Hospices Adapt As Volunteers Return to a Changing Landscape

Volunteers stand alongside the many other unsung heroes of hospice care, providing essential services that have seen massive disruption during the pandemic. As infection numbers begin to fall, providers are re-mobilizing their volunteer corps, applying lessons learned during the pandemic.

Hospices have kept volunteers as engaged as they could, often through the nearly ubiquitous virtual communication that has come to the fore since 2020. Recently, more volunteers began gradually returning to the bedside, though in diminished numbers.

“The national average is that most places have lost 30% or 50% of [the volunteers] they had before the pandemic, and how you’re doing now has a lot to do with what you did for the last two years,” Melissa Moré, director of volunteer services at Florida-based Suncoast Hospice, told Hospice News. “If you come to a complete stop, and you’re still waiting for something to wake you up and say, ‘it’s go time,’ then you’re not in a good place.”


During the pandemic, Suncoast, an Empath Health subsidiary, took steps to keep their volunteers engaged. They continued to provide training to new volunteers via Zoom to reduce attrition, as well as conducting regular webinars and other activities.

Tidewell Hospice, another Florida-based Empath subsidiary, also sought ways to keep volunteers as active as possible without requiring person-to-person contact, according to Stacy Groff, vice president of specialized services. 

Tidewell volunteers maintained virtual contact with patients during 2020 and 2021, wrote them letters, and made or collected items that could be delivered to their homes. They made pillows, fidget mats, and caddies for walkers, among others.


Through efforts like these, volunteers are a source of comfort for many patients. But volunteerism is also legal requirement for providers.

The U.S. Center for Medicare and Medicaid Services (CMS) requires that volunteers provide at least 5% of hospice patient care hours, a rule that is temporarily suspected during the COVID-19 public health emergency. At some point, however, providers will again need to ensure they are in compliance.

The nation’s 420,000 trained hospice volunteers generate more than $469 million in annual savings for providers, according to 2019 data from the National Hospice & Palliative Care Organization (NHPCO). These individuals provide more than 19 million hours of service each year at an estimated financial value of $24.69 per hour, NHPCO reported.

Among the most simple but critical supports that volunteers offer patients is companionship. The act of spending time with a patient may be low-acuity and low-tech, but the pandemic underscored its importance as millions of seniors languished in isolation due to infection control concerns.

The prospect of once again leveraging volunteerism at pre-pandemic levels is welcome news for providers, but most will not be able to simply pick up where they left off. Hospices will need to adapt to a changing health care and social environment.

This includes not only the long-term effects of the pandemic, but the reality that volunteers are aging along with the rest of the population. Many may no longer be able to remain active in the coming years, according to Groff.

Generally speaking, the pool of hospice volunteers bears a somewhat close resemblance to the hospice patient population. Many are retirees who have daytime availability to spend with patients or associated tasks.

With COVID still lingering, these seniors remain among the most vulnerable to the virus in addition to coping with the effects of aging.

“You’ve got a whole generation that’s aging out of the volunteer pool. The younger boomers and the Gen Xers are going to be a completely different animal to deal with,” Groff told Hospice News. “We have to learn how to adapt now. And I think COVID probably taught us a little bit about how to pivot and move and do things differently.”

These pivots will likely involve new ways to communicate with and recruit volunteers. Many of the activities such as training that shifted into the virtual space during the pandemic will likely remain there to a large degree.

Some of the concerns of younger volunteers echo those of paid health care staff, such as more flexible scheduling.

The ability to strike a healthy balance between workload and personal life has become increasingly challenging for hospice employees as demand rises and the labor pool dwindles. Many of these issues also apply to the unpaid volunteer workforce.

Volunteers in hospice also need the resilience to cope with the emotional toll that can come with working with the dying.

“We have to work a little harder to get people engaged, because people aren’t falling over themselves to do this work. We have to think about how we become more flexible,” Moré said. “I think it’s forced us to work a little harder. We’ve relied on senior adults who have time to give, but that landscape is changing. We’ll have to attract a different type of volunteer.”

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