Volunteers ensure terminally ill don't die alone Medicine Volunteers stay by side of terminally ill who have no one else

Flo Harrison watches the dying patient as she sits with her Monday August 22, 2011. At the Kaiser Permanente Santa Clara hospital, a program called "No One Dies Alone" allows volunteers to sit and comfort the terminally ill. less Flo Harrison watches the dying patient as she sits with her Monday August 22, 2011. At the Kaiser Permanente Santa Clara hospital, a program called "No One Dies Alone" allows volunteers to sit and comfort the ... more Photo: Brant Ward, The Chronicle Photo: Brant Ward, The Chronicle Image 1 of / 9 Caption Close Volunteers ensure terminally ill don't die alone 1 / 9 Back to Gallery

Therese Becker was at work at Kaiser Santa Clara Medical Center when she got word that a woman was dying.

The woman was older - Becker doesn't remember how old - and never married, and her only family was a nephew in Fresno who wouldn't be coming to see her. So Becker sat with her, and she held her hand and talked to her, and for 15 minutes the woman stared blankly at the ceiling.

"And then she rolled her eyes to the right and she looked right at me. And she rolled her eyes back and died," Becker said. "She knew that I was there. She knew she wasn't alone. That will probably stay with me the rest of my life."

Becker is manager of spiritual care services at Kaiser Santa Clara, and last year, she and a volunteer created the No One Dies Alone program at the hospital. The premise is simple: When patients are about to die and have no one to sit with them, volunteers stay by their side.

Sometimes they'll hold a patient's hand, or talk softly or read. Sometimes they'll play music. Sometimes they'll just sit, knowing it's enough to be a quiet presence in the room. Most of the patients who die are unconscious, and it's impossible to say whether they're even aware someone is with them.

"But one of the things we've learned is that hearing is the last to go," said Laura Donnelly, the volunteer who started the program with Becker. "We feel that they can hear us and know that they're not by themselves. That's my hope, anyway."

The program spreads

The No One Dies Alone program started in Eugene, Ore., more than a decade ago, and has slowly spread to other hospitals around the country. The Kaiser Santa Clara program started in March 2010 after Donnelly and Becker heard about a similar program at Stanford Hospital.

In each place, the impetus is the same: someone in the hospital - a nurse, a volunteer, a clergyperson - notices a patient on his deathbed, with no friends or family, alone in the chaos of hospital life.

"If someone is dying, and they want someone to be with them, to hold their hand, that just seems like a good thing to do," said Susan Scott, coordinator of the Stanford program, which began three years ago.

The programs are volunteer-based, although at both Kaiser and Stanford, hospital employees make up a good portion of the volunteers. While there is definitely a spiritual element to the programs, they aren't religion-based.

Volunteers undergo hours of training before they're allowed to be with a patient. They're told what to expect when a person is dying - how his breathing might change, how his hands and feet might grow cold.

And they're taught how to sit quietly and just be a supportive presence. Volunteers aren't there to just sit in a chair and occupy space - they're not supposed to knit or send text messages or read to themselves to pass the time, Becker said. They're focused on the patient.

Flo Harrison cried the first time she sat with a person who died.

"I'm not really sure why," said Harrison, a volunteer with the Kaiser program. "It's actually a very peaceful time for all the people I've been with, whether I was at the actual death or not. I feel so fortunate that we're able to be with these people as they pass into this whole new dimension that we have no idea about."

Attending funerals

More often than not, volunteers know nothing about the patient they are sitting with, and it's become common practice to look up obituaries after the fact - to read about the life they only touched at the very end. Sometimes volunteers will go to the funerals.

Earlier this year, the Kaiser group held a memorial in honor of all of the people they had sat with.

"We had one gentleman who came to the memorial, and he had been beside himself with guilt because he had not been by his wife's bedside when she'd passed away," Donnelly said. "He'd been exhausted, and his children had told him to go home and get some rest, and a volunteer was with her. At the memorial he was able to talk to the volunteer, and that meant a lot to him."

Some patients who die alone have mental illnesses that have left them disconnected from the world for years or decades, or their entire lives. Others have outlived their families and friends. For some, their families live too far away to make it to the hospital in time to be with them when they die.

Deciding what's best

Some patients may be lifelong loners - and volunteers will leave them alone on their deathbed too, if they sense that's what's best.

Volunteers will also sit with patients whose families are too overwhelmed to be there around the clock. That was the case for Troy Mann, who died in Santa Clara last year at age 90. His four children were taking turns sitting with him, but after a week, "we'd gotten to the point where we couldn't do it at night because we were just so tired," said his daughter, Christine Perkins of San Jose.

"It was such a comfort to know there was someone sitting with him," Perkins said. "This is just my take, and it's purely nonmedical, but I really believe that people can sense when there's somebody there that cares, when they're not alone. If somebody's holding their hand or talking quietly to them, I think it gives them a sense of peace."