Working With Diversity, Northern Ireland Section 75 Equality Scheme Advice

Please note it is essential to check with each patient/client about their individual requirements.

Special Considerations
Judaism is not just a system of worship but a system of life. Patients and clients will vary as to how how strictly they observe the Jewish code and may be prepared to relax some observances in hospital. However, where a patient or client wishes to follow their religious and cultural practices in a hospital or residential facility staff should do all they can to enable this. Some needs are described below:

Diet
Many Jews will ask for Kosher food. In essence, this means that specially prepared meat (and only lamb, beef or chicken; definitely no pig-meat) and only true fish (i.e. with fins and scales) can be eaten and that milk and meat products are not mixed. Pigs, rabbits and birds of prey are not kosher.

At home strict Jews will keep separate dishes and cutlery for meat and dairy foods. Meat and milk/dairy must not be mixed in a dish, but also they must not be mixed at the same meal. Some will require that strictly kosher meals be ordered, others will simply refrain from eating forbidden foods like pork or shellfish.

All fruit and vegetables are kosher, but only cheese produced under the supervision of the Rabbi may be eaten. Kosher foods should only be prepared with dishes, utensils, cookers and equipment reserved for kosher food. The patient or client should obviously be consulted over his/her level of dietary observance.

Fasting
This will vary with a strictness of the individual person. The most likely time when a Jewish patient or client may wish to fast is Yom-Kippur, the Day of Atonement, which usually falls in late September/October. When the person observes this fast, they would also wish for quiet so that they can pray.

Modesty
For some ultra-Orthodox Jews, it is considered immodest for men to touch women other than their wives. For such patients thought needs to be given about what contact is necessary between nurse and a patient of the opposite gender.

Some Jewish men will need to keep their heads covered at all times, some while praying, others not at all. Some ultra-Orthodox Jewish women will wish to dress modestly at all times (i.e. no bare arms) and some married women may be wearing a wig or will keep their hair covered at all times.

Some observant Jews wear a beard all year and may have sidelocks. During certain periods of the religious calendar, Jews may not shave at all.

Contraception is not strictly acceptable, but most Jewish families will use some method of family planning.

Birth
The birth of a child is a joyful time for the family, so there could be plenty of visitors. Normally a baby boy will be home before the time of circumcision on the eighth day after birth. This is delayed if there is any doubt about the health of the child. A specially trained practitioner called a Mohel carries out the procedure in the home.

Judaism is very much part of life and culture. People are born Jews (through the maternal line) rather than coming to faith. It should be stressed that many Jews do not belong to a synagogue, and that even those who might call themselves Orthodox do not always follow the strict dietary code of Judaism, so it is important to check needs with the person or their family.

Because Jewish people are required to observe strict rules of hygiene, a container of clean water should be available near the bed and odorous or waste products should be removed when the patient or client desires to engage in a period of prayer or study.

Care of the Dying
Judaism has always believed in life after death. For Orthodox Jews this takes the form of bodily resurrection at the future time of the coming of the Messiah. For Progressive Jews, it takes the form of a spiritual afterlife. However, Judaism does not stress such beliefs and rather puts the emphasis on this life and the importance of leading a good life on this earth.

According to Jewish law and tradition a dying person should not be left alone, and many families will wish to sit with their relatives during the last days/hours.

Traditionally a Jew before dying should have the opportunity of saying a special prayer or confession vidui and to receive the Affirmation of Faith (the Shema). These prayers can be said on their behalf by a relative or Rabbi, but it should be stressed that a Rabbi is not essential and that if these prayers are not said nothing untoward has occurred.

If a patient or client his/her relatives wish to see a Rabbi, then the person's own Rabbi should be the first call. If this Rabbi is not available or cannot be contacted, then you should ask if the person was Orthodox or Progressive and then contact the local Rabbi as appropriate. The Rabbi or relative may wish to say a prayer after the patient or client has died, but again this is not essential.

Last Offices
After death all tubes and apparatus should be removed. In some cases the son or nearest relative (if present) may wish to close the eyes and mouth. The arms should be extended by the side. The body is cleaned and wrapped in a plain linen shroud in preparation for burial.

Some Orthodox Jews will wish the deceased's body to remain where it is until their funeral director can come to take it away, but most will be happy for the body to be taken to a hospital mortuary until it can be collected. If the patient dies on the Sabbath they cannot be collected on that day.

Mourners if not sure what to do, should be instructed to contact their Synagogue/Rabbi who will put them in touch with the Funeral Director used by their Synagogue. If they are not members of a Synagogue they should contact the local Synagogue/Rabbi.

Orthodox Jewish families will probably want watchers to stay with the deceased until collection. In this situation necessary arrangements will need to be made with the Mortuary.

Funeral
Orthodox Jews can only be buried (cremation is forbidden) and the funeral should take place as soon as possible – usually within 24 hours. Progressive Jews allow cremation as well as burial and, again, would require the cremation to be as soon as possible.

After the funeral, the immediate family of the deceased mourn for a week. This is the Shiva ceremony during which the immediate family stays at home, saying prayers and receiving condolences from visitors.

Health and Social Care