IAMA hospice volunteer sitting a vigil for a dying stranger. AMA!

No question. I just came here to tell you that you are awesome.

Thank you! It's definitely not for everyone, but I have the right constitution and the time. It's important to me that no one die alone.

I am a hospice RN. To clarify: hospice is not one national organization. Nationally, hospice consists of hundreds/thousands of private companies, some for-profit, some not-for-profit. Protocols vary among these companies; mine does not use ketamine or methadone. Biggest problem is relatives who are afraid to give the patient pain meds for fear it will hasten death. It has been pointed out that the stress of pain will also hasten death. More importantly, even if pain meds would hasten death (they won't), how selfish is it for relatives to demand that the patient live a few more hours (in agony) from lack of pain meds? Think about that.

oh honey, i have thought about that. a lot. ugh.

My mom is currently fighting stage IV colon cancer. Things seemed to be going good, and then bam-- world turned upside down these past few weeks. Were still currently seeking treatment, but as a family, we all see whats coming down the road. I'm extremely concerned that she'll die an agonizing death. I'm wondering, how well is pain managed for weird cases? She has cancer thats spread to the brain, lungs, but its her abdomen I'm most concerned about. I remember the agony she was in before her surgery, when her digestive tract got blocked off. Can large enough doses of morphine mask/numb that experience?

P.S. Sorry to hear about your friend :(

honey, morphine is not the only drug. they literally give people methadone to numb the pain. the goal of palliative care is to keep a person comfortable, and the doctors, nurses and hospice workers will do everything and anything in their power to manage pain levels. don't you worry about that.

Thank you for the info. I've read as much, but I feel better getting it straight from the source. Anyways, you're doing an amazing service for people...but i'm sure you already know that!

thank you. it feels rewarding.

how much aide and comfort can you provide while doing an AMA? sorry to be that person but it's the first thought that came into my head when i read your title line.

he's in a coma, so there's not much i can do. i stroke his hand and talk to him every few minutes. i think that people can sense other people around them, even in altered states. i think i talk more to his ICU nurse to be honest. i always have questions about everything ever.

I walked my dad to his end from lung cancer. I almost met my end recently with some crazy intestinal problems and questionable surgeries, a nice visit to the ICU, and over a month in the hospital. I can reassure you from being in both positions, the person in the bed mostly feels the presence of the person there with them. You don't need to say a thing. Sometimes the words only make it harder. It's about not being alone. It's so important, and I can't possibly give you enough praise for doing what you do.

ohhh this makes me feel good. thank you. i'm sorry about your father and your experience, but i'm so glad you recovered. thanks again for your kind words.

Why are you on reddit instead of with your friend? (not judging just curious)

Why didn't they give you the night off for your friend's accident?

he's in a coma! and, i'm a volunteer. sometimes my hospice puts out a call for vigil volunteers and since the hospital was really close i responded.

i just happened to be at the hospital when i learned my friend was in the ICU here, so i went to sit with him. we aren't best friends or anything, but i knew he wouldn't have visitors at this hour and i didn't want him to be alone.

I am sorry for your loss, is there any chance for him at all?

absolutely none. liver failure is... liver failure. you can't really turn that one around. :(

Is your job weirder now that it has personally effected you?

not at all. i got into it because i was there for a friends death and i absolutely loved talking him through it and giving him comfort.

Well thank you for all your work with people.

Just out of curiosity, have people asked you for a last wish?

like "Tell my family....." or "Make sure my funeral has..."

all of my end-of-life patients have been non verbal, and my regular patients in the nursing homes have dementia. i spend a lot of time smiling and saying nice things.

Have the families ever requested something like "come to their funeral" or anything like that?

i have been invited but politely declined. even if i wanted to go, i have to detach emotionally, you know?

How old is your friend? I'm sorry for your loss.

He was 48.

How'd you meet your friend? :(

at the bar. ugh.

I'm so sorry for your loss, close friend or not.

oh man, the neighborhood is going to miss him. he was well-loved. it just sucks. thanks for your wishes!

Have you done this more than once, and if so have people ever confessed stuff to you to come clean before they pass?

i have done this more than once, but all of my patients were unable to speak.

That must be even harder not being able to speak with them. Much respect for what you do though, more people need to have the sympathy you do. All the best to you and your friend.

it is difficult because you have to guess about their personality, their lives, their wishes and their mental state. but it makes it easier because i don't have to listen to a dying person, which can be a very depressing experience.

Can you elaborate a little on why it can be "a very depressing experience"?

Do people ramble about what they wished they would have done and such?

Facing death is a pretty heavy thing, and I'm an empathetic person. Hearing what that person is thinking is likely harder than guessing.

For people with no family or family that won't come, how would you rate their experience with hospice? I feel that is positive, but it can't replace the feeling of a loved one, can it?

i don't think it matters if it replaces the feeling - after all, they're not going to remember it. what i think is important is that they don't die alone. that's scary and not humane.

My Dad was in hospice and ended up passing away this past May. He was relatively fine on a Friday, was sent to the hospital for a weekend stay by his visiting nurse, fell into a deep sleep by saturday that lasted a week and eventually died. Can't help but think they sped up the process by injecting him with who knows how many doses of Morphine. Have you encountered patients who come in fine one day but lose consciousness all together in a matter of hours?

of course! that's how it works a lot of times. the morphine was to keep his pain level low and allow him to relax. it might have killed him faster if his body was under stress from pain! i'm sorry for your loss.

What does death look like?

like someone is traveling without moving. it can be smelly. it can be weird. it can sound unsettling. but for me, it's just someone moving on. i've seen people give birth, and it's similar and different. it can be painful and scary, or it can be peaceful and painless.

How hard is it for you to see people in their last moments?

Has this changed your view on death?

What's the saddest thing you've seen at a hospice and what's the best?

it's not hard. it's like a little light goes on in my brain and all i want to do is support them, let them know that they are safe and loved. usually it's a relief when they go.

it hasn't really changed my view on death (which is that nothing happens after OR we become ghosts), but it has changed my perspective!

saddest thing? when people in nursing homes aren't taken care of properly.

best? when you crack a joke to someone on their death bed and they smile.

My main beef with some hospice volunteers is their seeming compulsion to inflict their religious beliefs onto people who are at their most vulnerable. I've personally had to listen to good-hearted evangs blathering about "Jesus" to people who lived their lives as committed atheists, and literally had to strong arm a couple of them, still proselytizing, away from the death bed.

Is there any code of ethics for hospice workers that prevents this sort of thing? I seriously would prefer dying in a crowded hospital ward with an overhead television blaring Fox News to spending my last hours in the company of some religious nut who won't shut up to a captive audience.

Thanks for this AMA. Your friend is lucky indeed to have you there for this transition.

oh yeah we are trained to keep religion out of it unless the patient or family wants to talk about religion. it can be very comforting.

When you say "shots we knocked back", do you mean you both had a shot of liquor?

many shots of liquor many times, unfortunately.

My grandmother just died yesterday while in hospice care. I just wanted to say thank you for all you do. It's amazing to know that people volunteer their time to make sure other people do not die alone, regardless of their circumstances.

i'm so sorry for your loss. it gets easier. then harder. then okay. then easier. then harder. then easier, and easier, and easier.

i mean, i think. i don't know you or how you grieve. just one thing - don't be afraid to grieve, hard. the point is it does get easier.

What kind of effect does this have on you personally? I know there must be some internal reaction to being around death all the time but at the same time it must also be a great feeling knowing that you were able to be there for someone when they pass on.

I'm just wondering what kind of effect this line of volunteer work has on you spiritually, emotionally, ect.

i don't know. it almost feels professional, like, okay, i just did that and that just happened. then, sometimes i feel sad, or happy. i feel tired, so i sleep, wake up and journal. after about a week, i feel refreshed, and ready to do it again.

How old is your friend? Is his liver failure alcohol related?

upper 40's. yes alcohol.

How did you get involved in this type of volunteer work? I have been with people while they died and I felt honored to be there to comfort them in their final moments.

Reminder to answer this...

aloha hospicegirl, not enough mahalo can be conveyed for helping make sure people do not die alone. i am sure your presence there is a comfort. mahalo nui loa, -asu

thank you darling.

So not really here to ask you anything, but just to thank you for what you are doing.

i saw first hand about a year ago how much help a hospice and the people who work and volunteer there are, when my grandpa spent his last time with us in one.

when i went to visit him and my grandma in there they where generally happy to have a place where they could just enjoy there last time together without any stress or pain.

so thank you very much.

that sounds like a live in hospice. i'm part of an organization that works with hospitals, nursing homes, and private homes, but we don't have a center where people live.

My wife's grandmother just passed away in hospice this morning.

Thank you for all that you do to help these poor people go out as comfortable as possible. Specially the ones with no family.

sorry for your loss. it's true, hospice care can ease the transition from this earth to wherever. don't forget to be extra tender, expect mood swings, and cry with her.

I am considering starting volunteering for hospice, but I am a full-time Pre-Nursing student at a University and I am also going to be volunteering at a local hospital soon.

How time consuming is being a Hospice Volunteer, and would you recommend it for a (usually) stressed out college student?

honestly, the time commitment could be as little as visiting one patient, for an hour once a week, in a nursing home close to you. the training for me was 16 hours, two full saturdays. you may be requested to get a TB test, flu shot, and fingerprints. at least that's how it was for the hospice that i volunteer for.

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i think i'm here because my parents had sex! simple as that.

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well, what if i don't think there's a higher purpose or plan? i mean, my goal in life is to make other people's lives better... and i want to raise thoughtful, compassionate children. but i don't think these things are true for everyone. some people might think they're put on this earth just to kill themselves drinking, like my friend did.

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no. he was ultra-depressed and told his family he was going to drink himself to death and then he did. he was a great man with a big heart and a bad addiction.

firstly, thankyou for being so compassionate!

i was wondering what your opinion is on assisted suicide?

i think assisted suicide is a humane way to allow a human to decide to end their life. if assisted suicide became an option, i would think that doctors, nurses, social workers, family members and the person would all need to discuss it thoroughly. there are people who want to die and are going to succeed. there are other people who don't want to "take their life," but instead desire to exit the world in a peaceful, guided way.

Can you describe yourself? You are a kind and brave person. Some people are one or the other, but to be both is to be blessed.

wow. what a profound question. i am a kind and brave person. i am blessed in so many ways, and suffer in many others. i have ADHD, depression and anxiety. i'm intelligent but not motivated. i did graduate from an excellent college. my family is beyond fucked up and has always been. i support myself, live alone, and struggle to deal with my mood swings. i'm young but precocious, and date and hang out with older people. i am exceptionally sensitive but can be surprisingly unaware of how my words affect others. i drink too much. i smoke too many cigarettes. i'm obsessed with my dog.

Thank you. I would appreciate your being there if I were dying. Thanks.

let me know when you do! j/k. that's a great compliment. you're welcome!

I don't really have any questions, just thanks for what you guys do :) When my life calms down a bit I'd like to volunteer. I've sat bedside with several relatives, and the hospice folks have always done a fantastic job of assisting. So, thanks. You guys really do make a huge difference and help family through the process.

go for it! do it! hospice always needs and welcomes volunteers.

Is there a difference (to you, personally) between when vital signs are lost and when you see the 'lights go out', so to speak?

Thank you for this very unique and touching AMA, I think what you are doing is very admirable.

hmmm. i'm sure there is a difference, but i'm not sure exactly what or when it occurs. i've heard about electrical activity in the brain continuing, but i don't really know too much to comment about it.

My grandfather passed away a year and a half ago while on hospice care. Sitting with him while he passed away was the single hardest thing I've ever dealt with. The fact that you volunteer for these people gives me so much respect for you. Thank you for being a great person.

you're welcome.

Besides all the machines and whatever, can you tell when a person is officially dead? Also, isn't it kind of eerie to be in a room with someone you know is going to die within the next few hours?

My last question is just something I'm really curious about because I'm picturing you holding the person's hand while they die. Do you ever come into physical contact with the people you sit vigil for?

breathing slows, heartbeat stops, pulse is non-existent.

it's not as much eerie as it is a very sacred moment.

oh yeah, physical contact is definitely something that occurs. touch is a primal human connection. a lot of these people are non-verbal or totally out of it, but you can still get a mesage when they squeeze your hand or smile at your joke. hugs, forehead stroking, if it's the right thing for my patient, i'm happy to comfort them in that way.

What can I get if I want to die alone? Can I get a guard to keep people away until I fully decompose?

What is WITH all of these needy parasite people, and their insistence on wasting as much time, energy, and resources of others as possible?

if you want to die alone, you can figure out for yourself how to make that happy, and then communicate those wishes to the people around you. hopefully they can respect that.

people who are dying are not needy parasite people. the are human beings who deserve dignity, comfort and support as they perform the last great act of living - dying. i didn't waste my time with these people. i didn't waste my energy. i volunteered my resources. i think it's important that no one die alone, and i'm proud of doing something to stop that.

i am going to die soon. how do i get a cute nurse?

make friends with the charge nurse and don't be a creep when you ask for a female nurse.

Chaplain of 6 years checking in.

I typically get horny when I'm around dying/death. It's pretty normal.

How do you react?

it makes me very tired. i nap for a long time, then usually journal about the experience. spiritual care is awesome for some patients, good on you for being there.

How old are you?

24