Tuesday, May 24, 2011

K is for Knowledge and Kindness - ABC's of Inspired Hospice Volunteers

All hospices are not created equal!  I’ve always believed that we volunteer with a good hospice, but now I really and truly know what an incredibly great hospice Inspiration is. 

This last month, a very sick friend in Las Vegas had been sent home from the hospital after being told that there was nothing more they could do for her.  She is alone in the world and was too sick and weak to take care of herself, so I readily volunteered to get hospice set up for her, fully confident that one or two phone calls would have a nurse rushing off to her aid to get her admitted.  Knowing how simple our hospice tries to make it for families in such stressful times, I had no idea of the nightmare this would become! 

First, I’d learned previously from Shar while searching for hospices for my mother-in-law in Pennsylvania, that I wanted a National Hospice and Palliative Care (NHPCO)accredited organization. 

Having located  those online at NHPCO.org, I started making calls, but it was a Sunday morning, so every hospice I reached had an answering service that promised a call back from a hospice representative within a half hour.  If your family member was in crisis, would you like to be relying on a hospice that is using an answering service?   I wouldn’t. 

Inspiration has a nurse and doctor on call 24 hours a day, 7 days a week!

When the Las Vegas hospices finally did return my call, they told me they could get someone out there the next day although I found one who would send a marketer out that afternoon, but for informational purposes only.  

Inspiration will have a nurse out within the hour to do an admit!

By this time I was so frustrated!  Then I learned that they wanted nothing to do with her because she didn’t already have a doctor’s order for hospice.  They don’t want to admit a patient until they are guaranteed they’ll get paid for every bit of effort they put into them.

If Inspiration cannot reach a patient’s doctor because it is a weekend, they will admit the person anyway because they have 48 hours to get the admit.  If the  patient is denied for whatever reason, then Inspiration assumes the costs and calls it a loss!

My friend’s story did not end well.  In the end, the only hospice that would talk to us, insisted she call an ambulance and go back to the hospital before they would admit her.  My sick, stubborn friend was determined to remain in her home and so there was nothing more I could do.  My sister was driving down to be with her and she took it from there, but still couldn’t get her onto hospice, because they said her disease wasn’t considered end-stage. 

Inspiration, in this same situation, would have admitted her for failure to thrive or debility!

My sister took care of her for the next several miserable nights and days, hurting her back and shoulder in the process.   Knowing my sister had to leave soon, the friend was so desperate that she resorted to attempting suicide because she wanted to die at home. That failed and obviously the  friend was  too far beyond what my sister could physically deal with, so she was forced to  call an ambulance and have her admitted back into the hospital.  The friend was extremely upset with the situation.  This story could have been so different if we could have located a truly knowledgeable, kind hospice like ours.

Inspiration Hospice, from the founding principles, to the protocol, to the staff they employ and volunteers they attract, is truly all about knowledge, kindness and compassion.  I think of the poem:

I have wept in the night
For the shortness of sight
That to somebody’s need made me blind;
But I never have yet       
Felt a tinge of regret
For being a little too kind.

Anonymous

Now THAT’S Inspiration!

Thursday, May 12, 2011

J is For The Journey of Love - ABC's of Hospice Volunteers

I have never been a caregiver to an aged parent or sick spouse; though I’m sure my time will come.  There is no teacher like experience though and so I feel sometimes that it limits me as a volunteer when I’m trying to empathize with the caregivers I meet. 


I can only imagine what a lonely, scary thing it must be as one is thrust, often quite suddenly, onto this journey that they are totally unprepared for.  For example, there is much research to be done when you are still young and caring for an elderly parent.  After all, what do you know of Medicare part D, incontinence, social security, osteoporosis and such?  Or what does the healthy person know of catheters, bed sores and long term care insurance?


Walking this road of care giving day after day can take a toll on one’s own health as all the time and effort seem to go into the patient’s well-being.  Sleepless nights are compounded by a lack of exercise and of course, the grief that all involved are experiencing.


Oftentimes, one cannot maintain their employment while being a full time caregiver. This can lead down a road of financial strain and even wreckage. 


A person’s social life can be lost by the wayside if they have no respite care and can’t get out of the house to go to lunch, church, work or even the store.  Such isolation is not healthy.


If one has dependent children in the home, things are even more stressful as there simply isn’t time for one person to meet everyone else’s needs.  The caregiver finds him or herself on a path that branches off into several directions, each needing to be traveled now.  The guilt will eat at them as they must choose just one, leaving the others for another day.  Even spouses and grown children can feel neglected in this situation, and often, of necessity, they are!


Is it any surprise that care givers are often more depressed than the sick that they care for or that they have a death rate 63% higher than their peers?


This journey of care giving, however fraught with obstacles, is a true journey of love.  It can bring frustration and fear, but also wonder and fulfillment.  Finding the joy in the journey though, often requires finding help. 


Sometimes you may wonder if the patient you visit really gets much out of your visits, but it may be that the caregiver is the one that needs you most, whether it is for respite care, physical help or just emotional support.


Here are a few ideas for helping the caregiver:
·      Make sure that you ask after the caregiver’s health and well-being.
·         Express your admiration that he/she has willingly taken on this role and stuck with it.
·         Express your understanding of how hard it can be.
·         Allow them time to open up and share the difficult parts.
·         Laugh with them over the humorous aspects of care giving.  
·         Ask how you can lighten their burdens. 
·         Often times, they won’t come up with anything, so mention specifics that you would be delighted to assist with. 
·         Follow through!
·         Let them know how it helps you when they allow you to serve.


We can never alleviate all their stress or make the illness go away, but we can certainly brighten their path and lighten their load as they proceed on this journey of love that we call care-giving.  That’s Inspiration!


Things that were bitter to bear are usually sweet to remember.

Wednesday, April 20, 2011

I is for Infection Control - ABC's of Hospice Volunteers

But wait!  Don’t leave!  There is more than one kind of Infection Control!  While the OSHA standards (p.56-59 of your Training Manual) of infection control are very important information, it’s the other kind of infection that we want to discuss today.

Remember my friend I mentioned last month who is going through chemo (amidst several other trials)?  I sent her the column, thanking her for the inspiration and mentioning how sad it is when is someone attempts to make the grieving person feel better by being falsely cheerful.  The effect this can have is that it causes the mourner to feel guilty for feeling pain, as if they needed anything else to feel bad about!

My friend concurred, but added “Or, when the grieving person has to try and console the one who is supposed to be doing the consoling.  It's so draining...”

We would never go in and dump our problems on these already troubled souls and likewise we mustn’t make their own burdens any heavier for them to bear.

We must balance our words and actions.  We should empathize, and provide understanding of their pain, but not to the point that they are comforting us!  They have a lot of exhausting mental work to do as their lives draw to a close and we are supposed to be there to help and support, to cheer and to comfort, not to spread pessimism. 


I know that when I am troubled, my favorite people to turn to are those that can listen to my woes, sympathize with me and then turn around and help me laugh about them!  Why not?  I can laugh or I can cry, but crying just gives me a headache and makes my eyes red and puffy. 


With practice, each of us can help our patients by: 


1. Finding out what is troubling them.

2. Empathizing with their problems and making sure that their pain is recognized.

3. Utilizing the hospice support services team of chaplains and social workers as needed. 

4. After they feel understood, trying to help them see not only how they can learn and grow from their trials, but the humor hiding in them, laughing with them about the ironies of life.


When my friends with young children bemoan some disaster their little ones have created, I always ask them if they have taken a picture.  In the stress of the moment, they often can’t figure out why, but I know that as the memory of the mess and the anger fade, that they will be able to look back on the situation and laugh.  The situation may even become a favorite family story down the road.  I also know that the sooner they see the humor in the situation, the better for all involved!

Laughter is liberating!  It means that you choose NOT to be a victim of circumstances, giving you a sense of control.

Laughter is uplifting!  It releases those feel-good endorphins that serve as natural pain killers. 

Laughter is healing!  It is the best medicine.  No prescription is required, it’s terribly cost effective and there are no side effects!

For anyone facing a terminal illness, I’d say that laughter is not just a coping mechanism, but a kind of courage. 

Anatole Broyard wrote about the final days of his life in “Intoxicated by My Illness”.  He said, “Illness is primarily a drama and it should be possible to enjoy it as well as to suffer it... Illness, after all, is not all tragedy.  Much of it is funny.”

Your goal as a hospice volunteer, is not to transmit the toxins of gloom and drear, but to be infectious with laughter and cheer.

Hospice patients are going through some of the darkest, scariest days of their lives, and yet they are days that need to be cherished for both them and their families. 

Have you noticed how being around happy people helps you be happy?  A positive attitude is contagious. 

Have you ever been where someone is laughing uncontrollably and soon everyone else is joining in even if they are just laughing at the one who started it?  Humor is catching! 

Control the kind of infection you spread.  Enter any care center where the halls are lined with lonely people in wheel chairs anxious for the touch of human kindness.  Something as simple as your gentle words and your tender touch can start a real pandemic… of joy!  That’s Inspiration!



"There ain’t much fun in medicine,
   but there’s a heck of a lot of medicine in fun."   
(Josh Billings)

Friday, April 8, 2011

H is for How to Help them Grieve - The ABC's of Inspired Hospice Volunteers

A little girl once went to visit a neighbor who had lost his wife.  When she returned, her mother asked what she’d been doing.  She replied that she had helped the neighbor.  When her mother queried her further on how she had done that, she said simply, “I sat with him and helped him cry.”
It really can be that simple! 
As hospice volunteers we work with many grieving people.  As we all learned in our training though, grief isn’t just about death.  We can lose loved ones to mental illness, divorce or simply bad choices.  We can grieve over lost jobs, houses or life styles.  We can grieve lost hopes and dreams. 
Our patients are grieving for the children or grandchildren that they will not see grow and have families of their own.    They are grieving the betrayal of a body that has seen them through so many years.  They are grieving the loss of friends and family that suddenly stay away because they don’t know what to do or say.  They grieve for the hobbies and skills they can no longer enjoy.  They grieve their lost independence.  They may grieve as they regret the way they lived their life.  Grief begins when they find out that they are going to die and then it morphs and changes throughout their last days. 
Please don’t negate their pain.  Don’t tell them that “everything will be okay”.  Acknowledge their loss. 
I have a dear friend whose husband lost his job and was forced to relocate to a distant state and while she remained behind trying to sell their home, in the middle of preparing for her daughter’s wedding, she got cancer and another un-related family crisis arose.  Just today, right after another surgery, she was handed more bad news.  Rather than try to paint a rosy picture and say everything would be all right, I wrote to her, “When this is all over you will look back on this time and think about how you grew more during these several months of trials than you did in the previous several years put together.  In the meantime though, only the language of our children can describe it adequately:  This SUCKS.  Big time.”
 As we visit with the patients we mustn’t be afraid to say that yes, they’ve been handed a raw deal.  Put yourself in their place.  When someone minimizes our pain, it seems to hurt even more.  Once our loss is recognized however, we can often move forward. 
Give them an opening, an opportunity to share and let them decide what to do.  Anger is natural.  Some may choose to scream, or beat on a pillow to vent their feelings.  Some people prefer to grieve in private and that is okay too. 
I have a long-admired friend who lost her young adult son in a terrible accident.  As the day that he was supposed to get married approached, I thought often of her and wondered if she might need some company that day.  When I asked her though, she said that she planned to send the kids off to school that day and have some private grieving time.  I was so inspired by her answer.  I had been going through my own grief and in the years after she told me that, it escalated dramatically as I watched helplessly while family members self-destructed.  There were several days where I followed her advice, sending the children off to school, turning off the phone and having my scheduled time to grieve.  By the time my husband and children came home I felt better and had applied make-up and a smile, able to fully function once again.  I also found that it cut down drastically on the nights that I’d wake up and be unable to return to sleep for the grief. 
When someone you know is grieving, it can leave you feeling utterly helpless.   You know that you cannot ever eliminate their grief.  It is something that each person must work through at some time in our lives, some more than others.  Nobody can do it for us, and it can’t be avoided, though many try through alcohol or other drugs.  You may not be able to lessen their pain, but you can bring them some measure of comfort, thus allowing them to work through it more effectively.   Open your training manuals often.  Refer to page 82 and review the information on how to help grieving people. 
Each person grieves differently and for different reasons.  If you are prepared and trained, then the right way to be there for each person will be apparent to you, whether it is talking, listening or simply sitting with them and helping them cry.  That’s Inspiration!

Tuesday, March 29, 2011

G is for Give Them Purpose - ABC's of Inspired Hospice Volunteers

Sometimes as I ponder the sweet souls I’ve met through hospice, I wonder about how my journey on this earth will end.  I can think of nothing worse than to live my final days and years as my grandmother did, considering herself to be nothing more than a burden to others.  She begged God to let her die and join the husbands she’d already buried.   I hope that at the end of my life, I will be as independent as possible, but more importantly, I want to be able to give back and serve others till the day I die.

As their bodies fail them, our patients have been suffering for extended periods before we ever even meet them.  Suffering is a very self-centered activity so anything we can do to help them focus on the needs of others is very beneficial physically and mentally to both them and their families.
I’ve always been impressed by my husband’s grandfather.  His gallant ways bridged the language barrier between us.   He never failed to hold my arm as we crossed the busy streets of Berlin.   I was even more impressed when he found himself in a nursing home in East Germany.  The wall had just come down and things had not yet become “westernized”.  The facilities were wretched and the nurses even more so. 
His attitude saved the day though.  After overcoming the initial shock of finding himself there shortly after the loss of his wife, he took it upon himself to be the gentleman he had always been.  The women in the facility loved him for his attentions and manners!  He had found a purpose for himself and brought light and joy to the lives of others as a result.  He thrived so well there that his health improved enough for him to return home for several more years. 
 How can we as volunteers help the patients we serve feel like they are still contributing members of society through their final days?  I’ve come to the conclusion that we can help some be as independent as possible, but most importantly, I believe that we can help give each of them purpose, even if they are bed ridden.  I believe that everyone of us can learn, teach, grow and give to the very end of our lives.
Sometimes all these patients have left are their mental faculties.  Ask for advice, and seek their wisdom and experience.  If there is anything they do or say that you can learn from and apply to your life, be gracious and let them know.  Ask them to expound upon lessons they’ve learned throughout their lives and tell them how interesting that information is to you.  You may be the beneficiary of gardening tips, parenting advice or ideas on riding out the recession from those that survived the Great Depression!
You may never find an opportunity to use the information you learn from these grand folks, but what a joy it is to see their eyes light up as they share with you.
Are there other ways that they can still feel useful?  Perhaps they can knit or crochet or are willing to learn.  Maybe their creations will go to their family members as a legacy, or maybe they’ll go to the homeless, living on and giving comfort and warmth to the needy after the patient has passed on.  Could they write letters or cards to distant loved ones or soldiers, or could you write those for them?
 We all need to be needed.  Recording a life story can accomplish this.  Many times a patient will tell you that none of their family wants to hear about their life, but remind them that these things often change after we pass.  Perhaps it will be a grandchild or unborn great-grand that will someday cherish this link to their ancestors and learn from their experiences. 
Many people become more spiritual as the physical body declines.  If the patient is a prayerful person, they may benefit from being asked to pray for a certain individual who is in need.  Even the bed bound can do this and it can give them a sense of productivity right into their final hours, shifting their focus off of their own losses.
 Every one of our patients has gifts that can be shared.  Often, they are a buried treasure that we must hunt for.  Once we dig them up and find ways for the patient to share them, they can leave this treasured gift behind as a part of their legacy.   We volunteers can give these folks a sense of purpose and usefulness.  All that is required is our time, attention and a sense of adventure.  That’s Inspiration!








Wednesday, March 16, 2011

F is also for Fresh Air - ABC's of Inspired Volunteers

Imagine being housebound or bedbound during this glorious spring weather, knowing that it is likely the last spring you’ll ever see on this earth.  For most of our patients, this upcoming holiday is the last one they’ll see and yet they are frustrated and sad because they can’t get out there and enjoy it. 
That is where each of us can be a breath of fresh air.  We can bring the outdoors in.  We can bring the holidays to them.  Whether it be bringing colorful leaves in the fall or potted daffodils in the spring, wearing seasonal clothing or providing seasonal treats that they can share with their visitors, you can make their last seasons enjoyable ones.  
I like to grow baby pumpkins and draw a silly face on each one with the words, “Happy Fall Y’all!”


One patient had raised animals as a girl and was delighted when my kids and I brought our baby chicks for a short visit one spring. 
In February, I brought a recent widower a card and helium balloons and after he signed the valentine card to his beloved wife, we released it to fly up to heaven. 
  What would you want if it were your last season or holiday?  My Grandma desperately wanted a home grown, vine-ripened tomato.  It was such a simple desire, but one she couldn’t fulfill herself from her facility.
Of course, we must be sensitive to allergies, religious observances and personal preferences.  Some people may not enjoy Halloween for instance.  Start by asking questions:  “I saw my first robin of the year today.  What is your favorite part of spring?”  or “Do you have a favorite Halloween memory or costume?”  or “How does your family celebrate Thanksgiving?”  Questions like these enable you to get insight into what they cherish so that you can respond accordingly.
Never underestimate the value in what you do.  You do make a difference in these people’s final days.  You are fabulous, faithful, focused volunteers who forget your own troubles and needs for a time and bring a breath of fresh air as you lose yourselves in service to others.  That’s Inspiration!

Thursday, March 10, 2011

F is for Forget Yourself - ABC's of Inspired Hospice Volunteers

When a young man serving in a volunteer assignment overseas got discouraged and wanted to quit, his father wrote him a letter that contained little more than just one piece of advice.  The startled young man applied his father’s words of wisdom and found himself very happy in his volunteer service.
The advice that father wrote to his son?  “Forget yourself and get to work!”
I have found this same advice to be very helpful in my own volunteer work.  At first I felt self-conscious, but I knew that I couldn’t be much use to anyone unless I “got over myself”.  So I learned to take a deep breath, repeat the mantra and dig in, concerned with the needs of the patient, and not what others might think of me.
A person who is feeling self-conscious is overly aware of their own actions and what others might think of them. Being too self-aware can impede one's ability to perform.  The truth, of course, and it's a good thing to keep in mind, is that most people are too busy thinking about themselves to concentrate that much on you. 

As self-consciousness is reigned in, a person gains the ability to lose one's self in service to others.   They find themselves feeling a flow, a state of energized focus or single-minded immersion bringing great joy in their work.  They have become selfless rather than selfish.

So, regardless of who may be listening, if I feel inspired to sing, I sing out!  It’s just me and the patient, and it’s certainly not about me! 

Next time you are feeling uncertain or anxious in your volunteering, try repeating the mantra and then just dig in and take joy.  That's Inspiration!





Thursday, March 3, 2011

"I See Dead People!"

I had a blast volunteering at the Junior High Career Fair yesterday, but I had a homemaker handing out fresh-baked homemade cookies on one side of me. The guy with the cool hand cuffs and leg irons (don't call him a bounty hunter or he'll slap them on you) was on the other.  Across the gym was a stunt man doing tricks.  The competition was tough and I had a little trouble attracting the students' attention at first.


Then I started calling out to them as they walked by, "I see dead people!"


That got them there. 

I have teenage sons- I know how to get their attention. 

Of the nearly 400 kids there, I only found one that had any previous notion of what hospice is.


To get to the heart of it quickly, I started by asking them if they were dying, would they rather die alone in a hospital because it is after visiting hours, or would they rather spend their final days at home with their friends, family and pets.  Of course most wanted to be at home.


That gave me the opportunity to tell them that hospice would facilitate that by bringing nurses, medical equipment and whatever else was needed into the home.  I then proceeded to show them some of the things that I do as a volunteer.  They were fascinated with  the enrichment activities for dementia patients. 


Only after they had heard my presentation did I then explain to them about the 11th Hour Program and how we sit with people who are actively dying until they pass. 

They were filled with enough new information to forgive me for tricking them with the "I see dead people" line.  One kid did keep asking if I could see any around us just then, but I eventually got even him on board.


On a final note of course, I told them that even teens can volunteer and how impressive that would look on scholarship applications!

Monday, February 28, 2011

E is for Empathy - ABC's of Inspired Hospice Volunteers

My husband and I have twins and they are complete opposites.  One is an early bird, the other a night owl.  One likes hot cereals, the other cold.  One is very loud and out-spoken and the other is on the extreme side of bashful and shy.  One is a boy, the other a girl.  Despite their differences, or maybe because of them, they are very close. 

Our son recently started sparring in Tae Kwon Do and took a couple of good hits.  When his eyes, as he put it, “started watering” her eyes immediately welled up.  This made me recall a time years ago, when they received their kindergarten immunizations.  Our son was so brave and hardly flinched.  Our daughter, however, when it was her turn, went into complete hysterics and it was as he watched her distress that he started to literally go into shock. 

The twin bond is a remarkable thing, but what we witness between these two is more important and deeper than that.  They each feel each other’s pain.  They demonstrate a deep-seated empathy for each other.

Empathy is a character trait that I highly value and have worked hard to instill in my children along with a love of good literature.  I think compassion is a wonderful by-product of reading.  How can you be inside the character’s mind and not develop empathy for his or her plight?

The ability to imagine oneself in another's place and understand the other's feelings, desires and actions, from the inside, is a very important tool for hospice volunteers.  It is certainly helpful in maintaining patience with a difficult client! 

A dementia patient’s abilities for instance, change rapidly, sometimes even minute by minute.  An empathetic volunteer will constantly and quickly adapt conversation or games to these ever-changing aptitudes.  This allows the patient to experience a greater sense of independence instead of contributing to their already over-whelming sense of failure and frustration. 

When empathizing with a patient, I try to never say, “I understand how you feel.”  That may seem to negate what they are experiencing since obviously I’ve never been terminal or confined to a wheel chair.  I might say, “I imagine that it must be very _____.” Or phrase it as a question to allow them to open up further.  “What was the hardest part of having to leave your home and move here?”

Naysayers might think that you are making them sadder, by delving into their grief, but I would refute that.  The saddest person is the one who doesn’t feel understood, the one who can’t express their anguish.  They want someone to acknowledge their losses. 

When I was visiting a nursing facility there was a sweet little lady that I loved to talk to.  By the end of lunch however, she was usually distressed.  “I keep telling them that I can’t eat this much,” she would repeat.  The busy aides would tell her to leave it and brush her off.  I, however, had the luxury of time to stop and talk with her and empathize knowing that what you or I could leave on our plate without a second thought was painful to her as a survivor of the great depression.  I had no solutions for her, but how much happier she was, just knowing that someone understood what was for her a moral dilemma!

For the crankier patient, you might have your work cut out gently helping them to call upon their own stores of empathy.  For them to imagine themselves in the caregivers shoes might make a tremendous improvement in their attitude and patience level and consequently, in the life of the beleaguered caregiver.  This will be most successful though, after you have commiserated with them so that they feel understood and ready to understand others.

Each of you by merit of being in this position,  probably already have a well-developed sense of empathy, but the fact that you are reading this shows that you are a top quality volunteer open to new ideas and finding better ways to serve the patients.  That’s Inspiration!

Want to develop greater empathy
in yourself or your family?

Try this game.  I call it “Defense Lawyer”

First, ask your family what a defense lawyer is and what they do. 
Then challenge each other to watch for opportunities to play the game. 
For instance, the family is driving down the road and dad gets very frustrated with a driver in front of you going well below the speed limit. 
Ask, “Who would like to stand up in defense of this client?”

 With some practice, hopefully the kids will pipe up
with legitimate reasons why the driver is so slow, such as
 “she’s searching for an address”,
or “he’s old and scared of the traffic”.

What have you got to lose? 
The whole family becomes less judgmental and more empathetic,
 and with any luck, one of the kids may grow up to be lawyer!

Tuesday, February 22, 2011

D is for Discerning - The ABC's of Inpsired Hospice Volunteers

I am a retired Air Force wife.  Forget what the commercials say, because that is the toughest job in the military!  You no sooner find yourself transplanted to some foreign land far from friends, family and the English language than they send your husband away for a year or more at a time.  Most often you are pregnant when this happens and several major appliances are guaranteed to break down as well as the car, but not until the most recent hurricane has passed and the power has finally returned!
I jest, but only in part.  There were also lots of wonderful things about being a military wife like the travel, the food and, most importantly, the friends!  We learned to make friends fast and we relied heavily upon each other, forming bonds stronger than most because we were each other's family.  And, because of the nature of our husband’s careers, we got a whole new set of friends every year or so!
 There are certain friendships though that I can seldom look back on without getting teary-eyed.  Those are the friends that were with me through the most stressful times.  Those are the friends that in difficult times discerned my needs and set about resolving them often before I even realized what my needs were!

These women knew the truth in the Hindu proverb, “Help your brother’s boat across and your own will reach the shore”.
I’ve tried ever since to be the kind of friend and neighbor and volunteer that notices others’ needs and sets out to help before they ask, or sometimes even before they realize their own needs.
To discern is to see or recognize something that is not immediately clear or obvious.   As volunteers we need to be discerning first, of where a patient is in their end-of-life journey.  They may be in a stage of grief where they need to vent, or perhaps they may feel the need to plan or they may be in denial and want to discuss anything and everything but their reality.  Some days they may need to reminisce and other days discuss their belief system. 
Secondly, we need to discern what their physical needs are that day.  Things are changing fast for them and so their needs are ever-varying.   You can inquire as to how you can assist, but most often you will find that they don’t want to tell you because that is too much like “asking” for help.  They are ever so appreciative though when and if you can “discern” their needs and fulfill them!  This will require open eyes as you look around their home and open ears as you read between the lines of the conversation.  It will also require an open heart as you examine their situation and wonder what you would want or need were the tables turned and you found yourself in their shoes.  It may even require an open mind as you appeal to your higher power for inspiration.
 While going through some recent trials, I penned this verse which I firmly believe.
Far better than praying for self,
Is when other’s needs we discern,
For when another’s prayers we answer,
Our blessings are multiplied in turn.
There is a secret to being a hospice volunteer.  Others wonder how we can deal with such sad situations and spend all of this time around death.  They wonder how we can bear to lose so many friends.  The secret is, and I think every volunteer will readily admit it- that we get much more out of volunteering than we ever put in to it.  That is what keeps us going.  That is what keeps us strong enough to continue discerning and fulfilling needs.   That’s Inspiration!