Back in the summer, I referenced one of Devra Lee Fishman's Hospice Girl Friday columns, 'The Loner', where Fishman describes her inner world as she responded to a request from her volunteer supervisor. Though she was initially unsure about offering to help, she chose to step forward when she recognized her hesitation was only an excuse for not thinking about her own (not quite imminent) death.
About two-thirds of the way into the article, she realizes her internal world was stealthily influencing her feelings toward her volunteer responsibilities. Once acknowledged, she resolved to address her concerns about 'her own end-of-life scenario'. Her decision freed her energy to fully serve the residents of the hospice. The final third of the article in particular prompted me to consider how my own internal hurdles impacted my service during my first year as a hospice volunteer.
I think the biggest one tied back to my own initial experiences visiting my mom while she was a hospice resident. I remember the first thing I noticed about the hospice was its peacefulness. It contrasted to her previous room in a major Boston hospital. At the hospital, busyness was the word. Nurses and doctors came in and out of her room at all hours to check in. Unpredictable beeping at varying decibel levels left no silence unbroken. The hospital staff was accommodating at all times but no amount of kindness there could change a simple reality: the requirements of a major hospital room made simple visitation a difficult proposition.
By contrast, the hospice seemed designed for visiting. This was a major improvement! But I was not the only one who noticed. As a result, my mom had a lot more visitors as a hospice resident than she did as a hospital patient.
On some days, she spent the time I visited just resting or sleeping, no doubt partly recovering from earlier conversations and visits. Though I understood the importance of having others stop in when I was not there and was grateful for all the extra support from her friends, colleagues, and hospice staff, I could not help feeling rejected during the times when she slept through my visits.
It took me a few weeks of volunteering before I recognized how this memory influenced my service to the hospice. I noticed my behavior during home visits (when I went to see people choosing to remain at home while on hospice care) contrasted with how I approached my weekly shifts at the residence facility. During home visits, I was open, warm, and engaged. My shyness and introversion which sometimes made me anxious or uncomfortable around new people was gone. On these visits, I served the organization as the best version of myself and engaged with patients, their families, and their caregivers in ways I am proud of.
My shifts at the residence, however, brought back old habits and patterns limiting my full potential to serve the organization. The best version of myself, so easily accessible on home visits, was locked just beyond my reach whenever I stepped through the front door of the hospice. The courage I relied on to accept and share the burden of suffering during my home visits was replaced with the familiar hesitancy I loathed about myself. Rather than naturally serving as a comforting presence within the house, I second-guessed my decisions and worried about what others thought. At the worst times, I felt like a lingering guest: encouraged to stay yet obviously excess to requirements.
The difference in how I approached the two types of volunteer shifts baffled me at first. I did not understand why I regressed during my residence shifts. There were lots of possibilities. Perhaps I was simply not ready to return to a hospice so soon after my own loss.
The first suggestion about what was going on with my residence shifts came during a home visit. I started spending an hour or so a week with a man who did not appear to benefit at all from my presence. We often watched TV shows together in his native language (let's just say it wasn't English or Japanese). Some days, he was in a great deal of pain and could not communicate very well. On other days, he simply chose not to communicate. Our short, infrequent conversations often explored the exact purpose of a hospice volunteer- so, what do you do?- and I consistently failed to come up with a satisfactory answer.
There was no ill-intent in this question. The point of a volunteer was simply not clear to this man. I understood his point of view completely. It wasn't very clear to me, either.
Despite this open question, I was happy to visit each week. I learned more about a country I had never seen and developed a good rapport with the caregiver. His family stopped by on occasion and it was a pleasure to put faces to photos as I met the important people in this man's life I'd (occasionally) heard about (2). Despite our shared difficulty in pinpointing the exact benefit of my presence, I was always encouraged to return the following week each time my visit concluded and greeted warmly each time I returned.
I realized one day how crucial my internal state was during this particular experience. Though it was not evident why I was there or exactly clear what I was supposed to be doing, since I had been asked to be there I felt I was in the right place. It was easy to show up for my weekly visit and simply be there even if the benefit of my presence was not obvious to me or the patient. To put it bluntly, the question of how my presence helped just wasn't my problem and I gave the matter very little thought.
I did not have this easy sense of belonging at the hospice residence. Each visit with a resident brought to mind my own self-doubt about whether it was appropriate to use up the little time someone had left talking with me. How would I feel if I came to visit only for my friend or loved one to sleep through it thanks to a volunteer's insistence on conversation earlier in the day? I knew.
But I also had plenty of shifts at the residence where I did feel perfectly comfortable with the residents. These visits almost always followed a direct request from the staff or from a resident's family. As I felt during my home visits, I was at ease knowing my presence was wanted. (3)
The recognition of how my own experiences influenced my volunteering was a sort of breakthrough for me. I started to adjust my approach at the residence. A helpful change was to focus on gathering more information. I spoke with the nurses or aides about the resident's schedule. If the person was expecting visitors later on, I kept my interactions brief or made sure to ask if my company was wanted. A resident waking up after a long nap was a good candidate for my visit, I learned, while someone struggling to sleep through the night might benefit from being left alone during a rare period of rest.
The most important change was to ask directly. The best person to ask about whether a given resident was expecting visitors was always the resident in question. Based on the response, I could tailor the rest of my interaction. Though a small adjustment, I feel the results have been significant and I now try to pass the information along to volunteers coming in after me whenever possible.
The entire process summarizes a larger lesson from my first year volunteering. Big transformations always start by acknowledging the small stirrings within. Though it is possible to serve effectively while harboring internal conflict, the surest path to my best self requires acknowledging my own feelings and addressing these in healthy ways. To find and unlock the best qualities I sometimes lose sight of requires I first become my own judge. When no one else, after all, can know what I'm missing out on, using another's perceptions or judgments doesn't do me much good.
Footnotes / imagined complaints
1. Just say no always works, right?
Initially, the piece left me confused. Why not just say no? I'd said no plenty of times as a volunteer. Sometimes, I did so in situations very similar situations to the one Fishman described. It was an important idea stressed during training- 'you can always say no', we new volunteers were reminded time and again. The consequences for saying no were nil as a volunteer (and not just because of the technical details regarding the at-will nature of being a volunteer).
Outside of logistical concerns, saying yes to all requests might actually harm the patient. If I responded to a request inappropriate for me, I might create a negative experience for the hospice residents and their families. As a volunteer, my role is to serve the hospice organization to the best of my ability. The day I can no longer effectively serve will be the day I walk away from my volunteer role. Saying yes to requests beyond my ability will only push me closer to this end.
Like all gut reactions, though, my initial firm response- why not just say no?- softened with time. In considering different perspectives, the possibility of my training being different from her training occurred to me (duh). Unlike me, Fishman may not have been encouraged to turn down requests and thus did not consider the response as a possibility. I also wondered if perhaps the article was incomplete (an often necessary consideration when writing about the details of hospice work). It was a short piece and perhaps I was making assumptions to fill in blanks, answer questions, or account for back story.
I suspected Fishman was a stoic sort of person, perhaps the type who could volunteer at the hospice without allowing her internal struggles to impact her service. But this was again another guess on my part. Eventually, I recognized her individuality and acknowledged my confusion was a result of my assumptions.
2. Here's a snippet from one of my favorite conversations...
Me: Hey, Mr. ___, nice Christmas tree.
Mr. ___: Oh, my daughter put it up. She is crazy.
3. I wonder who will be my last friend?
I remember during training the volunteer coordinator said one way to think about being a volunteer was to consider yourself the last friend a person could make. I (maturely) responded by laughing out loud.
It wasn't the ideal response, I admit, but the thought of me walking through a door and announcing "Hey, I'm the last friend you'll ever make" struck me as darkly comedic. I'm surprised more of my visits don't start with a patient pretending to fall asleep.
