I chose to volunteer with the Athena Hospice Program because it offered a unique opportunity to gain a better understanding of patient care outside of an acute clinical setting. Through this program, I’ve come to appreciate how healthcare extends beyond prescribing medication and treatments. It includes offering palliative care and companionship support as people approach end of life due to age or terminal illness. Having worked at an assisted living facility for four years in high school, I quickly learned that I enjoyed working with elderly people. I appreciated their wisdom and outlook on life, and that I could connect with them beyond our age and lived experiences.
My patient was “Rochelle,” an 86-year-old woman living with dementia who had a bright personality. At our first visit, I remember her being delighted to see me and my fellow volunteer, welcoming us as if we were old friends and showering us with admiration and encouragement. I drew from my previous experience of working with my dear residents to be an active and engaging presence. If “Rochelle” was a bit drowsy, I’d rouse her and see if she was interested in talking or participating in the activities going on that day. I would use cues from our surroundings to prompt conversations, such as complimenting her sweater and encouraging her to keep up her performance during an activity. I would then ask her about her opinions on different seasons, foods, activities, careful to avoid questions phrased in ways that would require recollection of past events. Due to her dementia, I noticed that some questions would make “Rochelle” draw a blank, though once I rephrased the question in the present and future tense, she was more comfortable answering. This role has reinforced my belief that a big part of being a physician is knowing how to effectively communicate. The science and medicine are not as useful if the physician is not able to establish a sense of trust and comfort with their patient.
The Athena Hospice Program allows pre-med students to develop and refine their interpersonal skills. I’ve recognized the importance of leading through actions and leaning into creativity. When I sense that a resident may be feeling lonely or isolated, I try to bring them into my conversation with “Rochelle” or ask the two residents if they know each other or even suggesting that the residents engage in the activity going on that day. Instead of outrightly pointing out personal anxieties such as loneliness or feeling disconnected, I find that it’s better to take action to address these issues. I believe that navigating these experiences, will enable me to effectively connect with patients and provide better care. I have grown to value the importance of community and developing a support system among care providers. End of life care is sensitive and long-term in nature at times. It is a transitioning period characterized by sensitivity, reflection and anxiety. It can also be an uncertain and changing time. I recall feeling a bit shocked when “Rochelle” was not her usual self, most likely due to sundowning since we visited her in the afternoon, and we regularly went in the morning. My fellow companion volunteer and I debriefed in the car after our visit, reflecting on the experience and making sense of it. We continued these reflections at our monthly volunteer meetings where we heard about the impact that our work took on us and shared strategies on how to take care of ourselves in order to excel in our companionship role.