Vigil Companion Programs - So No One Dies Alone

Vince Chiles

As a hospice social worker and supervisor, I have witnessed the myriad of family dynamics played out at the end of life. The love, the sadness, and the struggle for acceptance of an approaching death is seen through the relationship between husbands and wives, brothers and sisters, parents and their children. And then, there are those who outlive their support systems. They often find their way onto hospital wards in the last days or hours of life, and are literally all alone. Some may muster a request for companionship in the last moments of life from a nurse, who due to the constraints of her patient load, can only stay a moment or two before rustling off.

Such was the experience of Sandra Clarke, a critical care nurse at the Sacred Heart Medical Center in Eugene, Oregon. Ms. Clarke was asked to stay by a dying patient. She had to finish her other duties, and when she returned her patient had died. Troubled by this lonely passing Clarke was inspired to start ‘No One Dies Alone,’ a vigil volunteer program that provides companionship to those who have no one in the last moments of life.

Hospice volunteer programs have been providing vigil companions to their patients for decades in the absence of families when commitments or distance keep them away. But for hospice to occur the patient or a surrogate has to consent to the care. These faculties or resources are not always available to patients, who either through longevity of life, estrangement, or distance, have no one. Some of our most frail fellows are completely alone. That’s where programs like Sacred Heart’s ‘No One Dies Alone’ and other vigil companion services come in. They are volunteer programs that are often run by medical facilities whose mission it is to provide a compassionate presence to those who have ‘No One.’

The philosophy of the vigil companion programs is to provide an empathetic witness to the transition that occurs with death. They assert that because no one comes into life alone in the best of situations, no one should leave alone either. As a result of this care philosophy volunteers are available around the clock to sit with those who need this desperate company whenever necessary. Nurses are the eyes and ears of these services, identifying the need through their clinical insight and intuition. They notify the coordinators who in turn alert the volunteers of their duty. Volunteers may sit in silent reflection, play soft music, or provide a gentle touch of comfort. They are trained to alert the medical staff of any problems or concerns that might arise. The service may lesson the effects of complicated grief for distant family members or staff. Overall, vigil companion services reinforce the patient’s dignity and worth of companionship in this most vulnerable time. When provided well these services assure ‘No One Dies Alone.’

Reference: No One Dies Alone, Sandra Clarke, CCRN; Summer 2002 (Vol 8, No.3) Supportive Voice, the official newsletter of Supportive Care of the Dying: A Coalition of Compassionate Care.

Vince Chiles, MSW