Ask the Rabbi about dealing with Alzheimers

July 13, 2015 by Rabbi Raymond Apple
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Rabbi Raymond Apple answers questions about Alzheimer’s and the Mourner’s Kaddish.



Rabbi Raymond Apple

Rabbi Raymond Apple

Q. What is the origin of “Kaddish Yatom”, the Mourner’s Kaddish?

A. Despite the popular view, Kaddish did not begin as a mourner’s prayer, and Kaddish Yatom is only one version of Kaddish.

The Kaddish is an amalgam of phrases commencing with a passage from Ezekiel 28:33. When the people are in exile, says Ezekiel, God will ensure that His Presence is revealed: “I will magnify Myself and sanctify Myself (‘v’hitgaddalti v’hitkaddashti’) and I will make Myself known in the eyes of many nations, and they shall know that I am the Lord”.

These Divine words were adapted to become “yitgaddal v’yitkaddash” – “May He be magnified and sanctified” – and to express our faith that the redemption will come.

The Kaddish prays that God’s kingdom may come “in your life and in your days and in the life of all the House of Israel”, implying, according to the medieval authority Abudarham, “May the redemption not be delayed and may it come without ‘birth pangs’”.

The congregational response to the first paragraph, “Y’hei sh’mei rabba” – “May His great name be blessed for ever”, is highly emphasised by the sages and whoever says it, is assured of a place in the World to Come (Shab. 57a).

According to Talmudic sources, Kaddish was recited by a preacher after his sermon or a scholar after his discourse (Sotah 49a, Ber. 3a). The expanded Kaddish (“Kaddish Titkabbal”) said after the Amidah comes from another custom recorded in the Talmud, that when a master finished his Amidah, his disciples said, “May your prayers be accepted”; at a later date it became customary for the officiant to say after the Amidah, “Titkabbal” – “may the prayers and supplications of all Israel be accepted” (Tzof’nat Pa’ane’ach 1:12; J. Ber. 4:3).

None of this material suggests a link with mourning, but Rabbi DS Telsner, in his “The Kaddish – Its History and Significance” (ed. GA Sivan, Jerusalem, 1995) puts forward the idea that the development of the mourner’s version of the Kaddish may have come about as the result of a shift in emphasis.

At first the Kaddish honoured the living (“in your life and in your days”). During the medieval persecutions it consoled the survivors of the catastrophes and implied that they should not let their tragic experiences weaken their faith in redemption. Eventually it memorialised those who had lost their lives, and so it became a prayer for the dead rather than the living.

This theory reflects the fact that the Mourner’s Kaddish probably arose in north-west and central Europe in the Middle Ages. Another medieval source, the Machzor Vitry, speaks of a mourner conducting the service on Saturday night, probably because of the belief that at the end of Shabbat the dead are selected either for punishment or for reward.

Eventually the mourners recited Kaddish without necessarily conducting the service, and finally Kaddish at the end of the service became the mourner’s prerogative. This is often linked to a tale about Rabbi Akiva which suggests that a person’s son can redeem the parent from torment by saying Kaddish (Kallah Rabbati, ch. 2, etc.)


Q. Can you give any halachic advice about dealing with Alzheimer’s disease?

A. In 1998 Professor Moshe D Tendler, a medical ethicist, the son-in-law of the late Rabbi Moshe Feinstein, spoke on the subject to the 9th annual International Conference on Jewish Medical Ethics. He urged individuals in the early stages of the disease to give a family member a power of attorney to make their future medical and legal decisions.

Knowing what distress the disease can cause to caregivers, he said it was possible for a husband to enter into a religious contract for a gett at some future point when three experts, usually doctors and rabbis, determined that the patient is no longer competent. This would dissolve the marriage from the date at which the contract was drawn up.

Regardless of this consideration, he stressed that “Honour your father and mother” meant that a child must do all they can for an ailing parent but empowered them to put the parent into a nursing home if his/her condition became literally unbearable. The family must help financially but in the final analysis the expenses of caring for a parent must come from the parent’s estate.

Treatment must not be withheld; halachic advice must be sought in relation to “heroic” measures such as life-support systems.

Rabbi Apple served for 32 years as the chief minister of the Great Synagogue, Sydney, Australia’s oldest and most prestigious congregation. He was Australia’s highest profile rabbi and held many public roles. He is now retired and lives in Jerusalem.

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