The term hospice refers to the overall physical and emotional care given to the dying and their families, in both inpatient and home care environments. Inpatient hospices frequently utilize volunteers to provide company and companionship to terminal patients in conjunction with their medical and nursing staffs. Hospice volunteers undergo various degrees of facility orientation and hospice training prior to formally beginning their service to the organization. Volunteer hospice training frequently includes familiarization with the physical and emotional processes of dying, the stages of death, the definition of and method of dealing with grief and different methods of providing care and support to the terminal patient. In order to meet all legal and medical care requirements, hospice training may also involve infection control, privacy and formal advanced directives.
Hospice training for volunteers may involve approximately twenty to forty hours of instruction and orientation over the course of a few weeks. In turn, volunteers are asked to volunteer a given number of hours per week for the minimum of a year. The amount of time hospice volunteers pledge can range from two hours per week to whatever maximum the organization establishes. Volunteers are asked only to pledge what time they will consistently be able to serve. Hospice training is generally conducted in small groups and classes are held as needed.
Communication and company is strongly emphasized in hospice training for volunteers. These are not small or unimportant tasks. The processes of death and dying frequently scare away friends and family and terminal patients are often lonely in the midst of the most alienating of situations. Listening is the primary means of communication taught to volunteers during training. Depending upon their condition, terminal patients may feel the need to relate memories, anecdotes or autobiographical information and volunteers are trained to listen actively.
Hospice training also introduces the philosophy of palliative care, or comfort care, to volunteers and their role in pain control. For instance, pain medication is most effective when administered before the pain has become severe. Patients are sometimes reluctant to ask for pain medication, believing they must wait for a nurse to offer the medication. Volunteers are taught in hospice training to recognize signs of increasing discomfort — such as irritability, restlessness or conversely, a type of stoic immobility — and notify staff of such. The patient's medication schedule may be changed to reflect more frequent pain medication administration.