JEWISH ETHICS AND FAMILY RESPONSIBILITY FOR THE ELDERLY

LOUIS J. NOVICK Executive Director, Maimonides Hospital Geriatric Centre, Montreal

The responsibility of offspring to their parents, which is expressed in honoring them, supporting them financially when they require it and the children have the means to supply it, and being physically present when such presence is necessary to sustain the emotional health of parents, is a basic tenet of Jewish ethics. When aged parents require a level of care that their children cannot themselves provide, seeking admission to a good long-term care facility may fulfill the imperative of the Fifth Commandment, "Honor your father and your mother. "

his article examines the basis in Jew­ "lead him in and out" is defined as receiv­ T ish law and ethics for the assumption ing the parent joyfully when he visits the of responsibility by adult offspring for the son's home and accompanying the parent well-being of their aged parents, the nature when he leaves until he is out of sight. of this responsibility, and the lengths to Honor for a parent is expressed therefore which it should extend. It also presents by giving him direct personal service. situations in which the assumption of such The duty of honoring one's parents falls responsibility clashes with other values and on daughters, as well as on sons. Thus we in which the negative reladonship between learn in tractate Kiddushin 30b, "Every aged parents and their mature offspring duty relative to the father that is given to makes this assumption of responsibility the son to perform on behalf of his father difficult to achieve. falls equally upon men and women." It is From the Fifth Commandment (Exodus recognized however that "a man has the io:ii) is derived one form of responsibility means to carry out his duty whereas a that oflfepring have for their parents: "Honor woman does not have the means to do so your father and your mother." The gram­ because she is subject to the authority of matical root of the Hebrew verb for honor, another (i.e., husband)." However, "If she "kabed," connotes weightiness. Thus, the be divorced, both of them (i.e., son and Fifth Commandment demands that one's daughter) are equally obligated." parents be endowed with weight or worth. Although it might seem obvious that How are we to express by our actions the veise in Kiddushin that imposes upon the sense of worth that we feel for our the son the responsibility of giving services parents? The Baraita in tractate Kiddushin to his parents imposes upon him simulta­ 31b of the Babylonian Talmud, in defining neously the responsibility of financing these how a son is to show honor (kavod) to a services, there is an apparent difference of parent, states, "Honor means that he must opinion between the Jerusalem Talmud give him food and drink, clothe and cover and the Babylonian Talmud with regard him, and lead him in and out." The phrase to the latter responsibility. The Jerusalem Talmud states that honoring father and mother includes financial responsibility on Presented at the World Conference of Jewish the part of the son, whereas the Babylonian Communal Service, Jerusalem, Israel, July 4, 1989. Talmud states that it does not. The author is particularly indebted for information derived from "Honor Thy Father and Mother" by Some commentators feel that the two Gerald Blidstein. Talmuds are not in fact in disagreement

387 / Journal of Jewish Communal Service because their conclusions relate to two concrete services but of relating to them different sets of circumstances. They hold with an attitude of respect and reverence. that the Babylonian Talmud discusses a Concrete services may or may not be accom­ situation in which either the father is pros­ panied by such an attitude. The Hebrew perous or the son is poor. Consequently, word for reverence is "mora." the obligation of the son's supporting his The obhgadon to show reverence for par­ parents does not even come into question. ents is derived from a passage in Leviticus The Jerusalem Talmud, in contrast, dis­ 19:3 that states, "You shall each revere his cusses a situation in which the son is pros­ mother and father." Examples of reverence perous and the father is poor; hence the are given in the tractate Kiddushin 31b as commandment of honoring one's father follows: "Reverence means that he (the and mother demands that the son support son) must neither stand nor sit in his his parents financially. This understanding (father's) place, nor contradict his words, of the two Talmuds, however, leaves unre­ nor tip the scale against him" by taking solved the stand of the Babylonian Talmud sides with his antagonist with whom he concerning the responsibility to be assumed has a dispute. The principle inherent in by a prosperous son whose father is poor. these examples is that everything must be Faced with this dilemma, Rabbi Achei, done to sustain in the parent a sense of author of Sefer She'iltot who lived in the self-worth. eighth century in Babylon and Israel, ruled Rashi, in his commentary on the above- that a son was indeed obligated to give mentioned passage in Leviticus, states that financial assistance to his parents if they the verb in the phrase, "You shall each were poor. However, this obligation was revere," appears in the plural rather than rooted not in honor but rather in tzedakah. the singular form in order to indicate that The right of parents to charity dispensed the obligation to revere one's parents is by their offspring took precedence over incumbent on both women and men. the right of others to that charity. In all the talmudic discussions of what From a practical point of view. Rabbi constitutes honor to one's parents, no Achei's decision ensured the financial sup­ mention is made of the value to parents port of needy parents by their offspring of their offspring's physical presence, which since medieval Jewish communities were can bring much satisfaction when the par­ granted the autonomy of governance that ent-child relationship is a positive one. permitted them to enforce the giving of Neither do the medieval codes of Jewish charity. However, they would not have law—Maimonides, Tur, and Shulchan been able to enforce financial support on Aruch — 6iscuss the factor of physical pres­ the basis of the requirements of the Fifth ence in relation to the factor of honor. Commandment alone. The necessity of such presence is implied, Concerning the extent to which a son nevertheless, since how else could ofl&pring was obhgated to go in financing his parents' give direct service to parents. needs, Rabbi Moses Sofer, also known as However, the physical presence of chil­ Chatam Sofer (i76i-i839) and who lived dren is described in the midrashic literature. in Hungary, ruled that, although the ex­ Thus, in B'raishit Rabbah 2. (P:369), we tent of giving charity is ordinarily limited read the following concerning God's com­ to one-tenth (tithe) of one's assets, in the mand to Abraham to leave his father's instance of charity given to parents "as house and go to the land that God would long as he (the son) possessed enough for show him: his own sustenance, he must give the rest to his parents" (Responsa Chatam Sofer, Now the Lord said to Abraham: "Get thee •Yoreh De'ah 2.51:3). out of thy country and from thy kindred Anothet responsibihty that offspring and from thy father's house unto the land have for parents involves not the giving of that I will show thee" (Genesis i2.:i). What Family Responsibility for the Elderly / 389

is written in Scripture just prior to this? Maimonides based his decision on the "And Terah died in Haran" (Genesis 11:31). incident in tractate Kiddushin 31b involv­ Rabbi Isaac said, "Terah actually lived 65 ing Rabbi Assi who lived in Babylonia. years more after Abraham left." But firstly "Rabbi Assi had an aged mother. She said we infer that the wicked are called dead to him, T want ornaments.' So he made even when they are alive, for Abraham was apprehensive saying, "When I leave, men them for her. She then said, 'I want a will profane the name of God because of husband as handsome as you.' Thereupon me, for they will say, 'He left his aged father he left her and went to Palestine." and went off.' " So God said to Abraham, Faced with the hint of incest in his "/ release you from the obligation of honor­ demented mother's remarks, Rabbi Assi ing your father and your mother but I will reached the limit of his endurance in caring release no other from their obligation; fur­ for her personally. Although the Babylonian thermore I will inscribe his death (in the Talmud makes no mention of the provi­ Bible) before I inscribe your departure." sions for his mother's care made by Rabbi Assi before he left her, Maimonides states Rabbi Solomon Luria, also known as that it is inconceivable that a person with Rashal, who lived in Poland (i510-1573), the high moral stature of Rabbi Assi would stated that a son's leaving his father in have ignored the dictates of the Fifth order to go live elsewhere can be "bitter as Commandment that he must, at the very death" to the latter (Yam Shel Shlomoh, least, make arrangements for meeting his Kiddushin, 1:71). mother's needs through other people. The Physical presence does not require that Talmud probably makes no mention of parents and offspring live in the same these arrangements because their having house. Indeed, in most cases, parents may been made was deemed to be self-evident. prefer to live separately in their own home. Maimonides does not release the son Living in the same geographic area, how­ from the responsibility of providing care ever, affords opportunities for getting for his demented parent. Indeed, he must together to enjoy one another's company, continue to provide it personally if he is to discuss problems as they arise, and to able to do so and is released from the duty give emotional support. Modern transpor- of caring personally for his parent only if tadon and the telephone, it is true, provide he has reached the limits of his endurance. opportunities for social contact that did Even then, his responsibility for caring for not exist in the past. They are unable his parent does not end. Although he is however, to supply the degree of contact not required to supply care personally, he that living in the same geographic area must supply it through others. makes possible. Neither is the obligation to show rever­ Nevertheless, there are conditions under ence for a parent diminished just because which may be attenuated the responsibility the latter is demented. It is pointed out in imposed upon offspring for carrying out Kiddushin 30b that "there are three parmers the functions required by the ethical im­ in a man —God, his father, and mother." peratives discussed above. One such condi­ A person owes the gift of life to his parents. tion occurs in the presence of dementia in Another condition under which may be the parent. Maimonides states, attenuated the responsibility of offspring to carrying out the functions discussed above relates to the poor relationship that If one's father or mothei should become mentally disordered, he should try to treat sometimes exists between parents and chil­ them as their mental state demands, until dren. Sefer Hassidim, an ethical work dat­ they arc pitied by God. But if he finds he ing from the twelfth century in Germany, cannot endure the situation because of theit states, "It is best that a father and son extreme madness, let him leave and go away, separate if they quarrel with each other for deputizing othets to care for them properli'. much pain is caused; and I do not mean 39° I journal of Jewish Communal Service only the pain of the father . . . but even the well-being of parents that is incumbent the pain of the son." upon offspring. Thus Maimonides writes Although offspring are permitted to in his Mishnay Torah, Ishut 13:14, reduce the frequency of their visits with a parent who is abusive of them, the respon­ If a man says to his wife, "I don't want sibility of providing service to the parent your father or mother, brothers or sisters and of showing him reverence is not dimin­ coming to my home," he is listened to and ished. The parent is not excused for his she must go to them .... They may not poor behavior. His punishment however, come to her unless something untoward the rabbinic sources state, must come from such as sickness or childbirth occur. For we do not force a man to admit others to his the hands of God, not from the hands of property. Similarly, if she says, "I don't want his offspring. your mother or sisters coming into me and I That honor and reverence are due the do not wish to live in one court with them abusive parent is demonstrated in the be­ because they harm me and pain me," she is havior of Dama ben Nednah, a Gendle listened to. For we do not force someone to man who lived in Ashkelon, Israel. In allow others to live with him on his property. tractate Kuddushin 31a, it is written, "Once he (Dama) was seated among the great men of Rome, dressed in a silken gold MODERN APPUCATIONS OF garment when his mother came and tore FAMILY RESPONSIBIHTY the garment from him, slapped him on Two-thirds of the 387 residents of Maimo­ the head and spat in his face, but he did nides Hospital Geriatric Centre, whose not shame her." average age is 86 years, are demented. A What are one's obligations toward one's condition of admission is that they require in-laws? No halachic source defines these a type and degree of nursing care that is obligations. There is a clear indication in impossible fot them to obtain at home. the Torah, however, that in-laws should Offspring with the best intentions are sim­ be honored. Thus, the prophet Micah (7:6) ply incapable of supplying such care. Not speaks of an evil period when "the son only do they lack the knowledge and skills dishonors the father, the daughter rises up necessary to do so but they also lack the against the mother, the daughter-in-law superhuman strength required to deliver it against her mother-in-law." over a 24-hour period every day of the year. In addition, one may derive from the Paradoxically, therefore, the imperative of talmudic expectation of a husband's atti­ the Fifth Commandment requires them to tude toward his wife what his attitude help their parents secure admission into a toward her parents should be. In tractate good long-term care facility since such a Yevamot Gib, it is stated that a man should facility is best endowed to give them the "love his wife as himself and honor her services they need, without which they more than himself." Honoring his wife's would either suffer greatly or die. The parents would be a reflection of the love most critical factor in making the decision and honor the husband harbors for his to seek nursing home care is not the lack wife. Furthermore, it is stated in tractate of endurance of the offspring of which Mo'ed Katan lob that both husband and Maimonides speaks, although that too is wife must each mourn the death of the an important factor, but rather the profes­ parents of the other. In i6b of the same sional knowledge and skills the parents tractate it is written, "A man rends his must have at their disposal and which the garments at the death of his father-in-law offspring do not possess. Too, the children or mother-in-law in respect of his wife." of many of the residents of Maimonides Hospital Geriatric Centre are themselves Property rights are yet another factor in their sbcties and sevendes. They certainly serving to attenuate the responsibility for Family Responsibility for the Elderly / 591 lack the endurance to give their parents is ordinarily the case in Ashkenazi families. the heavy physical care they require. Hence, the diminution of the father's role Consider these two case examples that occasioned by his poor health and exacer­ illustrate conditions in which family re- bated by his admission into a long-term sponsibUity may be attenuated. care hospital caused him particular mental anguish. His daughter's visits served to re­ mind him more acutely of his reduced status. The daughtet of Mrs. J., a resident suffet- He responded to this perception with agita­ ing from advanced Alzheimer's disease at tion and even violence. The psychiatrist on Maimonides Hospital Geriatric Centre in our staff advised that the daughtet reduce Montreal, visits her mother regularly and the frequency of her visits to her father. helps feed her at lunchtime. Mrs. J. no longer recognizes her daughter. Hence, she is inca­ pable of using the lattei's physical ptesence CONCLUSION to maintain a relationship that would satisfy her emotional needs. The daughter honors The responsibility that offspring bear for Mrs. J., nevertheless, by visiting and pro­ honoring and revering their parents, for viding her with feeding service, according to giving them financial support when they the impetative of honoring one's parents. require it and the offspring have the means She upholds the worth of her mother even to supply it, and for making available their though the latter has lost the capacity to physical presence when such presence is understand the concept of self-worth. necessary to sustain the emotional health of parents is a basic tenet of Jewish ethics. Recently, a male resident in Maimonides This responsibility may be attenuated under Hospital Geriatric Centre became very agi­ certain circumstances. However, even when tated when visited by his daughtet. At times, the child is not responsible for providing in his agitation, he would strike her. When she left he became calm. care and support personally, he or she Both father and daughter were recent must ensure that it is provided by another arrivals in Quebec from Morocco. In the means. This is the imperative of the Fifth Sephardi ttadition, the father is held in Commandment, "Honor your father and unusually high esteem. His control over your mother." members of his family is much greater than