Teen volunteers help bridge generation gap

Patients just love them’

Anyone with doubts about the commitment of today’s teen-agers need look only to the state of Florida. There, more than 200 teenage hospice volunteers are shattering any negative images of their generation by providing direct hospice patient care in homes, nursing homes, inpatient hospice, and assisted living facilities.

These teen-agers are doing volunteer work that would challenge many adults, such as providing visitation and interacting with terminally ill elderly patients.

It all started in 1994 when officials with Hospice of the Florida Suncoast in Largo stumbled upon a local organization that was handing out community grants for intergenerational programs that stressed interaction between youth and elderly residents.

"We thought, Let’s just give it a try on a small scale,’" says Kathy Roble, MS, director of volunteer services for Hospice of the Florida Suncoast. "Of course, some of us were skeptical. Why would a young person choose to be here with the dying when there could be other fun things to do? We soon found out that some young people were eager to do it."

In 1994, the hospice staff recruited 20 teen-agers, put them through the same training as adult volunteers, and assigned them patients in the hospice’s 67-bed residential facility. Today, the hospice has partnerships with most area high schools where their volunteers come from and have expanded their program to include home visits.

Using teen-agers can be tricky, but the rewards extend beyond patient care, says Roble. "Teens learn about life," she says. "They are amazed at who these people are and were. They learn that every day is a gift."

They also become advocates of hospice. While not a goal of the program, an obvious by-product of the teens’ volunteer experience has been their loyalty to the hospice movement. In a very real sense, the Hospice of the Florida Suncoast’s teen volunteer program is raising a generation that isn’t afraid to confront death, unlike the death-denying culture that hamstrings hospice’s efforts today.

Mary Lee Warren, executive director of Judith Karman Hospice in Stillwater, OK, agrees that teen-agers can be a valuable resource. "When you get the right ones, they are like candy bars in the freezer," she says. "Patients just love them. They love talking with them."

But using teen-agers comes with challenges, says Warren, an expert in volunteerism. Teen-agers require training and supervision, and their emotional needs must be monitored closely in light of their close proximity to dying patients.

Eight years ago, the hospice had significant questions about just how to operate a volunteer program made up of high school students with varying degrees of maturity, limited exposure to death, and little life experience to draw upon, not to mention practical barriers, such as the need for transportation, structure, and supervision. During the initial pilot, hospice staff transported students to and from the hospice as a part of their school curriculum, allowing students to remain involved. But after the completion of the pilot, the teen volunteer program lost students because of the distance from their homes.

In order to address these concerns, the hospice established an advisory committee made up of key stakeholders: hospice staff, school officials, nursing home staff, parents, and students themselves.

The advisory committee determined that the structure and support needed by the young volunteers could be provided by assigning them patients living in nursing homes. This fit well, because volunteers can visit with their assigned hospice patient while being supervised by the nursing homes’ activities directors. An activities director is also able guide the teen to some other constructive activity if the hospice patient is asleep or indisposed at the time of the visit.

Hospice staff recognized that teen volunteers were more confident when in a group of their peers. So, they allowed students to volunteer in pairs. Student volunteers meeting patients for the first time showed up as a team. Over time, each volunteer’s confidence grew along with his or her familiarity with the patient, which resulted in more one-on-one visits.

For some teen volunteers, grief is a new emotion, and many lack the coping skills to handle it. And for those who have experienced loss in their young lives, unresolved grief can surface as a result of caring for a patient who dies.

To handle grief among volunteers, hospice officials turned to a separate program within the Hospice of the Florida Suncoast, the Child and Family Support Program (CFSP). CFSP offers grief and bereavement services through counselors who work specifically with children, hospice families, and non-hospice members in the community who have experienced the death of a loved one.

In addition, every school in the county is matched with one of these hospice counselors in the event of a crisis to help school children who have some affiliation with a person who has suddenly died, regardless of whether the cause is homicide, suicide, accidental death, or illness.

Counselors are invited to the Hospice Teen Council meetings and are available to teen volunteers at their schools. Knowing that students grow close to the patients they are caring for, counselors contact students when their patient has died. In addition, parents are contacted. The social worker/counselor is made available to those students to talk either by phone, at school, or at home.

The hospice also recognizes that students may not feel comfortable expressing their feelings to a stranger, and volunteers are encouraged to share their feelings with their parents. Because of this, parents are required to sign a confidentiality agreement that requires them not to discuss patients cared for by their children, but allows their children to discuss a patient with them.

In the end, says Roble, the teen-agers who give of their time get a lot more in return. For many of the teens that have come through Hospice of the Florida Suncoast’s volunteer program, the desire to serve the dying is hard to let go. Some go away to college and volunteer at a local hospice, while others say it affected how they look at death.

"They leave having learned that every day is a gift," Roble says.