Over the last year, I spent more time on my Hospice volunteer work with patients and their families. The time I spent with patients and their loved ones proved to be instructive on many levels. I participated in life celebrations for four patients. A change in Hospice providers gave me the opportunity to take a new round of training. I also gained an appreciation for the role of Volunteer Coordinator. 

Home hospice is not a full-time care service. Most of the caretaking duties for the patient fall to family members and other loved ones. Caring for a terminally ill loved one is hugely taxing emotionally and physically. Stress and exhaustion are inevitable, and burnout is a real possibility. As a result, one of the most essential services that Hospice Volunteers can offer a patient's family is respite. These services entail a volunteer spending time with the patient so the family caregivers can do something else, preferably an activity that helps them decompress. 

Sometimes in life, we encounter people who face immense life stressors, and somehow, they keep going; they rise up and address the nightmare. They inspire us with this superhuman strength and courage. These people also often demonstrate devotion that transcends all else in their lives while the rest of us can only stare in awe. When we see what these people do, we think that if it was us, we would fold. Nowhere is this more often on display than in a Hospice service. 

As a Hospice volunteer, it is impossible to form a deep connection with every patient. The primary reason for this is that many patients enter Hospice care very close to their end-of-life transition. Volunteers don't have enough time with these short-lived patients to form enduring bonds or complete much death work. Still, spending even a brief time with these patients is valuable to the patients and their families. For the volunteer, the experience, however brief, can also be rewarding. 

My first "young" patient was 53, uncomfortably close to my age. I realized that I was using the advanced age of my patients as a crutch, as an excuse not suppress my outrage at the unfairness. This kept me from realizing that I subconsciously wanted to fix my patients to some extent rather than accept them and their path entirely.

The volunteer coordinator directs the comfort care volunteers who, arguably, spend the most time with the patients outside of the patient's families. The person in this role also manages the critical 5% of all hospice hours that must be volunteer hours. The volunteer coordinator finds, trains, and supervises volunteers. Volunteer coordinators have challenging jobs; if they do well, the hospice organization meets major requirements for Medicare

As a Hospice volunteer, on rare occasions, I will connect with a patient more rapidly and on a deeper level than I expect. These fortuitous pairings are all down to luck, like most everything in life. I always try, with my patients, to make the most of our brief time together. But, there is a greater sense of urgency when I feel a powerful connection, and there is much to share and explore. I experienced this with Jim, a patient I was almost not assigned. We had a brief but rich time together. We learned from each other primarily because we were both curious and excited to share knowledge and experiences.

During that first meeting, like other first meetings, we discussed our lives and interests. This somewhat painful conversation gave me a good idea of what I would deal with when I visited Nancy. For Nancy, her entire life had been one horrible disappointment after another. No matter what I asked her or told her that elicited a response, she was dyspeptic and negative on a level I found disturbing.

There is no question that in spending time with hospice patients, assigned caregivers experience grief when a patient dies. We grow close to our patients through the sharing of a sacred space of death preparations. We experience grief because we come to love our patients.

I learned a lot about Susan's life. She could maintain an egoless distance from her history, own it, and speak her truth like no one I've ever met. She could recount mistakes and bad luck as readily as her triumphs and brilliant moves. But the most important lessons from her came in her bearing, strength, and quiet determination in the face of death. The fact that she chose to leave the world on her terms and stuck to that decision was powerful to witness.

As a Hospice Comfort Caregiver, I practice what I call silent, empty vessel, witness presence. I must be physically present but not take up mental, emotional, or spiritual space, allowing the person who is dying the room they need to process the end of their life.