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Hospice volunteers trained on the many facets of caring for a terminally ill patient often provide services based on facility, and government guidelines.
Training includes learning the hospice philosophy of care, and how it is a holistic method of treating a person who is at the end of life.
You are taught to be a good volunteer, and in order to be a great hospice volunteer, you must develop the gift of effective communication.
The first step to great communication occurs in the first meeting between the volunteer and the patient and/or caregivers.
There are three ways to conduct this initial meeting in order to develop a relationship, a bond, and a meaningful experience for the patient and family, or caregivers. These steps are the key to amazing communication that is not taught in traditional hospice volunteer training.
Blank Canvas Thinking
Within minutes of meeting your patient and their caregivers, it is tempting to think of things to say and begin with small talk. The focus of your conversation will be comforting, or helpful, and hopefully ease the stress for everyone. To remember you as the canvas and the patient as the painter will create a very different experience. Listen with an eagerness to learn from your teachers by offering a little information about yourself with a few questions to find out more about your patient. The answers will be your guide to building a road map to a successful volunteer experience.
When I met Ms. M, she was frail and sitting up in her hospital bed. I introduced myself, and said I looked forward to getting to know her. I asked if she had lived in this area for a long time. This is a non-threatening question, and opens up a discussion and the opportunity to learn about the patient. Ms. M did not want to talk right at that moment about the past, but dove head first into her future fears. I remember being fascinated that she was able to clearly state her contemplation of her terminal state.
"I want you to know that I always kept God in a little box. I would take him out from time to time when I needed him. I am discovering that he is so much bigger than I ever imagined."
She shook her finger at me as though this was a preaching moment, and then thoughtfully, and almost desperately said, "I am not afraid of dying. I am afraid of the moment I stop being who I know myself to be."
I felt gratitude for having clean slate thinking at this moment which allowed the patient freedom to share and me the honor of hearing poignant words that would frame much of my own thinking in future situations.
Nature gives us one of the most effective tools to use in communication, and all it involves is the awesome imagery of a tree. Take a moment to understand the roots, presence, and change of seasons.
Mr. R was referred to hospice due to his non-compliance with his doctor's orders. I wanted to understand what he and his wife needed in the way of support. Looking around the room in their tiny trailer all I could see were medications, calendars of medical appointments, home care equipment like walkers, wheelchairs, and bedside tables.
In referencing their roots, each of the couple had slowly begun speaking of their life when health issues were not at the forefront. I noticed their demeanor change as they talked about Mr. R's truck driving life, and how they raised their family with the finest vegetables from their own garden.
Talk of the present included their seeming inability to cope with both husband and wife, sick and facing terminal conditions but the conversation shifted to how their support of each other gets them through each day. Mr. R said sometimes he would try to cook a meal, and have to stop to rest. This explained some of the non-compliance with his doctor's orders as the couple was tired, and just trying to survive each day. Without clean slate thinking, it would be easy to judge a disheveled appearance but incorporating the tree pattern of thinking led to an understanding and empathy for their plight.
The third step for setting up a successful communication session, is to begin building a tool box for future conversations.
Everyone has had a dream or vision that came true, or died, because circumstances took the dreamer down a different path in life.
Start building on those wishes with a question to the caregiver. What topic has always been the one thing that makes the patient's eyes shine to hear or discuss. It's not always an immediate answer, but the question can come up many times and eventually you will have the full story.
I have witnessed multitudes of wishes—some fulfilled, some brushed off as an unattainable fantasy. If you listen with authentic attention, ask the questions, and eagerly hear the answers, you will eventually have the opportunity to make the wish a reality. Volunteers have a unique support system of the hospice team to make wishes come true in very creative ways.
What if the patient can't express their wishes?
A volunteer sat with an Alzheimer's patient and noticed no facial expressions or awareness. Through conversations with the spouse, the volunteer learned of this patient's love for children, and how she had been a kindergarten teacher in the past. With the help of the hospice team, and community assistance, the patient was taken to a child care center where the children were told of a special visitor who had a disease that would keep the person from remembering them, but not from feeling the love they could show her.
The patient was rolled into the room and each child, one by one, kissed her on the cheek and said, "I love you."
The volunteer and the spouse spotted it first. This was the first sign of emotion from this patient in quite some time. The tear rolled down her cheek, and a wish was fulfilled.
Begin the journey to greatness.
Our time is limited with our hospice patients. All volunteers are wonderful, because they have chosen the path of service. To be a great volunteer, take the opportunity at each meeting with the patient to lay judgment to the side, observe what is important and relevant to them—not you, and find the thing that makes them find moments of satisfaction and happiness. That is what a great volunteer does every time they walk through the door of opportunity into a patient's life story.