Questions
"What does it take to be a Hospice volunteer?" I've had a few people ask me that question. "How do you do that?" Another question I get. There is also, "Isn't that depressing?" One of my favorites is "Why would you want to do that?" Sometimes there are statements: "That's weird", "You volunteer? That's for old people", "Only retired people volunteer," or "That sounds hard, I could never do that."
Those are just some of the questions and statements I get from people when they learn about my Hospice work with the dying. To be sure, many other people get it. Or, at the least, they express appreciation. But, I am continually amazed by the number of people who don't understand the necessity of this work or, often, the critical role that volunteering plays in our fragile human society.
I've encountered several volunteers and hospice comfort care workers who hear many of the same comments and questions. When we talk about these situations, the consensus is that often people who ask these questions and make these statements really are looking to understand. Still, it feels awkward for most people to respond to such pointed and, sometimes, judgmental comments and hypercritical sounding questions. It does make me wonder why so few curious people don't kindly ask, "That sounds interesting; tell me more about what you do." I think it has to do with the topic of death and our current societal tendency to shy away from anything related to that topic.
“There is one essential requirement for being close with a dying person: the letting go of self-concern.”
Here are some of my thoughts on these queries and statements.
What does it take to be a Hospice volunteer?
It does take a special person to be a Hospice volunteer, but anyone can do this work. It is a unique person in our society who can be comfortable around death. At the least, it is not common in our current age to find a person who is willing to face their fears of being around death.
I believe that we all have the capacity to face death, ours and others'. Our consciousness and self-awareness are the product of millions of years of evolution. The fact that in our self-awareness, we understand that we are impermanent indeed suggests that we likely evolved the ability to face that immortality.
Indeed, in Victorian times, people were open about death; as with weddings and birth, end-of-life was a social affair. The whole family would gather around the death bed and bear witness and support the dying person. Perhaps this is because people died a lot more often, and it was accepted that was how it was in life. There were not the medical interventions that we have today. People died of the flu. People died of common infections. People died in childbirth. People died of traumatic injury far more often. Children died, often.
“If we listen and observe carefully the dying can teach us important things that we need to learn in preparing for the end of our own life’s journey.”
Thus, I think it just takes basic humanity to be a Hospice Volunteer. It only takes a willingness to set aside our awkward relationship with death in our modern society and be available to a dying person. At this time, that makes a person unique. But, if enough of us face that fear, caring for the dying will no longer be special. That's a worthy goal for accepting death and the willingness to spend time supporting the dying to become ordinary and universally accepted by all.
In short, it just takes a person with a bit of courage to support the dying.
How do you do that?
This abrupt question always reminds me of a story.
A traveler on foot encounters a man riding a horse and asks, "how do you ride that horse?" The rider immediately responds, "I just hop on."
The first step in anything is always the hardest. But once that first step is taken, the next one is a little easier, and then the next…
In a sense, I just hop on.
I merely signed up at a local Hospice and took the training, and then showed up at the location of my first assigned patient. I put one foot in front of the other.
Again, this is to say that supporting the dying and their loved ones do not require any unique, super-human ability. I don't think I'm doing anything more than the person who volunteers at a food kitchen. It is no different than volunteering at a homeless shelter. It is that simple.
“Birth and death are the only human acts we cannot practice.”
In the words of so many religious traditions the world over:
When you see a hungry person, feed them.
When you see a tired person, give them a bed.
When you see a sick person, heal them.
AND When you see a person dying, comfort them with your presence. Simple. Anything that gets in the way of that thinking is just noise.
We do this the same way people meet other human needs.
We step up to the need, and hop on.
Isn't that depressing?
No.
It is saddening to lose patients that I have come to love. But it is not depressing. The concept of death is not depressing to countless other people and me. It might be heartbreaking for people who don't accept it as part of life.
Most of us can imagine death with equanimity if it's not our own death (or the death of someone we love.) We all unconsciously deny our own ends as long we are not forced to face that incontrovertible fact by illness or injury. And some people do continue in their denial to the end.
“Service is the rent we pay for living. It is the very purpose of life and not something you do in your spare time.”
We all face circumstances that can lead to depression or lingering sadness. We all have triggers and sensitivities that wax and wain with our life events and occasions. I took a month off from seeing Hospice patients after my mom died. I needed that time to process the grief. I also took some time off after being in the hospital with a severe viral infection.
I would not recommend sitting with the dying if you are clinically depressed or have serious loss issues to deal with. That said, once a person "clears their plate" of overwhelming troubles, they can volunteer with Hospice if they so desire.
Why would you want to do that?
Because it is rewarding and fulfilling?
There are two reasons for this question: Either the person can't imagine spending time with the dying, or they don't understand the power of volunteer work.
An earlier question deals with the first issue, and a later section addresses the second issue.
That's weird.
It's only strange to people because of the dominant societal attitude toward death. That is that most people don't want to know about it and don't want to hear about it. Some people can acknowledge that people die, but it is an abstract concept that happens to others. Many of us walk around assuming we accept death, but we only accept that abstract others will die, not ourselves or those we are close to.
Our intervention-at-any-cost medical system has contributed to the notion that death is terrible and should be avoided, no matter the consequences. Many doctors admit that the death of a patient, even a chronically ill one with an incurable disease, is regarded as a failure on their part.
So, yes, it may seem weird to people who believe that the subject of death and commerce with the dying should be avoided. But keep in mind, that is because of our modern society. It was not always that way. There have been times, like in the Middle Ages and Victorian times, when death was contemplated and readily acknowledged. Again, This is also thought to be the case because of the amount of death at that time. People, even very young people, died all the time. Families also lived together multi-generationally. Today we live apart in nuclear families, and many people don't have experience with death and the grief that follows till their parents die. These days, many people are in their fifties when their parents die.
So, yes, it's only weird because of our current way of living and medical technology. It is not a good thing, as we all have to deal with death at some time in our lives.
You volunteer? That's for old people.
Only retired people volunteer.
This is one of the most significant issues I have encountered, affecting our global society. This is the notion that volunteerism is either for old and retired people or suckers. I have experienced this a lot, and it is something that we need to stand against.
“You matter because you are you, and you matter to the end of your life. We will do all we can not only to help you die peacefully, but also to live until you die.”
In the USA, our military is a volunteer force. Those who make the military their career are paid a fraction of their private industry counterparts. People do this because of their love for the country, which is far greater than their love of money. Many of the social services for the poor and dying rely on volunteers. The US political system relies heavily on volunteers to run grassroots campaigns and just about every other aspect of a campaign. Many people volunteer at their children's schools. Most homeless shelters, food banks, and soup kitchens are volunteer-run.
Dame Cicely Saunders, the founder of the Hospice movement, believed that everyone should devote 5% of their available time to volunteering. She insisted that would result in a much better world for all of us. This spirit lives on in Hospices worldwide, where 5% of worked hours must be volunteered. This is a requirement for a US hospice to receive Medicaid funding.
It is not hard to imagine that Saunders was correct in her assessment that universal 5% volunteerism would make for a better world. Currently, 25% of eligible Americans volunteer an average of about 52 hours per year. That works out to about 2.5% of a standard 40-hour workweek. That means we are at about 1/8th of the way to a goal of everyone spending 5% of their time. 8 times as many volunteering hours could make a massive difference in our society. Homes for the homeless could be built for the cost of materials. Many gardens could be cultivated to grow more food for the hungry. The ill who have no health insurance could be cared for. And the dying would all have people to support them and their loved ones.
Furthermore, volunteering for others in need feels suitable for the doer. Volunteers almost universally report that they gain a sense of satisfaction and well-being from the work they do for others in need.
In some sense, we all need to give back to society to have a community for everyone. Provincialism is the killer of society. Thinking that you only owe support and care to your country, city, social circle, family, or (in extreme cases) yourself hurts all the greater social constructs you benefit from. We all benefit from a healthy society and should contribute to that society. And, to be clear, making lots of money and paying taxes is not a contribution to society. That's a contribution to the government. Your taxes do nothing for humanity.
It goes much deeper than that. Service is the rent we pay for living. All you really have is your life, and that is not forever. But the fact that you have a life and how good it is has much to do with the society you are in. It would help if you wanted that society to be as healthy as possible and improve.
That sounds hard; I could never do that.
It's really not that hard. We all have the capacity to support others. Just as there are many ways to support people in the birthing process, you can do many things to help the dying. There are many ways that hospice volunteers help the dying, and it is up to the volunteer how "close they get to death."
Not all Hospice volunteers sit with patients or participate in death vigils. Volunteers can do clerical work at the Hospice office, run errands for patient families, make keepsakes for patients and families, deliver flowers and other pick-me-up gifts, and many other non-patient-facing activities.
“The evidence is that people who enter hospice don’t have shorter lives. In many cases they are longer.”
That said, I think everyone can sit with the dying. We all have that in common. We are all born, and we all die. None of us has control over when we are born or die. We don't get to practice either of those events. And we rely on others for support and help at those times in our lives. It has been that way for tens of thousands of years. We surely have an innate capacity to support the dying. There are plenty of examples in history and societies across the globe where the support of the dying and participation in a person's dying process has been a societal norm.
It can be challenging, but you can do it.
I hope this clarifies some confusion over what hospice work is and who can do that work. Our current way of living, society, medical technology, and attitudes restrict our innate ability to come to terms with death. Those things make people think that they could not possibly support the dying.
We all can face death and support those who are dying. Anything that gets in the way of that ability or belief in that ability is just societal noise.
