It is a tremendous zechut for a patient to be able to fulfill mitzvot, to daven and continue in their regular way of life. Aside from the reward one receives from performing a mitzvah, especially in a difficult time, there are also mental and medical benefits. This is true especially for an elderly person in the terminal stages of life. There is significant benefit to a patient following his routine and habits, with great emphasis on the matters that give their life significance, such as prayer and mitzvot1. However, there is a stage in disease progression and in old age where one should not pressure a patient to keep mitzvot. Granted that on principle a sick person is obligated in mitzvot just as much as a healthy one, but when the fulfillment of mitzvot is burdensome on a patient and has potential to impact them negatively, they are exempt from the mitzvah2. As well, there are aspects of mitzvot that are fundamental to the mitzvah and others that are additions, elevated forms of the mitzvot, or stringencies. For a patient who is having difficulty functioning, it is enough on the one hand to fulfill the most basic requirements of the mitzvah, but on the other hand there are cases where not being able to fulfill the mitzvah entirely is uncomfortable for the patient and even can impact their mental health. It is the responsibility of the patient’s caretakers to find the balance between assisting the patient maintain their lifestyle and prevention of overburdening of the patient.
- A patient who is in distress and unable to focus is exempt from the requirement to put on tefillin. If the patient wants to be stringent upon themselves, they are permitted to put on tefillin3.
- A patient with gastrointestinal problems is exempt from tefillin, even if they are not in pain, if they are ambulatory, and even if they are not having diarrhea. They are forbidden from being stringent on themselves. If they know that they will be able to be careful and keep a clean body through Kriyat Shema and Shemoneh Esrei, they should begin the prayer service without tefillin; between the blessing of “Ahavah” until Kriyat Shema they should put on tefillin with a bracha, and after Shemoneh Esrei they should remove the tefillin4.
- One who cannot maintain a clean body during Kriyat Shema should recite the Kriyat Shema and its blessings at their proper time and put on tefillin later in the day if possible5.
- One who is being administered laxatives is exempt from tefillin; however, if there is no immediate need for the bathroom and they estimate that they will not feel this need for the duration it would take to walk a parsah (72 minutes), they are permitted to put them on6.
- Regarding a patient confined to their bed in the hospital with a putrid smell or object in the room, if they cannot wait for the staff to clean the room, they are permitted to put on tefillin without a bracha. If afterwards they clean the room, they should put on tefillin again with a bracha7.
- If a patient cannot put on tefillin independently and there is no man available to place the tefillin on him, a woman may assist them in putting them on. If necessary, a child or non-Jewish worker may place the tefillin on them and the patient should make the bracha. One should make the bracha after tying the tefillin and not beforehand as traditionally done8.
- Regarding a patient with a bandage or cast on their left hand: if the area where the tefillin tie would be is exposed, even if the forearm is covered, he should place the tefillin there with a bracha; if the area with the tie is covered, he should put on tefillin without a bracha. Ashkenazim should make two blessings on the tefillin shel rosh and Sephardim should make one9.
- Regarding a patient whose right hand is paralyzed and will not recover, it has become his weaker hand and therefore he should place tefillin on it instead of his left10.
- A patient with a bandage on his head is obligated in the mitzvah of tefillin. According to Ashkenazim, if the box is placed on the head without a separation and only the straps are placed on the bandage, he should make the bracha on the shel rosh as well as the shel yad. If the box is placed on the bandage, he should make one bracha on the shel yad alone11.
- It is permitted for a patient to eat and drink before prayer. This matter is not stated exclusively for those who are actually sick but also those who feel weak. A patient is permitted to take medicine before prayer, even if they could take it after the prayer service12.
- A patient may pray sitting down or even lying down partially on their side or with their head raised slightly with pillows13.
- If a patient is weak to the point where they cannot turn over, they are exempt from prayer. If possible, they should meditate on the words of the prayer service14.
- Even if the patient cannot turn and pray, it is best for them to recite the Kriyat Shema, since the main intent is in the first verse. If they cannot recite the first verse, they should meditate on the words15.
- The time of Kriyat Shema in the morning is ideally up to three halachic hours and for prayer up to four hours from the start of the day. These times are found in halachic calendars, and a patient may rely on the lenient opinion of the Gra16.
- It is best for a patient who is having difficulty rising in the morning and is worried that they will miss the time for Kriyat Shema to wake up for a few minutes and say it, at least in their head.
- A patient who wakes up late should try to recite the Kriyat Shema by the fourth hour. There are those who permit one to say Kriyat Shema with the brachot from the fourth hour until noon, and some prohibit making the brachot. In special situations, Kriyat Shema can be recited all day17.
- In special situations, the time for the Shemoneh Esrei is until noon18.
- The morning blessings should ideally be said when one wakes up. If one is delayed, they may bless them until the fourth hour or until noon, and in extenuating circumstances even throughout the day19.
- A patient with a catheter which drips urine into a receptacle is permitted to perform any matter that requires a state of sanctity: reciting the Kriyat Shema, praying, making brachot, learning Torah, wearing a talit, and putting on tefillin with a bracha, on condition that their outer clothing is clean and the smell of the urine is not detectable throughout the room20. Ideally one should cover the catheter and the urine receptacle21.
- A patient with a catheter should make the bracha of Asher Yatzar in the morning and have in mind for the entire day. If the flow of urine is obstructed, when it is renewed they should make the bracha again22.
- Colostomy or Ileostomy: regarding a patient who has an opening in their abdominal wall to allow the exit of stool, it is permitted to recite the Kriyat Shema, pray, learn Torah, and put on tefillin. This is on condition that the bag has been changed, the opening is covered, and the smell has subsided23.
3. Shortened Prayer for an Infirm Patient24
An infirm patient who is unable to pray the entire prayer service, may shorten their prayer and skip certain parts. We will not present here the numerous laws surrounding this shortening, however we will offer up the principles in an organized fashion.
- The most important sections of the Shacharit service are Kriyat Shema and the Shemoneh Esrei. If possible, the patient should recite the three parshiyot of the Shema and pray the Shemoneh Esrei. There are a few ways to shorten the Shemoneh Esrei, which will be explained later on.
- For Kriyat Shema one should add, if possible, the blessings before and after it. If necessary one may shorten the first bracha, Yotzer Or25.
- The Pesukei Dezimra, recited beforehand, are of secondary importance compared to the blessings of Kriyat Shema. One should say at least “Baruch She’amar”, “Ashrei”, and “Yishtabach”, and based on the time and abilities of the patient one may add additional paragraphs26. If necessary, one may skip Pesukei Dezimra, and in any case should not say “Yishtabach” if they did not say “Baruch She’amar” and “Ashrei”27.
- The morning brachot are preferentially recited before deciding to add paragraphs to the Pesukei Dezimra and to sections that are not brachot, such as the korbanot and piyyutim. When necessary, one may make the bracha of “Netilat Yedayim”, say “Elokai Neshama” and Birchot HaTorah, and the other brachot may be completed per their abilities throughout the day.
- One may skip the sections of prayer after the Shemoneh Esrei28.
The most important part of the Mincha service is the Shemoneh Esrei. A patient should recite the Shemoneh Esrei, and if they are unable to, they should say “Havineinu” or the shortened prayer explained later on.
The most important parts of the Arvit service is the Kriyat Shema and the Shemoneh Esrei. The brachot of Kriyat Shema are of secondary importance. Granted that “the Arvit service is optional”, but the Jewish people have already accepted it upon themselves as an obligation. A patient has grounds to be lenient and rely on the fundamental requirement (or lack thereof). To contrast, Kriyat Shema is not optional but obligatory. Therefore, a patient should recite the Kriyat Shema and, if possible, should add the Shemoneh Esrei or the shortened prayer. If they can add more, they should add the brachot of Kriyat Shema as well.
Shortening the Shemoneh Esrei
Ideally one should say the full Shemoneh Esrei even if they must say it sitting or lying down, as explained earlier.
If the patient is unable to pray the full length prayer, they may pray an abridged version. There are a number of variations for this, based on the time pressure and the abilities of the patient as well as other halachic limiting factors. The variations are: 1) “Havineinu”; 2) the abridged Shemoneh Esrei; 3) “Tefilla Ktzara” (“Tzorchei Amcha Merubim”); 4) a freeform shortened prayer29.
- The “Havineinu” prayer is comprised of seven brachot: three introductory brachot and three conclusory brachot, between which is a single bracha encompassing all the middle brachot. This prayer is halachic considered the Shemoneh Esrei in every fashion. The one praying it fulfills his prayer obligation, and even if he feels better afterwards, does not need to go back and pray a full prayer30. “Havineinu” is not said in the winter and on motzei shabbat, since the prayer does not include a mention of Havdalah or the request for dew and rain31. Despite this, a patient may rely on the poskim who hold that if the person will remember to recite these things, they may pray the “Havineinu” prayer at those times32.
- An additional possibility for motzei shabbat or winter is to pray a shortened prayer – a prayer with nineteen shortened brachot33.
- When a patient is unable to say these prayers, they are permitted to say a short prayer, beginning with the words “Tzorchei Amcha Rabim”. The shortened prayer is one bracha, without the introductory or conclusory brachot. If the patient feels their strength return during the prayer, one must recite the Shemonei Esrei or “Havineinu” again34.
- When a patient is unable to say this prayer, he is able to pray in any fashion he chooses, and if he is unable to pray verbally – he should meditate on his thoughts in accordance with his abilities35.
- A patient who eats and is satisfied by a kezayit of bread is biblically obligated in reciting the Birkat Hamazon, and may exempt others from reciting it even if the other person ate more than them36.
- A patient who ate a kezayit of bread over the time it would take to eat a “pras” of bread (around six minutes) should say Birkat Hamazon without mentioning God’s name37.
- A patient who receives artificial nutrition (via nasogastric tube or PEG) and does not receive any oral benefit from eating does not may a blessing before or after nutrition, and it is best if he hears a bracha after he eats and someone else fulfills his obligation for him38.
- A patient who knows they cannot eat two kezayit of bread within the aforementioned time frame for each piece (12 minutes), should wash their hands without making the bracha “Al Netilat Yedayim”39.
The Abridged Birkat Hamazon40
- Birkat Hamazon is comprised of four blessings and additions: three initial brachot which are biblically ordained, a fourth rabbinic bracha, and additional paragraphs which are not fundamentally part of the bracha.
- A patient who is unable to say the entire bracha, should say the four brachot (until “LeOlam Al Yechasreinu”), with no additions “Harachaman” etc. If this is difficult for him, he may forego on the fourth blessing as well and end with “Boneh Berachamav Yerushalayim, Amen”41. If this is also difficult for him, one may rely on an abridged version with four brachot. This version is also permitted to recite without the fourth bracha42.
- When reciting the abridged version, it is proper, if possible, to say the first bracha in its totality.43
- A further abridged version includes a condensed second and third blessing into one44, but it seems that the difference between these two versions is not significant.
- If necessary, one may rely on a condensed first bracha alone4545.
- See the introduction of Prof. A.S. Abraham to his essay ‘The Elderly Patient: Nursing Issues from a Halachic Perspective’, Assia, 6 (5749), page 133. In the essay itself (pages 133-139) the author discusses the fulfillment of different mitzvot by the patient. For expanded discourse on the issues dealt with here, see the Medical Halachic Encyclopedia, volume 3, entry ‘Patient’, pages 429-457.
- See Igrot Moshe Responsa, Orach Chayim, volume 1, article 172. Rav Moshe Feinstein exempts a patient from leaving the hospital to hear the shofar due to the fact that one does not need to spend more than a fifth of their assets to perform a positive commandment, and preservation of life is more important than all of his assets combined. In the Kovetz Shiurim, volume 2, article 46:1, Rabbi Elchonon Wasserman writes that a patient and those assisting them are exempt from praying due to the principle “one who is occupied with a mitzvah is exempt from other mitzvot”, and the patient is occupied with returning his body to strength. Rabbi Waldenberg (Tzitz Eliezer Responsa, volume 14, article 27:1) writes that there is no obligation for man to place himself in a state of sickness and suffering in order to force himself to eat a kezayit of matzah, maror, or drink the four cups, even when there is no danger involved in the act. This is also the conclusion of Rabbi Yaakov Ariel in Ba’Ohala Shel Torah Responsa, volume 2, article 92: “A patient who can only fulfill a positive commandment with great difficulty and suffering… is exempt from the fulfillment of the mitzvah”.
- Rema, Orach Chayim, 38:1; Mishneh Brura, ibid, subarticle 5.
- Shulchan Aruch, Orach Chayim, 38:1; Magen Avraham, ibid, subarticle 1; Mishneh Brura, ibid, subarticles 1-4; Tzitz Eliezer Responsa, volume 20, article 45, responsum 3.
- Mishneh Brura, article 90:3.
- Nishmat Avraham, Orach Chayim, article 38:1.
- Even though one should not think about Torah in a putrid space, it is permitted to perform a mitzvah in such a place under extenuating circumstances. See regarding blowing the shofar when one has urinary incontinence: Biur Halacha, article 588, “שמע ט’ תקיעות”; Yabia Omer Responsa, volume 6, Yoreh Deah, article 29; Tzitz Eliezer Responsa, volume 15, article 32:12. So writes the Nishmat Avraham, Yoreh Deah, article 19:1 in the name of Rabbi Shlomo Zalman Auerbach regarding putting on tefillin.
- Maharam Schick Responsa, Orach Chayim, volume 15; Yehuda Ya’aleh (Asad) Responsa, Orach Chayim, article 19; Kaf HaChayim, Orach Chayim, article 27:8; Yabia Omer Responsa, volume 9, Orach Chayim, article 7:2; see as well his writings in the Taharat HaBayit (Jerusalem 5750), volume 2, article 12:45 (in Mishmeret HaTaharah, page 212, he writes that even a woman who is niddah may place her husband’s tefillin on him); Shevet HaLevi Responsa, volume 1, article 8; Nishmat Avraham, Orach Chayim, article 27:2. Rav Waldenberg (Tzitz Eliezer Responsa, volume 13, article 7) brings down an opinion that prohibited women from putting tefillin on others and rules that it is best for men to perform this, but if there is no one else, the woman may place them and he can make the bracha. The aforementioned sources deal with a woman or child putting the tefillin on and not a non-Jew, but see Rabbi Shoval Ben-Shlomo, “Placing of Tefillin by a Woman or Non-Jew”, Yeshurun, 19 (Elul 5767), page 551-559. According to the Maharam Schick, a woman may put tefillin on someone else because she is connected to the obligation of tefillin, and following this one should not have a non-Jew put on their tefillin. The Shevet Halevi disagrees because the main aspect of the mitzvah is not the tying but the wearing of the tefillin. According to this rationale, Rav Ben Shlomo writes (ibid., page 558) in the name of Rabbi Yosef Shalom Elyashiv that a woman and, less preferably, a non-Jew, may place tefillin on a patient if there is no other person, and the patient should make the bracha when the tefillin are wrapped and not beforehand. See also what the Rabbis and Rebbetzins of Beit Hillel write, ‘A Halachic Perspective on the Employing and Rights of Foreign Workers’, Beit Hillel, 18 (Tevet 5780), page 8, https://bit.ly/3qYJ25E.
- Shulchan Aruch, article 27:16.
- Mishneh Brura, article 27:22. The Imrei Yosher (volume 2, article 14) writes that in this case one should wrap on their left arm, but the other poskim disagree. See Yabia Omer Responsa, volume 9, Orach Chayim, article 7:3. The Nishmat Avraham (Orach Chayim, article 27:2) writes in the name of Rabbi Shlomo Zalman Auerbach that if the doctors believe that the arm will heal eventually, he should place on his left, and if not, his right; it is also written in the name of Rav Auerbach that if the arm is totally paralyzed with no sensation, it is considered as if the patient has no right hand and he should place on his left.
- Mishneh Brura, article 27:16.
- Shulchan Aruch, Orach Chayim, 89:3; Mishneh Brura, ibid., subarticle 24,28; Biur Halacha, ibid., “וכן אוכלין”; Kaf HaChayim, Orach Chayim, Article 89:36.
- The Shemoneh Esrei prayer: Shulchan Aruch, Orach Chayim, 96:6. Kriyat Shema: ibid. 63:1.
- Shulchan Aruch, Orach Chayim, 94:6; Mishneh Brura, ibid. subarticle 21.
- Shulchan Aruch and Mishneh Brura, ibid.; Shulchan Aruch, Orach Chayim, 62:4.
- Kriyat Shema: Shulchan Aruch, Orach Chayim, 58:1. Tefillah: ibid., 89:1.
- The Shulchan Aruch (Orach Chayim, 59:6) rules that after the fourth hour one may recite the Kriyat Shema without the brachot for the rest of the day. The Biur Halacha (ibid. “קורא בלא ברכותיה”) rules that one who was totally unable to say it in time may rely on the poskim that permit reciting the Kriyat Shema with its brachot until noon. In the written responsa of the Yalkut Yosef (article 58:6) Rav Ovadia Yosef rules like the Shulchan Aruch that one should not bless after the fourth hour.
- Shulchan Aruch, Orach Chayim, article 89:1.
- The Mishneh Brura (article 52:10) writes that ideally one should make the brachot until the fourth hour, when necessary until noon, and one who is lenient to rely on the poskim allowing to bless all day should not be denied this; he also brings there the opinion that they also may be said at nighttime, any time one is not asleep. Rav Ovadiah Yosef (Yechave Da’at Responsa, volume 4, article 4) rules as well that the time of the brachot is all day as a last resort. The Yalkut Yosef (article 46:25) rules that one who makes these brachot after nightfall has what to rely on. Rabbi Meir Mazuz (Mishneh Brura, Ish Matzliach Edition, on the Mishneh Brura, ibid., footnote 5) disagrees with him regarding this.
- Igrot Moshe Responsa, Orach Chayim, volume 1, article 27; Or LaTzion Responsa, volume 2, chapter 6, article 15; Tzitz Eliezer Responsa, volume 8, article 1; Yalkut Yosef, article 76:25; Rav Shlomo Zalman Auerbach, whose opinion is brought by Rav A.S. Abraham in ‘The Elderly Patient: Nursing Issues from a Halachic Perspective’, Assia, 6 (5749), page 133, and in the Nishmat Avraham, Orach Chayim, article 76:9.
- According to Rav Moshe Feinstein (Igrot Moshe Responsa, ibid.) one is obligated to cover the catheter; according to Rav Eliezer Waldenberg (Tzitz Eliezer Responsa, ibid.) this is a matter of piety; and according to Rav Shlomo Zalman Auerbach, one is not obligated to cover it at all.
- Tzitz Eliezer Responsa, volume 8, article 1:22-26; ibid., volume 12, article 2; ibid., volume 18, article 78:7; Nishmat Avraham, Orach Chayim, article 7:1.
- Tzitz Eliezer Responsa, volume 9, article 6; the opinion of Rav Shlomo Zalman Auerbach is brought in the Nishmat Avraham, Orach Chayim, article 76:9; Minchat Yitzchak, volume 6, article 11-12; ibid., volume 10, article 8; Shevet Halevi Responsa, volume 3, article 17.
- For the text of the abridged Tefillot Shemoneh, see – The Prayer for an Infirm Person (https://ad120.tzohar.org.il/articles/%d7%a1%d7%93%d7%a8-%d7%aa%d7%a4%d7%99%d7%9c%d7%94-%d7%95%d7%91%d7%a8%d7%9b%d7%aa-%d7%94%d7%9e%d7%96%d7%95%d7%9f-%d7%9c%d7%97%d7%95%d7%9c%d7%94-%d7%aa%d7%a9%d7%95%d7%a9/)
- According to the second opinion of the Shulchan Aruch, Orach Chayim, 59:3, an individual should not say “kedusha” in the blessing of “Yotzer Or”. The shortened version of the bracha of “Yotzer Or” for an individual is found in the Siddur of Rav Saadiah Gaon (Mekitzei Nirdamim Edition, Jerusalem 5701), page 13. This text was established by Rav Shlomo Goren as the abridged prayer for a soldier in a time of need. See Rav Shlomo Goren, Meishiv Milchama: Questions and Answers Regarding the Army, War, and Security – Volume 2, Jerusalem 5754, article 128, page 260-263.
- The “Halleluyah” paragraphs after “Ashrei” are preferential to the other sections. The two psalms beginning with “Halleluyah Hallelu” (148 and 150) are preferential to the others. Additional details are enumerated in the Shulchan Aruch, Orach Chayim, 52, and Mishneh Brura ibid. See the summary of Rabbi Eliezer Melamed, Pninei Halacha, Tefillah, Chapter 14, article 5-6 (https://ph.yhb.org.il/02-14-05/). The general principles of shortening prayer are stated for one arriving late to synagogue and needing to skip in order to pray with a minyan, and they apply to one who is forced to shorten their prayer in a time of need as well. See: Rav Shlomo Goren, Meishiv Milchama (earlier in the previous endnote), pages 257-264; Igrot Moshe Responsa, Orach Chayim, volume 4, article 91:2.
- Shulchan Aruch, Orach Chayim, 53:2.
- Rav Shlomo Goren, Meishiv Milchama (earlier endnote 25), page 263.
- See a summary in the Nishmat Avraham, Orach Chayim, article 110:2; and the Medical Halachic Encyclopedia, volume 3, entry ‘Patient’. Pages 444-445.
- Shulchan Aruch, Orach Chayim, 110:1. The Biur Halacha (ibid., “או שלא”) writes that one who is not able to pray due to being ill or preoccupied is permitted to recite “Havineinu”. Granted he writes that nowadays we are not accustomed to praying “Havineinu” due to being preoccupied, however the Gesher HaChayim (volume 1, chapter 1,3,5) writes that a patient may pray “Havineinu”.
- Shulchan Aruch, ibid.
- Gesher HaChayim (earlier endnote 30).
- See: Shulchan Aruch, Orach Chayim, 104:1; Mishneh Brura, article 110:6. The full text is found in the Chayei Adam, volume 1, principle 24, article 31.
- Shulchan Aruch, Orach Chayim, 110:3, regarding one who is in a state of peril and is not have peace of mind. The Gesher HaChayim (earlier endnote 30) adds that this is the case of a sick person.
- Gesher HaChayim, ibid.
- Responsa of the Radbaz, article 2’224; Biur Halacha, article 184, “בכזית”; see the Tzitz Eliezer Responsa, volume 11, article 13. According to Rav Waldenberg, if one eats a kezayit, even according to the lenient authorities who establish this as 15 grams, he should make a Birkat Hamazon. However, anything less for this does not qualify for a bracha.
- The Pri Megadim (article 210:1) believes that since he is satiated, he is obligated in Birkat Hamazon, even though a delay of “a pras” is not considered a meal. The Mishneh Brura ibid. brings his opinion, however in the Shaar HaTzion (subarticle 10) writes that it is unclear, since a status of a meal may be necessary to say Birkat Hamazon. Other Achronim also disagree on this issue. See: Ben Ish Chai, First Year, Parshat Masei, article 7; Igrot Moshe Responsa, volume 1, Orach Chayim, article 76; See as well the Nishmat Avraham, Orach Chayim, article 210:1. There is disagreement regarding the duration of “eating a pras”, and the decision to use six minutes is according to the ruling of Rav Eliezer Melamed, Pninei Halacha, Brachot, chapter 10, article 7.
- Tzitz Eliezer Responsa, volume 13, article 35:3; Minchat Yitzchak, volume 13, article 18:23; Nishmat Avraham, ibid.
- Nishmat Avraham, ibid.
- See the abridged text for Birkat Hamazon [page – Prayers for an Infirm Person https://ad120.tzohar.org.il/articles/%d7%a1%d7%93%d7%a8-%d7%aa%d7%a4%d7%99%d7%9c%d7%94-%d7%95%d7%91%d7%a8%d7%9b%d7%aa-%d7%94%d7%9e%d7%96%d7%95%d7%9f-%d7%9c%d7%97%d7%95%d7%9c%d7%94-%d7%aa%d7%a9%d7%95%d7%a9/]
- Or LeTzion Responsa, volume 2, chapter 46, article 25.
- Kaf HaChayim, Orach Chayim, article 187:4; Or LeTzion Responsa, ibid.; The Medical Halachic Encyclopedia, volume 3, entry ‘patient’, pages 439-440.
- In the abridged version brought in the Bayit Chadash, article 192, and the Magen Avraham, beginning of article 192, the first bracha should be said in its entirety, but in the text brought by the Kaf HaChayim and Or LeTzion Responsa (earlier endnote 41) even the first bracha is shortened.
- Or LeTzion Responsa, ibid.
- Ben Ish Chai (First Year, Parshat Chukkat, article 11) brings a version for woman who do not say even the abridged text, and according to him even one shortened bracha is enough, brought by the Shulchan Aruch, Orach Chayim, 187:1: “בריך רחמנא מרן מלכא דעלמא מריה דהאי פיתא בריך רחמנא דזן לכולא”. According to the Mishneh Brura, ibid., subarticle 4 (and the Shaar HaTzion, subarticle 7), this version is appropriate for small children in place of the first bracha alone, and one should add to this the abridged version of the other brachot. The Or Letzion Responsa, which brings the text of the three brachot according to the Kaf HaChayim, exchanges the Aramaic text for the first blessing with Hebrew text. It seems that according to the Ben Ish Chai this version is appropriate for a patient that cannot say the three brachot.