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Companioning 
Started by Digger
26 Oct 2012, 3:54 PM

The recent death of my ex-wife of liver cancer drew me into the role of primary care giver for the last months of her life. I was grateful for my prior training in Hospice and the support of close friends. She died at home and was not on any pain medication.

I learned so much from her. Her passing helped to define the role of companioning. I have since run into many people in the position of supporting someone through the dying process and many do not consider hospice. 

I am defining companioning as 'the art of compassionate presence with one who is dying'.

This is evolving into a short course titled, Companioning The End-Of-Life.

I would love to hear of others who have experienced being in the unique position of a companion. 

Dale 
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26 Oct 2012, 9:39 PM

Welcome to Virtual Hospice Digger.

We have several hospice volunteers sharing on Virtual Hospice. Do you consider all hospice volunteers who support people through the dying process to be companions? What is your definition of companioning?

I look forward to connecting you with others.
Colleen 
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Reply by Brayden
27 Oct 2012, 12:04 AM

Dear Dale,
Thanks for posting on this site and I know you will find it rewarding. I have been a Hospice Companion for 15 years through our organization in Winnipeg. I also volunteer at  Jocelyn House, (a four bed private hospice) every week. In the past I have also volunteered in two Paliative Care Wards in our hospitals. I can truly say that it is myself that has learned and benefited the most from this opportunity. Like how privelaged can you get when a family calls you to the hospital to be present for the final breath. I have done follow-up bereavement support as the need presents itself. Hoping to hear more from you.
Brayden 
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Reply by Digger
27 Oct 2012, 5:17 PM

Hello Colleen and Brayden,
A companion has the following skills/qualities:

    • Compassionate presence
    • No agenda
    • Creates safe space
    • Non-verbal communication skills
    • Understands boundaries
    • Practices self-care
    • Advocates (Advance Care Plan)
    • Familiar with ADC or after death communications 
    • Comfortable with altered states of consciousness

As you are aware, many people do not contact hospice at all. Companioning is for the average person who suddenly finds themselves at the bedside of one who is dying. Not all hospice volunteers are companions. Most current hospice training does not cover the last two points on the list.

Dale
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Reply by Plum1
29 Oct 2012, 5:43 PM

Dear Dale,
I volunteered for a number of months as a palliative care volunteer while also being present to my parents, aged 100 and 90. I finally needed to let go of the volunteering when my parents began to need even more time. I would say that I have been 'companioning' in all of these relationships. I also happen to be a psychologist and in my years in this work, have learned to be open to all the surprising and powerful tpyes of communication before and after death.  I am not sure how ADC would be officially defined, but I think I would be open to its reality.

Being with someone who is on the journey towareds death is truly a privileged experiernce. I have not yet had the experience of actually being present at the death of a person. I hope to be present at the death of my parents. A few months ago, the doctor was giving us the message that Mom was very close to death, and while present to her, I was paying special attention to all that she was communicating to pick up what her needs were, what was important to her. Mostly, I was showing in every way I could that I loved her, and appreciated how she had loved me. She is now 101, nearing 102, and, while I and she celebrate each moment of her life with us, I also know that she is close to another dimension of life. She often refers to a desire to "go home", and for me that is a metaphor for that state of being which will come after death. So we journey together in that sacred space wihich is open to both realities.

What do you hope for in opening up this topic of 'companioning'?

Plum1
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Reply by Digger
29 Oct 2012, 6:11 PM

Hi Plum1

Thanks for sharing your experiences. I agree with you about sharing death being a privledged experience.

Companioning is a term that the average person can use to describe the experience of being with someone through the dying journey. Often the primary care giver is the companion. Companioning is your way of saying to the dying one that you will be there no matter what, no matter where, no matter when. Companioning is more than this. A companion is attuned to feeling states and is able to communicate non-verbally in a variety of ways. Some of us are naturals at this, others like myself, had to learn the skills.

Companioning supports what we call a 'good death'. No fear, no suffering, little or no pain, no unnecessary interventions.

I love the metaphor of 'going home' or taking a trip. Using metaphorical language is a great way to communicate with a dying loved one. Your parents are fortunate to have such sensitive and caring companion.

Dale


 
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Reply by eKIM
29 Oct 2012, 8:22 PM

Hi Dale,

I am sorry to hear about your wife’s passing.  I cannot imagine the range of emotions that one would go through.

I am pleased to see your posting.  I have long wanted to see a section of Virtual Hospice that drew hospice volunteers (and other interested people). 

The experience of being a hospice volunteer, or at a deeper level, (I would imagine), a “companion to the dying” is so profound that it is hard to explain to another who is not involved in this service.  Even one’s spouse, as close as they are to you emotionally, cannot fully understand.

In my experience, it is difficult to connect with other volunteers to share experiences, and on-going training with.  This is ironic, in that there are thousands of volunteers worldwide who would have much to share, especially with relative newcomers, such as myself. 

I began volunteering as a resident support/spiritual care volunteer two and a half years ago.  I still feel like a “babe in the woods”, volunteering in this area.  Previous to this I had no training or experience in the social services.

I would be keen on continuing this thread, this conversation with any and all who are similarly interested, for two reasons:  a) I would like to learn more about companioning,  b)  I would like to fine a group of volunteers and others who would like to post and share thoughts and ideas specific to being a hospice volunteer.

I look forward to hearing from you, Dale and also Brayden and Plum1

Ekim

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Reply by Plum1
30 Oct 2012, 1:38 AM

Dear Dale and Ekim,
It is amazing how we find ourselves drawn into these sacred relationships. And even with all the training, I believe we learn most from the experience of being with someone, open to what we will learn from her or him. Picking up the cues on how someone is feeling is aomething we keep learning, I believe. Hopefully, we have a natural sensitivity which can be developed even further. And communicating non-verbally ourselves is partly what comes from our hearts, and partly what we may gredually learn from watching others who are gifted in that way.

As far as my experience of non-verbal communication goes, I beleive powerfully in what we can communicate through our eyes. Mom and I say a lot to each other siltently through our eyes. And touch is huge way of communicating, but it does call for sensitivity to boundaries, and the particular state of the person. A dying person, and an older dying person for sure, is extremely sensitive, and needs to be touched with great gentleness.  While volunteering in palliative care, I took advantage of being allowed to give foot and hand massages. This kind of touch comes naturally to me, and I saw how, when the person desired it, it was an incredible way of communicating compassion, care and healing. The person receiving became very peaceful, comforted.

Ekim, you mention that you volunteer as a support/spiritual care person. The spiritual dimension of the dying process is very important to me. When a dying person is open to relating to their spiritual experience, or brings it up, I have had such deep and meaningful moments of sharing and prayer.

What other aspects of companioning come to each of you out of your experience?

Plum1
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Reply by Digger
30 Oct 2012, 3:56 PM

Hi Ekim,

I will be flying to Calgary from Vancouver Island this weekend to give a workshop called Companioning The End-Of-Life. I will be talking about:

    • common fears of the dying
    • the dying journey
    • qualities and skills of a companion
    • companioning the good death

I have just finished hosting a Wednesday evening discussion at home to review the course material. The feedback from others was so helpful, as are forums like this.

I am hoping that Colleen will approve this post. I don't want to violate the discussion guide lines around promotion but if you are in the Calgary area and would like to come let me know.

Dale
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30 Oct 2012, 8:09 PM

Hi Dale,
Thank you for being sensitive to the guidelines with respect to promotion. While the guidelines state: "No commercial postings, advertisements or solicitations," we are happy to hear about educational opportunities. You may consider submitting your future workshop date for evaluation and inclusion in our calendar of Courses and Conferences. (Scroll down to "Add an Event.")   

I'm enjoying this conversation about companioning. As eKim says, a discussion that draws volunteers together is overdue. Thanks for getting it started.
Colleen 
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