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End of Life Companion program unveiled

SYRACUSE, N.Y. — A new program at University Hospital hopes to ensure that no one dies alone.

End-of-life companions puts a specially trained volunteer at the bedside of a dying patient when family or other loved ones cannot be present for the final goodbye.

"When no one else can be there, we will," said Pat Knox, University Hospital's palliative care coordinator, who directs the program.

Despite the talents of medical professionals, death does occur in hospitals everyday. "Death is a part of life," said Knox. "We want to ensure that as a hospital we are there for the patient, no matter what."

As the region's Level 1 Trauma Center and as a facility that undertakes some of most complex medical cases, University Hospital attracts patients from throughout a 17-county area and some families may have to travel several hours to get to the hospital.

"Dying alone does happen," Knox said. "It's not always possible for family to get to the bedside in time for the last goodbye. In some cases, patients have no families, and they are truly alone."

For these cases, University Hospital has developed a new program, called End-of-life Companions. When death is imminent—expected to occur within the next 24 to 48 hours—an End-of-life Companion is requested and can be at the bedside often within an hour. A special call list notes each companion's availability and the time it takes for them to get to the hospital.

Once at the hospital, the companion meets with the patient's nurse to be briefed on any special ethnic, spiritual, religious needs or requests. Then the companion will take his or her place at the bedside and remain there until family arrives or death occurs. Companions volunteer in four-hour shifts. If a companion is needed beyond the four-hour assignment, another companion will be contacted to take up the bedside presence.

During this time, hospital clergy, nurses and physicians will come and go to treat the patient as needed, such as administering pain medication, but the end of life companion will remain at the bedside.

"We're there with that patient to do whatever we can for them," Knox said of the companions' role in the final hours of life. "If patients want to talk, we'll listen. We'll hold a hand or provide a sip of water. We'll play comforting music or read for them. Most importantly, we'll let them know that they are not alone."

The program, which began Dec. 18, has attracted 31 volunteers from all segments of the SUNY Medical University community. There are nurses, administrative assistants, administrators, computer technology personnel and students. Knox said the volunteer training tries to prepare companions as best as possible for what death will look like and what emotions to expect. The signs that death is at hand are varied, such as changes in breathing, a slow down in circulation that makes the hands and feet cold and a growing restlessness. Patients near death may have a vision of deceased spouse or family member.

For some volunteers, this will be a new experience, for others, not so new. Darlene Noyes, a former registered nurse who now serves as the institutional compliance officer for hospital affairs, recalls being at the bedside of a dying patient. "It is a privilege to be with someone as they depart from this world to the next," she said. "For the family, patient and the companion, this program will provide comfort for all."

The impetus for the program came from a medical student, who heard that a patient had died with no one in the room. Hoping to find a way to prevent that, the student sought out Knox, a specialist in palliative care. Together, they developed a tentative plan that was supported by administrators.

Knox said most people have two wishes in death: that they not feel pain and that they not die alone. "With our medical staff and now our end of life companions, we'll make sure a patient's final wishes are granted."

The End of Life Companion Program is supported by SUNY Upstate's Volunteer Initiatives Office with funding from the Advocates for Upstate Medical University. For more information on the program or to volunteer, call 464-4498.

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