THE FIRST VISIT
Your first visit to a patient/family can be a challenge. Will they like me? Will I be able to help? What will I do? These questions are natural, but trust yourself. How you interact will be based on your life experiences, your common sense, your intuitions and the knowledge you gained in volunteer training.
Maintain an attitude of openness and receptivity to the needs of your patient and family. They will let you know what they need. You, in turn, need to let them know what you can offer. The relationship will unfold step by step in a very natural way.
BE YOURSELF
Relate to the patient with the same personality displayed in any other situation. People who are ill appreciate being treated naturally, and in this way are reassured that their illness has not set them apart any more than in the obvious ways. Relate to the patient, not the illness.
The volunteer role is that of friend and supporter, not expert or authority. You are not expected to know all the answers. Refer medical questions to the Hospice nurse. Clear communication with the family: Hospice staff will let you know the initial needs and expectations of the patient/family. Be aware that these may change as the patient's condition changes.
CHANGING NEEDS
It is your responsibility to stay in touch with those changing needs and to state clearly to the family what you can and cannot offer in terms of time and availability. This will prevent awkward and possibly painful misunderstandings.
Regular phone calls to check in are often appreciated, and sometimes result in meaningful and substantive conversations. Some people find it easier to open up in an unplanned phone contact than during a scheduled visit. Again, in most instances, it is up to you to take the initiative in getting things going.
LISTENING
Always remember, your function as a volunteer is to meet the needs of your patient/family, not your own. Their situation is always the focus of your visit. In most instances this means listening more than talking. Avoid the natural tendency to swap medical stories or confide in them. Remember, you're establishing an objective relationship, not a subjective one.
Your support might involve listening to the same stories over and over again; stories that, for whatever reason, satisfy a need of the patient or the family member in the telling. It may mean listening non-judgmentally to outbursts of anger, frustration, and resentment. If you are the target for some of these negative feelings, don't take it personally. Such outbursts can release tension and might lead to the expression of other concerns.
Take a book, crossword puzzles or needlework to keep you occupied if a patient is sleeping. By your having something to do, the patient feels less pressured to entertain you. Sometimes not talking, but sitting with a patient and caring by simply being there, is the greatest gift of all.
SHARING INFORMATION WITH OTHER TEAM MEMBERS
As a volunteer, you will often become a trusted confidant. It is in the best interests of the patient and family that all pertinent information be shared with the team. At no time should a volunteer promise not to tell anyone any piece of information shared by a patient or family member.
The patient and family will have been assured confidentiality by Hospice. They will also understand that Hospice care is provided by a team of professionals who must communicate with each other. Use your common sense when deciding what information other team members need to know.
DEPENDABILITY
To people in crisis whose lives are subject to so much unpredictability it is essential to know that they can count on someone or something. The lives of seriously ill persons can have little variety and few distractions. Therefore, each outside contact can take on heightened significance. What may be a minor part of your week could be the single event the patient has been eagerly awaiting for days. It may also be the only opportunity the primary caregiver has to have some private time away from the responsibilities of patient care. Never offer more than you know you can deliver. If an emergency requires you to change plans you have made with the patient and family, be considerate and let them know.
PHYSICAL CONTACT
Some people like to touch and be touched; others don't. You need to be flexible with this issue and sensitive to the needs of your patient and family. Patients and family members usually welcome appropriate physical gestures as a means of communicating caring. Hand holding, a hand on the arm or across the shoulders tells them I'm here. I care. Such contact is a way to connect without words. Conversation might be tiring for a patient or family member.
This dimension of the relationship will, of course, evolve naturally with the passage of time and the intensity of events. Be open. Do what feels right based on what your patient and family indicate they need. Some people may not need such support.
MEET PEOPLE WHERE THEY ARE
Hospice always respects the needs and decisions of each patient and family. Supporting and accepting their values, choices and life patterns is essential. It is never appropriate to give unsolicited advice, no matter how much you disagree with the family's way of dealing with their situation.
Patterns of interaction between family members, no matter how they seem to you, have been formed over years of association and are rooted in a history of which you are not a part. Your responsibility is to work as helpfully and harmoniously as possible within the given structure, not to try and change it. Be accepting and non-judgmental at all times of the feelings, words, actions and decisions the patient and family share with you.
LITTLE THINGS MEAN A LOT
Your personal grooming and manner of dress can affect a patient's mood. Color and attractiveness can help lift the spirit. Don't wear perfume or aftershave lotion. A patient's sense of smell can be extremely sensitive; strong fragrances can be nauseating.
Positive attitude and pleasant expression mean a lot. This does not mean phony cheerfulness or overly bright chattiness, but merely a clear message of caring and attention. However, you need not always be cheerful--being sad together may be more appropriate than cheerfulness. The patient or family member may need to cry. Even a few tears on your part are normal. Between visits, cards can remind the patient that you care when you are not present.
