Hands-on and Meaningful
The Hospice Program teaches students the physical, mental, and emotional skills they need to work in a hospice care home, skills which often extend well beyond the classroom. Students learn specialized hospice caregiving techniques such as mouth care, skin care, resident positioning, changing bedsheets, bed baths, lift assists, and foot washing. At the center of these practices are the principles of palliative care, concerned mainly with quality of life and resident comfort.
Many of the hands-on techniques the students learn can be easily transferred to other medical fields, which makes this an ideal course for future nurses, doctors, counselors, and related professions. Students hone their communication skills as well, developing healthy social habits that can benefit their everyday lives for years to come. Mental and emotional skills are outlined in the Mindfulness section.
At the heart of this program are the volunteer shifts that students are encouraged to work at one of six local hospice care centers. Students get a chance to practice hands-on skills in a real work environment, bonding with patients and learning the trials and tribulations of working in palliative care.
For many students, their first shifts are a nerve-wracking experience, and the work they do as volunteers can be both mentally and physically challenging. In-class journaling and discussion are meant to give students the emotional skills they need to cope with the situations they encounter during volunteer shifts.
In preparation for the volunteer training that students receive at comfort care homes, they will learn and practice the essential nursing assistant techniques of comfort care using home health equipment and supplies donated by InterVol, including a hospital bed, incontinence pads, disposable briefs, draw sheets, linens, pillows, toothettes, mannequin, wheelchair, walker, crutches, and bedside commode. These hands-on skills include the following:
- Universal/standard precautions
- Mouth care
- Skin care
- Turning and positioning
- Bed making (occupied and unoccupied beds)
- Bed bath
- Lift assists from bed to commode
- Lift assists from from bed to wheelchair/recliner/chair
- Walking assist
- Brief change
Students practicing mouth care: Suzannah Sheeran, Charlotte O’Connor, Rory Sommerville, and Rachel Green. Photos by Amelia Hamilton Photography
Mouth care is an important part of comfort care, and is used to prevent dry mouth and infection, since residents may no longer be able to drink water and keep their mouths wet on their own. A dampened oral swab, or toothette, is used to moisten the resident’s lips and mouth, usually while sleeping, after eating, or during a bed bath. Hospice care homes strive to make patients as comfortable and happy as possible, and mouth care is one practice used to accomplish that.
During the in-class lab activity, students practice mouth care on each other, taking turns practicing their techniques and learning what it’s like to be in a resident’s shoes. Technical concerns such as aspiration or biting are important to keep in mind, but empathy plays a major role in these exercises as well. Discussion questions posed throughout the activity help students think about what the residents are going through, considerations that strengthen their social and emotional skills.
Pictured above: Corey Zhang, Sarah Smith, Nikole Fandino, Sybil Prince, and Andreas. Photos by Amelia Hamilton Photography.
Bed changing and baths are a necessary skill, both in hospice care and in the larger medical field. It’s an ideal lesson for students who hope to be nurses or take care of their own family members. Residents with progressive diseases can develop bed sores from being in one place for too long, so re-positioning them is important to the process as well.
The students first use a damp washcloth to gently wash the resident, working from their face to their feet and placing towels on the bed underneath. Next, the volunteers use the draw sheet to roll the resident onto their side, changing one side of the bed sheets first before switching to the other side. Residents may also have a diaper or bed pan that will need to be changed.
In Their Own Words
In class we’ll learn how to turn the patient or how to get them up to use the commode, how to give a bed bath, but I think the most important one we did was to learn how to have hard conversations.
I’ve never had to be that mature, and calm down and keep a straight head when there’s physical issues going on. I was really nervous of hurting somebody.
You think one mistake and everything’s gonna be your fault, which is really not the case. You just need to practice more and not be too afraid, and you’ll get over it.
When there are awkward times, because sometimes they just want you to sit there with them, in silence…you obviously want to do something in the moment to make them feel better…[you have] to get over that uncomfortableness, because I guess again it really comes back to as long as they’re comfortable and they’re okay.
Growing through Hospice
The nature of hospice care brings students in this program face-to-face with bodily fluids, human anatomy, and fatal diseases — an extremely realistic way to prepare them for the difficult situations they’ll encounter in adulthood. Many students find that although they initially have aversions or discomfort regarding certain types of care, once they find themselves in a position to actually provide that care, they are much more equipped to do so than they think. Guest speakers come into the class and discuss how even if they feel uncomfortable, the resident is probably more uncomfortable, and so it is up to the volunteers to help alleviate that. It’s not all so scary, though, and hospice work is a very rewarding way to make someone else’s life better. The skills learned in this class, both physical and mental, will benefit students forever.
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