and I want you to meet some very important people.

Hi – I’m Elaine Kurczewski and I’m a hospice volunteer in

Chicago, Illinois.  

Hi – I’m Daniel Lee – everyone calls me Juno - and I’m a hospice volunteer

in Clearwater, Florida.

Hi – I’m Gail Cherochak and I’m a hospice volunteer

in Gaithersburg, Maryland.

Hi – I’m Alex Silva,

and I manage hospice volunteers in San Diego, California.

Those four individuals are part of a growing number of people

all across America --- more than 63 million strong --- who make

sure they find… “Time – to help others.”

Remember back in history class, we learned that our nation

was born of volunteers?

General George Washington led the original Continental Army

that was comprised of colonialists who volunteered to

fight in the Revolutionary War.

And so began a tradition of volunteering –

that continues today.

According to the Corporation for National and Community Service –

a federal agency that compiles data and tracks trends in

volunteering --- the tens of millions of Americans who

volunteer each year generally do so to raise funds or help

provide various services.

Today –we’ll learn about one very special kind of volunteer

opportunity - for hospice.

You know, when we’re with friends at social events and

they ask about hospice and what I do – their reaction is strange

and negative and they’re concerned about me being

depressed and about it being depressing and upsetting and

they just don’t know what hospice is.

Well, before we talk about all that hospice IS …

let me tell you what hospice ISN’T:

Hospice isn’t a place where people go to die.

 Actually, hospice is about living.

Hospice is medical care that focuses on quality of life – by

managing the physical pain and symptoms of the patient… and the

emotional – and often spiritual pain - of the patient and his or

her loved ones.

The goal of hospice care is for people with a life-limiting

illness to spend their last months at home if they choose,

among loved ones, as comfortable as possible.

Hospice is unique in health care today because the care comes to

the patient – wherever he or she resides,

including private homes and apartments,

assisted living facilities and nursing homes.

Sometimes, hospice services begin while the patient is

waiting to be discharged from the hospital.

The modern-day hospice movement came to the United States in the

early 1970s.

 The first hospice established in the U.S.

is in Connecticut.

It was founded by volunteers – as were most of the hospice

programs that followed.

Today – there are about five thousand hospice programs

around the United States.

Most are community-based nonprofits.

 Some are for-profit businesses.

Either way, one thing the vast majority of hospice programs

have in common is that they receive funds from Medicare –

the federal health insurance program.

 In fact, Medicare is the main source of revenue for many

hospices.

But – in order to receive funds from Medicare,

a hospice must do certain things – one of which is to utilize

volunteers at least some of the time.

As a teen volunteer, I basically go to a patient’s home,

um, either for just talking or celebrating a birthday party for

them because everyone loves a birthday party and a lot of the

patients tell me that it’s their first birthday party.

Lots of times I just go there, talk,

see how they are and I just hear the most exciting

life stories because these people have lived a long time

and they kind of impart their knowledge on what they’ve seen

throughout their whole life, to me.

It’s fun for me and it’s probably very relieving for them

to kinda have someone different to talk to.

Volunteers may also help by running errands,

driving the patient to and from appointments,

pretty much anything that will make the patient more

comfortable and lighten the load on the care giver.

But not all hospice volunteers are directly involved

in patient care.

Some volunteers do crafts – like sewing a memory bear from the

clothing of a family’s loved one - that is then given to the

family.

Or they volunteer at a hospice’s Thrift Shop which sells things

like furniture or clothing

that have been donated in good condition.

As a volunteer for my hospice, I work primarily on maintaining

the website, getting out new information about events,

I work with the marketing people who are designing brochures to

make sure the information is consistent and that we’re

getting out a really great message to the public and that

we are presenting a really good image to our clients who might

want to use our services.

Hospices often are on the lookout for people with special

skills and training, like notaries,

beauticians and barbers, massage therapists,

handlers of therapy animals, …and providers of complementary

or alternative therapies like healing touch,

aroma therapy and music therapy.

And hospice grief camps for children – many of which are

offered at no cost to the participants -

rely on volunteers.

In fact, many hospices use volunteers to check in with

loved ones by telephone periodically for about a year

following a patient’s death.

Many hospices also provide students with an opportunity to

fulfill community service requirements.

Student social workers, nurses and other aspiring professionals

often volunteer to get a feel for the end-of-life care part of

the health care continuum.

Thank you so much for coming in.

Please, have a seat.

When someone lets us know that they’re considering becoming a

hospice volunteer, the first thing I do is thank them.

 People have so much on their plates these days that we are

really thankful when they choose hospice as a way to spend some

of their precious leisure time.

When someone is considering becoming a hospice volunteer,

often they ask: What will my time commitment be?

What happens once I’ve applied to be a volunteer?

Will I be trained?

What happens if this turns out to be harder than I thought?

While we can’t answer for every one of the nation’s hospices,

we can give you some idea of what to expect.

I spend about 2-to-4 hours a week with my hospice activities

and I might spend the whole time with a person because they need

someone just to be with them.

Other times, it might just be 15 minutes because they’re tired,

they need to rest and they don’t need me right then,

and that’s okay because it’s about them.

But everything that I do with a patient,

every time, it is documented.

The reports filed by the volunteers are absolutely

essential for a number of reasons.

For one, we are required by Medicare to document that at

least 5% of total hours of patient care are delivered by

volunteers.

The volunteer’s report helps complete the whole picture of

how a patient and/or care giver is doing.

And the reports help me assess how the volunteer is doing,

in terms of both skills and attitude.

The volunteer’s report also documents compliance with the

number and frequency of volunteer visits specified in

the patient’s individual care plan.

If you think being a hospice volunteer sounds like a big

responsibility --- you’re right.

 That’s why hospices go to great lengths to make sure an

applicant is a good fit.

I got on their website and found out who to call,

I called and made an appointment for an in-person interview.

 Came in for the interview and was given a packet

with an application to fill out as well as an

application for a background investigation,

forms to fill out about patient confidentiality and the rules of

the hospice.

The forms are only half of the process.

 I meet with prospective volunteers for about an hour.

It’s not like a job interview- more like an informal

conversation that allows me to get to know the person.

I look to see whether the volunteer is receptive to the

hospice philosophy and if they have some degree of comfort with

being around death and loss.

I’m assessing the volunteer’s maturity…

And whether they seem to be healthy emotionally.

Do they have a strong religious, cultural or ethnic bias that

could be problematic?

I ask about their motivation to volunteer…

And about their schedule – how often they are available

and for how much time.

And whether the applicant has had significant losses in his or

her own life.

If the applicant has had a recent loss,

I need to determine whether the applicant should wait a little

longer before becoming a hospice volunteer.

The process from application to acceptance may take some time,

but each step is important to assure the relationship between

volunteer and hospice is mutually beneficial.

Once the interview, background check and other requirements are

complete, hospice volunteers receive plenty of training

before being okayed to see patients.

Okay!

Lets go ahead and get started.

Welcome. Thank you all so much for coming in and

volunteering for hospice....

–Orientation is the time when we not only learned

how to spend time with patients, but we learned from other team

members as to what their role is and how we can fit in and

blend with that.

So, when I was there, we did it multiple evenings over several

weeks – uh, I know now they’ll do it in a weekend.

 But the point is that we learn how to interact with our team

members as well as the patient.

–We believe training is crucial to providing the best possible

care to patients and families.

And when someone is properly trained,

they can perform their duties with confidence.

All volunteers are given a comprehesive orientation about

hospice philosophy, the team approach to providing care,

hospice regulations and policies,

ethics, and privacy regulations.

We also talk about how the patient’s terminal illness

affects the rest of the household,

spiritual care and grief counseling services.

Federal guidelines require the hospice to provide volunteers

with additional training for specific tasks

not covered in orientation should such needs arise.

And hospices are required to provide ongoing education for

volunteers to maintain their skills and learn new ones.

And do you get into your garden at all?

Yes, yes in fact I help out in the building with the flowers.

–After orientation I felt very comfortable and very competent

to talk and spend the time with my hospice patients.

But then you wonder – oh my God – what if they ask something

that I can’t answer?

 Where do I go from there?

We teach new volunteers that hospice care is comprehensive

and designed to meet each patient’s individual needs.

 In order to do that well…

care is delivered by an interdisciplinary team,

of which the volunteer is a very important part.

Each team member represents a different discipline and brings

different skills to the table – for example: Hospice physicians

have advanced training in controlling pain and managing

other symptoms in people living with advanced illness.

 But their real expertise is in their ability to provide pain

management that eases suffering… while honoring their patient’s

wishes to remain as conscious, active and independent

as they choose.

 The hospice nurse usually coordinates care with the

patient, loved ones, and other hospice team members.

The nurse also plays a pivotal role in communicating with other

team members about the patient’s needs.

The hospice social worker provides counseling and

mediation of patient and family conflicts,

assists in navigating the health care system and identifies

community resources to address things like financial concerns.

  The hospice chaplain helps patients find their own answers