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.Claxton-Oldfield, 2015
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. https://doi.org/10.1016/j.ijnurstu.2014.08.007
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 (accessed 20.01.14).
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 Database of
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.
European 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