New Jewish Chaplaincy program a perfect fit for Rabbi Krakoff.
Marty Scheer suffered a stroke more than three years ago that changed his life forever. In his late 80s at the time, he was an active man — driving and taking long walks with his wife, Fran. Now, nearly 91, he is housebound, uses a walker and has vision loss on his left side.
“It was very depressing, but last year I came to terms with this,” he said. His upbeat demeanor confirms that conviction.
He credits Fran with being his rock. He says he also is buoyed by visits from Rabbi Joseph Krakoff, senior director of the Jewish Hospice & Chaplaincy Network (JHCN) in West Bloomfield.
“I don’t need hospice, thank goodness, but I always enjoy his visits,” Scheer said. “He knows me — he’s listened to our history, how we met, how we live. He listens to all my stories; I feel comfortable around him and I can talk to him about anything … I would like him to give my eulogy.”
With a bit of pride, Scheer said, “He calls us his poster children.”
Marty Scheer is a “poster child” for a new, innovative JHCN program that Krakoff heads called LifeLinks. Designed to bridge the gap between diagnosis of a life-threatening illness (or certain progressive-decline illnesses) and the eligibility for hospice care, LifeLinks provides spiritual and emotional care for Jewish clients during this time, plus navigation to other comprehensive resources of the Jewish community.
Scheer was referred by his doctor because he was looking for visits from a social worker and a rabbi. Krakoff has been visiting him since last September.
When Krakoff and Rabbi E.B. “Bunny” Freedman, JHCN executive director, were brainstorming the idea for LifeLinks in February 2015, they knew buy-in from physicians was important.
“I was motivated by the idea of reaching out through doctors who were just sending people home [after diagnoses],” Krakoff said.
“People are lost; they are being confronted with finality,” Freedman said. “We realized this was huge. Who is walking you through this? Who is navigating for you? This is home-based palliative care [comfort and symptom management] and there is no charge.
“We started in May 2015 and people are coming to us to find out how to do it. We think we’ll be at the forefront of this.”
The rabbis have taken word of LifeLinks to more than 100 doctors so far.
“The work JHCN does through their hospice care and now with their LifeLinks program is exemplary,” said Dr. Jeffrey Margolis, a Royal Oak oncologist, who has been referring patients to the LifeLinks program. “In my mind, it is truly the birthright of every Jew to receive thoughtful and compassionate care — exactly what JHCN provides Jewish patients as they approach the end of life.”
Todd Stern, CEO of Chicago-based Seasons Hospice & Palliative Care, with 26 programs in 19 states, knows JHCN because its Madison Heights office is one of many hospice partners JHCN works with locally.
“What LifeLinks is doing is innovative,” Stern said. “Just as they do for us for Jewish patients in hospice, LifeLinks is meeting the spiritual and emotional needs of [pre-hospice] palliative patients. It’s an add-on for [pre-hospice] palliative care, similar to JHCN as an add-on to hospice care.”
If a patient is pre-hospice, there is no provision and no funding vehicle for spiritual/emotional care, Stern explained. At this point, there is only funding for clinical care.
Once a person enters hospice, there is funding for both — hence the partnerships JHCN has with local hospices.
“We truly value our partnership with JHCN and consider them an essential part of our care team,” said Robert Cahill, president/CEO of Hospice of Michigan in Detroit. “Through education and teamwork, our clinicians have a deeper understanding and respect for Jewish tradition that is so important to providing a meaningful end-of-life experience.
Known for its high level of care, JHCN conducts staff workshops in spiritual/emotional care for Jewish patients at local hospices and for Seasons Hospice locations in Baltimore, Chicago, Los Angeles and Miami. The hospices then extend JHCN’s model to other groups.
“We are encouraging Jewish Hospice & Chaplaincy Network to bring its experience, knowledge and expertise to all ethnic and religious affinity groups,” Stern said. “They can teach by example the art of caring for each patient on their own unique religious, ethnic or cultural terms.”
A Perfect Fit
When Joey Krakoff was in rabbinical school, he did a rotation at Memorial Sloan Kettering Cancer Center in New York City.
“I thought I was ready,” he said. “The very first person I saw had just gotten a prognosis of a week to live. I was not ready, but I got drawn in, and we talked for three hours.
“When there is nothing more to do for the body, the real work begins in healing the soul,” he said simply.
“I was always drawn to this; I’ve always had an affinity for helping those who are ill,” Krakoff said. “It’s an honor and a privilege to be let in, to be trusted. You never know what you’ll find.”
What Krakoff found is a perfect fit.
After leaving Congregation Shaarey Zedek in Southfield in July 2014 after 16 years, he heard from Freedman that August asking him about doing work for the Jewish Hospice & Chaplaincy Network.
“I didn’t walk in with any more than the thought of exploring this,” Krakoff said. “I threw out some questions, and we decided to see how we could work together. The relationship evolved and grew organically.
“I was deeply impressed by the team of rabbis — all streams of Judaism, men and women — who got along and respected one another, and who are passionate and empathetic. I had never seen this anywhere. It told me volumes about the organization that Rabbi Bunny had built.”
The idea for LifeLinks began in February 2015 as a dream to create something to fill that void between patients and doctors after a diagnosis of a life-threatening or progressive-decline illness is given.
“I was at a crossroads in my career at that point,” Krakoff said. “Something clicked for me. We had half the program in our minds. We spent the next months talking, dreaming, visioning.”
LifeLinks started with a soft opening May 1, 2015, and then officially a month later. From June 1, 2015, to April 30, 2016, the program served 180 individuals — 87 under palliative care (being treated for pain and symptoms) and 93 for supportive care (social workers, referrals). All received spiritual and emotional care from JHCN.
“This all goes back to our mission: No Jew is ever alone,” Krakoff said.
“My mother had been in the care of the Jewish Hospice & Chaplaincy Network for what seems like an eternity,” said Lisa Shiffman of West Bloomfield. “Rabbi Krakoff and my mother have known one another for over 16 years. Over this time, she and Rabbi Joey have developed a relationship that is extremely special. Over the years, they shared deep discussions on all levels.
“My mother, Evelyn [Hoffman Kasle], passed away on April 29. Up until the very end, Bunny and Joey were there to offer her their love and support. The last thing Joey heard from Evelyn as he was leaving her home for his final visit was ‘Rabbi … I love you!’ That says it all; for she, without question, felt his sincere love for her.”
A longtime Conservative pulpit rabbi, Krakoff thrives on his connection with people. He still does some life-cycle events and teaches a few adult Jewish education classes.
As JHCN senior director, a newly created position that puts him “second-in-command,” he heads LifeLinks, does hands-on care, conducts workshops for hospices and, as part of development, will be planning parlor meetings hosted by those who have benefited from JHCN. These Celebration of Life gatherings are aimed at gaining lifelong support for the nonprofit organization.
“This is my last stop. I’ve found my calling,” Krakoff said. “I go home every day and feel I’ve made a powerful impact in people’s lives. There is such power in helping those who feel so powerless in such an emotional time. I feel I am doing God’s work.”
LifeLinks Helps Bridge The Gap
Individuals given a terminal diagnosis are often initially confused and understandably afraid; they and their families often have nowhere to turn. Rabbis Joseph Krakoff and E.B. “Bunny” Freedman of the Jewish Hospice & Chaplaincy Network (JHCN) in West Bloomfield created LifeLinks to deliver resources directly to their doors.
Many homebound Jewish patients diagnosed with terminal illness have pain and symptom management needs but choose not to enter hospice for various reasons, including fear and uncertainty.
Others would choose hospice care but are deemed ineligible by new, stricter government regulations that create barriers to entry.
Over the last three years, more than 400 of these patients have come to JHCN not yet ready for hospice but needing advice, guidance, solace and comfort. JHCN offers them supportive care, including navigation/advocacy, spiritual care/access to a team of rabbis, social work and volunteer services as well as Jewish community and heath care resources.
While working with supportive care patients, JHCN discovered many could not access adequate symptom and pain management — a gap existed in care delivery for these homebound patients.
When a patient is referred to LifeLinks by a medical practitioner, a nurse practioner who specializes in palliative care can visit, make an initial assessment and then establish contact with the referring doctor and make suggestions for treatment and/or prescriptions as needed for the patient’s care and comfort.
Eligibilty for LifeLinks includes individuals who have a terminal illness and/or progressive decline that may include chronic illness, uncontrolled pain or symptoms, and being frail and elderly.
Since June 1, 2015, about 180 patients have been aided by LifeLinks. There is no charge for services.
For more information, contact the Jewish Hospice & Chaplaincy Network at (248) 592-2687 or go to www.jewishhospice.org.
By Keri Guten Cohen, Story Development Editor