Sunday, March 29, 2009

Hospice Volunteer Training Ethical Issues

How should I respond when a patient’s family offers me gifts and gas money?

Is it okay to date my patient's unmarried caregiver?

Can I ask the family to only speak English when I’m around, so I won’t feel left out?

My patient wants me to help him commit suicide. He hates being alive in his condition. How do I handle this?

These are a few ethical questions that may concern hospice volunteers as they go about their duties of providing quality of life care for terminally ill patients. Perhaps you can think of many more. While training classes that certify hospice volunteers cover many topics, they don’t always cover the varied situations that can arise for someone playing the role of healthcare volunteer and friend.

The College of Nursing at Utah did a study that explores ethical issues hospice volunteers confront during their assignments with patients. These are the prominent themes resulting from interviews of hospice volunteers:

1) Dilemmas about gifts
2) Patient care and family concerns
3) Issues related to volunteer roles and boundaries
4) Issues surrounding suicide and hastening death

The study also concludes that hospice volunteer training should include more discussions after the initial training. This later training should include more ethical situations confronting volunteers and strategies for dealing with them.

You can read more here about this study of hospice volunteers and ethical issues.

Frances Shani Parker, Author
"Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes”
“Hospice and Nursing Homes Blog”


  1. I was a VA hospice volunteer while I was a student in college. While I volunteered as long as I could, classes necessarily limited the time I could spend talking with Hospice patients. Feelings of guilt when leaving the bedside of some of the patients to skip off to class was an issue I sometimes dealt with.

  2. this is an excellent post. I am forwarding this to our hospice volunteers to follow your blog.

  3. Thank you. I hope this starts more conversations about ethical issues hospice volunteers face.

  4. Thanks to your blog where some of the critical issues are given importance. please keep on writing

  5. Thanks for the encouragement.

  6. RN retiredJuly 03, 2009

    I am an RN but work as a sitter for an elderly woman who is currently at a long term care facility. The hospice nurse assigned to her seems to be more interested in the paycheck than her care and relieving my patient’s pain, I have spoken to her about the possibility of using a Fentanyl patch, but the objection is that it may decrease the patients’ life expectancy. The patient is 93 and a DNR. Any advice?

  7. RN, I would advise you to refer your patient concerns to the caregiver who hired you as a sitter. They should speak with the hospice nurse or medical director regarding any concerns related to the patient's pain management. It is important that hospice team members and caregivers maintain good communication in providing quality end-of-life care for patients. The quality of care depends on the context in which it is given.

  8. This a great site for all of the dedicated and angelic hospice volunteers. You are on the front lines and it give you a great place to share experiences and ask questions. Keep up the good work!