Tamiko Scian’s fears evaporated the moment she entered the evening-dimmed hospital room and saw the elderly man lying still on the bed, breathing quietly. “He looked at ease,” recalls Scian. “I walked in and whispered in his ear. I identified myself and told him I would be with him for a few hours.”
Scian, a human resources specialist at Suburban Hospital, had been nervous about signing up for the hospital’s No One Dies Alone program because she lacked clinical experience. But she volunteered anyway, moved to action by the holiday spirit of giving and because she missed her own recently departed grandparents. As the man edged toward death, Scian held his hand, read Bible passages, played classical music on an iPod and sang “This Little Light of Mine.”
Though the man did not speak, Scian felt a deep connection with him, and she says she was honored to witness and ease his final moments. “I could feel his spirit in the room,” she says.
Scian is one of 29 Suburban employees volunteering with No One Dies Alone since it began in February 2013. Of the current volunteers, 19 work in food services, information technology and other nonclinical jobs, says Pamela Fogan, director of volunteer services. Fogan is still seeking more volunteers.
The program is as simple and meaningful as it sounds, providing quiet support to patients who would otherwise die without a companion or witness.
About one patient per month meets the criteria of being close to death, without support of family or friends, and receiving only comfort care. When an eligible patient is expected to die in 24 to 72 hours, a group email goes out, inviting volunteers to sign up for two-hour or four-hour shifts.
“You don’t come into this world by yourself,” says volunteer Patricia Gabriel, a nurse educator. “And you shouldn’t leave by yourself.”
Remorse and Inspiration
The seeds for No One Dies Alone were planted on the other side of the nation, where a dying patient asked Sandra Clarke, a nurse at Sacred Heart Medical Center in Eugene, Oregon, to sit with him. She tended to her other patients first, and the man passed away before she returned to his side. Her remorse inspired her to create the program in 2001. The concept has since been embraced by hospitals nationwide.
Customization is encouraged to fit the needs of each hospital. Suburban’s team rewrote Clarke’s orientation materials and created supply bags for volunteers to use, containing battery-operated candles, an iPod loaded with classical and gospel music, a printed labyrinth that volunteers can trace with their fingers for prayers, books about death and different religions, and a journal for jotting down thoughts as they sit with a dying patient.
Suburban is the only hospital within the Johns Hopkins Health System with the program so far, says Rev. Barbara McKenzie, a chaplain at Suburban, though all the hospitals have pastoral care departments that provide spiritual support to people coping with illness, trauma or grief.
During a recent 90-minute orientation, six potential volunteers—four women and two men—learned that a person’s final hours may be characterized by sporadic breathing, agitation and bursts of lucidity.
The volunteers are taught to read the body language of a person who can no longer speak: a deep, contented breath when a loving hand is placed on a shoulder, a brow that unfurrows at the sound of a soothing voice. “Always assume they can hear,” social worker Marie Tax tells the group.
Most program recipients are elderly people without loved ones nearby. Once, volunteers tended to a dying man while his wife, who was in her 90s, navigated two hours of Montgomery County public transportation to be by his side when he passed. In another case, a son flew to Maryland from Manhattan to say goodbye to his father but could not stay until the man died.
“Just Be in the Moment”
For Gabriel, used to the problem-solving adrenaline of the emergency room, the program offers an opportunity to “just be in the moment,” honoring the life that is departing. “There is a sense of honor and respect that you’re able to be there,” she says.
When Gabriel was a teenager, her 40-year-old father dropped dead of a heart attack on the bathroom floor, instantly and alone. “No one even heard him fall,” she recalls.
A few years later, her 9-year-old brother succumbed to disabilities he had suffered his entire life, surrounded by family members in his final moments. “I do believe he absolutely heard us,” says Gabriel. The last words from her brother, the only boy in a six-sibling family, were “I love you,” she says.
“It really is just being with the person,” says Mary Aguilera-Titus, a massage therapist at Suburban who helped bring the program to Bethesda. “It’s only right to leave this world with somebody there.”
Suburban Hospital employees interested in volunteering with No One Dies Alone should contact Pamela Fogan at firstname.lastname@example.org.