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Attracting New Volunteers

If your hospice needs new volunteers, most do, what is your recruiting perspective?

Do you recruit thinking only of the needs of your hospice -- am I going to make that 5% target this month or do you consider the needs of the potential volunteer pool?

Being a volunteer myself, who has a busy schedule, I prefer to volunteer with hospices that are conscious of the limited amount of time I have.  Unfortunately all of the hospices I volunteer with in my local area are not using an electronic form of reporting such as HVA's Patient Data Vault.  I am constantly having to deal with paper and envelopes.  When I run out of forms or envelopes I have to have them mail me a new supply, sometimes delaying my form submittal.  Then I have to find a mail box, which is hard to find these days, or get to a post office.  I find it to be a hassle, knowing that better alternatives are available.  If I knew a hospice had easier reporting methods, I would change hospices.

How To Be More Successful in Your Volunteer Recruiting

If you want more volunteers to consider joining your organization, you need to update your management and reporting tools.  Your probabilities of getting a volunteer to come to your hospice if you are still pushing paper and mailing envelopes will be less in this day and age.  Younger volunteers and computer savvy professionals will favor a competitor that is using the Patient Data Vault (PDV), over a hospice that does not use a computer-based reporting tool that is accessible via the Internet.

If you are using the PDV, use it as a marketing tool!!  Put it in your advertising.  Also add that members will receive free memberships to HVA upon completion of their training if they come to your hospice.  There are many resources that are valuable to new volunteers that are about to make a life changing choice of serving those who are dying.  Successful recruiting is about making your hospice stand out compared to its competitors.  Let HVA help you improve your recruiting odds!!

Hospices located in college towns can draw college students easier if they advertise that they care about the volunteer's time and that they use the latest technologies such as the PDV, which allows volunteers to easily submit reports and communicate with their volunteers about patient-related activities using the latest technologies, including text messaging.

If you are interested in trying HVA's inexpensive PDV service, which many hospices have been using for several years, contact HVA at (866) 489-4325.  It will improve that care that you provide and make you volunteers happier and your volunteer program more efficient.

Greg Schneider
President, HVA

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Good Blog to Check Out

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This blog post is about a long-time HCF member that has her own blog, Frances Shani Parker.  I'm sure you have heard from her many times on the HCF.  Frances is a very dedicated hospice volunteer and an author. 

 

I hope you will check out her blog: Hospice and Nursing Homes Blog at http://hospiceandnursinghomes.blogspot.com/

 

Check it out, it is filled with good info.

 

Greg Schneider
HCF Creator
President, HVA

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A Balance To It All



 I woke up excited. I had the opportunity to facilitate an in service about Touch Awareness in Caregiving to a group of hospice nurses in my favorite hospice.

When I arrived I was told by the Nursing Director that a resident had died the night before. She had been with him all morning as staff and friends had participated in bathing his body and preparing him for his journey from the house.

All staff, including the nurses attending the in service, were asked to participate in the ceremony of departure. The body would be carried out shortly before the in service was scheduled to end, therefore I was asked if I could end a bit earlier than scheduled.

 The door bell rang; it was time to come to the dining room for the ceremony.

Once there we formed two lines and a bowl of rose petals appeared. We passed the bowl around and all took a handful of petals. Then we were told the deceased wanted us to sing Amazing Grace.

While singing, two well dressed men came down the stairs slowly carrying a gurney with the deceased gentleman draped in a shroud, bringing attention to the serenity in his face. It could have been the streets of New Orleans!

As they passed through the dining hall between the two lines  we sang as we sprinkled rose petals on the body.

There I was looking into the face of the deceased, someone I had never known, who didn’t know me, singing, welling up with tears, sprinkling rose petals and realizing that the sacredness of the moment transcended personal relationships.

This was honoring the cycle of life; the human spirit; human suffering and the profound ordinariness of this extraordinary morning.

As the gurney proceeded out the door and through the garden we began to take our places at the table; some with bag lunches and me looking in the fridge for leftovers.

The lunch was somewhat silent for a few minutes. We were digesting food for the soul. Our eye contact and quiet breaths together told the story of the blessed honor we had shared. Then, as if a bell had rung, the talk about the afternoon schedule began.

I finished my lunch and left to go down the street to see a client in another residential care facility.

As I walked outside I was aware of people walking fast; wearing black, and looking at their palms with plugs stuck in their ears. I had to be careful as everyone was in some kind of  personal isolated state, connecting with life through cyberspace. The outside world suddenly felt  empty.

I paused. Remembering the gentle aroma of rose petals, I expressed silent gratitude for my morning in the hospice.

Blessings,

Irene Smith www.everflowing.org


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Identifying Pain At The Bedside


How do we identify pain? What denominators do we use to quantify pain? Does our need to be free from suffering play a role in this denominator and how do we separate these fine lines?

These are constant questions for me in working with the dying. I have strong belief systems about how I want to die and what I want and don’t want in the process. Do these “don’ts” interfere with my ability to clearly hear my clients and act as a non-judgmental witness?

As an advocate of alternative medicine, I am a believer in expression rather than repression. When I have pain I want to feel it. I want to be in relationship with my pain so I know how to work with it and move with it without contributing to the physical and or emotional stressors that might increase the level of discomfort experienced.

Louise was in the final stages of her life when I was asked to see her 3 times a week. That was in October. She died in February.

Louise had no control over her body. She could raise her right arm and turn her head slightly to the right. Sometimes in a session she kept her head in constant movement. Louise was grateful, always said thank you for coming and always greeted me with a smile. I consider her level of trust a precious treasure and often related that to her which seemed to please her.

She was moved from the skilled nursing facility to the hospice in December. Once in the hospice she became quite agitated and began calling out for help and moaning loudly. Of course, how to relieve Louise’s pain was top priority and her discomfort was partly assessed through the degree of  vocal expression.

Pain medication would quiet the moaning, however sometimes when I went to see her after being told her comfort had been restored I would find her whispering “help” in a voice that could not be heard. The need to call out was still present. The team was relieved. Louise was quietly resting.

There were also times when Louise would call out that she hurt all over and pain medication subsequently  brought her needed relief. Other times she would decline medication and a volunteer holding her hand was the perfect support.

The agitation and vocalizing lasted for about a month. Arnica and Rescue Remedy were introduced as adjuncts to her pain medication to see if that would help the anxiety beyond the pain.

I am reminded of two visits when Louise was yelling out and I told her the nurse would be in to give her  medication. ”I don’t want any medication” she said.

Through many of our sessions Louise called out for help and moaned loudly, declining medication and stating she was not in pain. Maybe the moaning was pleasure. Sometimes I’d ask if the touch felt good and she’d say yes. Maybe the moaning was bliss. Sometimes she called out “oh” the entire session.

Once, in the last couple of weeks, I arrived and the volunteer with her said Louise was moaning loudly but she did not want any medication.

This is a human being that was unable to move her body for many years. The only movement she could produce was through her voice. Should her comfort be assessed by the silencing of her voice or by the ability to use her voice?

When are sounds pain and when are they a coping strategy for releasing pain? How fine the line.


“When I die allow my voice to fill the temple and the movement of my limbs to be as wind through the trees. Do not silence or still this passion that has been so responsible. Allow me to participate in this dance with spirit, loose and wild and free. Allow me my process.”

Irene smith

I would love to hear your feed back on this topic.

Blessings,

Irene Smith

www.everflowing.org
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Hospice volunteer's survey

I am a student at Kennesaw State University. We are conducting a survey regarding the hospice motivation, which can be useful for a better finding and training of hospice volunteers. The survey is approved by the IRB of the university. The survey is completely anonymously and voluntary. The survey will take 10 minutes of your time. If you are interested in participating you can click on the link bellow. Thank you very much for your time and help. Sincerely Kremena Kirilova

http://www.surveymonkey.com/s/volunteersmotivation

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The Language of Touch

Greetings,

The attached link is to an Everflowing you tube trailer showing a touch exercise during a Touch Awareness in Caregiving day long workshop . The participants are hospice caregivers . The person being touched is a piece of clay. The sculptor[ the person touching] was creating the upper torso ,face and head. The voice is me, Irene Smith, in a dialogue that has been added. What you hear is not the instruction to the participants.

I would love to hear your comments

https://www.youtube.com/watch?v=jc6DKfXXyZE

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Help!

I recently had a patient who would be peacefully resting and then suddenly cry out "Help!" The first time he did this his family came in and shushed him. They convinced him that there was nothing wrong. I was torn, I knew that they were exhausted, but I also knew that something was wrong with my patient. The next time my patient asked for help I rubbed the hand I had been holding and gently asked what him what was wrong. I told him that I was present and would help him. At first, he said that he didn't know what was wrong. I told him that I would wait, and he could tell me when he knew what was troubling him. He started talking about his "home". He was worried about his home. I asked him what he was worried about with regard to his home. After he told me, I asked him if he would be comforted if I had someone to look in on his home for him. He said that he would and visibly relaxed.
I see this phenomenon over and over again. Many times, patients who have been calm suddenly have fears. The desire to go "home", I believe has a deeper meaning. I believe that when people are faced with going to their divine home, whatever that means to them, that they want to make sure that their physical home and business are in order. Some of these people have not lived in their physical home for years. That doesn't matter. They still want it buttoned up, loved ones and pets taken care of, and things looked after. I was so glad that I had the opportunity to really hear what this patient needed help with.
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I Made soup

Last week while preparing for a presentation on listening, I leaned back in my chair at the computer wondering what story I could tell about listening deeply. Not just involuntary hearing but truly listening to the meaning of the words. Listening with my heart as well as my ears.

My heart burst open and I started to cry. I heard my mother say "I made soup."

My mother had severe crippling arthritis, scoliosis and heart disease. Her physician was an osteopath and she combined acupuncture, herbs, supplements and homeopathic medicine in her health care. She never went to the hospital .She would simply stay in bed for days at a time.

Cooking was very painful for mother so friends would bring food or take her out to eat most of the time. This was her program for the last 20 years of her life.

I*n her last few months every time Mother called me she would say "honey, I made vegetable soup. It’s so good!"

My response was always , "Great Mom." I actually remember being somewhat bored by these conversations and not really interested in her soup.

I harbored a well of anger with my mother and didn’t work through that before she died. It clouded all our communication.

Last week, 16 years later I got it. "I Made Soup"meant, honey I’m out of bed today; Im feeling strong and I was able to cut vegetables. It’s a glorious day!"

" I Made Soup" was a statement of mother’s courage and independence and her ability to push through her suffering .

Deep Listening is a practice and a philosophy developed by Pauline Oliveros. It is said in this practice that listening deeply requires the temporary suspension of judgment and a willingness to receive new information. It is a process of learning.

Truly listening allows us to not only hear what someone says and, what they think, but allows us the understanding of what it means to them and why it matters. There is perhaps no greater way to show our respect than to truly listen to someone.

Many blessings and please share your listening stories . Your stories mean so much to the community.

Irene smith

www.everflowing.org

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Reverie Harp is Magical

I have the pleasure of having a reverie harp. I take it to some of our patients and it is so wonderful. My latest experience was with a totally non communicative patient who is often agitated. He has never made a sound other than the occasional groan. I tuned the harp in his room, and while I was doing that he sat up slightly and spoke 3 garbled sentences! I then placed the harp on his chest and strummed it. I would wait for the vibration to almost completely stop, and then I would strum it again. He became so deeply relaxed and peaceful that it was a joy to witness.!
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Everflowing Approach to working with Pain

Reading the Massage Magazine special issue on pain relief I am reflected into how working with pain differs in my hospice massage practice from more traditional modalities.

A couple of months ago I was working with an intern at an inpatient hospice. We went into see a woman with cerebral palsy who was not on our list of referrals.

Sabrina had spent most of her life in hospital wards. Her body was a roadmap of surgeries and called out loudly for tenderness.

Sabrina spoke of her legs and back being in great pain. She continued to speak of her discomfort as I positioned myself sitting comfortably at the foot of her bed. As I slowly lifted the sheet to assess her right leg my heart shed a tear for the dwarfed limb that was exposed.

I cupped my hand around the thigh and softly spoke," I am honored to offer this limb some tenderness....I feel your leg loves the attention.... Im so glad were here."

While gently holding and tenderly petting this leg Sabrina replied, "If someone had done that years ago I might still be at home."

I covered the leg as Sabrina asked me to touch her back. Although she was in a lot of pain she requested that a nurse position her onto her side so I could touch the exact spot.

After positioning was completed I sat comfortably behind Sabrina on her bed, uncovered her back and with Sabrinas permission I came very close. With one hand slipped under her head pillow as to hold her, I simply laid my other hand on her back and said, "Oh I know you have been in pain for a long time. I'm so glad were here."

As I became comfortable, slowly exhaling, I felt Sabrina going to sleep. Her pain had been validated. She expressed her gratitude before the silence..

After a couple of minutes I slowly removed my hand from underneath her pillow and changed places with my intern.

The Everflowing intention is never to remove pain from someones body. The intention is to validate and honor the symptom ology that is being experienced, and to create an environment where the clients anxiety about having pain can be eased.

We are in a culture that insists that pain is something we have to get rid of. We essentially make pain wrong therefore when pain appears we are afraid of it getting worse; we defend ourselves, hold ourselves tightly. We want the pain to go away. This directs a profound degree of energy to the pain, and creates anxiety.

As an Everflowing practitioner, I want to create a resting place as I walk into a room or up to someones bed; a place of stillness first, and then a place of very gentle movement like a breeze or a soft wave of water as the tactile relationship begins. A place where there is no resistance; a vulnerable place.

This is achieved through slow body movement, slow speech, slow audible breathing; and my willingness to find my own place of physical comfort; just being comfortable and breathing as I slowly speak to my client. I am just a witness.

This resting place, this alternative rhythm, eases a lot of tension in the room. There appears to be more empty space and the client might begin to find comfort as well.

If I can stay grounded and comfortable in body and mind then the static and resistance has been broken. The cycle has to reestablish itself.

This change in the pain cycle can cause a decrease in the pressure being experienced by the client and give the client an alternative strategy for coping with the pain.

Pain is multidimensional when someone is dying and may be my clients most familiar response to his or her condition. I cannot assume that alleviating it is the kindest strategy. I feel I must validate the existing relationship and give models for reestablishing a more compassionate communication with ones self and ones environment.

This is the Everflowing approach to pain. I look forward to your sharing your approaches and stories.


Blessings

Irene Smith www.everflowing.org

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Professional Concerns

I have been concerned for a long time about the way the field of hospice massage is growing. As with any therapeutic intervention that becomes mainstream ,the integrity of the field is suffering.

Practitioners with the desire to serve ;however without sufficient training to work with dying persons, are being hired by program co ordinators that have no knowledge in what is needed to facilitate a safe massage program.

I am alerted to hospice programs taking on massage practitioners that have no training in adaptations from working with healthy people on a massage table to working with seriously symptomatic persons in beds.

Many hospice co ordinators are corporate administrators who believe that a massage certification is all a practitioner needs to massage hospice clients.

Although some schools have continuing education programs for working with the dying, massage schools do not teach working with dying persons in core training as a general rule. Sometimes the topic will be minimally addressed in a geriatric or oncology course.

.

Twenty seven years in hospice massage gives me the experience to outline what have proven to be challenges in this field ,and areas of training needed for safe relationships between clients and practitioners, and organizations

If you are a massage program co ordinator, educational director for a massage school, or hospice massage practitioner these are a few of the areas that require knowledge in this field.
*Hands on precautions as pertains to massage not nursing.

*Modification of standard massage techniques to meet the needs of the physically and emotionally fragile client. This includes; intention, amount of pressure facilitated through the hands, the speed of technique delivery, and the duration of a session.

*How to adapt massage for working with people in beds and chairs; including body mechanics for the practitioner. Practitioners need to know how to comfortably reach the client to prevent injury to themselves.


*How to gather sufficient information for treatment assessment.

*How to work in a home setting. This involves working in a bed; being with family; communicating with other team members; reporting; setting limits ,and what to take as equipment.


*How to cope with the emotional impact of clients dying which includes personal coping strategies as well as support systems.

This is a specialized field of service that requires practitioners to have sufficient information, supervision and support for the safety of the client and the massage practitioner.

If you are an administrator , educational director or practitioner reading this please go to my website www.everflowing.org and check out the educational resources. Resources are available to give you the information you need. You may download articles for free that will serve you well. You may also ask questions on this site.. Go ahead use me!!!

Many times patients are so hungry for touching, and practitioners are so hungry to make a difference that they don"t recognize the difference in a safe and unsafe session. It’s up to the integrity of the schools, co ordinators and teachers in this field to see that wisdom prevails.

Blessings

Irene Smith www.everflowing.org

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Introduction

Well, hello everyone.

I am looking forward to our sharing of experiences with assisting the dying and their families. After reading many of your posts, I know I will be gaining a lot of insight.

warm regards,
Deanna



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The Big Lie

[My comments: Tolstoy's novella, The Death of Ivan Ilyich, provides insight into the life of a high court judge in 19th-century Russia who left serious reflection on his own life until hours before his death. The process of dying, which for him started after the realization that his illness was not going to improve -- no matter what his doctors told him, was physically and emotionally painful. His suffering was perpetuated up until the very moment of his death by what he referred to as The Big Lie.] Supporting Others at the End of Life At some point in our lives most of us will be required confront the death of a friend or loved one. Some of us will be bold and brave enough to offer our support to a friend or family member throughout their dying process, while the rest of us will attempt to support a friend or family member from the periphery in the best way we know how. Generally speaking our society approaches a death situation with trepidation because we are not sure how to handle it. What should I say? Will I say the wrong thing? Can I be in the presence of someone dying or will the realization of my own mortality be too much to face? This reluctance and ultimate aversion to face a death situation with open eyes and open mind may satisfy the needs of the person who is not dying but the person who is dying can incur incredible suffering by our lack of willingness to accept the situation for what it is. The book refers to this aversion as The Big Lie. The following excerpt from the book expresses Ivan’s frustration with all of those around him who seemed to ignore the fact that he was dying:
Ivan Ilyich suffered most of all from the lie, the lie which, for some reason, everyone accepted: that he was not dying but was simply ill, and that if he stayed calm and underwent treatment he could expect good results. Yet he knew that regardless of what was done, all he could expect was more agonizing suffering and death. And he was tortured by this lie, tortured by the fact that they refused to acknowledge what he and everyone else knew, that they wanted to lie about his horrible condition and to force him to become a party to that lie. This lie, a lie perpetrated on the eve of his death, a lie that was bound to degrade the awesome, solemn act of his dying to the level of their social calls, their draperies, and the sturgeon they ate for dinner, was an excruciating torture for Ivan Ilyich. And, oddly enough, many times when they were going through their acts with him he came within a hairbreadth of shouting: "Stop your lying! You and I know that I'm dying, so at least stop lying!" But he never had the courage to do it. He saw that the awesome, terrifying act of his dying had been degraded by those about him to the level of a chance unpleasantness, a bit of unseemly behavior (they reacted to him as they would to a man who emitted a foul odor on entering a drawing room); that it had been degraded by that very "propriety" to which he had devoted his entire life. He saw that no one pitied him because no one even cared to understand his situation.
This excerpt illustrates the complexity of the situation and how it can result in suffering for the person who is dying. While Ivan was a prominent court judge in his career, he still found it difficult to openly express his own frustration with the situation. Had he felt more supported by those around him, he likely would have felt more comfortable expressing why he was unhappy with others, which would have benefited him immensely at the end of his life. Creating a safe environment that permits open communication is so important. Compassionate Caregiving Helps to Alleviate Suffering Hospice volunteers are trained to be very sensitive to the potential emotional and physical suffering of the dying as well as the impact that has on friends and family. You can help to alleviate some of the suffering of someone who is dying by not avoiding the situation and being willing to talk truthfully about someone's impending death. This does not mean that you have to focus on the topic when you come to visit them but rather be open to the possibility of a discussion if the opportunity arises. Let your dying friend or loved one lead the way. In my experience the discussion may take a very circuitous path as the person who is dying relaxes and finds the ease and courage to bring you into this most intimate discussion. Here are some thoughts from Ivan on this topic as he discusses how his caregiver Gerasim is the only one who seems to understand:
Gerasim was the only one who did not lie; everything he did showed that he alone understood what was happening, saw no need to conceal it, and simply pitied his feeble, wasted master. Once, as Ivan Ilyich was sending him away, he came right out and said: "We all have to die someday, so why shouldn't I help you?" By this he meant that he did not find his work a burden because he was doing it for a dying man, and he hoped that someone would do the same for him when his time came. In addition to the lie, or owing to it, what tormented Ivan Ilyich most was that no one gave him the kind of compassion he craved. There were moments after long suffering when what he wanted most of all (shameful as it might be for him to admit) was to be pitied like a sick child. He wanted to be caressed, kissed, cried over, as sick children are caressed and comforted. He knew that he was an important functionary with a graying beard, and so this was impossible; yet all the same he longed for it. There was something approaching this in his relationship with Gerasim, and so the relationship was a comfort to him. Ivan Ilyich wanted to cry, wanted to be caressed and cried over, yet his colleague Shebek, a member of the court, would come, and instead of crying and getting some affection, Ivan Ilyich would assume a serious, stern, profound expression and, by force of habit, offer his opinion about a decision by the Court of Appeals and stubbornly defend it. Nothing did so much to poison the last days of Ivan Ilyich's life as this falseness in himself and in those around him.
If you are in a situation where you have a friend or loved one who is going through their dying process, you may find our resources helpful. Visit the Hospice Volunteer Association website and our Hospice Community Forum. If you are dealing with the serious illness of a child, you will also find our Hannah's Friends website helpful. Greg Schneider Founder & President Hospice Volunteer Association
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Sun Coast

I'm interested to learn how any other agency that uses SunCoast gets the volunteer reports/hours input timely considering the volunteers are not like paid staff who input their information directly.
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CAREGIVERS STORE

Just Published!!
by Rashani Rea & Kathy Douglas

Those who companion suffering daily, such as hospice nurses and volunteers, will surely appreciate this beautiful work. With 62 original art collages by Rashani Réa, five beautiful chapters by Kathy Douglas, and a foreword by Jean Watson, this exquisite book is a peaceful refuge for contemplation, inquiry, reflection and inspiration for those who traverse the joys and sorrows of nursing.

Kathy Douglas, RN, MPH-HA is a nationally recognized nurse leader, filmmaker and entrepreneur. 

Rashani Réa is a prolific artist and musician, a creatrice of sanctuaries and a respected spiritual mentor.

“This is a beloved book and beyond a book. It is an evocative, poetic, ecstatic, and inspirited sacred, experiential calling. A calling to you--YES, YOU.” 

— Jean Watson, PhD, RN, AHN-BC, FAAN, Living Legend (AAN)

“Those who companion suffering daily need to turn inward to metabolize what they have witnessed. This exquisite book, filled with beautiful images and poetic wise words, is the inspiration and support needed to grow a wise heart.” 

— Frank Ostaseski, founder and director of the Metta Institute and author of The Five Invitations: Discovering What Death Can Teach Us About Living Fully

“In this unique time of the COVID-19 pandemic, this book should be considered a tribute to the tremendous courage being displayed by nurses around the world. There is much wisdom conveyed throughout by those who have been there serving others with such grace.” 

Greg Schneider President, HVA, co-author of The Changing Face of Hospice Volunteering in Hospice and Palliative Care 

Buy Now