You are about to embark on the rewarding and beneficial experience of hospice volunteering.
Volunteers fill a special place between loved ones and professional caregivers.
It is essential that you be trained as a volunteer. We are not dealing with a casual fad or a
matter of fashion. Instead, we are dealing --- quite literally --- with matters of life and death,
and moral and ethical issues that will affect every one of us, directly or indirectly, as time goes
The philosophy of hospice is to affirm life by providing support and care to those in the last
phase of an incurable illness so that they can live as fully and comfortably as possible and die
Without volunteers, the hospice could not provide the kinds of services which are needed to
enhance the quality of the lives of our patients and their families.
Volunteers support the Hospice and patient care either through direct or indirect patient care
activities. Volunteer functions can include, although are not limited to:
●Brief respite for the caregiver;
●Art and music enrichment;
●Running errands or shopping;
●Assisting with light yard or household tasks; and/or
●Administrative activities (e.g. filing, mailings, answering phones, data entry)
We thank you for giving of yourself to support others!
Contact Rachel Rodriguez, Hospice Director by email at email@example.com or call 432-336-2004 Ext. 4870 to help get you started !
Hospice is considered to be the model for quality, compassionate palliative care for people
facing a life-limiting illness or injury who have a prognosis of 6 months or less to live. Hospice
care is provided by a team of trained professionals to provide an individualized plan of care
that focuses on pain and symptom management related to the terminal diagnosis and related
conditions. The focus is to treat the symptoms of the disease, not to cure. The hospice team
consists of a physician, nurse, hospice aide, social worker, chaplain and volunteer. The team
focuses on the physical, emotional and spiritual needs of the patient. (CMS Medicare and
Medicaid - Medicare Hospice Benefit)
The hospice philosophy recognizes dying as part of the normal process of living; it affirms life
and neither hastens nor postpones death. Hospice care treats the person rather than the
disease, working to manage symptoms so that a person's last days may be spent with dignity
and quality, surrounded by their loved ones. Hospice care is also family-centered - it includes
the patient and the family in making decisions. Hospice exists in the hope and belief that
through appropriate care, and the promotion of a caring community sensitive to their needs
that individuals and their families may be free to attain a degree of satisfaction in preparation
In most cases care is provided in the patient's home. Hospice care is also provided in
freestanding hospice centers, hospitals, and nursing homes and other long-term care facilities.
Hospice services are available to patients of any age, religion, race, or illness. Hospice care is
covered under Medicare, Medicaid, most private insurance plans, HMOs, and other managed
Typically, a family member serves as the primary caregiver and, when appropriate, helps
make decisions for the terminally ill individual. Members of the hospice staff make regular
visits to assess the patient and provide additional care or other services. The Hospice staff is
available on-call 24 hours a day, seven days a week.
Hospice care is a patient and family-centered approach that includes, at a minimum, a team of
doctors, nurses, aides, social workers, chaplains, counselors, and trained volunteers. They
work together focusing on the patient's needs whether physical, emotional, or spiritual. The
goal is to help keep the patient as pain-free as possible, with loved ones nearby. The hospice
team develops a care plan that meets each person's individual needs for pain management
and symptom control.
The hospice benefit provides for hospice related pharmaceuticals, medical equipment, medical
supplies, 24-hour access to medical care, and bereavement support. Hospice provides nursing
visits, personal care and psychosocial support, as well as pain management, counseling, and
other therapies needed for the terminally ill patient. Hospice care is offered in four levels of
care (as defined by the Medicare benefit): Routine Home Care, Continuous Care, Inpatient
Care (short-term), and Respite care (short-term).
Counseling or grief support for the patient and loved ones are an important part of hospice
care. After the person's death, bereavement support is offered to families for at least one year.
These services can take a variety of forms, including telephone calls, visits, written materials
about grieving, and support groups.
The Medicare Program is a national health insurance benefit offered by the federal
government. Hospice is a covered service to qualified patients. The Hospice Agency must be
certified to provide care and be reimbursed from Medicare.
The Medicare and Medicaid Conditions of Participation (CoP) outline minimum health and
safety requirements for Hospice Agencies. Each of the conditions have minimum standards
that must be met to be qualified for medicare certification. Note: These Conditions of
Participation are the basis for the Agency's policy and procedures.
Regulatory agencies that oversee an agency's program include:
●State licensing and/or survey agency
●Medicare - medicare certification (CMS, Centers for Medicare & Medicaid Services, contracts with State licensing and survey agencies for oversight of CoP adherence)
●The Joint Commission (TJC) - voluntary accreditation organization
●Community Health Accreditation Partner (CHAP) - voluntary accreditation organization
●Accreditation Commission for Health Care (ACHC) - voluntary accreditation organization
History of Hospice
Hospice is a place of meeting. Physical and spiritual, doing and accepting, giving and
receiving, all have to be brought together...the dying need the community, its help and
fellowship...the community needs the dying to make it think of eternal issues and to make it
listen...we are debtors to those who can make us learn such things as to be gentle and to
approach others with true attention and respect.
-Dr. Cicely Saunders (quoted by Stoddard)
The origins of hospice go all the way back to medieval times and are actually rooted in
hospitality. When travelers were on long journeys and became ill, they needed a place to rest,
a way station of sorts. Hospice referred to those who kindly offered a safe place for the sick
and weary travelers.
St. Christopher's Hospice was the first hospice in modern times, created in 1965 by Dame
Cicely Saunders, who lived in London but who began her work with terminally ill patients in the
late 1940's. Following the establishment of St. Christopher's, the word "hospice" was coined
and the concept of hospice care spread across England.
Dame Saunders introduced the United States to the idea of specialized care for the dying
during a visit to Yale University in 1963. It was that particular lecture that launched a chain
reaction of events that resulted in hospice care programs as we know them today.
Hospice care concepts began to be recognized in earnest by hospital professionals when
President Ronald Reagan and U.S. Senator Bob Dole encouraged Congress to include the
payment for hospice services as part of the Medicare benefit. That 1982 passage was only
temporary, but in 1986 the Medicare Hospice Benefit was made permanent by Congress, and
states were given the option of including hospice in their Medicaid programs, something all
Overview of the Volunteer Program
No other form of healthcare embraces the volunteer as enthusiastically as hospice.
Volunteers are fundamental to the hospice concept and are used in nearly all aspects of the
program. The Medicare program requires the Hospice to provide volunteer staff sufficient to
provide administrative or direct patient care in an amount that, at a minimum, equals 5% of the
total direct patient care hours of all paid hospice employees and contract staff.
Volunteers are an integral part of the Hospice, filling roles that range from direct contact with
patients to providing clerical support for the organization. Hospices that participate with
Medicare are required to utilize volunteers alongside their paid clinical and administrative staff.
The Volunteer Coordinator or a designated manager is responsible for recruitment, training
and retention of volunteers, their assignments and tracking of volunteer hours and the
resultant cost savings for the Agency. The Volunteer Coordinator attends the IDG meetings to
report on volunteer assignments, update volunteer assignments based on IDG review and
determine if any new patients or patients with condition changes may benefit from volunteer
Types of Volunteers
Direct Patient Care Volunteers serve as members of the Hospice in a variety of supportive
ways that include: sharing hobbies, assisting with errands, transportation, companionship,
listening to concerns, and staying with the patient to provide respite for the caregiver.
Administrative Volunteers may perform a wide variety of office and support functions including
reception, clerical tasks, follow up bereavement activities and assisting with a variety of
administrative support projects. This means support of patient care activities rather than
general support activities.
Recruitment, Training and Retention of Volunteers
Recruitment of Volunteers
The Agency must document active and ongoing efforts to recruit and retain their volunteers.
This may be demonstrated by maintaining a manual with evidence such as advertisements in
local newspapers, bulletins, flyers, media announcements, etc.
Another function of the Volunteer Coordinator or designated manager is to ensure that
volunteers receive adequate training prior to any volunteer assignment. Other members of the
interdisciplinary team may participate the in volunteer training program, but it is the
responsibility of the Volunteer Coordinator or designated manager to coordinate and
document the volunteer training activities.
The Volunteer Coordinator or designated manager is responsible for retention of the
volunteers. This can be achieved in a variety of ways. Thorough orientation and support of the
Volunteer is a basic for keeping volunteers. Expressions of appreciation also aide in retention
and can be achieved through luncheons, Volunteer of the Year awards, etc.
The Volunteer Coordinator or designated manager is also responsible for assigning the
volunteer to the patient or family desiring volunteer services. An understanding of both the
patient and the volunteer's interests, backgrounds is important when assignments are being
made. Attempts to "match" the volunteer to the patient is important and can facilitate the
patient/volunteer relationship. The Volunteer Coordinator or designated manager is
responsible for developing the volunteer care plan and reviewing documentation of the
volunteer visit made by the volunteer with the patient and/or family. The Volunteer Coordinator
or designated manager is available to provide guidance and support to the volunteer as
Tracking Volunteer Hours and Cost Savings
Medicare anticipates that the Hospice will use the volunteers to supplement the care being
provided by the paid staff who work directly with the patients and their family members, both in
the patient's home and the inpatient setting.
The Volunteer Coordinator or designated manager is responsible to ensure that the volunteers
document and submit the hours they work. This should be maintained on a log. The Hospice
must document a continuing level of volunteer activity.
The Hospice must document the cost savings achieved through the use of volunteers.
Documentation includes the following:
●The identification of necessary positions which are occupied by volunteers;
●The work time spent by volunteers occupying those positions;
●Estimates of the dollar costs which the Hospice would have incurred if paid employees
occupied the positions identified for the amount of time spent by volunteers.
Here's an important point to remember:
This documentation must be up to date and available for surveyors.