Commonly Asked Questions

Hospice is a unique program dedicated to providing medical, emotional and spiritual support to patients and their families during the final months of life. Hospice professionals -- including physicians, nurses, chaplains, social workers, home health aides and volunteers -- work in coordination with the patient, his or her personal physician, family and caregivers, to provide relief of suffering through pain and symptom management as well as other services that enhance the quality of life. The hospice team helps both patient and family to understand and constructively address their fears and concerns, to attend to "unfinished business", and to approach death in a better-prepared and more peaceful manner. Family support continues for a year after a patient's death, offering a variety of bereavement and counseling services to family members.

Any person facing the advancing stages of any life limiting illness may receive hospice services if the following conditions are met:

• Aggressive treatments are not working or providing relief to the patient
• The patient or their legal representative elects to receive hospice care
• The patient, family and physician agree and understand that the focus of care is on comfort, pain control, symptom management, emotional and spiritual support, not on cure
• The physician thinks that the patient will live six months or less if the disease runs its normal course

Hospice cares for the entire family, not just the terminally ill family member. Through services such as symptom relief for the patient and emotional, spiritual and practical support, patients and their families can prepare for death in ways that are meaningful to them. Hospice provides dignity in dying for families and their loved ones.

Hospice care includes a wide variety of services to relieve the patient and family of many of the burdens associated with a terminal illness.

Hospice patients are cared for by a team of doctors, nurses, social workers, certified nursing assistants, clergy and volunteers. Together, they form the interdisciplinary team, which develops a detailed plan of care for each hospice patient based on the specific needs and desires of each patient and their family.

The Plan of Care, which is coordinated by the Registered Nurse assigned to the patient and overseen by the patient's physician, specifies which team members will provide services, how often they will visit and the goals for the care they provide. In addition, LightBridge provides medications, supplies and equipment related to the hospice diagnosis. A registered nurse is on call 24 hours per day, seven days a week to assist with any needs a patient may have.

No. The goal of hospice is to help patients live every day to its fullest with the greatest level of physical, emotional and spiritual comfort possible. LightBridge recognizes dying as a natural process and we seek to neither hasten nor postpone death but to rather embrace the quality of life that remains.

Hospice is a program that had originally been associated with the terminally ill cancer patient. Current practice makes it available for any terminally ill person in the end stages of cancer, Parkinson's, Alzheimer's, heart disease, or other life limiting diseases or conditions while the majority of patients are older, the program is available to anyone - regardless of age, sex, religion or disease - who has been diagnosed by a physician as having a life expectancy of six months or less. The care that is provided is not meant to cure the person. It is palliative, which is care aimed at relieving or reducing discomfort. Hospice does not work to hasten death, but to enhance the quality of life that remains and to provide support to caregivers.

Hospice is a philosophy of care, not a place. Hospice care can be provided wherever a patient lives including:

• Personal Homes
• Residential Care Facilities
• Assisted Living Facilities
• Long Term Care Facilities

Interdisciplinary Team Approach:
In hospice, all members of the care team - physicians, nurses, social workers, spiritual care coordinators, nursing assistants and volunteers - work together to coordinate and deliver care.

Family Focus:
Hospice care focuses on the entire family. The hospice team supports the family in caring for their loved one and provides spiritual and psychological support to both the patient and their family members.

Comfort vs. Cure:
For most home health care providers, the goal is to make the patient well. With hospice care, the staff and family recognize that the patient will not get well if the disease process follow its normal course. They focus on comfort and support rather than cure.

Grief Support:
Hospice care does not end when a patient dies. Hospice staff maintain contact with the family for one year after the death of a patient to help them deal with their loss.

The LightBridge team assesses and treats not only the patient's physical pain but they also address the emotional and spiritual pain of the patient, their family and caregivers.

The goal of our pain management program is to continually maintain a balance between the alleviation of pain and a patient's functional level so that the patient can continue to interact with their loved ones. Hospice nurses and doctors are specially trained in the use of a variety of pain medications and other techniques for pain and symptom relief.

Spiritual and psychological pain may also be experienced by both the patient and their loved ones. This is addressed by the entire team, with particular emphasis on the assessment and support provided by our spiritual care coordinators and social workers.

The patient's physician remains responsible for their care and works in collaboration with the LightBridge nurses and team members serving the patient. In addition, the Hospice Medical Director is always available for consultation on pain management or other specific care issues.

Anyone can refer a patient to LightBridge. Many referrals originate with the patient's physician or with the staff of the facility where the patient lives. Others come from hospital discharge planners, social workers and families themselves. To be admitted, a patient must agree to treatment aimed at comfort rather than cure and have an advancing disease process which results in a limited life expectancy as certified by a physician.

At any time during a life limiting illness it is important to consider all care options, including hospice. Hospice becomes an appropriate choice when curative treatments are no longer effective and the patient and physician believe that comfort care is the right choice.

It is helpful to remember that hospice professionals agree they can be more effective when given optimal time to guide patients and their families through the challenging maze of concerns. The sooner the hospice team is in place, the more time patients and families are afforded to focus on the quality of their relationships and living life to its fullest.

With the increased care and support provided by the hospice team, a patient's condition may significantly improve. If the patient's condition improves and stabilizes they may be discharged from hospice. If the patient should need to return to hospice care at some point in the future, LightBridge can assist with readmission.

Hospice care is covered by Medicare, Medi-Cal and most private insurance companies. LightBridge can assist you in determining what specific benefits are available from your insurance carrier or HMO.

No. A unique feature of hospice care is that continuing support by the hospice team is provided for families for a year following the death of a loved one.

Hospice is a unique program dedicated to providing medical, emotional and spiritual support to patients and their families during the final months of life. Hospice professionals -- including physicians, nurses, chaplains, social workers, home health aides and volunteers -- work in coordination with the patient, his or her personal physician, family and caregivers, to provide relief of suffering through pain and symptom management as well as other services that enhance the quality of life. The hospice team helps both patient and family to understand and constructively address their fears and concerns, to attend to "unfinished business", and to approach death in a better-prepared and more peaceful manner. Family support continues for a year after a patient's death, offering a variety of bereavement and counseling services to family members.

Ohr Ami is a Hebrew phrase meaning "Light of My People". It is the name of The Jewish Hospice Program, the first hospice program in San Diego County specifically dedicated to the needs and concerns of the Jewish community.

Hospice is not a place but a concept of care. Ohr Ami provides hospice care wherever the patient resides -- at home, in a skilled nursing facility, hospital or other healthcare facility. Ohr Ami does not have its own hospice building.

Ohr Ami strives to be a living embodiment of the Jewish value of hesed (loving-kindness). Hospice staff exemplify this value and the services they render provide a continuous stream of acts of hesed to their patients and families. Providing comfort, dignity and peace of mind is both our mission and our passion. Our commitment is to bring to patients and their loved ones physical, emotional and spiritual support, all within a Jewish context. Ohr Ami is accredited by the National Institute for Jewish Hospice.

It is true that the word "hospice" stems from the Latin word "hospitium" meaning guesthouse and was originally used to describe a place of shelter for weary and sick travelers returning from Christian pilgrimages. During the 1960's, Dame Cicely Saunders, a British physician began the modern hospice movement by establishing a Christian hospice, St. Christopher's Hospice, near London. However the philosophy of hospice is in consonance with basic Jewish values, including the recognition of the Divine image in each human being and the sacred responsibilities involved in caring for one who is critically ill.

No it does not. Hospice is devoted to caring for terminally ill individuals whose life expectancy has been measured in months rather than years and for whom cure is no longer a realistic expectation. Under hospice care, the desired goals are to maximize patient comfort and improve the quality of life. Ohr Ami affirms the Jewish imperative u'va'harta ba'hayyim, "choose life". By helping to assure that a patient is kept as comfortable and pain-free as possible, by assisting patient and family to attend to end-of-life issues and by maximizing the quality of their time together, Ohr Ami honors the mandate to cherish life and live every day to its fullest.

Ohr Ami staff members have all been educated in the religious traditions, culture and history of Judaism and the Jewish people. They are aware of the rhythm of Jewish life that may affect their Jewish clients and families, including the Jewish holiday cycle and the significance of Jewish life cycle events. Families who keep kosher can rest assured that Ohr Ami staff and volunteers will be familiar with, and sensitive to, their dietary needs. All Ohr Ami personnel have been familiarized with Jewish laws and customs related to end-of-life procedures as well as Jewish funeral and mourning practices.

Spiritual care and guidance are available to the patient and/or family from a rabbi. Whereas all hospices have chaplains, who usually are not Jewish yet offer spiritual support to Jews and non-Jews alike, the chaplain for Ohr Ami Hospice will always be a rabbi. The Ohr Ami rabbi offers spiritual counseling, is a resource for information regarding Jewish rituals and traditions and provides assistance in dealing with end-of-life concerns within a Jewish context. Ohr Ami's Rabbinic Director oversees all the specifically Jewish aspects of the Program.

All members of the Ohr Ami care team are familiar with, appreciative of, and sensitive to, the diversity of Jewish expression within the community. They understand that the spectrum of Jewish life is such that their Jewish clients may range from very religiously observant to those who would identify themselves as secular. While some Jewish families may choose Ohr Ami Hospice to assure that Jewish traditions will be understood and followed, others may simply prefer that their hospice have a Jewish context. In any case, the team always respects and addresses the specific spiritual and comfort care needs of each individual.

The bereavement program for Ohr Ami families has unique aspects which recognize and address the specific ways in which Jewish tradition might impact the grieving process.

The Ohr Ami rabbi does not take the place of a person's synagogue rabbi. In fact, with a patient's permission, the Ohr Ami rabbi will be in contact with the congregational rabbi so that both can be of maximum support to the patient and family. The Ohr Ami staff values the role of the family rabbi and will always view the family rabbi as the leader in providing spiritual support when that is the wish of the patient and/or family. After death takes place, Ohr Ami urges the family to turn to their family rabbi for funeral officiation and for guidance through the period of mourning.

Absolutely! Ohr Ami offers members of the Jewish community the opportunity to fulfill the mitzvah of bikkur holim (visiting the sick). For further information contact the Director of Volunteer Services at (858) 458-3602. Ohr Ami welcomes the opportunity to coordinate with congregational groups in providing support to patients and families who are affiliated with a particular synagogue.

Ohr Ami, The Jewish Hospice Program, is a freestanding project of LightBridge Hospice. LightBridge Hospice is accredited by JCAHO, the Joint Commission on Accreditation of Health Care Organizations.

Ohr Ami was developed in collaboration with Seacrest Village Retirement Communities, Jewish Family Service of San Diego and the United Jewish Federation of San Diego County. It is the hospice of choice of Seacrest Village Retirement Communities.

Ohr Ami accepts donations via a non-profit foundation that LightBridge Hospice has established through the Jewish Community Foundation. Donations to Ohr Ami made through this non-profit foundation are tax-deductible and are exclusively used to benefit the Jewish community of San Diego County.

Tax-deductible donations can be made by check payable to the JEWISH COMMUNITY FOUNDATION with a note designating it for THE SAN DIEGO JEWISH HOSPICE PROGRAM FUND. Contributions should be mailed to The Jewish Hospice Program, 5280 Carroll Canyon Road, Suite 310, San Diego, CA. 92121

Contact Executive Director Pamela Hough or Rabbinic Director Rabbi Ralph Dalin at (858) 458-3602