Menorah Manor Offers Neshama Program

This article originally appeared in the Tampa Bay Times on March 10, 2020. It was written by Tampa Bay Times reporter Waveny Ann Moore.

Her mother’s death was imminent, and Judy Hulvey had a decision to make: Should she move the 88-year-old former preschool director from Menorah Manor’s Alzheimer’s wing to the nursing center’s new Neshama suite?

Neshama means spirit, soul or breath in Hebrew. At Menorah Manor, it’s a special place to die, enfolded by loved ones. Hulvey’s mother was the first to use the suite, which was converted from a semi-private room.

“The minute I walked in, I said yes. It was so quiet and so peaceful. There was a big super comfy chair next to the bed. On the other side of the wall, there’s a big couch,” the hairdresser said.

She kept watch as her mother, Phyllis Hulvey, who had suffered from Alzheimer’s for nine years, lay dying. “It was just so amazing. I have never seen anybody pass away and being in those peaceful surroundings, I knew my mom passed away very peacefully,” she said. “I was able to get in bed with her and hold her. I was able to sit in that big comfy chair and listen to her breathe.”

Menorah Manor describes the program, which is open to the wider community, as a “specialized approach,” with end of life services and amenities that offer comfort and dignity to the patient, family and friends. The suite includes a mini-fridge, coffee maker, snacks, beverages, aromatherapy, a relaxation music channel, books, Wi-Fi and USB charging stations and bluetooth speaker. In-house chaplain Rabbi Aaron Lever gives reiki treatments, plays the reverie harp, a therapeutic instrument, prays and listens. There is Hospice support. And a Neshama teddy bear.

“This is the bear to die with," Lever said, going on to speak of the significance it takes on for those left behind.

Ann Marie Winter, executive director of the Area Agency on Aging of Pasco-Pinellas, praised the program, thought to be unique for area nursing homes. “No matter how prepared a family is intellectually for the passing of a loved one, you are never ready for the gut punch it’s going to be," Winter said. "So anything that can be done to help both the person that is passing away and the family is so important in the grieving process.”

Winter noted that many Florida seniors have family living out of state. “If you are able to stay with your loved ones, somewhere that has resources for you, someone you can talk to, that is so much more helpful,” she said.

Menorah Manor CEO Rob Goldstein said the organization wanted to offer the best possible end-of-life services to patients and their families, with an emphasis on comfort, privacy and dignity. “That can be difficult to accomplish in a semi-private room,” he said.
Goldstein and others on the Menorah Manor team sought advice from Suncoast Hospice before setting up the program, which launched in October.

“We gave them a tour. They were interested in things like wall paint color, the kind of furniture we had in there,” said Stacy Orloff, vice president of innovation and community health at Suncoast Hospice. “There is a lot of research that has been done on the how color affects our mood, so certainly you want the rooms to reflect calmness, warmth and comfort.”

She said the Menorah Manor suite is modeled after rooms at Suncoast Hospice care centers, located in Palm Harbor, Pinellas Park and Bayfront Health St. Petersburg. “I do think that what Menorah Manor has done, especially in relationship to, and with us, is very unique,” Orloff said, adding that she is unaware of similar programs at nursing homes in Pinellas County.

Tim Simpson, a registered nurse and executive director of Seasons Hospice and Palliative Care of Pinellas County, which has an inpatient center at Mease Continuing Care, in Dunedin, also commended the program.

“The things that they offer are very unique. I haven’t seen any other facility in Pinellas County where they dedicate a room for people at the end of life. I did do that model in Chicago” for two nursing homes, said Simpson, who moved to Pinellas County a year ago.
“I think, honestly, it is a commitment financially what Menorah Manor is doing. That (suite) traditionally would be generating revenue from two beds, but they know that this is right thing to do. It’s all choice. It sets them apart from other nursing facilities in the fact that they are committed to this,” he said.

"Menorah Manor residents who spend a lot of time here at Menorah should be able to pass away at Menorah Manor,” Goldstein said, rather than being transferred to a hospital or another center to die. “This is their home and they should not have to leave at the time when end-of-life services are needed.”

The program, which is covered by insurance, without additional charge, is also available to those whose families decide not to move them from their regular room, he said. A number of Neshama services are portable.

Hulvey was pleased with the spiritual support she and her mother received from the rabbi. “Even though we are not Jewish, it did not matter. He was just trying to help another human being pass nicely. He talked to me and he prayed with me and he prayed over my mother,” she said. “To me, at that point, it doesn’t matter what religion you are. And to him, it didn’t matter, which to me, it was a lovely thing.”

While Menorah Manor is the only skilled Jewish nursing facility in the Tampa Bay area, many of its residents are not.

Lever, who was a chaplain at Gulfside Hospice and Moffitt Cancer Center, describes his role in the Neshama program as “a spiritual midwife.”

“It’s a birthing process. It’s a process of letting go. Those types of things that happen in someone’s dying experience is so personal, is so intimate. By creating that space, we’ve given the residents and their families that birthing place to allow what will happen to happen," Lever said. "It became very popular that hospitals would promote their birthing suites. It’s the same idea, but it is at the other end of the life spectrum.”