ESCANABA - Who hasn't read obituaries for individuals in which it states that the individual "died surrounded by loved ones and family?" One can only imagine the comfort it gives, not only to the person who is going through the process of dying, but also to those family members whose primary focus is to make those last moments as comforting as possible.
Unfortunately, for a number of persons, death comes to them without feeling the comforting presence and love of a family member or friend to ease them on their way.
No one should die alone.
This is the premise of the "No One Dies Alone" (NODA) program offered by OSF Home Care Services, a program of volunteers whose mission is giving time and attention to those whose death is eminent.
NODA was founded in November, 2002, by Sandra Clarke, CCRN, at Sacred Heart Medical Center in Eugene, Ore. One night while making the rounds at her hospital an elderly patient asked "can you stay with me?" Knowing that the end was near, she told him, "sure right after I attend to some other patients." After 90 minutes she rushed back to his side only to find that he had passed away, alone. She felt horrible about this poor man who had requested her presence. The lonely death of this elderly patient led Clarke to conceive of a volunteer companion program for patients who would otherwise die alone.
According to Ilene Kotajarvi, volunteer coordinator for OSF Hospice, the NODA program began locally in April 2009 and currently has 10 nursing home and assisted living facilities that utilize NODA volunteers and will be expanding to Dickinson County. Volunteers have currently donated more than 500 hours to the NODA program.
According to Kotajarvi, the focus of Hospice does not involve physical care.
"The Hospice program is palliative rather than curative," Kotajarvi said. "It doesn't offer treatment or cures, but rather comfort and care. It's intended to provide relief for caregivers and companionship for the patient."
Kotajarvi said both Hospice and NODA volunteers are trained in death and dying.
"It is natural to be scared when they first go into it," said Kotajarvi. "Basically we tell them to feel free to hold their (patient) hand and talk with them if they wish. Sometimes just sitting there is all that's needed, especially when the patient is no longer communicating."
Kotajarvi said a number of volunteers pray, read the Bible for the patient or say the Rosary. "They should follow the patient's lead," she said. "If the patient is opposed to any of those things, then they won't do it."
Caring for patients who have no local family members is the primary reason why health care establishments value the NODA program. When death of a patient becomes imminent, health care workers discuss with family members to see if they approve of a NODA volunteer being made available. Volunteers generally work in two to three-hour shifts.
"When we begin to notice that death appears near, I call Ilene and ask for volunteers to be set up," said Marci Stemick, director of nursing for Christian Park Health Care. Several volunteers may be requested for an individual to fill the need.
"We try to set them up at different times," she said. "Some can only sit an hour and others can sit as long as four or five. We try to do what's best for the patient. I feel it's important for dying members to have somebody at their bedside when the time comes. Just having someone there to talk to them, play music for them or just sit by their bedside is very comforting."
Mary Jo Valentine, social worker for Christian Park Village, said even when family members are available, NODA volunteers can still play a part in assisting the dying patient.
"Let's face it. Even residents with families can't have them by their bedside around the clock," she said. "The family has to go home to take a shower or to eat. They just might need a break."
An article they read in the Daily Press prompted Phil Norman and Judy Djerf to volunteer for the NODA program.
Norman of Bark River has been a NODA volunteer for the past two years and said he feels it's a privilege to be able to offer comfort to the individuals that he serves.
"It's all about being with people and caring for people in times of stress," he said. "It's giving them some relief. Somehow it didn't seem right not to have someone available. Partly because when my parents passed away, I was blessed enough to be there when my mom passed and I was able to talk with my dad two days before he died. It was a wonderful conversation."
Norman said all the patients he has worked with thus far have been in area nursing homes. While the majority of them are comatose or otherwise unaware of their surroundings, he feels it's important to be there nevertheless.
"I feel we're brought together for a reason," he said. "Sometimes I look around and see something religious in the room. I usually bring a Bible with me and when I pray with them, I whisper to them, hoping they can hear me. I talk to them and pray over them and read the Bible to them and while I'm talking, I can see their eyes flicker. Other times I just sit and and hold their hand or keep my hand on their arm."
There have been times when Norman had the opportunity to speak with a patient's family member, particularly those who live out of the area and are unable to remain with their loved one for any length of time and offer them encouragement as well.
"I know the nurses appreciate that we're there," Norman said. "They are there to care for their patients and have love for them, but, let's face it, they can't be with them all the time. We're there to fill the void. Sometimes while I'm there, one of them will peek in. You can tell they really care for their patients."
Djerf, who is a retired X-ray technician and has a degree in accounting, said she felt a NODA volunteer would be a benefit to her own family if the need arose.
"If a member of my family was in that situation and I couldn't be there for them, I think it's important that someone is there with them," she said. "For the most part, shortly before a patient dies, they sleep a lot, but it's still important for someone to be there."
The volunteer said NODA volunteers are generally called in if the patient is considered to be actively dying.
"I generally just talk to them. Sometimes I read from the Bible. But usually I just touch them, hold their hand, play music and just try to make them as comfortable as possible. This kind of assistance is particularly important if there is no family living in the area or else they cannot be there for one reason or another. If we're called, we usually can be there and we all try to go."
Families of the patients generally appreciate the assistance provided by NODA volunteers, Djerf said.
"Having worked in a hospital setting, I know the nurses and staff do everything they can to help the patient, but it's impossible for them to stay with one patient for an extended period of time when there are other patients to care for," she said. "Everything we (NODA volunteers) do to help the patient and the family is so appreciated. It's very comforting to the family that someone be there when they can't. Even the nurses are thankful as well. If there's a need that we can't take care of, we just call or use the call light and they come right away."
Djerf said coping with death is a part of life - albeit a difficult part.
"It's hard sometimes but that's part of the process," she said. "You go into this knowing what you're there for."
