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Rabbi Isaac N. Trainin Bikur Cholim Coordinating Council

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About Being a Visitor

Tips For Visitors...

Bikur cholim visiting skills are skills for life. They include being fully present, and being a good listener and knowing proper visiting etiquette. These guidelines will help you in communicating your caring intention and being an effective visitor:

Being fully present
Being a good listener
Keeping it real
Etiquette do’s and don’ts
Anxiety and depression
Building trust
Engage in reminiscing

Being fully present

  1. Try to put yourself in the other person’s place.
  2. Put aside daydreams and distraction from one’s own problems or concerns.
  3. Be alert to truly being with the person in front of you.

 

Being a good listener

Listening skills communicate empathy and understanding and can help facilitate a conversation.

Your posture conveys interest:

  1. Maintain good eye-contact, sit at eye level if possible.
  2. Use non-verbal encouragement such as nodding one’s head or "uh huh…"
  3. Lean forward slightly, and relax.
  4. Avoid fidgeting, or making impatient gestures like watching the clock.

Listening:

  1. Remain neutral and non-judgmental, with an open heart. This way you are more likely to really hear what the person is trying to convey. You can help them to put these feelings into words.
  2. Reflect what you hear expressed, not how you would react. Listen between the lines to what emotion or feeling is being voiced. For example: "That sounds very hard," "You are very concerned about what you are going to hear."
  3. Become comfortable with silence. Allow the person time to think and react. This will also convey an acceptance of what is being communicated without judgment.
  4. Above all, compassionate listening is being interested in what the person is sharing and being sensitive to take your cue from them. Follow their lead. Talking about the latest movie you saw or the recent surgery could be equally appreciated.

 

Keeping it real

  1. Never say "I know how you feel." Everyone experiences pain differently; even people who suffer the same ailments perceive it differently. You can say "It’s sounds like you think (feel) it’s pretty bad (sad/mad/glad). I’m here and I’m listening."
  2. Use open-ended questions to keep up the conversation. These begin with "How… What… Could you tell me more about…?" Closed-ended questions that are less likely to elicit conversation begin "Who, When, Where."
  3. Try not to mind-read and finish another person’s sentences. When you truly listen actively you may be surprised where the person was going with his/her thought.
  4. The visitor should not minimize or laugh off fears expressed by patients, even when they seem exaggerated.
  5. Don’t be afraid to clarify or gently explore what you are hearing. When a person is willing, you may ask questions to get to the heart of the matter.

 

Visiting Etiquettes Do’s and Don’ts

Do’s:

  1. Knock on a patient’s door before entering. Do not enter suddenly.
  2. Ask if the patient would like a visit. This question gives some control back to a patient.
  3. Say hello to all patients in the room.
  4. Do not shake hands. This is for the patient’s sake.
  5. Ask if you may sit down. Introduce yourself—who you are, where you’re from, and the intention of your visit.
  6. Sit on a chair, not on the bed so that you are at eye level with the person you are visiting.
  7. If necessary, look around the room for cues to conversation. Ask about photographs, drawings, or other objects.

Don’ts:

  1. Don’t wake up a sleeping patient. Instead, leave a note or card indicating that you were there.
  2. Don’t stare at a person’s scar or disfigurement.
  3. Don’t fear using humor, if appropriate and sensitive to that person’s situation.
  4. Don’t interrupt if the patient is with the doctor. Return at a different time.
  5. Don’t offer medical advice, nor question the doctor’s judgment. Resist the temptation to give advice or criticize the staff. Redirect questions more appropriate for the medical or social worker with a statement such as, "That would be a good question to ask the nurse/doctor/social worker."

 

A word about anxiety and depression in those you are visiting.

To foster communication, it is extremely useful to recognize any emotional issues common to people experiencing illness or disability:

Anxiety is often the inevitable result of the uncertainties of illness and hospitalization. The loss of control over one’s life may often bring feelings of self-doubt and helplessness.

Depression can be a normal and limited emotional response to a current illness; or even a physiological reaction to the stress, depletion, or "chemical imbalance" caused by the illness. Often people respond to the opportunity to express his/her thoughts and feelings. It is not necessary or helpful to reassure the patient too quickly or unrealistically. If the patient speaks of feeling depressed, it can be useful to listen and get him/her to focus from generalized malise to identifying his/her worst worry.

It is more helpful for the visitor to remember that often just listening to the patient’s fears and frustrations, anger and bitterness, can, by itself, aid in the healing process. By allowing the patient to vent negative feelings and doubts, and then reflecting them back in a thoughtful and friendly manner, the bikur cholim visitor may help put these feelings in perspective.

 

Confidentiality — "a sacred trust" — re-emphasized

The bikur cholim visitor is obligated to always protect a patient’s privacy. Commonly, institutions such as hospitals will ask for a signed statement of confidentiality from volunteers.

An important distinction must be drawn, however, between tale-bearing and helpful reporting. You must be alert to situations that might call for professional intervention. Observations you have made that may be crucial to a patient’s well-being should be referred to either your group coordinator or to the institution’s staff. All communication and the activity of bikur cholim is to be kept confidential. When in doubt speak to a chaplain/rabbi.

 

Building trust in a visit

Building trust with someone you've just met sometimes takes time, and not everyone will choose to open up personal discussion initially, if at all. If you want to build trust it is important to be consistent, keep promises, be discrete and emphasize the confidential nature of all interactions that take place in a visit.

To maintain engagement, you might bring along some cards, or a book to read from, and be prepared to talk about general subjects of interest. Possible topics for discussion: current events, community developments, art and music, jokes, movies. Things you could bring: crossword puzzles, checkers, scrabble, interesting photos. Try going for a walk with person in a wheelchair for a change of scenery.

 

Engage in reminiscing

"People say 40 years ago were better times: What do you think?" Reminiscing can be a useful part of a visit — especially when visiting the homebound/elderly/nursing homes.

What reminiscing can do for us:

  1. Learn from the past — thinking about how things were and what we were like reminds us of life lessons.
  2. Feel better — laughing about how we managed without money or convenience and thinking about positive things makes us feel better.
  3. Positive aging — exercising our minds keeps us active and alert mentally even when our bodies slow down physically.
  4. Have fun comparing neighborhoods, lifestyles — comparing neighborhoods reminds us that we have a lot in common. Sharing brings closeness.

Topics for sharing memories:

Inventions that changed your life
What are some of the things you had in your home that no longer exits? How did you manage? What was the experience like for you? What household chores were you responsible for that, due to technology, are no longer necessary? Describe the job — its importance, e.g. ice-cube tray. How did the technology change our lives? How does it feel to talk about it now?

Neighborhoods
What did every neighborhood need — and have — that no longer exists? What was your old neighborhood like — peddlers, neighbors, stores? What kinds of memories are attached to this? What unique qualities of living then would you like to see in existence now? Negative changes, positive changes?

Amusements
What did you do for fun? What was fun about it? Who played with you? What do you remember most fondly? What are your favorite recreations or pastimes? How have your tastes changed over the years?

To the visitor: listen, learn, and appreciate the continuum in Life.

"Let your fellow person's honor be as beloved in your eyes as your own."
—Pirke Avot 2:15

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