Direct Care Hospice Education

The Direct Care Hospice Education program prepares volunteers to provide direct care to hospice clients and families
in compliance with Maine State regulations

Direct Care Volunteers do not provide physical care

A certificate is awarded when the participant achieves the program outcomes and has completed 22 hours of study
which includes the Core Curriculum (13 hours) and the
Direct Care Hospice Education module (9 hours)
CORE CURRICULUM Outcomes        print a copy

Children’s Developmental Stages and Understanding of Death [1 hour]
    Examine developmental perspectives of children’s growth (developmental and cognitive stages)
    Describe how children acquire an understanding of death
    Gain insight into how children perceive their own imminent death

Communication Skills
[1.5 hours]
    State the difference between a social relationship and a helping relationship
    Demonstrate reflective listening skills
    Demonstrate effective body language
    Identify and avoid barriers to helpful communication
    Allow the client and family members to share their experiences related to the loss
    Be prepared to respond openly and honestly when children and/or adults ask questions about
        dying or death

[1 hour]
    Respect value systems of the hospice person and family
    Identify and keep personal boundaries
    Maintain confidentiality of hospice person/family information at all times, limiting discussion to
       individuals or agencies identified in the Pine Tree Hospice "Authorization to Release
       Confidential Information" signed by the client and on file at the PTH office
    Read the Pine Tree Hospice Confidentiality Policy
    Recognize situations in which Mandated Reporting is necessary
    Identify the role of the volunteer when abuse or domestic violence is suspected or confirmed
    Discuss ways of honoring the wishes of both the client and the family when differences, such as
       pain management issues, exist

Family dynamics
 [1.5 hour]
    Identify family dynamics expected to occur during the end of life
    Describe the role of the volunteer in dealing with complex family issues and dynamics
    Support existing family dynamics, unless the family environment is unsafe
    Report, in a timely manner  to the Pine Tree Hospice Coordinator of Volunteers and Client
       Services, any unsafe environment or when abuse, neglect or mistreatment is suspected or

Grief, loss and transition
[1.5 hours]
    Examine the concept of coping with loss and change
    Define the different types of grief, including anticipatory grief
    State cognitive, behavioral, physical and emotional manifestations of grief
    Recognize situations that can interfere with coping with grief
    Identify ways a volunteer can assist a person or family with transitions and losses related to
        life threatening illnesses and death
    Communicate an understanding that each person has permission to grieve or cope with
        transitions in his/her own way

Hospice Philosophy [.75 hour]
    Discuss the philosophy and purpose of a volunteer hospice program
    Describe services offered by Pine Tree Hospice
    Become familiar with the Pine Tree Hospice Mission Statement and the Maine State Regulations
        governing a volunteer hospice program
    Briefly describe the difference between a volunteer hospice and a Medicare hospice
Personal Death Awareness [1.5 hour]
    Examine personal views and beliefs about death
    Achieve a level of comfort in discussing death
    Discuss issues related to advanced care planning, including a discussion of "The Five Wishes"
        published by Aging with Dignity
    Discuss the use of ethical wills

Personnel Issues [.75 hour]
    Describe the Pine Tree Hospice organizational structure
    Read and comply with the Pine Tree Hospice Sexual Abuse Policy, Elder Abuse Policy, and
        Infection Control Policy
    Review and plan to complete and submit required paperwork to the Pine Tree Hospice office
        on time
    Identify the appropriate resource person(s) when questions or problems arise

Spirituality [1 hour]
    Define and state the goals of spiritual support
    Identify behaviors to avoid when giving spiritual support
    Discuss how a volunteer can help a hospice person/family achieve their spiritual goals
    Be prepared to help the dying and the bereaved to say to one another:  "I love you", "Thank you",
       "Please forgive me for...", "I forgive you for...", "Good Bye"   
    Discuss ways of praying with a person/family when invited or with permission
    Identify resources in the community that can offer spiritual support
  Demonstrate tolerance of religious or spiritual beliefs which differ from one’s own; if
      tolerance is unacceptable, know that reassignment is an option

Stress Management: Conventional And Complementary Therapies [2 hr]
    Define stress, name some causes of stress, and recognize how stress affects us and those around
        us: body, mind, feelings and spirit
    Discuss balanced nutrition, physical activity, restful sleep, joyful diversion and service to others as
        conventional ways of managing stress
    Briefly discuss the origin, beliefs and current practice of some complementary therapies
    Select and use conventional and complementary therapies for yourself and others to relax, to
        minimize pain, and/or to promote physical, mental and spiritual wellbeing
    Consult the NIH National Center for Complementary and Integrative Health website for current
        information (
    Support people who use complementary therapies

Volunteer Roles: and Introduction [.5 hr]
    Discuss the roles and general expectations/boundaries as a PTH volunteer

HOSPICE EDUCATION MODULE Outcomes        print a copy

Funeral Arrangements [1.5 hours]
    Become comfortable discussing a list of tasks, such as funeral arrangements, with a hospice
        person and/or family
    Identify funeral services available in the community

Multidisciplinary Management And Hospice Resources [1 hour]
    Become familiar with additional community resources for hospice clients and families
    Report client/family needs and suggested referrals to the PTH Coordinator of Volunteers and
        Client Services in a timely manner
    Explain the various roles of PTH volunteers and other hospice team members (medical hospice
        as well as other community providers)
    Develop an understanding of a Pine Tree Hospice team meeting
    Using resources such as the Funeral Consumers Alliance of Maine (, be
        prepared to discuss alternative funeral arrangements when requested by client/family

Pain and symptom management [1.5 hours]
    Briefly describe health problems commonly experienced at end-of-life (ie COPD, degenerative
        neurological diseases, CHF, sudden cardiovascular and cerebrovascular events, pneumonia,
        systemic infection, kidney failure, liver failure, metastatic cancer)
    Define palliative care
    Be prepared to use, and to teach the family to use a pain rating scale to assess and document
        level of pain
    Discuss health problems associated with various chronic Illnesses
    Identify medical interventions in the management of pain and other symptoms that may occur
        during the dying process
    Identify ways a volunteer can assist a person receiving palliative care

Psychological perspectives on death and dying [1 hour]
    Describe the phases of living with a life threatening illness as described by Kenneth Doka, Ph.D.
    Identify the physical, psychological, social, and spiritual tasks of coping with dying as described
        by Charles Corr, Ph.D.

Support During Stages Of Dying [2 hours]
   Be prepared to discuss ways a volunteer can assist a hospice person/family to cope with the
        various needs and losses during the dying process including:
            a) physical changes (eating, digestion, breathing, weakness, skin changes, bleeding, pain,
            b) mental, spiritual, emotional and social aspects (unresolved conflicts, withdrawal, visions,
                restlessness, confusion, giving permission)
            c) signs of approaching death (final 1-3 months, 1-3 weeks, days or hours, minutes)
            d) final days or hours before death (general agitation, temperature, digestion, breathing,
                decreased awareness, eyes, pain, saying goodbye)
   Practice doing a "Life Review" or "Guided Reniniscence" using objects in the client's
        environment or history to begin the discussion

Volunteer roles [2 hours]
    State the responsibilities expected of a hospice volunteer
    Know where to find a copy of the Pine Tree Hospice Policy Manual
    Know what a volunteer should do in the home when death is imminent or has occurred
    Read and sign the forms to be filed in the Pine Tree Hospice office