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An end-of-life companion

An end-of-life companion: how one volunteer added quality of life right to the end

4 August 2016
By Heather Wiseman

When Sandra Mugavin, 63, retired from nursing in October last year, she knew she wanted to keep using her skills and be of value to her community. Working as a volunteer for Warrnambool & District Community Hospice, supporting people who want to die at home and their families, has proven just the opportunity she was looking for.

When people retire they tend to enjoy a break. Why did you want to keep making a contribution?

Towards the end of my career I worked as a care coordinator for people with dementia. As well as staff, I had volunteers and I always really valued that they’d come in each day to help us. I always said when I retire that’s part of what I want to do – volunteer and give back to the community.

Before that I spent many years as a district nurse, working both on hospital wards and out in the community. I often did palliative care in the home, which is where my passion has come from. It is a wonderful thing, to be able to support someone to live out their dream and be able to die in their own home.

I wanted to continue to use some of my skills and I always said that I would volunteer. At Warrnambool & District Community Hospice we offer 24-hour support. It would be virtually impossible to offer that without volunteers.

“She liked talking about funny things her kids did when they were young on the farm.”

What sort of support do you provide?

I have supported one person who has died so far. I visited her two or three times a week for about three hours at a time, and I did one overnight sleepover in the six weeks before she died.

At night I provided practical support like showering her and getting her ready for bed. I made sure she had her medications. It is not our role to give any medication – we just make sure they take it. I slept on the couch on and off and helped if she needed to go to the toilet during the night.

I might have washed a few dishes, made the bed, and emptied and disinfected her commode, but that’s about it.

As volunteers we are happy to do the dishes or shop or clean, or whatever needs doing. But that wasn’t needed in this instance. This lady was living at her daughter’s house and her daughter had the household running very efficiently. But the daughter needed to continue working and she could do that knowing someone was there for her mother.

The lady’s son-in-law was a great support to her too and they got on very well, but she felt more comfortable having a volunteer help to shower her. It was nice that we could give him a little bit of respite when he needed it.

Mostly volunteering it is about being a companion. I built a lovely relationship with the lady. We used to sit and chat and talk about her grandchildren and her family and where she worked. She loved the garden so we talked a lot about the garden and what plants she had. And she liked talking about funny things her kids did when they were young on the farm.

You find out what the person enjoys and you encourage them to talk about whatever that may be. We always asked how her grandchildren were. She had taken up the new rage of colouring, so she would ask me what I thought about the colours she’d chosen and tell me who she was giving each of her pictures to. We had a lovely rapport.

What did it mean to her, being able to die at home?

She talked about how happy she was to be at her daughter’s house. It was in the country so she could hear the birds chirping in the trees and the koalas. She often slept with her bedroom door open a bit in the summer so she could hear the birds and she loved to hear the rooster crowing in the morning.

How did you feel about her death?

As much as I was sad, I was very happy that she died fairly quickly and that she didn’t have any ambulances at her front door, which is what she wanted. She died peacefully in her own bed with her daughter and son-in-law with her. I think she was very much at peace and very happy. That was her last wish, to die at home, and it was granted.

Did you need any specific training to work for the hospice?

Yes. The hospice runs an eight-week training course that you go to once a week and it was very informative. I learnt heaps. Once you’ve graduated from the training, you’ve got your police checks and immunisations done, and signed the confidentiality forms, you’re able to start volunteering.

And there’s back-up, if you need it?

We always have the main carer’s mobile number so you can call them or our manager straight away if we’re concerned.

Then there is also the nurse-on-call or a doctor who can visit if they are needed.

Are you the sole volunteer, caring for each patient?

No, but we try to limit it to just two or three main people going to the house, so the person who is dying and their family get to know us and we can build a rapport with them. You don’t want them to feel like there’s a multitude of people coming through. It’s more like a friend popping in to say hello.

Sometimes we might have two volunteers go instead of one if we are caring for someone who is very frail or really unwell.

Does it ever get too much?

We are all very committed but we still have our time away and volunteering doesn’t leave us drained. There are enough volunteers that you can choose what days you make yourself available. We all still have our family lives.

There are plenty avenues for support within our team and our manager is excellent at supporting us. There are counselling services available. The core group of people supporting a family can also meet and discuss the way they are feeling if they need to.

Is it a big advantage, having a nursing background?

Not really. I guess it might help you know what to expect, but with the education and support we receive everyone seems to cope.

We have people volunteering from all walks of life. We do have a lot of retired nurses and some nurses who are still working who volunteer on their days off, but you don’t need a nursing background.

We’re not there to provide advice or health information. If we feel the patient or their family needs advice we refer them to the local palliative care nurse or their doctor. If I was concerned about anything I would report it to my manager.

Have you met new people through volunteering?

Oh yes. I’ve met a really lovely group of people who are like-minded and some really great friendships have been formed. We have monthly meetings and socialise afterwards, so we get to know one another.

Everyone is passionate about what we do and is really committed about giving the best care we possibly can so people can die at home. We are all very focussed on achieving that.