"You matter because you are you, and you matter until
the last moment of your life. We will do all we can, not
only to help you die peacefully but also to live
comfortably until you die."
-Dame Cicely Saunders
Founder of the Modern Hospice Movement
“A hospice volunteer is someone who listens to me
until I hear what I’m saying.”
- a hospice patient
Why volunteer for hospice?
Who volunteers for hospice?
What is the role of a hospice
How are Horizon Hospice
volunteers prepared for their role?
Why volunteer for
To give back to the community
Learning and Education
To become more comfortable with the realities of
illness and death
To develop new skills or refine old ones
Beneficent utilization of time
Help make informed personal or career choices
Expression of faith/ belief/ spirituality
Who volunteers for
People with time: the retired, those
between careers or in transition.
Those who seek a “comfort level”
in the face of illness and death.
Family members of hospice
patients who saw “hospice in
action” and want to give back.
What is the role of a hospice
Listening and supporting
Errands and breaks for caregivers
The “eyes and ears” of hospice
Fill roles that cannot be filled by other team
Laundry and Dog-walking
Organizing photographs and mementos
Assist patient with “life review”/ help them tell
Reading/ recreational opportunities
Help patient fulfill their hopes and dreams
before they die
Education of patient and family about home-
based care / advocate for patients in long-term
Bereavement support for family members after
Communicate with team
Write reports after visits for patient charts
Attend hospice meetings and educational
Helpful suggestions for hospice
Change your view of dying persons as “sick” people.
Death is a natural part of the life-cycle.
It is not your role to fix things for people. Fixed people
rarely feel good about being fixed, as it implies there is
something “wrong” with them in the first place
Hospice volunteering is more about being than doing.
As we are a doing society, this can be a challenging
There is no such thing as “just” a volunteer.
As a hospice volunteer, you are equal in importance to
the other team members in providing care.
Horizon Hospice volunteers are an integral part of
our team and a fully integrated component of the
organization’s human resources. Horizon Hospice
was founded by volunteers, and we continue to
rely on them for support in quality patient care,
bereavement support and administration.
Implementing the Philosophy
Volunteers are part of the Provide them the information
team so invite them to they need to be effective,
team meetings! including team extension
Provide comprehensive numbers, and patient
training and orientation information.
Provide job descriptions Allow them time off between
Provide ongoing assignments, and opportunities
opportunities for education for self-care
Advertising: print media
Word of Mouth: other volunteers
Faith communities: church
The worldwide web:
Horizon Hospice website:
at Horizon Hospice
Should demonstrate good listening
Undergo a “behavioral interview” to
demonstrate good judgment
Application process includes two
reference checks and interview.
Volunteers undergo orientation and
training similar to new staff and their
competencies are tested.
Photo ID’s, training manuals and safety
equipment are distributed to all
Volunteers are offered a Hepatitis
vaccine and must undergo a two-step
Mantoux test for TB
Personnel and health files are kept on all
Training Syllabus includes:
History and Philosophy of the hospice
movement in general and Horizon Hospice in
The Mission Statement
Scope of Services.
Therapeutic relationships and boundaries
Spiritual and Bereavement Care.
Active Listening and Communication skills.
Home and Street Safety.
Infection Control and Universal Precautions.
Nursing and “Hands-on” Care.
Scenarios for discussion and role–
play exercises in volunteer training
The primary caregiver is so relieved to see the volunteer because
she is totally burned out with care-giving.
It is your first telephone call to the family or patient since you took on
the assignment. How do you begin the conversation?
The family has left for an event and you are alone with the patient
who is too tired to have a conversation or who dozes off.
The family leaves and the patient tells you: ”I just wish this was
You are sitting at a patient’s bedside when a family dispute erupts
downstairs. Voices are raised and doors slammed. The patient is
The brother or sister of a patient asks you out on a date.
The caregiver or patient ask you to volunteer a full day next week
even though the suggested volunteer limit in the Horizon Hospice
manual is four hours per week.
You notice the patient is in a soiled or unclean environment.
The family offers you a gift before you leave. Imagine that gift, large
medium or small.
The patient tells you she has doubts she is going to get better and that
she still has many things she feels she wants to do in life. She tells
you it is grossly unfair that she has worked hard to raise a family and
now just when they all had flown the nest and she was about to retire
and enjoy life, she gets “hit by this.” Imagine your conversation.
The patient dies during your visit.
Active Listening Scenarios
What to do with Suicidal
Ideations/Abuse or Neglect
Social Work Role on the Hospice
What are boundaries?
Boundaries are understood,
sometimes unspoken, physical and
emotional limits of the relationship
Boundaries are a framework that
give patients and hospice team
members a range of acceptable
Boundaries are an excellent way to care for
yourself as a hospice volunteer.
We ask our volunteers to give their assigned
patient no more than 4 hours of their time in any
one week period
Role Play: The caregiver of a patient asks you to
return tomorrow for another eight hours, even
though today you already completed your four
hours for the week.
Friendly Volunteering vs.
A hospice volunteer relationship is an
important part of the therapeutic process
As patients and families face end of life
issues signs of intimacy may appear.
Patients and family members often want
to talk about really personal issues. An
untrained ear might interpret this as an
invitation to friendship.
Brother or sister of patient asks you out
on a date.
You give your personal home phone
number to the patient/ family.
The family offers you a gift before you
leave. Imagine that gift: large, medium or
The patient asks you to bring him to the
bank and then to the gambling boats.
Social or Therapeutic?
Casual friendly or An agreed upon
romantic in nature purpose and time
Serve the interests of frame
both parties Hospice Volunteers
Are for mutual devote self to interest
interest and pleasure of patient
carry the authority of
knowledge and skill
Boundary Crossings and
How to know when they are
Blurring of boundaries can occur one
small step at a time and almost without
Be aware of your feelings
Ask yourself can I share this with the
volunteer coordinator or the hospice
Are you making special exceptions to the
plan of care?
Do you feel a sense of entitlement or that
this is “your” patient?
Are my boundaries
How would I feel if my actions were
published on the front page of the
Tribune, or if someone told my
friends and family about them?
Ashamed, embarrassed, proud,
How to know if you are
crossing the boundary line
If I feel uncomfortable telling the other
team members what happened, then it is
quite possible that boundaries were
If I am unsure how to behave or about
the ethics of a situation, it is always best
to ask advice from a team member.
Always act in the best interest of the
Why is this an issue?
Hospice volunteers are caring
people and want to do what’s best
In hospice work, boundaries can
easily become blurred due to the
nature of what we do and the
setting (We are in patients’ homes
and in their world.) The population
we serve is vulnerable and may
not be aware of interpersonal
The family leaves and the patient says “ I just
wish this was over.”
(Segue: suicidal ideation)
The patient tells you she has doubts she is
getting better and that she has many things she
still wants to do in life. She tells you that it’s
grossly unfair that she’s worked so hard to raise
her family and now just when they have all flown
the nest and she is about to retire, and enjoy life,
she gets hit by this. Imagine your conversation.
The primary caregiver is relieved to see the
volunteer because she is totally burned out with
You go to patients home and discover
the patient has bruises and is fearful and
uncommunicative during your visit. This
is totally out of character from previous
You notice the patient is in a
Nursing home staff remain unresponsive
to your suggestions for relieving patient’s
Role of the Social Worker
Provide emotionally supportive
Advocate for community resources
Connection between patient/ family
expectations and volunteers
Assists with advance directives,
benefits and funeral planning
Ensures Patient rights respected
Sarah is a young, single hospice volunteer who
is assigned to a patient with stage IV Lung
cancer. Recently, the patient—who is actively
declining-- has been asking her questions of a
very personal nature that she feels
uncomfortable answering. The questions relate
to her religious and spiritual views as well as her
dating history! When Sarah asks for guidance,
what might you say to her as a team member?
Invitations to attend Annual Recognition
weekly team meetings, event with the
Quarterly educational presentation of Awards
in-services and support Discounts for annual
groups benefit and other
Communication with fundraising events
team members while on Invitations to memorial
assignment: each services
volunteer is provided Biannual newsletter
with the telephone Team skills
extension of the nurse,
social worker, chaplain,
coordinator. They in
turn, are provided with
Volunteer Community Network
bring these skills to Workplace, schools, colleges,
Hospitals, community events
their families, homes
Knowledge of hospice
allows trained Hospice volunteer
volunteers to help their
communities make Communities of faith:
Parent, spouse, child, sibling
informed choices Extended family
about end-of-life care
and the hospice option
What volunteers say:
“Hospice patients and “ Volunteering for
their families give me hospice is more about
so much more than I being with people than
could ever give them.” doing things for them. It
is truly a ministry of
“I have volunteered with presence.”
organizations but with “Each case is so
hospice I feel especially unique. In over 20
valued as part of the years as a volunteer
team.” with Horizon Hospice, I
haven’t been with two
I enjoy being on the patients who were
team. I never feel alone similar.”
and it’s good to have