First Hospice Visit

"Volunteers ... can reap many gifts depending on how fully present they are during each visit, how empty they are are of any expectations or agenda, how capable they are of accepting the individual unconditionally and how comfortable they are simply sitting in the silence. So much can be communicated without words, and in fact, quite often a patient is too tired or too weak to talk. Just the presence of a caring companion at the bedside can convey enough serenity to bring comfort and ease some of the fear and loneliness of dying." -- Mary Jo Bennett, "When Autumn Comes: Creating Compassionate Care For the Dying," p. 100

I couldn't have asked for a better patient than "Janice" to initiate me as a hospice volunteer. I was filling in for Janice's regular volunteers, who were out of town for Thanksgiving. I was nervous as I entered the nursing home to see her; so much so that the Director of Nursing said to me, "You're out of breath. Were you running?" Janice is an elderly patient dying from cancer and has no surviving family. Fortunately, she rated her pain a 0 on a scale of 0-10.

When I got to her bedside, Janice was eating and said, "I'm so glad you're here. I was beginning to get lonely." That made me feel like whatever else happened during that two hour visit, me being there made a difference to the patient. I cut up her potatoes so she could eat them. Janice told me I looked like Bette Midler, and we talked about Thanksgiving in particular, cooking in general, the weather, flowers, and other sundry things. Janice expressed her appreciation for how nice the hospice I'm volunteering for has been to her. After 45 minutes, Janice apologized and told me she needed to take a nap because the medication she takes makes her sleepy. I told her she had nothing to apologize for, and that if she's tired, she should rest. Janice woke up a few times from her nap, always smiling when she realized I was still there. Twice, she apologized again for sleeping, and worried that I was bored. I told her I had books, an iPad, and knitting, so there was no chance of me being bored. I gently woke Janice up before I left to say goodbye and see if she needed help with anything before I left.

I learned three important lessons from my first hospice visit:

A. Being there really matters. Janice said that plainly when I got there, and then her face conveyed it every time she woke up from her nap and realized she wasn't alone. How cool it was to get home and read the above-quoted passage from "When Autumn Comes" (a must for hospice volunteers), which echoes this experience, especially in the last sentence.

B. Being silent is very hard. I found myself wanting to make small talk with Janice. I give myself a "B-" in that regard. I will need to work on letting the client always initiate conversation. This gives them control over whether they want to speak or not, and especially if they are actively dying, they might not want to talk. Second, keeping my mouth shut allows them to choose the topic they want to converse about. If I was going on about Thanksgiving turkey and Janice had really wanted to talk about her fears of dying, I would have precluded that by my chatter. On the other hand, if I had forced a conversation about death and Janice wasn't interested in talking about that with me, that's not cool either. I can tell that to be a good hospice volunteer, I will need to get very comfortable being silent. Bennett's excellent guide for hospice volunteers gives several suggestions for things to do to with a silent patient, including prayer, meditation, and gently stroking the patient's forehead or hair.

C. Leave earlier than I think I need to. I was rushed getting to the nursing home, and it stressed me out. It would have been better to be there 10 minutes early so I could have relaxed and better gathered myself before visiting the client.

Visiting Janice was a pleasure, and I look forward to many more assignments as a hospice volunteer. Truly, it felt like I was doing what I was meant to do.