A Hand to Hold

For those nearing the end of their lives, hospice volunteers across the country offer comfort and compassion


For many people, there is no more heart-rending experience than watching the death of a loved one.

But while death provokes fear in some, Alice Dawkins sees an opportunity to talk about life and strengthen family ties. Where some see sorrow, the 47-year-old pediatric nurse sees a chance for compassion and laughter. Where some see only the end, she sees hope.

It is for those reasons that Dawkins spends time with the dying. As a volunteer at the Stella Maris Hospice in Timonium, where hundreds of terminally ill patients come every year to spend their last days, Dawkins is a lifeline for patients and their loved ones at a time when they may feel most alone.

Across the country, thousands of volunteers like Dawkins lend a hand at hospices every day by helping people get through the final stage of life. Whether it's keeping water glasses filled or working with patients in a garden, volunteers serve in a variety of ways.

Dawkins has read to her patients and brought them music. She's played card games and taken them shopping. Sometimes, she and patients pray together. Much of the time, she just listens. Dawkins is prepared for anything.

"Sometimes, I leave here laughing," says Dawkins, a Cockeysville resident who spends a few hours at the hospice every Monday and has done so for the past four years. "Sometimes, I leave here crying. I always leave here with a feeling of pride, though, that I have contributed in some way as part of a team that cares for people's spiritual, emotional and physical needs.

"I want to create a positive experience for patients and their [families] when they are here," she adds. "I want them to know that each life has meaning."

Once considered on the fringes of traditional medicine, hospice care has become mainstream in the past couple of decades. In medieval times, a hospice was considered a place of shelter and rest for weary or ill travelers, according to the National Hospice and Palliative Care Organization, based in Alexandria, Va. The word was first applied to specialized care for dying patients in 1967 when the first hospice was started in a London suburb. Seven years later, the first hospice in the United States opened in New Haven, Conn.

But it wasn't until 1982, when Congress introduced the Medicare Hospice Benefit, that the concept really spread. Last year, a record 1.06 million Americans sought the services of hospice-care providers, an increase of 100,000 from the year before, according to the Alexandria organization.

About 3,600 Medicare-certified hospices meet those patients' needs, including about 30 in Maryland. Experts predict that the numbers will steadily grow. There are about another 200 volunteer hospice organizations in the country that are generally free of charge to patients.

As demand grows, Dawkins and about 500,000 other volunteers like her across the country play a vital role in the care and support of hospice patients. The federal government requires that 5 percent of all patient care at hospices that receive Medicare come from volunteer workers.

"Hospice isn't a place, it is a philosophy of care," says Jon Radulovic, vice president of communications at the Alexandria organization. "Most people don't realize that 80 percent of hospice care takes place in the home. Many people mistakenly believe that by choosing hospice, you're giving up. Nothing could be further from the truth. Hospice is about loving, compassionate care. It's about making people feel comfortable in their home or making a place feel like home so that patients can live as full a life as possible right up until the end.

"Volunteers are an important part of that," Radulovic says. "Something happens when a person is terminally ill. Friends and family are so often afraid of saying the wrong thing or doing the wrong thing, they don't visit as much. Death is not something that everyone is comfortable dealing with. The patient then starts feeling very isolated. Volunteers just being there, being good listeners, [are] so valuable. It has a profound effect on people's lives."

A need to assist

Hospice volunteers are not ordinary people, but neither are they superheroes. They are usually people who have grappled with death themselves and feel a need to assist others who are dealing with it, too. Many have experienced hospice programs because of family members or friends.

Others dealt with death early in their lives and came to realize the importance of finding support during the bereavement process. Dawkins lost her older brother to a violent beating when she was 15, and her mother died 10 years ago.

Dawkins tells her hospice patients, "With a support group, you can be better off. Support services helped my family get through our loss. That's what we're here for. ... Anyone can do this work," she says of volunteers. "They just need to have a sense of peace about death."

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