Over the past several months, a microscopic entity forced us to face our fragility and vulnerability. This invisible creature brought our lives to a halt, forced us to live and work in near isolation, and, most egregiously, experience the heartache and extreme pain caused by knowing that our loved ones were dying alone in an intensive care unit. It’s time for change.
Adding to this travesty, we witnessed the awful human capacity for brutality and callous behaviors. The images of George Floyd’s murder are forever emblazoned in our memories and go well beyond comprehension, reflecting the very worst of our human nature. It’s time for change.
However, in contrast, we also witnessed tens of thousands of people filling the streets of nearly every major city in the world protesting this inexcusable behavior.
I believe this offers some proof that there are more good and decent people than not. Seeing the emergence of this next generation of voices advocating for social justice, exposing racist behavior, and demanding change offer some degree of hope for humanity.
But will we really change? Will we have the tenacity to do the work necessary to bring about the change? Will we persevere? It will not be easy.
We are facing, centuries upon centuries of racism.
Culture change and subsequent policy changes do not happen overnight.
“Change does not roll in on the wheels of inevitability but comes through continuous struggle. And so we must straighten our backs and work for our freedom. A man can’t ride you unless your back is bent.”
Martin Luther King, Jr.
We have to have the courage, a strong will, the intestinal fortitude to press ahead to fight the good fight. These words echo in my mind nearly every day.
“Seek justice, relieve the oppressed, defend the fatherless, and plead for the widow.”
Written by the prophet Isaiah some 3,000 years ago, these words are still relevant today as we are confronting the same abhorrent behaviors that lead to injustice, oppression, children abandoned, and older adults marginalized, mistreated, and misaligned.
My life’s path led me to “…pleading for the widow,” and more explicitly advocating for the treatment of older adults living in nursing homes. While I am in no way equating ageism with racism and the recent horrific events, I do want people to know that far too many older adults are dying alone and, in far too many cases, prematurely. They suffer the consequences of ageist thinking, negative stereotypes that often lead to neglect and abuse.
Now, I want to be very clear that in the 30 years or so of working with people in nursing homes, the overwhelming majority of caregivers I met, are providing heroic care in a system that needs significant overhauling. But you don’t need a lot of bad apples to ruin the pie.
So how do we change the way people think about aging, older adults, and nursing homes?
Convinced by my research and the research of many others, I strongly recommend that nursing homes be required by regulation to implement and maintain a sustainable, dedicated robust volunteer program managed by a person that is certified in volunteer management (CVA). Coupled with having a professional manager of volunteers is implementing an onboarding process for recruiting, screening, and training well-qualified volunteers. It’s time for change.
Requiring this volunteer workforce would not only improve the quality of care and the quality of life for the people living in nursing homes, but it would provide a platform for educating the public as to what it means to live and work in a nursing home, (not to mention the impact the volunteer program would have on the nursing home’s CMS star rating)[i].
A robust volunteer program acts as a bridge to the greater community attracting new workers while correcting ageist thinking. How many people, who, having rarely ever thought of nursing homes recently witnessed because of COVID-19, the numerous social media posts depicting older adults and their loved ones peering at each other through glass windows, longing for the joy of embracing one another, sharing a kiss, breathing in the satisfaction of feeling connected?
How many people watched the social media posts of direct care workers donned in personal protective equipment (PPE) doing their best to provide excellent care while offering to make those personal connections on behalf of their loved ones? Who will post these images once the virus is gone?
Who will continue to tell the story?
Your volunteers will. Volunteers are not “nice to have” or a “supplement” to your nursing home staff. Instead, volunteers bring valuable gifts to your nursing home. They bring their passion, their love, their talents, their skills, their time, and most of all the feeling of connection. They are the conduit for change by engaging the community through a robust volunteer program. Educate your volunteers, and they will tell the story for you. They will become your champions.
Recently, while researching articles focused on nursing home volunteers, I found this quote:
“If non-pharmacological interventions were reimbursed in the manner that pharmacologic interventions are, it is likely that most costs would be offset by the decreased use of psychotropic drugs in the nursing home and related adverse events”[ii]
Professor Jiska Cohen-Mansfield
Well trained and professionally led volunteers are a “non-pharmacological intervention” with proven results. Now is the time to recognize volunteers as a necessary, vital, and integral part of your care delivery. Now is the time for change.
I would love the opportunity to be part of your change. See my contact me page for details.
For the past nine weeks, like many of you, I’ve been sheltering in place with the occasional brief excursion to the grocery or drug store only to hurry home to resume hiding. The one saving grace and antidote for this insanity comes through the online courses I am teaching.
Of particular joy for me was launching “Volunteer Management and Aging Services.” Now, at the end of the semester, it has been extremely satisfying to read the students’ final exam submissions. I ask them to explain what they were taking away from the course, and as they move into their careers (administrators, health care workers, and social workers) how would they apply what they’ve learned.
I am so encouraged by what my students expressed in their responses.
They explained how valuable and necessary volunteer support is to the paid staff. They talked about having a fully integrated volunteer and paid workforce, led by a trained professional, working together to fulfill the mission of the organization. Many of them admitted that before taking the course, they thought of volunteers as “unreliable.” Their perception of volunteers and volunteering has changed; they now realize that volunteers are more than just a “nice-to-have” add-on. Instead, they now understand that a viable and sustainable volunteer workforce should be led by a trained director of volunteers and that it won’t happen by accident.
They talked about developing an organizational philosophy concerning volunteers while garnering input and support from the board of directors to the frontline workers. Many of them expressed surprise at the importance of developing and executing a cost-based analysis of the volunteer workforce as well as producing eye-popping impact statements that go well beyond just talking about what happened. I am hoping and believing that this class of students will be the first of many cohorts to bring these ideas to their workplace.
In the meantime, I’ve been contemplating my work as an advocate for long-term care volunteers.
I have been feeling very concerned thinking about the thousands of older adults that are now under quarantine as a result of COVID-19. Thinking about the pandemic and its impacts on the people living and working in nursing homes renews my resolve to convince long-term care providers that they are ignoring a valuable and viable resource by not cultivating what I call “super” volunteers. I explain this in detail in my book “Creating the Volun-Cheer Force.”
For this article, I wanted to find out what volunteers around the world are doing during this crisis. Searching the internet and social media, it did not take long to discover that volunteers around the globe are providing remarkable, innovative, and critical support to a variety of service providers and individuals while in some cases even exposing themselves to the risk of contracting the Coronavirus.
One of my “go-to” sources is Twitter, as it is a near-real-time continuous conversation with people reporting on events from around the globe. Searching on the word “volunteers” was eye-opening as “tweet” after “tweet” expressed heartfelt gratitude for volunteers who are delivering meals, medicine, prescriptions, and other supplies to shut-ins, and to those who are too ill to leave home. Volunteers are making personal protective equipment (PPE) and even wearing PPE while being trained to provide nonmedical supports to hospital staff and patients.
At the writing of this article, most of the tweets about volunteers were coming from the United Kingdom. When it became apparent that the Coronavirus was going only to escalate, The Royal Voluntary Service working with the National Health Service (NHS) called for volunteers across the U.K. More than 750,000 people responded, the biggest response since World War II. (Johnstone, 2020)
Catherine Johnstone, CBE, Chief Executive of Royal Voluntary Service, reports that “600,000 NHS Volunteer Responders are now ‘on duty’”
Stacey Dooley, journalist and filmmaker in her documentary “Lockdown heroes: Lying on a bed fighting for your life,” interviewed some of the people who decided that it was more important to help others than to avoid contact with others. What she is capturing is the soul of the human spirit that wants to pursue something meaningful and, in this case, often lifesaving.
The volunteers in the U.K. are doing everything imaginable from working in hospitals and care homes to providing meals to the homeless to going shopping for people who cannot get out because they are caring for loved ones at home.
Who are these people?
Some include trained medical providers others are professionals such as analysts, teachers, travel agents, among others, all doing what they can to provide support.
A calculations analyst makes hundreds of sandwiches in his kitchen, which he then distributes to the homeless while a financial regulator volunteers at a hospital, who admits at first, he was scared but now provides companionship and comfort to the patients. He shares that he has been combing one woman’s hair. He observes that “…when you are fighting for your life, care and compassion are what’s important.”
“…when you are fighting for your life, care and compassion are what’s important.”
A teacher and her friend, who is a travel agent, are making PPE scrubs for frontline workers. They report that they are working 60-hour weeks and have made thousands of scrubs and hats. They now have enlisted the help of 120 seamstresses!
One of the more remarkable stories is the South West Blood Bikes. These volunteers ride bright yellow motorcycles with the word “Blood” painted in large red letters on the bike’s front panel. They transport blood samples between hospitals, hospice providers, care homes, and now during the pandemic, pick up and deliver prescriptions to people who are not able to get to the pharmacy, along with a variety of other urgently needed supplies (SWBB.org.uk).
And, of course, there are volunteers around the globe from Canada to Dubai delivering meals.
Artem, a student at Moscow State University, delivered 100 bottles of antiseptic to the people of Krasnoznamensk among them veterans, elderly and families (Volunteers of Krasnoznamensk)
In Vancouver BC, the Coal Harbour Community Policing Centre (http://wechcpc.com/wechcpc/) recruits and trains volunteers to provide support to the Vancouver Police Department now patrolling neighborhoods dawned in “…gloves, washable masks, eye protection, [and] personal vests.”
Just as in the U.K. and elsewhere, it’s not hard to find volunteers doing remarkable things here in the United States, starting with Dan Owarzani…
a retired postal worker and veteran, now making deliveries for the Castle Garden Center, added four bags of groceries and some pre-made meals to a customer’s flower order. During her initial call to order flowers, she mentioned that she had not been out of her house in weeks. That’s when Dan took his cue. When asked why he did this, his response reveals a simple truth we all should embrace, “I would want someone to do the same for me.” (PowerOf.org)
Social media rings with stories like these. People are delivering groceries, providing virtual concerts, virtual birthday parties, happy hours, companionship, providing food and shelter, making PPE, teaching, and mentoring students.
May 8 marked the World Red Cross and Red Crescent Day, founded in 1828 by Jean Henri Dunant
Today, nearly 12 million volunteers and 450, 000 staff are serving about 160 million people. The volunteers are responding to emergencies to include earthquakes, conflicts, migration crises, and health epidemics.
I’ll stop here as I have now well exceeded the recommended 1000-word limit for blogs. Suffice it to say; volunteers are providing valuable and critical support to millions of people around the globe. It’s amazing to see how people from all walks of life, cultures, and traditions are working together to survive this horrible event.
If properly trained, what could volunteers be doing for the people living and working in nursing homes?
In the field of aging and, in particular, in long-term care communities, we need to get serious about training a cadre of “super” volunteers who will take on critical responsibilities that will provide valuable and meaningful support to paid staff who are operating at or beyond the brink of exhaustion. Just like the financial regulator who rolled up his sleeves to help, dawning PPE, then walks into a hospital to visit with patients and even in some cases comb patient’s hair. Hence, our cities and towns are home to many similar such people who, given the opportunity and training, are ready and willing to roll up their sleeves too.
Later, this year, via the Aging in America (AiA2020) Virtual Conference, I, along with colleagues, will be presenting research that offers empirical evidence that personalized volunteer activities and the use of psychotropic drugs and other quality measures are correlated. I’ll write more about this in an upcoming article. In the meantime, I will continue to speak out for nurturing strong, well-managed volunteer workforces!
The National Volunteer Care Corps is a great beginning!
I think that this is an excellent beginning. I think the stats in the article are a bit understated, however. By 2046 the first of Millennials will begin turning 65 just as the first of the Boomers begin turning 85. This means that by 2050 the numbers of older adults in the U.S. will be approaching 100 million. In other words, we are just at the foot of the Mt Everest.
Every possible resource will be needed to support an ever-aging population. Now is time to start exploring and exploiting every possible resource to include what I call “super” volunteers, i.e., highly committed, self-starters looking for ways to give back to their community. I’ve been training volunteers at this level for about 25 years.
The time for creating a sustainable volunteer force is now!
Without a doubt creating a sustainable volunteer force is hard work and requires expert leadership. Yes, recruiting is tough but setting the bar low only leads to failure. Set the bar high and you will find people that can jump that high. Yes, there will be a fair amount of attrition right up front, but the people that make it through the vetting and training process do not quit. I know this from experience.
Shifting the mentality about volunteers in the U.S. will not be easy but it is necessary if we are to have even a fighting chance for addressing the needs of 100 million older adults.
And to finish, how many people started in long-term care support services as volunteers? I haven’t found any research exploring this question but after 25 years, my guess would be a majority of them. I’m one of them. So, in addition to meeting the needs of older adults wherever they may be living, volunteer programs become a great recruiting tool as well.
As for the “nay-sayers,” my attitude is that there is always going to be that cohort of negative people telling us it can’t be done. I know, they told me that for 25 years. I recruited and trained over 700 volunteers for nursing homes in the meanwhile.
Your comments are welcome…
I welcome your comments and I would encourage you to read my book, “Creating a Volun-Cheer Force” If you’re looking for a keynote speaker or workshop presentation addressing volunteering, working with older adults or the aging well, please contact me.
While researching this article, I came across the blog “The Voice of Volunteering,” launched at the European Association for Palliative Care (EAPC) 15th World Congress in Madrid in May 2017. Moreover, while their focus is on volunteerism in the hospice and palliative care settings, in my opinion, it is more than relevant to the world of long-term care support systems (LTSS) in the United States. The EAPC Madrid Charter has three key aims:
Promote the successful development of volunteering for the benefit of patients, families, and the wider hospice and palliative care community.
Recognize volunteering as a third resource alongside professional care and family care, with its own identity, position and value.
Promote research and best practice models in the recruitment, management, support, integration, training, and resourcing of volunteers.
For this article, I would like to focus on:
“Recognizing volunteering as a third resource alongside professional care and family care, with its own identity, position, and value.”
While there is ample anecdotal evidence that supports the expansion of volunteer programs in long-term care, good stories are not enough to turn the heads of owners and operators. What is sorely needed is quantitative evidence that shows that volunteer programs managed by a person trained in volunteer management is achievable, justifiable and efficacious in meeting the psycho-social needs of the people living in long-term care communities (Candy, 2015).
With that said, most recently, I, along with colleagues, with a grant from the University of Nebraska at Omaha, College of Public Affairs and Community Service (CPACS) completed a study of 52 nursing home volunteer programs.
The study revealed that nursing homes that promoted volunteers engaging residents in personalized, individualized activities such as grooming, and meal assistance, for example, were also reporting fewer urinary tract infections (UTI’s) and less use of psychotropic drugs.
While this was a small study, it is a step towards providing hard numbers to the impact volunteers can have on outcomes. I am pursuing similar studies.
When we talk about volunteers as a resource with their own identity, what are the ingredients of their identity? For starters, the volunteers are there because they want to be there. They have come to the nursing home without expecting remuneration for their presence or the work they perform.
Volunteers have come of their free-will ready to serve in some capacity that they may prefer or are offered by the professional staff. They bring skills, work experiences, life experiences, and most importantly, a willingness to be open to the people they serve.
Volunteers are confidants. There is evidence that the people in nursing homes are more likely to confide in a volunteer with whom they have nurtured a relationship (Claxton-Oldfield, 2015).
These relationships take time to develop, and that is precisely the commodity that volunteers bring with them to the nursing home where they offer their gift of time freely to the people they engage. The volunteer’s relationship with the residents is different from that of the professional staff in that the volunteer is relating to the person not as a “professional” but as an “everyday” someone “grounded in the everyday interpersonal experiences of nonprofessionals” (Brazil & Thomas, 1995, p. 42).
Volunteers are compassionate and caring people, esteeming those that they encounter.
They are people that can and desire to learn new skills. They are looking for “meaningful” ways to engage the residents. Volunteers, well-screened, and trained beyond the initial orientation play a critical role in providing “independent” emotional support (Candy, 2015). The residents, because of this vital support, feel more in control and experience positive emotional well-being. The resident enjoys not only improved psycho-social health but physical health as well (Horey et al., 2015).
Claxton-Oldfield (2011) and his wife, visiting three different hospice providers discovered volunteer programs that offered as many as twenty volunteer positions, to include: administrative duties, bereavement counseling, drivers, gardeners, receptionists, support group facilitators, kitchen support and tour guides to name just a few. While this is in the environment of a hospice, I believe that all these positions and more are transferable to the nursing home environment.
Volunteers are in a position to
learn from the staff and to provide valuable, and much needed support for the
successful operation of a nursing home. Families report that they appreciate
having someone to talk with other than the “staff.”
‘And I think, for [my husband],
the fact of having somebody from outside, not just staff, is important. I think
the staff that deal with you all the time, there is some humiliation in your
situation that staff has to deal with at another level, his physical needs, so
this is strictly someone to talk and be a friendly face, a kind face.” (Weeks et al., 2008)
Also, volunteers may act as a mediator when relationships are strained. Alternatively, the volunteer offers comfort to the family, knowing that a well trained and qualified “friend” is with their loved-one when they cannot be there themselves (Claxton-Oldfield, 2015).
In my opinion, a well-run nursing home includes a fully integrated team made up of professional staff, families, and volunteers, each with their own identity, position and value.
How do you measure and calculate the value of a volunteer’s impact on the professional staff, the families of your residents, the residents under your care, the community in which you live and operate? What is the return on your investment?
The brand of volunteer program that I promote requires serious investment and not just monetary. It requires a sincere commitment on the part of leadership to create a culture that embraces the volunteer, elevates the volunteer manager as equal and indispensable position working with leadership to discover and address the individual needs of the residents,
“…to ensure that residents of nursing homes receive quality care that will result in their achieving or maintaining their highest practicable physical, mental, and psycho-social well-being.”
The starting point is pulling your staff together and developing a philosophy statement concerning volunteers and moving on to engage the staff in outlining areas where volunteers could be trained to provide support, not to replace paid staff but to compliment them.
With a well-supported and robust volunteer program starting with leadership, I contend that the return on your investment will show up in your higher star rating due to less use of drugs, fewer falls, fewer UTI’s for starters.
The return on your investment will show up in better retention rates as staff will feel valued and supported not only from within your organization but from the community in which you operate. Your volunteers become an ambassador to the community.
They become recruiters not only for your volunteer program but for new workers. I know this personally, I started as a volunteer. How many of you started as a volunteer?
While it is not easy converting to dollars, the value of a smile, a warm hug, an agitated resident, now calmed not with drugs but with personalized attention, a staff person weary but pressing-on feeling like they have real and valuable support, and a community that embraces you and understands the challenges you face, it can be done, and there are nursing homes doing this.
Their impact reports reflect both the intrinsic and extrinsic value of the volunteer force, and they are remarkable!
Professional staff, families and yes, volunteers, each with their identity, position and value, all coming together to form a cohesive team for people who need professional help, the hug of a loved one, and the listening ear of a volunteer.
I would love to have the opportunity to speak to your group or lead a workshop where I can share in detail how this can happen for your long-term care community. Feel free to contact me at firstname.lastname@example.org for details.
Brazil K, & Thomas D. (1995)
The role of volunteers in a hospital-based palliative care service. J
Palliat Care, 11(3) 40-42.
Candy, B., France, R., Low,
J., & Sampson, L. (2015). Does involving volunteers in the provision of
palliative care make a difference to patient and family wellbeing? A systematic
review of quantitative and qualitative evidence. International Journal of
Nursing Studies, 52(3), 756–768.
Claxton-Oldfield, S. (2015).
Got volunteers? The selection, training, roles, and impact of hospice
palliative care volunteers in Canada’s community-based volunteer programs. Home
Health Care Management and Practice, 27(1), 36–40. https://doi.org/10.1177/1084822314535089
Help the Hospices, (2012).
Volunteers: vital to the future of hospice care. A working paper of the
Commission into the future of Hospice Care. http://www.helpthehospices.org.uk/our-services/commission/resources/?cord=DESC
Horey, D., Street, A. F.,
O’Connor, M., Peters, L., & Lee, S. F. (2015). Training and supportive
programs for palliative care volunteers in community settings. Cochrane
Mackay, M., Bluck, S. (2010) Meaning-making
in memories: a comparison of memories of death-related and low point life experiences.
Death Studies 2010;34(8):715–37.
Weeks, L.E., MacQuarrie, C.,
Bryanton, O., (2008). Hospice palliative care volunteers: a unique care link.
J. Palliat. Care 24, 85–93.
Association for Palliative Care (September 19, 2018). “The voice of volunteering
– supporting and learning from the EAPC Madrid charter on volunteering in
hospice and palliative care.” Retrieved from: https://eapcnet.wordpress.com/2018/09/19/the-voice-of-volunteering-supporting-and-learning-from-the-eapc-madrid-charter-on-volunteering-in-hospice-and-palliative-care/
July 10, 2019
Not surprisingly, one of the first objections I get for promoting and creating robust volunteer programs for long-term care communities is that it appears that I’m supporting the use of free labor. Nothing could be further from my mind! For sure, there are a lot of regulations and laws governing the use of volunteers but that should not deter you from creating and taking full advantage of a strong volunteer force.
For this reason, I’ve made it my mission to identify and highlight nursing home volunteer programs that have successfully created positive and sustaining partnerships between nursing home paid staff and volunteers. In these programs, paid staff and volunteers complement one another rather than compete with each other. The professional staff view and embrace their volunteers as an indispensable component for providing great and personalized care. Rather than seeing the volunteers as free labor to be exploited, the staff welcomes them as their working partners. The volunteer is an integral part of the care team and thus rejecting that “us and them” culture.
Like any great program, great volunteer programs do not happen overnight. Successful volunteer programs like those that I’ve written about or witnessed first-hand require a careful, sober, well-thought-out, intentional effort guided by professional volunteer managers. The process of creating and sustaining a successful volunteer program involves everyone in the life of the nursing home beginning with the management team, the medical staff, the housekeepers, the dietitians, the social workers, and life enrichment coordinators to name a few.
Working with the Department of Labor, unions if they are involved, and other regulatory bodies such as Health and Human Services, in the development of your volunteer program, and the volunteer job descriptions will ensure that duties assigned to the volunteers are not in violation of labor laws and do not give the appearance of replacing staff with free labor. In talking with the Baycrest Health, Director of Volunteers, Janis Sternhill at Baycrest Health in Toronto, during my visit, she said that in 30 years of their volunteer program history, there might have been two or three times when their labor union objected to a job description, but working together they were able to resolve those issues.
After 25 years of recruiting and training volunteers for nursing homes and witnessing first-hand the impact of outstanding and well-managed nursing home volunteer programs, I am confident in my claim that nursing homeowner/operators would do well to make serious investments in their volunteer programs. Current research shows that when you can discover and address the underlying individual needs and desires of the people under your care, you will likely be providing not only quality care but you will be maximizing their quality of life as well, and that means improving customer satisfaction and positive outcomes for them and for your professional staff.
A “listening ear”
Certainly, there is no doubt that the professional staff must be trained to garner to have this deeper level of insight into their resident’s lives and what matters to them. However, the reality is that time may not be on their side. Recently, while visiting someone in a nursing home, the hallway outside the person’s room I was visiting, was chaotic as call lights were going off, and aides were running about trying to meet everyone’s needs. Discovering underlying needs is one area where volunteers can be very effective. They can be trained to befriend and learn what matters to the person they are visiting. They, the volunteer become the “listening ear,” learning and then if appropriate and respecting confidentiality, relaying what they have learned to the professional staff.
Beyond being present for your people, staff in the exemplary programs were surveyed as to what help a volunteer could be trained to provide, again without violating labor laws and or giving the appearance of exploiting people as free labor. From the programs that I have had the privilege of studying, the director of volunteers give the new volunteer a general orientation and training. The volunteer is then asked as to what department or area of the nursing home they would like to be involved. With that knowledge, the volunteer manager then works with the staff in that area to discover what their needs are and how the volunteer may complement their effort.
Finally, the volunteer program is not about free labor, it’s about providing community support, for an often overwhelmed care staff. The volunteer program is about exposing people from the community-at-large to the long-term care community and like me, and many other people for that matter, going on to become more deeply involved. Lastly, the volunteer program broadcasts the message, “We care. We care enough to go the extra mile to make sure that the people in our care have the very best and that includes great volunteers who have the ‘luxury of time’ to give to your loved ones.”
Let me help you!
If you would like to learn more about how I can help you create or enhance your nursing home volunteer program, please contact me. I would love the opportunity to help you.
I am thrilled to announce that “Volunteering in Long-Term Communities” volunteer training is now available online!
Over the years, I’ve had the extreme pleasure of training hundreds of volunteers in person, but what always lingered in the back of my mind was the question of reaching a wider audience. There are some 15,000 nursing homes in the United States, and many of them cannot afford to hire a dedicated volunteer manager, and if they do have a volunteer manager, it is likely someone splitting their time between activities and managing the volunteers. As a result, training the volunteers may be limited by time and availability of the “trainer.”
My volunteer management experience taught me early on that managing volunteers is not a part-time job. It requires the volunteer manager to not only work hard to recruit volunteers, but it also includes providing meaningful training so that the volunteer feels prepared and is useful in their role.
Volunteers want training…
Volunteer training does not or should not stop after the initial orientation so providing ongoing training is essential for the volunteer to grow in their position. Research shows that volunteers want ongoing training. And finally, the volunteer manager must work to stabilize the volunteer force by putting processes in place that promote volunteer retention.
While I cannot solve the challenges of funding and time, I can develop volunteer training programs specifically designed for people volunteering in nursing homes and make them accessible to everyone and in their own time. This makes the online training platform extremely valuable to volunteer managers and well as the volunteers.
From my experience in instructional design and teaching online gerontology courses, I have learned what people are looking for in an online course. Those same principles come into play as I design courses for the long-term care volunteer. The training should be “lean and deep,” meaning that the training material is presented in clear and understandable language using various learning styles and that it should be interactive to keep the “trainee” engaged and moving forward.
In this new course, there are eight modules. The first module opens by giving context to the volunteer experience presenting the changes that are taking place in our population, i.e., that the number of people 65 years of age and older is exploding. I want the volunteer to understand the magnitude of the need and statistics associated with the people they will be meeting.
However, I’m careful not to paint a “doom and gloom” picture as some do. Instead, volunteering is an opportunity for the community to become more deeply involved in the life of the nursing home to not only enhance “person-centered” care but to learn first-hand about career opportunities.
From there, the next module deals with ageism and the negative stereotypes that influence the way we view aging and older adults. For me, this is an exciting topic because by the end of this module the volunteer realizes that living in the nursing home is far more than just a “waiting to die” station but instead there is the opportunity for learning and personal growth.
The remaining modules present the various functions of a nursing home and levels of care, communications both verbal and non-verbal and of course, HIPAA, Resident Rights and most important what “person-centered” care really means and how the volunteer can support staff in the delivery of that level of care.
If you oversee the volunteer program at your nursing home then, please consider taking advantage of this online training by encouraging your current volunteers and new volunteers to take this course. Doing so will give them in-depth insight into the aging process and offer them new ideas for creating personalized activities for the people living in your community.
If you are someone that has been thinking about volunteering in a nursing home, this course will give you a solid foundation from which you can rely on and grow in during your volunteer experience.
There is nothing more damaging to a volunteer program than to launch people into a volunteer experience unprepared. More often than not, the volunteers become discouraged and likely do not return while you end up with a “revolving door” volunteer program.
Volunteers, adequately trained, stay on the job adding real value to your long-term care community. However, they need critical insight and tools for that to happen. The learning platform I’m using is user-friendly and is accessible either on your computer or mobile device. The modules are easy to navigate and follow a logical progression, building on upon the other.
Please share this article with the people you know that would appreciate having this resource available to them. If you have questions about the training, feel free to contact me and I would be glad to talk to you.
When you think about a volunteer what comes to your mind?
I see someone who is engaged, aware of his or her community needs and committed to helping others. Not remaining mere spectators, they step up to the plate to contribute their time, skills, and their knowledge to meet those needs.
They have the ability to lend a helping hand without any expectation of payment for their efforts but they will likely walk away from the experience with a deep sense of personal satisfaction of having helped someone.
However, what about the volunteers in a nursing home do they really add anything to the environment or are they just “…another thing to manage?”
Anne Gross wrote one of the earliest articles I could find concerning the value of volunteers. At the time, she wrote the article “Why Nursing Homes Need Volunteers” in 1961, she was the director of volunteer services at Mt. Zion Hospital and Medical Center in San Francisco.
At the hospital she observed that the obligation of the facility goes beyond just providing shelter, and medical care and extended to providing for the emotional support of the “involuntary patient” (Gross, 1961).
According to Gross, the volunteer can offer something that the care staff cannot offer, i.e., the “luxury of time.”
Daily activities of living such as deciding for oneself what to wear each day and getting dressed can be transformed into a hectic impersonal routine (Claxton-Oldfield, Gosselin, & Claxton-Oldfield, 2009) when performed by care staff who may be responsible for picking out clothes and dressing several dozen people each morning.
Conversely, the volunteer has the “time” to talk with the person, asking what they would like to wear, picking out the clothes and then getting dressed. The nursing home resident’s sense of control is restored and now they have the opportunity to express their personal tastes, likes and dislikes. This “luxury of time” extends to many aspects of the resident’s daily life in the nursing home.
Volunteer groups such as the “Silver Spoons” (Musson, Frye, & Nash, 1997) showed that volunteers could be trained to feed residents. For the nursing aide mealtime can mean sitting in the middle of a circular table surrounded by residents that need help with eating.
The experience becomes a mechanical effort for everyone involved in getting the chore completed as quickly as possible in contrast to a volunteer who transforms the chore into a leisurely meal filled with conversation.
These are only two of many examples I could give showing how a volunteer can contribute to the nursing home environment. However, does the staff recognize the value of a volunteer?
I bring this up because volunteers that have not been trained or have received little training may not be a help to the staff but rather may create more work for the staff. When this happens the staff become resistant to the presence of volunteers seeing them as “one more thing to manage” (Berta, Laporte, & Kachan, 2010).
Volunteers want training; they enjoy the sense of mastery, i.e., believing they have the skills to provide real help. The difficulty is of course is that far too often volunteers receive little or no training. Because of this, staff is likely to have a dim view of the volunteer.
With increasing demands on the long-term care community and their staff, volunteers can play a key role in providing real and valuable help, if they receive quality training.
In addition, staff needs training to recognize the value of the volunteer realizing that the volunteer can complement the care staff by offering “personalized” help in many of the non-medical tasks.
This level of training needs to be emphasized in the long-term care community. In the end, the nursing home becomes more than just shelter and food; it becomes a place where volunteers working along side professional care staff provide for the needs of the whole person.
I welcome your thoughts on this topic.
Berta, W., Laporte, A., & Kachan, N. (2010). Unpacking the relationship between operational efficiency and quality of care in Ontario long-term care homes. Canadian Journal on Aging, 29(4), 543–556. doi:10.1017/S0714980810000553
Claxton-Oldfield, S., Gosselin, N., & Claxton-Oldfield, J. (2009). Imagine you are dying: would you be interested in having a hospice palliative care volunteer? The American journal of hospice & palliative care, 26(1), 47–51. doi:10.1177/1049909108327026
Gross, A. (1961). Why nursing homes need volunteers. The Modern Hospital, 97(4), 101–103.
Musson, N., Frye, G., & Nash, M. (1997). Silver spoons: Supervised volunteers provide feeding of patients. Geriatric Nursing, 18(1), 18–19.
There just isn’t enough exposure for great nursing home volunteer programs. Most communities have their own newsletters or social media outlets, but where can someone go to learn about programs from a wide variety of communities, all in one place. The answer: “VolunCheerLeader.com”
This blog is created to highlight great programs and I’ve already identified a few of them, but there are many more great programs out there and so I want to hear from you. If you are a director of volunteers for a long-term care community and you think you have a great program, let me know about your program and I’ll feature you right here just as I have others. People in the professions of caring for older adults need to hear about your program. It is my hope that they will be encouraged and inspired to create great programs of their own.
Volunteer programs developed and led by professional volunteer managers are crucial to insuring that the psychological and social needs of the people living in long-term care communities are met. In gerontology, we refer to the bio-pyscho-social model, referring to the physical, mental, and social needs of people.
The Centers for Medicare and Medicaid (CMS) is placing an increasing emphasis on meeting not only the biological (physical) needs of people but also the psycho-social needs of people living in long-term communities. Research is showing that the psycho-social needs going unmet leads to increased physical or medical issues that raising the cost of care.
“Super” volunteers that are recruited, screened and properly trained are in the perfect position to meet those two areas of human need. The “super” volunteer plays a critical role in elevating quality of care and most importantly, quality of life of both the people that live and work in long-term care communities. To date one of the common themes that I hear is:
“At first we were hesitant about allowing volunteers to do more but now we realize we couldn’t do what we are doing without them.”
Let’s make this our meeting place. Come to VolunCheerLeader.com to learn, to comment, to present, and most importantly elevate the role of volunteers for long-term communities.
For the past 25 years, I have been advocating for people to visit the people living in nursing homes. So often nursing home residents do not get visitors which may lead to feelings of loneliness and uselessness.
Over the last seven years I have been advocating for nursing homes to not only expand their volunteer programs but to expand the role of the volunteer in their nursing homes.
With the workforce shortage only growing more acute for the foreseeable future, I believe we need to develop and utilize every resource available to ensure that the people living in nursing homes are getting quality care and have quality of life.
Last year, I made it my mission to search out exemplar or premier volunteer programs and to highlight them at VolunCheerLeader.com. To-date I have identified several great programs, but now it is my extreme pleasure to report on and highlight, in my opinion, what I think might be the premier nursing home volunteer program boasting some 900 adult volunteers and 300 youth volunteers. However, it is going to be a bit of a chore for me to keep this article to a reasonable length. Advocates for volunteers will enjoy this reading on a remarkable volunteer program.
During March of 2016, I attended the American Society on Aging conference. I met several like-minded people also advocating for expanding the role of nursing home volunteers. During our conversations, I was encouraged by them to contact the director of volunteer services at Baycrest, in Toronto, Canada.
I contacted Syrelle Berstein. My initial conversations with Syrelle revealed that Baycrest has been training and recruiting volunteers to provide friendly visits, staff support, administrative support, and encouraging the volunteers to create and facilitate their own activities. I was anxious to go there and see the program first-hand.
Over the next several months, Syrelle retired and Janis Sternhill, M.Ed., stepped into the directorship. I stayed in touch with Syrelle and asked if she would facilitate my visit. She graciously agreed. During the week of June 11, 2017, Syrelle immersed me in the Baycrest culture of care and the Baycrest volunteer program. Having developed the program, she could highlight the salient aspects of the program.
On my first full day in Toronto, Syrelle picked me up at 10 a.m. at the apartment where I was staying, (I use Airbnb these days). We drove to the Baycrest campus which was just a few minutes away. As we entered the campus, I was immediately struck by the enormity of the operation. We drove by building after building, passed by a huge parking lot, and cruised alongside the Baycrest childcare center and then we reached the assisted living high-rise. We parked and began to walk towards the Apotex and Jewish Home for the Aged. I thought to myself, as Syrelle explained what was happening in each building, that this campus is not only comprised of all levels of care but it includes a research center and ties to the University of Toronto. In my mind, this is the perfect setup.
As we approached the glass doors, of the Apotex they automatically parted to the left and right, welcoming us into the foyer of the building. Syrelle logged in as she is now a volunteer herself. The tracking system keeps record of who is in the building and what they are doing.
For the volunteer coordinator, this is great as she can report on volunteer activity in near real time and collect data on the volunteer program.
Once Syrelle logged in, we turned to go through another set of glass doors. As they opened, what I saw literally took my breath away. Before me the ceiling burst upward into a large open area, an atrium that extended eight stories upward culminating into a magnificently sky lit ceiling. (see Figure 2) I was stunned! It was exhilarating! I looked at Syrelle in amazement and asked, “Is this the nursing home?” “Yes,” she said with a big smile. It took a few minutes for me to take it all in and to collect myself.
She then gently turned me to the left to see the area where residents, with the help of an army of volunteers, were creating various ceramic pieces and paintings (see Figure 3). This is where I met the first in a series of many Baycrest volunteers, each of them wearing the bright yellow “Baycrest – Volunteer” lanyard and identification badge. The finished items were on display in large picture windows, facing the interior of the atrium. They were quite colorful and added to the ambiance of this beautiful area.
Once I had regained the ability to breathe again, we moved on with our tour of the facility. It was unlike anything I had ever seen or even imagined in regards to a long-term care community.
As we walked and were greeted repeatedly by volunteers and staff, it soon became very apparent to me that Baycrest not only embraces the concept of person-centered care but has successfully created a wonderful authentic, relational culture that is felt from staff to resident, from staff to volunteer, from volunteer to volunteer, and from staff to staff. It was truly amazing. (Amazing was a word I found myself repeating numerous times throughout my stay).
Syrelle arranged for me to attend several of the activities that volunteers were facilitating or for which they were providing support. Our first stop was to a morning session led by a speech pathologist who was assisted by several Baycrest volunteers. In this case, the volunteers could encourage the residents to take part in the exercises while providing some level of comfort and trust for the resident. In some cases, residents feel more comfortable responding to volunteer requests more readily than staff.
Moving on, we attended a comedy hour conceived and facilitated by Baycrest volunteer, Murray. In his early years Murray was a stand-up comic traveling throughout the United States bumping shoulders with the likes of Alan King and Billy Crystal. Today, he was showing clips of his favorite comedians and sharing a few of his own jokes as well. The audience loved it. I’m certain that they received a healthy endorphin boost setting the tone for their upcoming lunch. Murray facilitates this activity weekly.
From there we toured the assisted living area and then had lunch with Larry, the Baycrest volunteer I met in the speech pathology session. From the volunteers that I had the opportunity to meet, Larry represents what I believe Baycrest is looking for in their volunteers, i.e., a high level of commitment, a warm and outgoing personality, possessing the skills to create and/or facilitate activities, having an authentic desire to make a difference in someone’s life, understanding the significance of what they are doing for the staff and residents and finally possessing a great sense of humor. There was a lot of smiling and laughing during my time at Baycrest.
I asked Larry how he came to volunteer at Baycrest. He told me that after retiring he wanted to stay engaged and was seeking out volunteer opportunities. After several unsuccessful tries at various agencies, Syrelle invited him to try Baycrest. That was two plus years ago. He admitted that initially his motivation was not altruistic but rather he just wanted something to do, something where he could make a difference.
Since then he has discovered the richness of volunteering and working with older adults. He recounted stories of his experiences and talked about how much he has learned from the people he has come to know. As with many volunteers, I have interviewed about their experience, Larry too, talked about how much he was getting from the experience and how good it made him feel. This is a theme that is repeated over and over, “I feel like I’m getting so much more than I’m giving.”
In meeting with the new director of volunteer services, Janis Sternhill, I was reminded again, how critical a great director of volunteers is to creating, growing, and maintaining a sustainable volunteer program. Janis’ experience and expert knowledge of volunteer management, research and her obvious passion for both the volunteers and the residents were unmistakable.
As Janis and I talked about the role of the volunteer, Janis addressed the fact volunteers have the time to sit with a resident, get to know them, their likes, their dislikes, their fears, and their joys. Volunteers get to know someone well enough to even know if a smile means they are really happy. “And it’s not just about the time, but it’s also about meeting that honest need to listen to people.”
She continues by saying that the staff are relieved knowing that the resident is relaxed when they go into their room. The resident has a good experience of feeling validated, acknowledged, and like a human being.
“We have volunteers that come onto units and staff cheer because they know the residents are going to be happy…and the staff can focus on those needing their attention.”
I asked Janis if they are measuring the impact of the volunteer visit and she said that the Baycrest researchers have finished two studies. The first two studies focused on the overall engagement of the resident, i.e., how often did they smile, how often did they speak, what were they doing before the volunteer came in, what did they do after the volunteer came in, and what activities were they doing.
The researchers also interviewed staff in the same manner, i.e., what was the staff doing before the volunteer arrived, what were they doing during and after the volunteer visit. Feedback from the staff was included as well, i.e., how was your experience with the volunteer, and what did you notice on the unit when the volunteers were present, what happens when the volunteers are not on the unit?
And in like manner, the volunteers were asked, “How do you feel when you come onto the unit?” “Do you feel a difference when you are with a resident?” A third study is in progress to collect data at the individual level.
Janis talked about all the tasks that volunteers are doing and/or assisting with behind the scenes.
“Right now, volunteers are assisting in collecting data for the client experience surveys. Our quality department could not do these surveys without the volunteers. They are highly trained and it is ongoing. They get a list of clients to survey and then conduct surveys to find out the quality of life. If you get a company to come in here, you won’t get the same level of engagement as there is with a volunteer.”
As I mentioned above, this supports current research that reveals residents are likely to be more open with volunteers rather than professional staff.
The Baycrest Learning Institute Speaker Series (BLISS) is a new addition to the volunteer program. Professionals from Ryerson University came in and trained people to be facilitators who in turn trained volunteers to facilitate groups and give presentations. The goal however, is not the presentation, but the engagement of the residents in the presentation. Janis offered two examples. The first is a pianist who plays a musical piece and then elicits discussion about how the music makes them feel and other engaging questions. In similar manner, a volunteer from Morocco tells her personal story of life growing up in Morocco.
“This program was volunteer created, volunteer run, volunteer trained, and staff are thrilled.”
When I asked Janis about liability issues, her response was not surprising. “All of our volunteers are highly trained, and starting in January  they have to complete learning modules the same as staff do.” We went on to discuss having liability insurance and there was no “new” news on this topic. You evaluate the tasks volunteers will be doing, identity possible vulnerabilities and then create policies and training to reduce the chance of a mishap.
We discussed the budget and how she justifies the volunteer budget. I believe that it is an ongoing task. I suggested that one must connect volunteer activity to the bottom-line, showing that operations budgets are positively impacted when residents, staff, and families are happy.
Janis points out that,
“We cannot attract young people into gerontology if we don’t give them an opportunity to be exposed to caring for older adults. Providing volunteer opportunities provides that exposure. In like manner, what about the thousands of people who are retiring and looking for “something to do?”
From there, I brought up the subject of labor unions. Janis said that overall the relationship with the unions has been very good, she said, “They get it.” There were instances where the union leaders wanted some adjustments made to job descriptions or clarification as to what the volunteer job was and that the volunteer was not replacing a paid employee who had just left the organization. The unions want to understand what the volunteers are doing.
“If we want our volunteers to be healthy and strong, our aging population to be healthy and strong, there has to be a strong governmental support to support volunteerism.”
In meeting with the volunteer coordinator, Tehila Tewel, I had the opportunity to discuss their recruiting, onboarding and training process. It was reassuring to me, as the founder of Community 360°, that Baycrest also has a stringent vetting process and training protocol. For those of you that follow my articles, you know that I am not only a strong proponent of filtering for highly committed individuals but also adequately preparing the volunteers for the roles that they will be assuming. As a result, as it should be clear by now, Baycrest volunteers are embraced by care staff as a valuable and necessary asset in providing not only quality care but quality of life.
Tehila indicated that they host orientation/information session twice a month attended by some 50 prospective volunteers at each one. At those orientations, attendees receive information about Baycrest, working with our clients, programs offered to clients, wheelchair training, volunteer roles and responsibilities. They are also encouraged to apply.
For those that do apply, they then complete six modules of online training and other screenings and tests as required by the Ontario Long-Term Care Act.
Screening continues when they come in for their interview with a highly trained volunteer interviewer who will place them in the program that matches their skills and Baycrest’s needs. There are many specialized volunteer programs that have been created which require more hands-on training and education. Some of these are offered on-line and others are in classrooms settings. Most of the on-line courses and specialized training provide certificates upon completion. Volunteers are thrilled have the opportunity to learn from our professionals.
As with Community 360°, the attrition rate is high upfront but low on the back-end. One thing I have learned in this process is that no matter how desperate one may be for volunteers, simply putting warm bodies in place will not result in an effective or sustainable volunteer program. Filtering for and training highly committed volunteers is a more difficult path but one that will produce the kind of volunteer program that is in place at Baycrest.
Without exception, volunteers, wearing the yellow “Baycrest – Volunteer” lanyard could be seen everywhere and not just a few. It was so remarkable and refreshing to see, not only the incredible number of volunteers, but that they were truly making a positive impact on the quality of care and quality of life for the people living at Baycrest as well as the staff of Baycrest.
If you are a director of volunteers or are in the process of establishing a volunteer program in your long-term community, please take a good look at the Baycrest volunteer program.
Note: I could have written so much more about the program. For the sake of space and time, I will reserve my full account of this program for my upcoming book: “The Volun-Cheer-Factor.” Stay tuned!
Perceptions are everything. From my earliest days of military training to the present, I have been taught and now am teaching my own students and volunteers that perceptions powerfully influence the way people think and react. This holds true for nursing homes as well. Recruiting volunteers is challenging particularly when it comes to recruiting volunteers for nursing homes.
Several common questions I am asked by people I approach, “Will I get sick?” or “Are they kinda of senile?” reveals the perceptions people harbor when they think about nursing homes. They might think nursing homes are depressing, that people won’t even know I am there, I will get sick from being around the residents, it’s just a place where people are waiting to die. What people perceive becomes reality for them.
Poor public perception negatively impacts the quality of care as it leads to inadequate staffing and high turnover rates that can reach 100%, (Leadership Council of Aging Organizations, 2007). This means turning staff over every year! Imagine running a business having to hire and train new staff every year!
Volunteers can correct faulty perceptions of nursing homes. The volunteer becomes the bridge between the local nursing home and the community. The volunteer visits the nursing home befriending residents and staff. During their visits they are likely to encounter care staff who are highly committed and passionate about the care they provide and likely to encounter, what I like to call, “a living history book,” that is an older person with a life time of experiences to share.
Afterwards, the volunteer returns to their community sharing with their friends, neighbors, co-workers and others the marvelous stories, expressions of love and caring, and the deep need we all carry for relationships. The volunteer becomes the vehicle to correct the wrong-thinking and negative perceptions. One volunteer observed,
“I went in to dazzle them, but instead they dazzeled me.”
I am always looking for new volunteers, bridge-builders if you will allow me the metaphor. I am passionate about volunteers, recruiting them, training them and then having become a viable part of the care team. Among the many great benefits of the volunteer, is that they will become a positive image builder between your facility and the community.
Please contact meto learn more about volunteer training programs and what I can do to help you enhance your volunteer program.