saturday morning services, we stopped to read the inscriptions and dedications next to the memorial candles. They took my breath away. Here is but a sample of what was shared:

“I would have loved to love you.”

“Eternally grateful for the journey you were a part of, as painful as it has been. Your loss made way for those we watch grow, shaping me into a mother who strives for daily patience and gratitude.”

“Mothers Day 2011. You were and then you weren’t. Still wonder why I wasn’t supposed to be your mommy.”

“For the family I thought we’d have and the empty seat at our table that I wish we had filled.”

The Agam Center is working hard to make people feel seen and understand that their community is indeed there for them during their time of sorrow or struggle. We want to help people in the midst of a fertility journey see that they are truly not alone, and that there have been so many others – even right in their very synagogue community – who have walked this path with them. We are creating a space to mourn something that is usually so privately painful – particularly in a tradition that is, ironically, so “good” at supporting mourners in other circumstances. I am hopeful that we can begin to highlight ways that communities can create spaces for these losses and families unrealized.

Rather than staying home and feeling isolated, these mourning couples made a point to come to synagogue that week and watched as others learned about and began to appreciate the magnitude of the loss they were feeling. They came inside from standing on the fringe of the community and felt embraced and found solidarity, all without a word. This heartbreakingly beautiful display was our community’s way to show that all loss is real loss and to remind those still struggling that they are not alone in their grief of hopes for the family of their prayers.

May our communities know no more suffering. Amen.

Complete Article HERE!

Lap of Love brings end-of-life care to pet owners’ homes

Steven Schultz, DVM, of Lap of Love project, and owner Robyn Eckhardt with her dog Gemma during a check-up on the lawn of Eckhardt’s Lockport home on Monday, April 17, 2017.


[T]he end of a pet’s life can be difficult for the animal and for its people.

But an innovative approach to those final months, weeks or even hours is easing the way for both people and their beloved cats and dogs. Lap of Love mobile veterinary hospice care has been offered in Western New York since 2014 by a longtime Lockport veterinarian.

Dr. Steven M. Schultz provides both home hospice care for dogs and cats with any terminal diagnosis, care that can go on for months, and gentle at-home euthanasia. And Schultz said the gratitude of the people whose pets he cares for eases the burden of what could be a depressing job.

“What we are doing is so much less stressful for the pets,” said Schultz. “They’re at home, they’re relaxed, we’re relieving their pain and suffering. People, especially the elders, are so appreciative that we come to their homes, they don’t have to put their little cats in a carrier and haul them off to the vet, which is totally stressful, or try to get their big dogs into a car and get them to the vet because they can’t walk anymore.”

“End of life for our pets is a heartbreaking and extremely difficult time,” said Robyn Eckhardt of Lockport, whose 17-year-old dog, Gemma, a Lab-border collie mix, has been Schultz’s hospice patient for more than a year. “Dr. S. is the perfect vet for this. If we can help our pets go peacefully, without unnecessary stress on them – and you, which your pet can pick up on – it is better for everyone.”

The concept of veterinary hospice, which involves providing pain relief and life-improving measures for pets, rather than surgery, chemotherapy or other drastic treatments, is relatively new.

“Years ago, the concept of the human-animal bond was quite different than it is today,” said said Kathryn Jennings, executive director of the International Association of Animal Hospice and Palliative Care, a nonprofit that was founded nine years ago in Chicago. “Today, people are doing more for their pets when it comes to diagnosis and treatment. So when we’re looking at end-of-life, people also want to have more services available.”

Schultz dealt with many animal health issues that sometimes included serious illness and death at Countryside Veterinary Clinic in Lockport, which he operated for almost 30 years before selling the practice in 2012.

“By sheer coincidence,” he said, he and his wife, Sara, who have three adult children, sold their house at the same time. “So I said, let’s go out on the road,” he said.

During their travels, including a stay in the Virgin Islands and Texas, Schultz learned about two young veterinarians in the Tampa area, Dani McVety and Mary Gardner, who had started a hospice and in-home euthanasia practice called Lap of Love. “I said, ‘We could really use something like that in the Buffalo area,’ ” he said.

In 2014, after returning to Western New York, Schultz opened the local branch of Lap of Love, becoming the first in New York State to offer the group’s specialized services.

Schultz began reaching out to other local veterinarians to inform them of his new specialty. “Because I’ve been in this area for so long, I know most of the veterinarians, so I got a lot of referrals,” he said.

Lap of Love provides guidelines, Schultz said, “which are good for new or younger veterinarians,” but as an experienced veterinarian he has his own time-tested care protocols.

Schultz’s practice accepts two kinds of referrals, he said. The first is for dogs and cats that “have a terminal diagnosis of some sort, which could be cancer, heart disease, kidney failure – those types of things that aren’t going to be cured, most likely,” he said. These animals are generally older and their owners have decided not to pursue expensive surgeries, invasive tests or chemotherapy, he said. “That’s where hospice takes over and we just try to keep them as comfortable as we can, as long as their quality of life is good.”

Schultz usually receives a records transfer from the animal’s regular veterinarian, as well as any specialists. Schultz also examines the animal and talks with the owner, then provides his opinion on what steps should be taken to preserve the pet’s quality of life, and how to recognize when it is time to consider euthanasia.

“A lot of people wonder when is the right time to let go,” he said. “We go through all the things that make up quality of life, we go through questions and answers. As long as their quality of life is pretty good, we’ll keep going, but if it changes, we talk about peaceful euthanasia. How is their hydration, are they eating, are they able to keep themselves clean, how is their mobility, are they having more good days than bad days?”

More than 400 veterinary practitioners belong to the International Association of Animal Hospice and Palliative Care, said Jennings, although there are certainly more veterinarians providing mobile and hospice care. But membership “is on the rise, big time,” she said.

“If a pet had a chronic illness, years ago, veterinarians might suggest euthanasia, but today we have many more options,” she said. “Pet families are willing to do more for their pets, based on the fact that there is more availability in health care.”

Depending on the pet’s needs, Schultz may prescribe appropriate animal or human medication, as well as home-prepared food or prescription diets.

Anne Banas, of Clarence, has a unique perspective on end-of-life issues: She is a physician with Hospice Buffalo. “I’ve learned that knowing time is short can be a blessing,” she said. “Death is a natural part of life, and it doesn’t always have to be a medical emergency. When we know that time is short, we can focus on making the best of the time we have, and we can plan for a good death.”

In August, the Banas family was devastated by the death of feline Charlie, 16, who hid the symptoms of a lung tumor until it was a medical emergency. “It broke my heart that my 10-year-old daughter did not get the chance to say goodbye to her lifelong friend,” said Banas.

The family’s gray-and-brown-striped tiger cat, Daphne, is almost 15 and is living with either inflammatory bowel disease or lymphoma. “Pursuing diagnosis and treatment would not have changed her outcome in a way that justified the burden and distress,” said Banas.

“Dr. Steve is exactly what we needed,” said Banas. “He focuses solely on Daphne’s comfort and quality of life.”

When Daphne first became ill, the family had to drive her to the vet for injections of anti-nausea medication and steroids, Banas said. “Dr. Steve has been able to offer us options to treat her symptoms at home, avoiding the distress of car rides,” she said. “For now, she tolerates her medications well, and she seems to be quite happy.”

Banas said, “We don’t know how much time we have left with Daphne, but we take comfort in knowing that, with Dr. Steve’s help, we can keep her comfortable at home, and when it’s time, she can pass peacefully at home in our arms.”

Another part of hospice care is emotional support for the grieving pet owner, who, unlike those who lose a human companion, may be belittled for an emotional reaction. “This has been a disenfranchised grief in our society, at the end of a pet’s life and after the loss of a pet,” said Jennings. “Part of the concept of hospice is not only care for the patient, but also the concept of being able to offer compassion and support for the family and what they’re going through as well. And they want that.”

Robyn Eckhardt shares a moment with 17-year-old Gemma, who has seizures and is under the care of Dr. Steven Schultz through his Lap of Love practice.

Eckhardt said Schultz “was my dogs’ regular vet before he retired from his practice. I trust him implicitly.” When she heard that his new practice was offering hospice care, she said, “I was extremely relieved and happy … The thought of having to take Gemma, transport her to the vet’s office and have her last life experience be of stress, fear and in a cold, clinical environment is not something I want for her. I want her to be home, where she’s lived and been loved all her years.”

About a year ago, Schultz visited the Buffalo home of Laurie Reagan to euthanize 13-year-old Chloe, a Lab-cattle dog mix who was suffering from lymphoma. “She had always been very nervous and stressed-out at the vet,” said Reagan, “so I thought this would be a great alternative.”

Although Chloe had not been in hospice care, Reagan knew the end was near. “I had to carry her in the final few days, I had to hand-feed her, I couldn’t see her continuing through this process,” said Reagan. “I called my own vet to see if they offered a house-call visit, and they said no, but there was a service locally.”

The euthanasia visit was as peaceful as she had hoped, Reagan said. “It was amazing. He was very calm and quiet and I had set up a blanket, to make her comfortable.”

Although saying goodbye to a beloved animal is difficult, Reagan said she was comforted by the visit. “He was so sympathetic and kind, and understanding and empathetic about an owner going through this,” she said. “I would absolutely recommend this service, and I did, to a friend of mine in a similar situation. And I would do it again.”

The euthanasia is a gentle two-step process that begins when Schultz sedates the pet deeply. Afterward, he said, “a lot of people like to make their own arrangements, which could mean a lot of things, from burying them in their backyards to taking them to the SPCA, to taking them themselves to one of the pet crematories,” said Schultz. “If I take care of it for them, which does make it easier for the pet owner, I arrange for either a private cremation, which can be somewhat expensive, or a communal cremation, which can be less expensive. We use the same crematory services any veterinarian can offer.”

Complete Article HERE!

That’s Funny!

[H]umor takes the sting away; it humanizes us; it helps us keep our perspective. Humor enriches us; it educates us; it brings us joy. Humor doesn’t dissolve the pain or make our life any less poignant, but it does help make things more bearable. That’s my philosophy, and I’m happy to share it with you. I hope that if you enjoy what you see, you will take the opportunity to share it with others.

End-of-life discussions head off hardship in times of grief

By Terry Savage

[W]ith Mother’s Day coming up, and Father’s Day soon after, maybe it’s time to have a family discussion about what will happen when the unspeakable happens. Death isn’t pleasant to talk about, but if you’re willing to have that conversation, you’ll make things much easier at a tough time in the future.

No one likes to think about mortality. Young adults consider themselves immortal. Middle agers are fighting the concept of growing older. And the baby boomer generation figures it can bend the rules of aging as it has changed so much of our society in the past 60 years. But sooner or later, our time will come.

Will we leave a giant puzzle for our loved ones and heirs to figure out? Or will we smooth the way to making this transition a bit less painful, leaving them able — and legally empowered — to handle the assets we leave behind?

By the way, this is not a discussion just for aging parents. Families with young children need to organize their finances as well. Who will know the passwords to access everything from bank accounts and 401(k) plans to your valuable cache of airline miles?

Years ago, I created a Personal Financial Organizer form — which is still available free at my website, TerrySavage.com when you sign up for my free newsletter. It comes to you by a link in a return email, and you can print out as many copies as you want, giving them to friends and family to create their own roadmaps to their finances.

This four-page form is used both as a discussion starter and an organizational tool. Once filled out, it serves as a guide to locating your investment accounts, bank and brokerage accounts, will and estate planning documents, cemetery deed, safe deposit box and keys, passwords and credit card account numbers, and myriad other documents that would be hard to find in a crisis or after you’re gone.

But Harris Rosen, a retired executive, has taken it a step further in “My Family Record Book” ($15.95 on Amazon.com). The octogenarian has explained not only what you should organize, but why — and he explains the pitfalls and consequences of not knowing this important information.

Rosen speaks directly to seniors, giving resources and references on everything from how to order a tombstone to services that will take care of your pet after you are gone! There is an entire section on downsizing after the loss of a spouse and advice on how to dispose of furniture and clothing to charitable organizations that will make good use of these items. But mostly he focuses on organizing your financial papers to make life easier for your survivors.

Two other books of a similar genre are the best-selling “Getting it Together” by Melanie Cullen, published by Nolo Press ($14.31 on Amazon), which includes downloadable forms, and the spiral-bound “Peace of Mind Planner” by Peter Pauper Press ($12.04 on Amazon). Both make your planning organized and accessible to family members.

By now you get the idea. Any of these tools will make the perfect gift for the upcoming holidays and provide a starting point for important discussions of end-of-life matters, from locating health care directives and powers of attorney to planning a funeral or finding the policies and assets that will allow the survivors to deal with financial issues.

Yes, it’s a tough subject to tackle on Mother’s Day or Father’s day. But it’s not nearly as tough as it will be to try to figure it out in a crisis when your loved ones are not able or around to help you. And that’s The Savage Truth.

Complete Article HERE!

A New Life for Dying:

Death Doulas and the Death Positive Movement

By Kristi Pahr

[O]ur great grandparents and their great grandparents and their great grandparents would have thought the way we die is strange. They died at home, we die in hospitals and nursing homes. They died surrounded by loved ones, we die surrounded by doctors and nurses. They died where they lived, we die where we die. Up until the mid-1800s, death was an everyday part of life. Members of multigenerational households, which were the norm, lived together and died together. Whether it came quickly or took its time, death happened in the home, just like birth. Just like life.

And when they died, their loved ones held space for them in their homes. Family and friends grieved them and remembered them and loved them through the transition and beyond. Today, though, death is scary. Death isn’t part of life anymore. We’ve removed it from the home and tucked it away in antiseptic, clinical, brightly lit spaces and it’s become foreign to us.

But, death doesn’t have to be frightening. Or solitary. Or clinical. Death can be peaceful and calm, serene and sacred. There is a movement of people taking death back. Pulling it from the cold, harsh confines of the hospital room, and bringing it back into the home and into the world of the living. Death doulas are on the forefront of the fight to reclaim grief and demystify death.

Death doulas, or spiritual midwives, serve a similar function to birth doulas or midwives, but on the other end of the spectrum. A birth doula helps the mother bring life into the world, a death doula helps when life is ready to depart the world. They provide support for the dying and the family, creating space, answering questions, asking questions and being a calm and loving presence during a time of great change.

Janie Rakow, president of INELDA, the International End of Life Doula Association, describes a death doula as, “… someone who acts as a guide and companion through the end phase of an illness. This work can start as soon as someone is admitted to hospice.” She says, “the doulas work with the dying person and their loved ones through the final dying process and into the early grieving stages afterward.”

Rakow explained that INELDA’s doula’s work generally runs in three stages. They begin by discussing death with the patient and the family, openly and honestly, allowing them to explore their feelings and their fears. The doula helps to establish what Rakow describes as “personalized, guided visualizations” and the dying’s preferences in music and readings are also defined. A vigil plan is also worked out during this time.

The second stage begins as the patient begins to actively die. The doulas hold space created during the establishment of the vigil plan and allow family to take breaks as needed, knowing that any changes will be relayed immediately. They don’t have to be afraid of not being present because the doula is trained to recognize the different stages and hallmarks of the dying process and can alert the family as things change. The doula is present during the death and stays with the family, providing comfort and support, until after the funeral home has come.

During the third stage, after the death, the doula helps the family to process their grief and answers any questions or concerns the family may be holding onto from the death.

While the term “death doula” is new, the concept of holding death and grief as sacred is not. Death becoming medicalized and moving into hospitals played a big part in it becoming something that families and loved ones feared. Grief over the loss of loved ones, the period of mourning after a death, were, until relatively recently, significant and special things. Now, however, we are encouraged to hide our grief, to consider it a messy and private thing, when, for generations past, it was a point of community. People were not expected to grieve alone when their loved ones died. They were lifted up within their communities and mourning was neither shameful nor private. They were given time and space to mourn.

Another group whose aim is to re-center grief and take back ownership of death is the death positive movement, begun by mortician Caitlin Doughty. She started The Order of the Good Death in response to the culture of fear that surrounds modern death. The group’s mission is to break down that fear and make death a part of life. According to The Order of the Good Death, the group is comprised of funerary professionals, academics and artists who strive “to bring death awareness and acceptance into a culture that is all too often death phobic.”

Both of these groups are working hard to bring death back into life and remove the stigma and fear modern society has pinned to the natural process. Both groups advocate for death as a sacred experience, a personal experience, a life experience.

By utilizing the services of a death doula, loss and grief can be refocused on the love and the sacred, instead of on fear and negative emotions. By joining, or just acknowledging, the death positive movement, people can help to de-stigmatize the process of dying, which in the end will make the idea of death much easier for everyone to digest.

Complete Article HERE!

Seattle chaplain: Far too few know about Washington’s Death with Dignity Act, end of life options

Washington’s Death with Dignity act was passed in 2008.

By Josh Kerns

[I]t’s a subject few are willing to talk about: our own deaths.

And even though Washington is one of just six states where doctor-assisted death is legal, very few utilize it, and many know nothing about their options. But a dedicated group of volunteers is working tirelessly to change that.

Retired Seattle chaplain Trudy James says death has always been a part of her life.

“My first baby died at 4 days old, my father took his own life when I was 35, and I became a hospital chaplain when I was 47,” she said.

As a chaplain, she was at the forefront of the AIDS epidemic, working daily with people young and old facing death. She helped build a community of volunteers to support them.

“They were suffering and they knew that they were going to die,” James said. “And what we learned is when they had people around them and things to look forward to and people to talk to, they lived longer and they died better deaths.”

That led James to create the Heartwork end-of-life planning groups.

She began offering workshops and training volunteers in congregations, senior centers, private homes and elsewhere to help raise awareness about the options, and to help people take control of their own end-of-life decisions.

Death with Dignity

Voters approved Washington’s Death with Dignity Act in 2008. It allows terminally ill adults with six months or less left to live to request lethal doses of medication from a doctor, refuse life-saving medical treatment like resuscitation, and to stopping eating and drinking to hasten death.

There are a number of steps involved in this, such as exams and repeat oral and written requests to a doctor who chooses to prescribe the medication.

“A lot of people don’t even know we have this new law in Washington. And if they do know or if they voted for it, they have no idea how to access it or what it would mean or what it offers them,” she said.

There are plenty of people and organizations opposed to doctor-assisted death.

Many religious groups and right-to-life advocates argue doctor-assisted death interferes with God’s will. Doctors in some religious-based hospitals are prohibited by their employers from discussing the law.

After seeing scores of people die extremely painful deaths over the years, James couldn’t disagree more.

“I say dying in intensive care with machines hooked up to all of you and not being able to speak to your loved ones isn’t really a natural death,” she said. “It’s prolonging dying, but it’s not prolonging living.”

This is not suicide

One thing James and other end-of-life advocates underscore is that they are not promoting or encouraging death – just awareness of the options. Namely, that those suffering from painful, degenerative conditions — ranging from cancer to ALS — can hasten their death.

And these advocates emphasize that this is not doctor-assisted suicide. They argue the word suicide should only describe those physically well enough who would otherwise continue living.

“These are people who are going to die anyway and they’re just reducing suffering for themselves and their family,” she said. “That seems to me what God would want.”

James’ experiences with her ministry and the workshops inspired her to produce a short film she could show at senior centers, hospices and elsewhere.

What started as a 12-minute, simple short is now a full-fledged 30-minute documentary called “Speaking of Dying.” It’s basically people speaking from the heart about their own experiences with illness and death.

James says even though people don’t want to think or talk about death, when they can learn their options and plan for it, it can bring incredible peace of mind. And she says it’s something we should all be thinking about and planning for with our families, friends or doctors sooner rather than later.

“There’s nothing that says you’re not going to die until you’re 75 or 80,” James said. “Many people die young and it’s so comforting if they’ve done some work with them and talk with them and tell them what they want.”

James will be hosting a special screening of the “Speaking of Dying” on Saturday, April 29 at Seattle Baptist Church. The goal is to celebrate the film’s second anniversary and raise money to help show and distribute it to more broadly.

“There is always grief when someone you love dies,” she said. “But I say it’s better when they’ve had a peaceful ending.”

Complete Article HERE!