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”

Who Wants a Hospice-Palliative Care Volunteer?

Everybody wants a hospice-palliative care volunteer, right? Wrong. I never assumed that patients would always be glad to have me as their hospice volunteer, and it’s a good thing I didn’t. One day I met a patient who made it clear I wasn’t wanted. My book Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes explains what happened. This is how the initial conversation went with a hospice patient named Lelia:

“When I first met her, she was sitting alone in a dimly lit room she shared with three other women. Her blouse was unbuttoned, exposing one sagging brown breast and a wormlike scar where her other breast had been removed. Depression embraced her like a close friend. A wary look in her eyes told me she had no place for a hospice volunteer on her agenda.

“What’s that, you say you a hospice volunteer, and you want to come see me every week? No, I don’t need to see you. I have enough visitors,” Lelia complained shortly after I arrived. Her tone reeked with annoyance at my intrusive presence in her gated world.

“Lelia, I came by to see you today because I hoped we could get to know each other better. I was thinking that I might be able to help you in some way, maybe with a problem or something.”

“No, I got enough help. Like I said, I don’t need to see you. I don’t need to see nobody. I just want to be left alone.”

© Frances Shani Parker

So much for making me feel welcomed. Fortunately, I was able to win Lelia over and have a very interesting relationship with her. Her story is one of my favorites.

What does research say about dying people wanting hospice-palliative care volunteers? According to the “The American Journal of Hospice Palliative Care" research at Mount Allison University yielded the following results using 100 adults:

Participants were asked to imagine they were terminally ill and told about services volunteers could provide. Finally, they were asked if they would want a volunteer and why. Eighty-nine participants wanted a volunteer, mostly for general support and lack of nearby family. What about the other thirty-five? Some sounded just like my patient Lelia by saying they didn’t need help. Other reasons included being private people.

In the total group, sixty-five participants were aware of the volunteer program. Among those who were not aware, 89% expected their family doctor to inform them of the program. These results indicate a need for more patient information regarding the availability of hospice-palliative care volunteers.

Frances Shani Parker, Author

Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.

Hospice and Nursing Homes Blog

Hispanic Elders Benefit from Architecture with Front Porches

I talk about the importance of a front porch in my book "Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes.” Baby Boomer Haven, an imaginary nursing home based on best practices of some, but not enough, nursing homes that already exist, has a great front porch. This is how a resident describes the front porch when she takes the reader on a tour:

“I love sitting in my rocking chair out here on the front porch surrounded by nature. It reminds me of when I used to sit on the porch getting my hair combed down South when I was a girl. That’s where I heard grownups tell stories about my family and African American history. The front porch is where I first grabbed a handle on life. In later years, that was where my own children learned life lessons and heard stories that were passed down through generations. Nowadays, other residents and I rock our chairs to discussions about everything imaginable.”

Did you grow up having a front porch or stoop where you could sit for hours interacting with and observing neighborhood happenings? Do you still have one? If you have had that experience, you’ll understand why the research I’m about to explain praises “positive front entrances” for elders in a low-income Hispanic neighborhood.

According to “Environmental Health Perspectives,” researchers at the University of Miami Miller School of Medicine theorized that Hispanic elders’ social, psychological, and physical functioning would be impacted by “architectural features of the built environment” (front porches or stoops) that promoted direct observations and interactions with the neighborhood. Studying a 403-block area in urban Miami, Florida for three years, they arrived at the following conclusions:

Elders living on blocks marked by low levels of positive front entrance features were 2.7 times as likely to have subsequent poor levels of physical functioning, compared with elders living on blocks with a greater number of positive front entrance features. The research supports what those of us who have had front porches suspected all along: “Architectural features that facilitate visual and social contacts may be a protective factor for elders’ physical functioning.”

Excuse me while I go sit on the porch.

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

Hospice Team Meetings and Technology

Hospice services are a team effort. By law, hospice agencies must deliver services using an interdisciplinary approach to patient care. As technology evolves and becomes more accessible, it can play a larger and more beneficial role in the implementation of hospice teamwork. How effectively have hospice teams been using technology to address challenges faced at interdisciplinary team meetings?

In a study reported in the “International Journal of Electronic Healthcare,” 190 representatives of hospice agencies were surveyed by phone regarding the level of technology use in hospice Interdisciplinary Team (IDT) meetings. Survey results indicate that hospice team meetings often do not incorporate technology, even when it could be beneficial. Over half of the participants did not include computers at meetings, even though computers could help them access patient records and medication lists for designing care plans. Technology can better serve hospice agencies if they use it more to enhance the social and product functions of the group process at their team meetings.

You can read more here about this study on technology and hospice team meetings.

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

Nursing Home Smoking: A Hospice Volunteer’s View (Video 1:16 mins.)

According to MI law relating to nursing homes, smoking is either not allowed or restricted to certain areas of nursing homes. This whole idea of smoking in “restricted” areas reminds me of a restaurant I visited where smokers and non-smokers were separated by five feet of aisle space down the center of a small room. I could actually see a cloud of smoke hanging over the non-smoking section. Where was the “restricted” area?

A nursing home is a healthcare institution. Considering the fragile mental and physical conditions of many residents, I question the safety of some of the restricted areas. Several of my hospice patients who smoked had oxygen tanks stationed near their beds. As if the fire hazard of smoking is not enough, the issue of healthcare should certainly be more of a priority.

All the nursing homes where I volunteered had indoor smoking areas to accommodate patients and staff who wanted to smoke. I held my breath to avoid second-hand smoke every time I briefly entered a smoking room to get a chair when they were not available in the halls. Smoke, which was both seen and smelled, floated into the halls every time the doors to smoking rooms opened. Whether they smoked or not, everybody’s nostrils were assaulted with sucker punches of first or second-hand smoke.

In this video, an elderly woman who uses an oxygen tank sparked a fire at an apartment complex for the elderly. While she was not in a nursing home smoking area, the resulting fire and crisis in having to protect, console, and evacuate all the other residents to buses taking them to a shelter could easily have happened at a nursing home.

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

BlogTalkRadio Interview with Frances Shani Parker, Author of “Becoming Dead Right” (30 mins.)

Earlier this week, I was interviewed by Patricia Grace, a certified senior advisor and host of the BlogTalkRadio Show “Aging with Grace.” This show airs weekly on Monday evenings in Pennsylvania and showcases discussions related to eldercare. BlogTalkRadio is the social radio network that allows users to connect quickly and directly with their audiences. Using an ordinary telephone and computer, hosts can create free, live, call-in talk shows.

Patricia Grace and I covered several topics during our interview. They included the following:

1) Hospice Care
2) Caregiving
3) School-Nursing Home Partnerships
4) Healthcare Research
5) Culture Change in Nursing Homes
6) Ten Tips for Becoming Dead Right

You can listen to the "Aging with Grace" interview here.


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

Caregiving with Sensitivity: Semi-Sensory Deprivation and The Virtual Dementia Tour (Video 3:04 mins.)

I have been a big fan of semi-sensory deprivation training for some time. For example, lack of eye care for nursing home residents is widespread in America and greatly impacts these residents’ quality of life. It’s only logical that if volunteer participants could wear glasses or goggles that have lenses smeared, so their vision is blurry, they can arrive at a better understanding of what patients with impaired vision experience. Simulations impairing speech, smell, taste, hearing, walking, talking, eating, touching, etc. help others really experience what patients are going through on a daily basis, and they provide great discussion. Nursing homes, hospitals, and medical schools are supportive of providing these experiences.

Because family members care for most patients with dementia, it is important that family caregivers develop more sensitivity to patients’ experiences. One example of training to improve their sensitivity is The Virtual Dementia Tour. This training developed by P.K. Beville for Second Wind Dreams “helps sensitize families to the needs of their loved ones” by helping them see, feel, and hear in ways similar to the experiences of an elderly person with dementia. Second Wind Dreams® is a national non-profit organization based in metro Atlanta.

In this video about the Virtual Dementia Tour, participants perform everyday tasks such as matching socks while wearing the following:

1) Dried corn in their shoes to simulate arthritis
2) Gloves with taped fingers to simulate declining age
3) Goggles to simulate impaired vision
4) Headphones to simulate background noise distractions that interfere with patients’ focus

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

Hospice and Nursing Home Poem: Volunteer-Patient African American History

My book Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes concludes each chapter with an original poem. I was inspired to write this poem while watching my hospice patient sleep. I thought about our common history that bridged our communication beyond her dementia and enhanced my respect for all she represented.

Deeper Than Words

The outside world arrives
wearing my willing face.
Toothless, your smile widens
like a baby’s hungry for attention.
Almost ninety-eight years old,
your inner candle still glows.

A hospice volunteer, I lean closer,
talk into your listening left ear,
“Today is Sunday, Miss Loretta.”
My news drifts away like smoke.
You stare at me through dying coals.
Whatever I ask, you whisper, “Yes.”

I stroke your age-softened arms
while your hazed mind masters sleep.
Watching you, I dream generations
of women, black and strong, each one
a book of sustaining stories
about joy, pain, courage, survival.

Within your warm brown frame,
spirits from our common history linger.
Aides say you have dementia,
that you don’t know a word I say.
Our language goes deeper than words.
We speak to each other’s souls.

© Frances Shani Parker

Frances Shani Parker, Author

Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback at many online and offline booksellers and in e-book form at Amazon and Barnes and Noble online stores.

Hospice and Nursing Homes Blog

Culture Change in Nursing Homes: What Works, What Doesn’t (Video: 1:59 mins.)

Most people agree that changes in the stereotypical, traditional nursing homes are long overdue. What makes a nursing home really feel like home? What needs to happen to make that a reality? What are some of the barriers that negatively impact progress? A University of Pennsylvania research study about culture change in nursing homes focused on these concerns. After staff interviews were done, three nursing homes reported these results:

Barriers to Change

1) Exclusion of nurses to culture change activity (While nursing assistants were not mentioned here, I’m inclined to believe they were also excluded.)

2) Perceived corporate emphasis on regulatory compliance and the "bottom line” (money)

3) High turnover of administrators and caregivers

Promoters of Change

1) A critical mass of "change champions"

2) Shared values and goals

3) Resident/family participation

4) Empowerment at the facility level

Clearly, changing nursing homes successfully involves input
from all levels of staff, residents, and community. Incentives encouraging achievement of new and shared goals are also effective.

You can read more details about this study here.

You can view this video on the importance of inclusiveness in culture change proceedings.

Frances Shani Parker, Author

Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.

Hospice and Nursing Homes Blog

Healthcare Disparities: Do You Treat Patients Differently Based on Race or Culture? (Video 3:43 mins.)

During my healthcare research, I have repeatedly come across data revealing major disparities in America’s healthcare system. Overwhelming evidence indicates that these disparities negatively affect certain racial and ethnic groups. America’s long history of overt and covert racism, with all its stereotypes and discrimination, continues to pervade its institutions in ways underestimated by many people, including those who are victimized by it. In my book Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes, I address this urgent matter:

“The responsibility for changing attitudes that cause disparities within the healthcare system rests with that system. This is not only a healthcare issue, but also a moral one. This system cannot continue to sit down in the middle of an unjust road, cause harm to others, and not be held accountable. Healthcare providers must own the fact that a large amount of research on disparities in racial and ethnic minority healthcare is true and make every effort to demonstrate equitable practices.

Better education in racial and ethnic cultural sensitivity, however, is not enough. Negative stereotypes are activated with and without intent, particularly in high-pressure work environments. Serious accountability from healthcare providers must include rewards and penalties. Incentives should be offered to encourage healthcare institutions to work diligently at lowering their incidents of disparities negatively impacting racial and ethnic minorities, as well as women and low economic groups. Solutions must be implemented with ongoing monitoring. Disparities of the magnitude that exists now will not be willed away.”

There is a tendency among some healthcare workers to assume that the solution to this problem rests with leaders of the “institution” when, in fact, it belongs to each person making up the institution. The question “Do you treat patients differently based on race or culture?” is one that every healthcare worker must explore at a personal level with honesty. In spite of overwhelming research to the contrary, most responders still say, ”Oh, I’m colorblind. I treat everybody the same.” Recognition of the problem is the first step toward improvement. Racial and ethnic disparities must be eliminated before America will ever realize true equality in healthcare among its diverse populations.

You can read more about cradle-to-grave African American healthcare disparities here: https://www.linkedin.com/pulse/african-american-pain-treatment-disparities-emergency-parker?trk=mp-author-card

This video defines and addresses the need for healthcare cultural competency:

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

Rural and Urban Hospice Financial Comparisons

If I asked you which hospices, rural or urban, face the most financial disadvantages, which would you say? According to reported research in the “Journal of Pain Symptom Management,” rural hospices fare no worse financially than urban hospices, at least in California.

In the California study, 144 hospices were urban and 44 were rural. Adjustments were made in financial performance factors such as size, years of operation, profits, insured patients, etc. Compared with urban hospices, rural hospices were at least as profitable per patient-day, and they were determined to be “significantly” more profitable than urban hospices when charitable donations were excluded. This study concluded that rural hospices fared no worse financially than urban hospices. These results indicate a need to look further into comparisons of rural and urban hospices on a national level. If any of you have reasons to disagree with or support these results, please let me know.

You can read more details about this study here.

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

Hispanics: Caregiving and Diabetes Research (Video 1:49 mins.)

As a hospice volunteer in Detroit nursing homes, it was not unusual for me to have regular contact with patients who had dementia. One patient named Raynell (pseudonym) is particularly memorable because she had both dementia and diabetes. This excerpt from my book “Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes,” describes how she attributes her diabetic symptoms of tingling and numbness in her legs to an imaginary man named Robert who was in love with her.

“Robert was an imaginary man who passionately loved Raynell, my eighty-year-old hospice patient. It could be said that he shared a room with Raynell and her three roommates. His presence demanded my attention many days when I went there to visit her. He stole sweetness from the moment by repeatedly pinching Raynell’s stout legs. He made her feet rise by pushing up her mattress. Strategically positioned near the foot of her bed, he escaped under it quite easily. That’s how Raynell explained the turmoil he caused her. I pulled up a chair in her world each week and made myself at home. While I respected her condition, often letting her take the lead in our discussions, I always remained mindful of my role as volunteer.“

© Frances Shani Parker

“Medical News Today” reports results of a study released by the United Health Group's Evercare® organization and the National Alliance for Caregiving (NAC) with these results:

1) In America, more than one third of Hispanic households (36 percent) have at least one family member caring for an older loved one. This is a larger percentage than other U.S. households.

2) More than four in 10 Hispanic caregivers (41 percent) have changed their work situation either by cutting back on hours, changing jobs, stopping work entirely, or taking a leave of absence. This is compared to 29 percent among non-Hispanic caregivers.

3) Most Hispanic caregivers are taking care of loved ones with diabetes, including 23 percent of loved ones with a form of dementia.
A 2007 Centers for Disease Control and Prevention national examination survey indicated that Mexican Americans are twice as likely as non-Hispanic whites to be diagnosed with diabetes and 50 percent more likely to die from diabetes as non-Hispanic whites

4) Reasons for Hispanic caregivng included family obligation (84%) and religion (93%).

This video titled “UMTV Latinos Living With Diabetes” showcases the Institute of Minority Health Education and Research founded by Patty Larraga.


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

Hospice Care: Can Miracles Save Lives? (Video 1:01 min.)

Do you believe in miracles? If so, you share company with many others. As a hospice volunteer, I noticed early on that many patients held strong religious and spiritual beliefs. These beliefs were important to them when making decisions about their medical care.

Caring Connections, a program of the National Hospice and Palliative Care Organization (NHPCO), has a community outreach guide titled “It’s About How You LIVE – In Faith" to help hospice organizations engage faith communities with end-of-life issues. This guide, done in collaboration with the Duke Institute on Care at the End of Life, is available at the NHPCO website for free downloading.

In this Fox News video clip, viewers witness the miracle of Val Thomas, a woman who was technically dead for almost 18 hours after two heart attacks. Rigor mortis had even set in. Yet, she lives!

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

Delaying Dementia with Bilingual Ability

Can you speak more than one language? If you can, you may have a better chance at delaying the onset of dementia symptoms. Dementia refers to a group of conditions that gradually destroy brain cells and lead to mental decline. Many conditions can cause dementia, but Alzheimer’s disease is the leading cause. Most people who have the disease are over sixty-five, with eighty being the average age of diagnosis.

Toronto researchers say that fluency in two or more languages may be able to stave off cognitive decline because of the mental agility required to juggle them in day-to-day life. Principal investigator Ellen Bialystok, an associate scientist at the Rotman Research Institute of the Baycrest Center for Geriatric Care, states, "How you learn the language probably doesn't make much difference; how good your grammar is probably doesn't matter. What matters is that you have to manage two complete language systems at once."

Among the unilingual people studied, dementia began to appear in men at an average age of 70.8 and in women at 71.9. Among those who knew two or more languages, dementia did not begin to appear in men until an average age of 76.1 and in women until 75.1.

You can read more about this research in this “Toronto Globe and Mail” news article.

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

Hospice Volunteer Memorial for Deceased Patients: Christmas Remembrance Tree (Video 2:57 mins.)

Hospice workers experience patients’ deaths on a regular basis. The frequency of these experiences can sometimes cause the individuality of each death to be overshadowed by the totality of them all. Al Poeppel, a hospice volunteer, has found a special way to honor each of his departed patients during the Christmas season.

The outdoor Christmas remembrance tree created by Poeppel is his labor of love. The decorated tree celebrates his deceased patients, supports their families, and encourages introspection among the general public admiring the impressive tree as they drive by. Each tree ornament bears a deceased patient’s name that helps Poeppel reflect on the times he shared with that person. Poeppel thinks families appreciate knowing that their loved ones are remembered. He also hopes that the tree reminds others of the importance of making the most of life.

In this video, you can view Poeppel’s amazing Christmas remembrance tree and hear his heartwarming story.



Season’s greetings to all of you who read my two-year-old blog. I hope the new year brings you many rainbow smiles.

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

"The Curious Case of Benjamin Button" – Intl. Trailer (2:35 mins.)

I’m a little partial to movies set in New Orleans, my hometown, and movies that deal with the elderly and mortality. This movie about a man named Benjamin Button (played by Brad Pitt), who is born in his eighties and ages backward, really grabbed me by the collar. His unusual story covers a time period from the end of World War I in 1918 to the 21st century.



Aging, a fascinating theme, is something none of us can stop, as much as we try to wrestle it to the ground. How extraordinary to live the highs and lows of life’s unpredictable journey, moving toward infancy while others become older! This movie, adapted from the classic 1920's story by F. Scott Fitzgerald, begins December 25, 2008.


Starring: Brad Pitt, Cate Blanchett, Taraji P. Henson, Julia Ormond, Jason Flemyng, Elias Koteas, Tilda Swinton

5 Golden Globe Nominations, including Best Picture



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

Bereavement Support: Holiday Grief (Video Poem 4:00 mins.)

The holidays can be a troubling time for many who are grieving the loss of loved ones. Through the years, people associate holiday traditions with familiar people and places. My book Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes includes these suggestions for dealing with grief during the holidays:

“Mourners have to decide the best ways they can adjust to the holidays. One option is to create new holiday traditions. If holidays were celebrated as a family, new traditions can be planned as a family, so everyone can have input. This will give family members an opportunity to discuss their feelings about the deceased loved one and possibly include something in the new tradition that commemorates that person in an uplifting manner. This could be a type of memorial that adds pleasure to holidays in the future, something that would have pleased the deceased.

Whether celebrating the holidays alone, with others, or not at all, people should always follow their hearts and do what feels best for them. There is no one way for everyone. There are different ways that work well for different people. Some people who found the holidays stressful, phony, or too commercial before their loved one died may want to redirect their holiday focus. They might choose to participate in an activity that is calmer and more meaningful to them such as volunteering at places where they can help others or sharing with others in another capacity. Others may want to celebrate alone or with a few friends, take a trip to another state or country, or just be involved with something they enjoy doing that may or may not have anything to do with the holidays, but everything to do with their own quality of life."

© Frances Shani Parker

This video by TheLightBeyond.com offers bereavement support based on the sympathy poem “Do Not Stand at My Grave and Weep.” The poem comforts with thoughts that the deceased loved one is reflected in nature.

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

Hospice and Nursing Home Christmas Story

Have you ever celebrated Christmas in May? A hospice volunteer in Detroit nursing homes, I shared a wonderful Christmas in May experience with one of my patients. Sometimes patients needed me to help them solve problems. One day, Inez and I had an especially great visit. I had been thinking about how to find a key for a music box her niece had given her for Christmas. She loved that music box and liked to have it on display, so she would have a good excuse to talk about it. She had never heard it play because the key was missing when she received it. She said her niece had tried to find a key, but with no success.

The music box was a lovely piece of handiwork. A wooden base supported a clear glass container. Inside the container lay a beautiful butterfly resting on a small floral bouquet. Underneath the box was a hidden switch that made the seasonal display enchant with spurts of brightness. Inez, my ninety-two year old patient, said that she often sat and watched the softly glowing scene blink on and off. One night, she and I quietly watched it together. That's when I realized how much this silent little music maker meant to her. Unfortunately, neither of us knew what song it was supposed to play. We imagined the Christmas song we thought it should play and hoped one day we could solve the mystery.

Getting the music box to play became my project, but I knew I would need some help. The next day, I explained the problem to Burton, a teacher at my school. He decided to become a part of the solution by checking out some stores that might have the missing key. It sounded like the search for Cinderella's shoe. After looking for two weeks, Burton finally found a matching key at a large toy store. The sales lady was so touched by his story about Inez's "musicless" box that she gave him the key free of charge. We couldn't believe our good fortune, which became Inez's thrill maker.

In the second week of May with spring showing off nature's fashion makeover from winter, Inez heard her cherished music box play for the very first time. She picked it up gently and carefully placed it near her hearing aid. The song we had wondered about for months, the song that had driven us to discover its name finally played the sweetest version of "Joy to the World." Just hearing the music box fulfill its purpose felt like a miracle. Inez grinned widely, thanked me, and told me to thank the nice man who found the missing key that made her music box come alive.

The mystery had been solved, and Inez was ecstatic. I thought nothing else that day could outdo the pleasure of hearing the music box play, but I was wrong. After Inez set her mechanical miracle on the window sill, so we could admire it playing and revolving, something wonderful occurred that surprised us both: The brightly colored butterfly started moving, slowing creeping up to the opening red flower. Inez and I gave each other eerie "Twilight Zone" looks. Then we shared rainbow smiles about the joy in our own little world.

© Frances Shani Parker (excerpt from Becoming Dead Right: A Hospice Volunteer in Urban Nursing Home)

Frances Shani Parker, Author

Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.

Hospice and Nursing Homes Blog