HOSPICE VOLUNTEERS - A VITAL PART OF CARING FOR THOSE WHO ARE DYING

What is Hospice?  

"At some time, in some way, we must all face the end of life, and most of us share a common hope that when death comes to us, or to a loved one, it will be peaceful.  We hope to be surrounded by those we love, feeling safe, comfortable and cared for.  When our life has ended, we hope that our loved ones, who are left behind, will be comforted and supported through their grief."  Living Lessons

Hospice volunteers come with a wide range of life experiences and skills that enable them to offer practical assistance and supportive care to meet the special needs arising out of the physical, emotional, spiritual, social and economic stresses experienced during the final stages of living, and during caregiving and bereavement.

Hospice volunteers work as part of the Hospice Pallative Care Team (consisting of the patient, their family and friends, healthcare professionals and volunteers) to ensure the needs and choices of those dealing with end-of-life issues are sensitively met.

Volunteers who have completed the training program are eligible to work with clients and their families providing compassionate care and support in the community in a variety of settings.  

They may work as:

• A home visiting volunteer providing support and respite for the terminally ill, their families, and caregivers.
• A volunteers on the Pallative Care Unit
• A bereavement support volunteer working in formal and informal group programs.

Individuals, who wish to contribute on a volunteer basis without taking the training program provided may become "Friends of Hospice" and participate in non-client related activities such as:

• Board Membership
• Fundraising Activities
• Office & House Support
• Thrift Shop

Hospice is not only a place -- it is a philosophy of care.  We believe that life is a precious and fragile journey of growth and development and that, although death may be a time of sadness and separations, dying is a part of life's journey that can be embraced with dignity, serenity and hope.

Volunteer Training

Hospice volunteer training is experimental in nature and active participation in the group process is necessary.  Facilitators provide a safe environment for participants to share an are available for debriefing after and between training sessions.

Training includes:
                             Communication Skills
                                 Comforting Skills
                       Community Pallative Care Team
                             Issues of Death & Dying
                            Dealing with Grief & Loss
                                 Pallative Care Unit 
                                    Care of Self
                                  Care of Spirit

Following 40 hours of training, volunteers receive orientation and work with patients and families on the Pallative Care Unit with support of an experienced hospice volunteer.  

The generosity of our community enables us to offer our pallative and bereavement programs at NO COST to the participants.

Information taken from Volunteer Training Program Nanaimo Community Hospice Society  brochure --- More inforamtion at www.nanaimohospice.com or contact them via email

info@nanaimohospice.com

Five Regrets of the Dying

Top five regrets of the dying

A nurse has recorded the most common regrets of the dying, and among the top ones is 'I wish I hadn't worked so hard'. What would your biggest regret be if this was your last day of life?

There was no mention of more sex or bungee jumps. A palliative nurse who has counselled the dying in their last days has revealed the most common regrets we have at the end of our lives. And among the top, from men in particular, is 'I wish I hadn't worked so hard'.

Bronnie Ware is an Australian nurse who spent several years working in palliative care, caring for patients in the last 12 weeks of their lives. She recorded their dying epiphanies in a blog called Inspiration and Chai, which gathered so much attention that she put her observations into a book called The Top Five Regrets of the Dying.

Ware writes of the phenomenal clarity of vision that people gain at the end of their lives, and how we might learn from their wisdom. "When questioned about any regrets they had or anything they would do differently," she says, "common themes surfaced again and again."

A palliative nurse has recorded the top five regrets of the dying. Photograph: Montgomery Martin/Alamy

Here are the top five regrets of the dying, as witnessed by Ware:

1. I wish I'd had the courage to live a life true to myself, not the life others expected of me.

"This was the most common regret of all. When people realise that their life is almost over and look back clearly on it, it is easy to see how many dreams have gone unfulfilled. Most people had not honoured even a half of their dreams and had to die knowing that it was due to choices they had made, or not made. Health brings a freedom very few realise, until they no longer have it."

2. I wish I hadn't worked so hard.

"This came from every male patient that I nursed. They missed their children's youth and their partner's companionship. Women also spoke of this regret, but as most were from an older generation, many of the female patients had not been breadwinners. All of the men I nursed deeply regretted spending so much of their lives on the treadmill of a work existence."

3. I wish I'd had the courage to express my feelings.

"Many people suppressed their feelings in order to keep peace with others. As a result, they settled for a mediocre existence and never became who they were truly capable of becoming. Many developed illnesses relating to the bitterness and resentment they carried as a result."

4. I wish I had stayed in touch with my friends.

"Often they would not truly realise the full benefits of old friends until their dying weeks and it was not always possible to track them down. Many had become so caught up in their own lives that they had let golden friendships slip by over the years. There were many deep regrets about not giving friendships the time and effort that they deserved. Everyone misses their friends when they are dying."

5. I wish that I had let myself be happier.

"This is a surprisingly common one. Many did not realise until the end that happiness is a choice. They had stayed stuck in old patterns and habits. The so-called 'comfort' of familiarity overflowed into their emotions, as well as their physical lives. Fear of change had them pretending to others, and to their selves, that they were content, when deep within, they longed to laugh properly and have silliness in their life again."

What's your greatest regret so far, and what will you set out to achieve or change before you die?

Taken from 

http://www.guardian.co.uk/lifeandstyle/2012/feb/01/top-five-regrets-of-the-dying?INTCMP=SRCH&fb=native#_=_

A Dying Person’s Guide To Dying

A Dying Person’s Guide To Dying

by Roger C. Bone, M.D.

By thinking ahead about what could happen - and about how you will deal with problems if they do happen, you can create a better life and a better quality of life for yourself and for the people who love and care about you. 

What I have to say is for the person who, like myself, is dying. We, too, need to plan - to think ahead in order to fashion, out of the time remaining, the best of what is possible.

As I am dying from cancer, I have learned some things that I think are important for a dying person to know in order to plan. I am a physician, but what I have learned has little to do with my medical training. I have learned this as a person; perhaps my medical experience was helpful because I have paid close attention to the actions and reactions of people around me.

First, it is likely that you will be surrounded by persons who mean well but, in the end, you must die your own death. Dying can be considered a journey one takes alone with a crowd. Family and friends are the first to gather around you, and they offer the most comfort.

Here are some pieces of advice to remember in those first few days after you learn the bad news.

One or two people - probably family members - will make enormous personal sacrifices to help you. If you are married, your spouse is likely to do this, but don’t be surprised if others - a daughter, a brother-in-law, or even a friend, step forward to offer extraordinary help. Be grateful, and accept help, from whatever source, graciously.

Some family members, but especially friends, will treat you differently. Even before you show signs of serious illness, people will have a different look in their eyes as they talk with you. You might consider this patronizing or over bearing. It may be difficult, but it is best to ignore their attitudes and treat them as you always have. They will come around to their normal selves when they get over the shock.

 

Happily accept all gifts from family and friends. It makes them feel better and you might receive something you really like and appreciate.

Don’t be afraid to ask to be alone. We need time to be by ourselves. Some family and friends may feel driven to fill your every waking moment with activities; perhaps they are trying to “take your mind off” your impending death, but they may also be doing the same thing for themselves.

Be your own counsel. No one, including your physician, religious counselor, spouse, or friends can understand 100% what you want and need. It surprised me that some people seemed to “bully” me with advice when they learned that I was terminally ill. We should remember Immanuel Kant’s advice to avoid accepting someone else’s authority in place of our own powers of reason. We are the ones who should be considering alternatives and making choices. We can, and should, ask for advice. Make telephone calls and read books - but ultimately, we should decide.

Slow down and ask your family and friends to slow down. There may not be a lot of time, but there is sufficient time in all but the most extreme cases to think, plan, prepare.

There are things you need to know from your doctors and other health care staff. You need not ask all of the following questions or ask them in this order. Still, these questions deal with crucial issues that need to be addressed and, hopefully, resolved.

What is my disease?

You should find out as much as possible about your disease. What is it? How will it affect me? And very importantly, how will it cause my death? First, ask your physician. Additionally, many popular books are available in bookstores and libraries which can give you a basic sense of your disease process and disease terminology. National organizations, such as the American Cancer Society, and often local hospitals can provide brochures, video tapes, or even lay experts to help you and your family understand your particular disease. Ignorance is not bliss; the more you and your family know, the better able everyone will be able to cope with what is happening.

Should I seek a second opinion 

about my disease and my condition?

Seek a second opinion! A second opinion will relieve your mind and resolve doubts one way or another that a major mistake has not been made. More importantly, a second opinion will offer a slightly different perspective that may help everyone’s understanding. Don’t be embarrassed about asking for a second opinion or think that you will make your physician angry. Second opinions are perfectly acceptable, and many physicians are happy when their patients seek second opinions. The original diagnosis is usually confirmed, and you are then more prepared to follow prescribed treatments.

What health professional do I especially trust?

Search for and then trust in a single individual. This does not mean you should not listen to all health professionals and follow reasonable directions and advice. But focus on one individual as the final helper. This normally will be the specialist physician in charge of your case. However, you may know your family doctor better than you know your cancer specialist. If this is the case, your family doctor may be the one to choose. But, if you do, make certain that your family doctor knows that he or she is serving that role.

Why am I going into the hospital?

There are four basic reasons why a terminally ill person would be hospitalized, but not all four necessarily apply to every patient. They are: (1) to confirm the diagnosis and analyze how far the disease has progressed; (2) to provide treatment that can only be given in the hospital, (3) to treat a severe worsening of the disease; and (4) to treat the final phases of the disease, if this cannot be done at home or with hospice. You should know which applies to you so that you can understand why things are done to you and what benefits you can expect.

What are the hospital rules about terminally ill patients?

Hospitals and medical centers have written rules and procedures that outline in detail how the hospital will deal with terminally ill patients. These are not “treatment” rules. These protocols or guidelines, as they are called, deal with how to handle end-of-life issues, such as whether the patient (or the patient’s family speaking for the patient) wishes extraordinary “heroic” measures to be used to keep the patient alive. Hospitals are obligated, and very willing, to share these protocols or guidelines with patients and families. 

Consider getting a durable power of attorney in which you name one or two people to make decisions or choices on your behalf if you should be incompetent or incapable of making decisions yourself. 

Read the “Do Not Resuscitate” policies of the hospital. Death should be peaceful, and you should not ask for anything that gives you prolonged agony.

You should be aware that nurses and other hospital staff may not know that you are terminally ill. This fact may not be written in your chart, which can lead to conflicts between families and hospital staff. The family may assume that everyone in the hospital shares their grief, and will not understand the workaday attitude of nurses, dietitians, or others. It is okay for the family to tell the hospital staff that you are dying since they may not know.

What resources are available from the health care community?

Most hospitals have many services available to patients and families to help with nonmedical aspects of your care. These include social services and psychological, financial, and religious counseling. For example, a visit, before hospitalization, to the hospital financial counselor by a family member to check on insurance and payment plans is a wise move. In the rush to admit a patient, important information may not get recorded. A 15 minute meeting with counselors can avoid stress and anger over incorrect bills. Similarly, meeting with the hospital social worker may be very helpful in arranging home care. Use these services!

What can I do if it seems that nothing is being done or if I don’t understand why certain things are done to me?

Hospitals, clinics, and doctors’ offices can be confusing places. You can begin to feel you have no control over what is being done to you, and you may wonder if anyone really understands your case. This is the time to call the health professional who is your primary contact - the one you decided you fully trust - your physician specialist or family physician. Ask this person to explain what is going on. Have him or her paged or even called at home if your situation is very upsetting. It is the physician’s responsibility to help you, and he or she will not be angry that you called.

How will I and my family pay for my treatment?

Financial professionals employed by hospitals understand billing and what may or may not be covered by Medicare, Medicaid, or private insurance. Consult them and be sure to ask every question to which you and your family need an answer. It is important that you and your family do not panic over billing. Ask for advice and help.

Sometimes the hardest part about dying is the effect it has on your family and friends. Helping them deal with your death helps you find peace and comfort. 

If you are not at peace with your death, ask the health professional you especially trust to help you find peace. That person will help or will get whatever help is needed. After all, it is the goal of all health professionals, to give you comfort and health during life and peace to you and your family at death.

Copyright © 1997 by the American College of Physicians. The American College of Physicians gives permission to reproduce and distribute copies of this plan provided it is not altered and its use is not for profit. Users can remove the left column (containing the book contents and the word “Top”) when making copies for distribution. For information on translation, subsidiary, and for-profit use, contact David Myers. Phone: 215-351-2642; fax: 215-351-2644; e-mail: dmyers@mail.acponline.org.

 

 

Interaction with a Dying Person

Interaction with 

a Dying Person

Facing Your Own Fears 

to Face Your Loved One

 From Angela Morrow, RN, former About.com Guide

The thought of dying often times evokes fear and apprehension in people. Thinking of others dying can make our own mortality seem very real. Research has shown that dying people are even ostracized from society, even avoided by close friends and family.

 In light of this, it is easy to see why many dying patients report feeling isolated and alone. This is certainly not the type of death most of us would choose. Being surrounded by friends and loved ones is how the majority of us would choose to spend our last months or days.

Why is it so Difficult?

 There are several reasons many people have a difficult time interacting with a dying person including not wanting to face the reality of their own death, not having the time to become involved, and not having the emotional reserves to deal with such an intense situation. Feelings of guilt over whether they could have done something to prevent or cure an illness, or over how their relationship with that person has been recently may also cause someone to avoid a dying person.

When someone is having a difficult time interacting with a dying person, it often manifests as avoidance of them, difficulty speaking with them, difficulty maintaining eye contact, and keeping a physical distance from them. These are likely to be perceived by the person who is dying.

Factors that may complicate an already difficult situation are whether the cause of death is viewed as socially acceptable or not (i.e. heart failure vs. AIDS), whether the death is perceived as “on-time” or not (i.e. an elderly person vs. a child), and where they die (i.e. a nursing home vs. their own home). Because everyone dies differently, the dying person may evoke more avoidance due to their level of pain or distressing symptoms and how they cope with them. Some dying people may not want to engage in full conversations but prefer brief, succinct communication. These things can increase the discomfort loved ones already feel.

Bridging 

the Gap

On one side, you have family and friends that are fearful or uncomfortable being around a dying loved one and on the other, the dying person feeling abandoned, isolated, and alone. How do we bridge that gap to bring these people together? Open communication is the easiest and best way to bridge that gap.

Let the dying person know you are feeling fearful or uncomfortable, or whatever emotion it is that you have. They’re going to figure it out anyway! It will let them know that you are taking steps to get past it and to give them what they need the most during this time.

Ask the dying person what they need or expect from you. Some dying people will want to talk very openly about their illness and their impending death. Others will want to avoid talking about it and choose to focus more on fond memories or their loved ones lives. Both are okay but knowing what it is the dying person wants to talk about during your interactions will go a long way. Some will not want to talk at all but may want you at their side to hold their hand, read them a book, or just to feel your presence.

Be honest about what you can offer. If they want you to visit daily and you can’t fit it into your schedule or don’t feel like you can handle that much emotional strain, let them know. Tell them what they can expect from you like, “Bob, I understand that you want me to visit you every day. I want to visit you as much as I can but every day may not be possible. I will be sure to visit you every Monday, Wednesday, and Saturday and if I can fit any extra days in, I will do it.” The important thing is to not make a promise that can’t keep.

Also, be honest about what you feel comfortable talking about. Just because the dying person wants to be open and frank about what is happening to them, you may not feel comfortable discussing every detail. Let them know if this is the case. Once everyone’s needs and expectations are in the open, the process of compromise can begin. 

Finding a place where everyone is comfortable and getting their needs met will help make interacting with the dying person a special experience that you can treasure.

http://dying.about.com/od/thedyingprocess/a/interacting.htm