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How Does One Keep Kosher When Receiving Nutrition Via PEG? >>

Hello Honorable Rabbi,

I work as a speech therapist in the rehabilitation department at Hadassah Har HaTzofim Hospital. Recently we admitted a patient after a stroke. Due to his condition, they inserted an abdominal PEG tube.

Now his condition is improving: he is allowed to eat solid and pureed foods orally, but is still prohibited from drinking. Due to this, he must receive maintenance fluids and dietary supplementation through the PEG (primarily dairy Ensure products).

The patient wanted to know how he should act according to halacha:

  1. Is it permissible to receive dairy Ensure through the PEG tube after eating soup with ground meat orally?
  2. If one must wait in between – Is it an obligation or preference to wait between eating meat orally and dairy nutrition that is inserted directly into the stomach, and if so, how long?

This essay first published on Kipa website

Blood Sugar Test and Intravenous Injection for Parents >>

Hello Rabbi,

Our father requires daily blood sugar tests and weekly injection into an open vein (procedures that could lead to slight blood draw). Is it permissible for us to do the blood test and injection for him?

Kashrut of Food Provided Via Gastrostomy Tube (PEG) >>

Hello Rabbi,

Our father requires nutrition through a percutaneous gastrostomy tube (PEG). Do nutritional supplements and formulas provided through it require kosher certification?

During a Siren: Is the Caretaker Obligated to Remain With My 85-Year-Old Mother Or Should She Go By Herself to the Bomb Shelter? >>

Hello Rabbi,

My mother is 85 years old, and lives in a retirement home with a 24/7 caretaker. She suffers from mild cognitive decline, her physical condition is good, but she moves around very slowly and is obese.

During warnings and sirens, the caretaker and her are unable to go down to the shelter, only reaching the lobby elevators. The caretaker asked me what she should do.

The caretaker is a hardworking and good woman, and tends to remain with my mother, but we do not expect her to risk her life. On the other hand, it is important that our mother does not remain alone.

I would appreciate hearing your opinion in the matter.

Siren in the Hospital: Should We Leave My Demented Father In Order to Run to a Shelter? >>

Hello Rabbi,

I am accompanying my father during his hospitalization. He is 90 years old with dementia and does not get around easily. During a siren, should I stay with him beside his bed, or run to a bomb shelter and leave him alone?

Pain Relief for Patients with Terminal Cancer >>

Hello Rabbi,


I have advanced metastatic cancer and suffer from pain. I have been offered pain medication administered gradually, so that I will suffer less and be able to say goodbye to my family. I understand that the dosage will increase over time and that there is a risk to my life. Is this treatment permitted?

Answering Repeated Telephone Calls from a Person with Dementia on Shabbat >>

Hello Rabbi,


Our mother has dementia and lives with a caretaker. During sirens, she experiences anxiety and asks the caretaker to call us again and again so that she can hear a familiar voice. Must we be available by telephone for her during a siren, even on Shabbat?

My Home Is Falling Apart Because of Caring for My Father: Is It Permitted to Say “Enough Is Enough”? >>

Hello Rabbi Cherlow,

My father moved in with us after refusing every nursing facility, but he refuses to accept help from anyone except me. I find myself collapsing—my children hardly see me, my relationship with my spouse is suffering, and he adamantly refuses to allow outside help or to move to assisted living. He claims that this is “a family sacrifice.” Does the commandment of honoring one’s parents require me to sacrifice the peace of my own home and my mental health because of his stubbornness?

The Smell in the House Has Become Unbearable, but Mother Refuses to Bathe. What Is the Boundary Between Help and Humiliation? >>

Hello Rabbi,


We feel that we have reached an impasse. My mother suffers from mild cognitive impairment, and she has stopped maintaining basic hygiene. She refuses to bathe or change clothes, and the situation in the house has become insufferable in terms of smell and health. Every attempt we make to help ends with shouting and accusations that we are “taking over her life.” Is it permitted for us to “force” her to clean herself? How can one preserve the dignity of an aging parent when one must treat them almost like a child?

Our Father Is Endangering Himself but Forbids Us From Intervening. Is It Permitted to Violate His Wishes in the Name of “Honoring One’s Father”? >>

Hello Rabbi,


My father is 84 years old. He is mentally lucid but has become very physically weak. Recently he has fallen twice at home, and only by a miracle did it not end in disaster. He adamantly refuses to allow a caregiver into his home or to even install an emergency call button, claiming that it “harms his dignity.” We, his children, live in constant anxiety, but he tells us: “If you honor me—do not interfere.” Does halacha require us to listen to him even when he is endangering himself, or does concern for his life take precedence over his wishes?

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