A Deeper Understanding

The roots of Bikur Cholim can be traced back to the Torah, when God visits Abraham after his circumcision (Genesis 18:1). This activity is among the most important mitzvot an individual can perform, and is one of the activities identified in the Talmud as exemplifying “walk[ing] after Adonai, your God.” It is among the activities described in the daily liturgy described as Eilu D’varim, unlimited value.

Bikur Cholim societies exist in Jewish communities around the world. The earliest Bikur Cholim society on record dates back to the 1300s.  Visiting the sick during Shabbat, often after morning services, was and is a common practice.

The scope of bikur cholim – visiting the sick – is vast, and includes visiting someone with a cold as well as attending an individual nearing death, and everything in between. Illness can sap emotional and spiritual energy as well as physical strength, so the support of family and community can be essential in promoting healing. Prayer, such as Psalms, on behalf of the sick can be healing. There is also a special prayer called the Mi Shebeirach prayer which is said for the sick in Synagogues.

Visitors need not be afraid to think outside the box. Visiting the sick can involve more than quiet, bedside conversation. Would quietly signing or playing music comfort them? If food is allowed, would their favorite dish or pastry cheer them up? In some places, even a visit from a loved pet might be allowed.

Not everyone will be comfortable with actually visiting the sick. Some may have health reasons of their own why it is not advisable. However, there are many other options that can also provide comfort. If the person is strong enough, sometimes a phone visit can help. Meals can be prepared and brought to the home to be used in the present, or when the person returns from the healthcare facility. Children and pets can be cared for so the person has one less thing to think and worry about.

Visiting the sick can be particularly challenging if the sick person is dying. Entering the room when death is imminent may take a lot of courage and can be intensely demanding. It puts us in direct contact with mortality, our own and that of others and may force us to face our personal grief, fears, vulnerabilities and sense of justice.

Practical Considerations

Bikur cholim involves an investment of time and energy. Visiting the sick involves focused attention, patience, perceptive listening, sincerity, openness, communicating lovingly and respectfully, and for some, praying.  Tone of voice and body language are very important aspects of bikur cholim because they are nonverbal ways of conveying care and concern for the ill person.

Among the practical questions that are important to consider and to ask before planning a visit are “When is a good time to visit?” and “How long should I stay?”  These questions may need to be addressed to the loved one closest to the ill individual.  And, it is important to not overstay one’s visit. In general a visit of 20-30 minutes is advisable depending on the level of illness.

Support for the sick can also include practical assistance, both for the chole and their family/household. Offering something specific like grocery shopping, preparation of meals, taking care of children, cleaning the house etc., is usually more effective than asking “What can I do?” or “Call me anytime.”

Text Sources

Bikur cholim is mentioned in the Babylonian Talmud several times. Nedarim 39a and 39b state that “[One must visit] even a hundred times a day” and that “He who visits a person who is ill takes away a sixtieth of his pain.” Nedarim 40a says that “anyone who visits the sick causes him to live and anyone who does not visit the sick causes him to die.” It also states that those who visit the sick are rewarded in the next world.

According to the Talmud, visits should not be very early or late in the day, and one should not stay too long. Relatives and friends are urged to visit as soon as possible. It is advised that a sick person not be informed of the death of a relative or friend lest it cause them more pain.

Jewish sources cite specific prayers to be offered at the bedside of the sick. The Shulchan Aruch (16th century Code of Jewish Law) suggests prayers to be recited both with and for the patient. One such prayer is one which emphasizes the connection of the patient with the entire Jewish people, “May God have compassion upon you among the sick of Israel”.  Simply saying, “May God grant you a refuah shlemah,” or a short “shalom” can have the power to impart concern, caring, and a connection to the community.

Emotional Considerations

As with all efforts to provide support to another, it is crucial to try to find out what that individual wants and needs. Possible questions to ask might be; “How can I make you more comfortable?” or “What do you need right now?”  Practical support can give an emotional lift.  As in all verbal communication, tone of voice and body language is very important.

Sometimes a sick person is near death and this may awaken a powerful appreciation of life and wellness in the visitor. It may foster great feelings of gratitude for one's own health and an added appreciation of the "miracles that are with us, morning, noon and night,” (meaning that God is miraculously keeping us alive constantly).

A personal visit to those who are ill can remind us that as long as there is life, there is hope. Many times visits to very sick people may present an opportunity for those visiting to communicate hopefulness and give energy to not give up. Remember that visitors are there to provide support, not to fix the situation. Tales of how others have dealt with their infirmities or similar illnesses are generally inappropriate, unless specifically requested by the sick person. It is good be open to the ill person’s emotional pain, and to listen to whatever they want to share.

When contemplating a visit to someone who is sick, it is important to first examine your own emotional state. Are you ready to be a calm, supportive presence? If not, perhaps a visit is not the best idea as your angst may only increase their distress.

Illness and Spirituality

A serious illness can generate deep spiritual questions in the ill person. If you feel comfortable you can help the individual explore the spiritual aspects of their situation.

Prayer can be a useful component of a bikur cholim visit. Although we have formal liturgy for the sick, one can also offer a spontaneous prayer, perhaps asking the individual what they would like to pray for. The visitor could offer a prayer of thanks for the skill and care provided by the doctors, nurse, and other staff. You can express gratitude for the opportunity to spend time with the individual, and for their friendship. You can ask for the blessing of their good health. (Note: Healing occurs on many levels, and the traditional blessing for healing speaks of healing of both the spirit and the body. You need not be explicit as to which you are referring to.)

Serious illness may raise theological questions about the nature of illness and suffering. A bikur cholim visit might provide the ill individual with a chance to explore their own views, without judgment. Potential questions might include: “What do you think?” “What questions do you have?” “What gives you comfort?”

If recovery is not possible, and death is near, such visits are a powerful opportunity for closure - to say what needs to be said, or ask what needs to be asked, while the person is still alive – to express love, ask for forgiveness for past wrongs, and to invite the person to say what they may be holding inside. Sometimes, the most meaningful thing a visitor can do is summon the courage to hold their loved one’s hand and tell them it’s ok to let go.

For both the person who is dying and their visitor, these final visits give a powerful glimpse into the journey the soul is about to take. It is not uncommon to hear a dying person communicating with loved ones “on the other side” as their soul prepares to join them.

Resources to Learn More

• Give Me Your Hand: Traditional and Practical Guidance on Visiting the Sick, by Jane Handler, Kim Heatherington, and Rabbi Stuart Kelman