An important part of that care comes from volunteers, those who feel a special calling to share compassion and kindness when a family needs it most.
Hospice is not a place. It's a concept that focuses on caring, not curing, for people facing a life-limiting illness or injury. Hospice involves a team-oriented approach to medical care, pain management, and emotional and spiritual support tailored to the patient's needs and wishes, according to the National Hospice and Palliative Care Organization.
Among the members of such a team are physicians, nurses, home health aides, social workers and clergymembers. One of the vital components of the support staff is the volunteer -- someone to fill in the gaps and help a patient, and his or her family, through the precious final weeks, days and minutes of life.
In fact, for most hospices, volunteers are not just a luxury -- they're a requirement. Federal regulations require that for hospices that participate in Medicare, 5 percent of all patient care hours must be provided by trained volunteers.
"That's because the philosophy of hospice, when it began in the 1970s, was all volunteer," said Clara Jehle, volunteer coordinator for Hospice of Montgomery. "Medicare wanted to retain that volunteer image, so they put in (that standard.)"
The volunteer provides companionship and socialization for a patient who is homebound or in a nursing home or assisted living facility, and helps the family meet its emotional needs, said Marti Galloway, manager of volunteer services for VistaCare Hospice.
"When you become sick with a terminal illness, your world just becomes increasingly smaller as you become sicker," Galloway said. And if the patient and the primary caregiver don't have adequate support, everyone's quality of life suffers.
That's where the most visible hospice volunteer steps in -- to provide respite care to a caregiver and family. It is not always easy, but it is emotionally rewarding.
"It's such a blessing to be invited into someone's home," said Mona McDermott, bereavement, social work and volunteer coordinator for Baptist Hospice. "It's a very special time in their lives. It can be sad, but it can also be healing, and a time to make wrongs right.
"To be allowed into someone's life and home at that time is incredible."
The volunteer is often relieving a caregiver, to give that person some time to himself or herself for a few hours.
In that time, the patient may want company or comfort, or nothing at all.
"If they want to talk, we talk, but if they want to sleep, we let them," said Gary Jones, a volunteer with Hospice of Montgomery for about three years.
The intimacy required at such a time means that the volunteer and family have to be a good fit for each other, and that's one of Jehle's tasks as volunteer coordinator for HOM.
"I look at the characteristics and personalities of the patient and the family, and see what fits best," Jehle said.
Giving back
Most who volunteer for a hospice have a personal connection. They had a close friend or family member who received hospice services, so they want to give something back.
"They realize how important it is to have someone to talk to, to have the things they needed," said Paul Cowley, chaplain of Wiregrass Hospice.
But it's crucial that such a volunteer be well along in the grieving process, something a coordinator can determine in the interview.
"If I think they're still grieving, I'll steer them to other ways to volunteer, maybe administratively in the office," said Galloway of VistaCare Hospice, which is owned by the Gentiva company.
In fact, many don't realize that there are several avenues for volunteering with hospice -- not just interacting directly with end-of-life patients.
"Whatever special skill they have, we see if we can find a way to use it," Galloway said.
For example, some ladies' church groups crochet or knit hats and lap blankets for patients; one group makes shawls that are prayed over as they're being made, Galloway said.
One of McDermott's volunteers made Christmas stockings for patients this year. Local church groups gave personal grooming items to fill the stockings. After that, a group of young people at the Mount Meigs youth facility put the stockings together.
"We have one group, one of the local churches, and they take up money to buy cases of Ensure, which are very expensive," McDermott said.
The ones who provide clerical help are just as important as those who sit with patients.
"There's a lot of paperwork we have to keep up with," said Cowley, the chaplain at Wiregrass Hospice, which, like VistaCare, is a for-profit hospice owned by Gentiva.
Galloway agrees.
"Hospice is a very paper-intensive world," she said. Any help with filing and organizing helps the medical records person to operate more efficiently.
Such help is even more important to the nonprofit hospices.
"We can never pay enough for staff," Jehle said.
There are even ways for the homebound to help.
"If you want to do bereavement or Christmas card mailings, we can bring the materials to you, and you can prepare it and we can pick it up," McDermott said.
Retiree Charlie Brown has volunteered with Hospice of Montgomery for five or six years, and his role is very straightforward: He runs plans of care between doctors' offices and the HOM office, twice a week.
His satisfaction comes in knowing he's helping the staff of HOM, and helping them in their mission.
"You'll certainly get some personal satisfaction out of helping," Brown said. "For me, it's ideal to spend some hours outside the home."
Linda Gates has volunteered with Baptist Hospice for almost two years. She works at a grief camp for bereaved children, which is an annual event each spring at Camp Chandler.
"It's to help them get through their grief, because children grieve differently than adults," Gates said. "Coming to the camp gives them a chance to talk about (their grief), and they're with other kids. I think that helps them open up."
She also sends notes each month to bereaved families. "I try to write something to give them some peace, something to let them know that we love them and that we care."
Some volunteers help with fundraising. While hospices receive Medicare, Medicaid and private insurance reimbursements, raising money is an essential component for both Baptist Hospice and Hospice of Montgomery, which are nonprofits.
Hospice of Montgomery has its annual Monte Carlo benefit; the Baptist Health Care Foundation raises money for Baptist Hospice through its annual Montgomery Family Christmas concert, which this year featured singer John Tesh.
Volunteers help with the behind-the-scenes work at those events as well.
All kinds of volunteers
While many hospice volunteers are retired, people of all ages find ways to help.
"We have some who have been volunteers for more than 25 years," McDermott said. "Some are almost 90 years old, and they're still very active."
Teens can help, too. Min-ji Kim is a senior at St. James School and is in her third year of volunteering. She helps Galloway with administrative functions at VistaCare.
Kim wants to be a doctor, and thought hospice would be a good way to expose herself to the medical field.
"If I have an opportunity, I'll continue (volunteering) at college," she said.
No matter the age, all hospice volunteers have a special gift.
"It takes a giver, a selfless, servant-oriented person. A person who gets pleasure in sharing themselves with another person, a helper, a nurturer," Galloway said.
The work can be challenging, but is very rewarding.
"Without exception, volunteers tell me they're the ones who were blessed by the experience," Galloway said.
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