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Ensuring No One Dies Alone

We come into this world with others. Usually people are delighted a new life is joining society. They send gifts and congratulations to the new parents. There is, however, no ticker tape parade when we die and in many cases, those with terminal illnesses dies without family, friends or loved ones by their side. They spend their final few hours, days or minutes alone. Essentially, we should have the same experience with death as we do at birth. Someone should be there when our final moments come. To ensure each dying patient has companionship Kaiser Permanente Santa Clara has created the No One Dies Alone program.

The original NODA program was started by Sandra Clark, a nurse at Sacred Heart Medical Center in Eugene, Oregon, after one of her patients asked if she could sit with him for a moment. She responded by telling him she would come back after completing her rounds. When Clark returned, the patient had died. The experience led her to create a program where no patient would die alone.

After reading an article about a similar program at Stanford University, Kaiser’s manager of spiritual care services, Therese Becker, found herself in tears. “I thought it was beautiful so I Googled the program and right there was Sacred Heart Hospital. I contacted the office and they sent materials on how to start the program. It was the best $50 I ever invested.”

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Becker contacted one of Kaiser’s long-time volunteers, Laura Donnelly, whose sister had recently sent a copy of the same article Becker read. Donnelly immediately signed on to become the program’s coordinator. “I couldn’t do the program alone,” said Becker. “The program would not exist if it were not for Laura.”

Kaiser’s program has been part of the services offered at the Santa Clara location for over a year and many of the experiences they’ve had are powerful. Becker has sat with many patients before they die, one in particular sticks out in her mind. “I walked into the room and took her hand…The woman looked over, saw there was a person there and then passed.”

Many of the volunteers are Kaiser employees who spend their lunch breaks or a few hours after work sitting with patients, but the program is not limited to Kaiser employees. Anyone with a compassionate heart and desire to be there for someone who may not have family members nearby is welcome to get involved with the program, pending they become a volunteer with Kaiser first.

Another volunteer, and Kaiser employee, Cristina Baldovinos, recently experienced one of the more amazing stories as part of her service. Prior to leaving for the day, Baldovinos was called with a request to sit with a patient. Baldovinos’ father had a similar ailment and the patient herself had the same name as Baldovinos’ sister. Baldovinos sat with her until the patient took her final breath. She returned to her desk, but felt she needed a moment before leaving for the day. The next afternoon, Baldovinos received a phone call explaining her father had died the previous day. His passing coincided with the time Baldovinos spent with the Kaiser patient. The experience for Baldovinos was powerful.

Based on many people’s feelings about death and how it coincides with religion, it is easy to assume Kaiser’s NODA program is religious-based, but it is not. Kaiser believes NODA is a human program and volunteers are not asked to do anything they are uncomfortable with.

When sitting with a patient, Kaiser asks that all volunteers be present. This isn’t a time to do crosswords or play with their iPhones. It’s a time to be there for the patient, who may or may not be conscious. Each volunteer has the option to take a bag into the room. Inside the bag are things like an iPod with music, flameless candles and a sound machine. There is also a notebook for the volunteer to write down their observations, and often volunteers will bring in a book and read aloud to the patient.

“The program was originally for people who didn’t have family, but we also offer respite for families,” said Donnelly. Many times family members cannot be at their loved one’s bedside 24 hours a day. They may have to return to work or take care of their own needs so Kaiser offers its services. “[Families] are very comforted by the idea someone is there.”

Recently, Kaiser held a small event to honor the patients who had been in the program. One gentleman, who was unable to be present when his wife died, was able to receive closure once he spoke to the volunteer who was with his wife during her final moments. Conversations like the one the gentleman had with volunteers serve as a reminder of why they got involved with NODA in the first place. Becker says that one of the best pieces of information she learned from the training manual is that “we aren’t born alone and under the best of circumstances we don’t die alone.” Kaiser, with the help of Becker, Donnelly, Baldovinos and all of the dedicated volunteers is trying to making sure no one in their care dies alone.

For additional information on Kaiser’s NODA program, contact Therese Becker at 408-851-6283 or Therese.M.Becker@kp.org.

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