Volunteers visiting the homes of those with life-threatening illnesses

Diana Senior

Adapted extracts from a report by Diana Senior on the start of the Befriending Network, which aims to provide volunteers to help out the carers in the homes of those who are critically ill. The Befriending Network was set up by The Natural Death Centre and is run by Diana from Oxford. At present its main focus is London and Oxford, and it hopes the activities there will act as a model for other regions in due course.

Since the end of 1994, the work of the Befriending Network has been mainly absorbed with recruiting volunteers, outreach work with users and their agencies, and developing the training programme. We have decided to target two areas for this work: North London and Oxford. We have continued to answer queries and give advice on matters related to caring for gravely ill people at home, mainly via telephone, all over Britain.

Staff

I continue as co-ordinator, working three days a week, based in Oxford. In February '95 we appointed Josefine Speyer to work one day per week to take responsibility for supervision needs for volunteers and workers, and to help develop and deliver the training programme. Early in '95 we advertised the part-time post of a London based co-ordinator to support the group of volunteers currently working in North London and to develop the service. Unfortunately we did not attract a suitable candidate. The post has been re-advertised, and we will hope to appoint someone for two days per week in the autumn of '95. In the meantime, Josefine Speyer had agreed to support London-based volunteers.

We also rely on volunteer help: the Oxford-based steering group, composed of five individuals from local organisations, have put time and energy into publicising the project and helping with outreach and information. In addition, a student apprentice works a couple of hours weekly with administration tasks and with building our data base.

Volunteers

Recruiting Volunteers In Oxford we have used various strategies. The following have been the most effective:

  • Appealing for volunteers through Oxfordshire Council for Voluntary Action.

  • A press release brought invitations to talk on local radio stations (the Bill Heine Show on Oxford FM and the Tonight programme on Fox FM) and a small piece in the Oxford Mail.

  • Holding an introductory public meeting at Friends House in Oxford, publicised through mail-outs to all likely voluntary organisations, student bodies, religious groups, GPs practices, the listings in Green Pages and the LETS system. The meeting was well attended by representatives from local caring organisations and people interested in volunteering. After interviews, twelve individuals decided to join the training programme, six are now in the process of being trained, with a further six opting to start training in September '95.

  • A small advertisement in the Oxford Times proved very successful, so that we have a training group of nine, as well as volunteers waiting to be trained in the autumn.

    In London, most of the seven volunteers on the training programme came through The Natural Death Centre's mailing list, with others attracted by an advertisement in Time Out, and through ads in local volunteer bureaux. We feel confident that we can attract further volunteers, using our experience in Oxford, when the London volunteers organiser is appointed.

    Profile of Volunteers: Volunteers are very varied in age and background. The majority are women (we have four male volunteers on our training programmes at present out of a total 16); ages range between early twenties to mid fifties, with the majority aged between 20 and 40. Most are employed, a sample of occupations reveals: care assistant; academic anthropologist; department store manager; occupational therapist. Most share some experience of loss in their lives, though this bereavement is not always related to a death.

    We have been impressed and moved by the qualities and skills the volunteers have brought to the Network. For future training programmes we will actively recruit volunteers from the ethnic communities in the areas where we are working. In Oxford we have been asked for befrienders bilingual in languages of the Asian subcontinent, particularly Urdu and Gudjerati; and we are taking advice on how to target such volunteers.

    Training

    The training programme for volunteers started in London in November 1994, with an introductory day for volunteers. This continued with occasional all-day training days, usually held on Sundays. Experience has taught us that volunteers need a structured programme, and that in order to ensure regular attendance, training sessions should take approximately the three hours volunteers have committed weekly to the Network. In London the training now takes place once a month on Sunday afternoons. The London volunteers are now confident to take on befriending links, so the training doubles as a support group.

    In Oxford we have instituted a six week introductory training programme. Sessions include work on participants' own experiences and fears around illness and death, the emotional and spiritual needs of the gravely ill and their practical needs both material and physical. Further training will be given regularly as part of the support group process.

    Most of our volunteers would probably be wonderful if they walked straight off the street into the home of a dying person, so we have been asked 'why train?'. In fact we do ask volunteers to share their skills in the group and deliver parts of the training themselves. The main benefits of the training process include:

  • The formation of a group; this promises mutual support to volunteers and is a way of encouraging their continued involvement in the Network.

  • It is a good way for the co-ordinator to get to know individual volunteers. This helps in arranging befriending links and in giving the necessary support.

  • It offers some emotional protection to volunteers who have not anticipated their own feeling around work with gravely ill people.

  • We hope that the training we give will be an aid to self-development, and therefore is something we can give to volunteers in return for their commitment.

    Future training needs

    As well as a commitment to spread training groups for volunteers throughout, Oxfordshire and beyond, we have been asked by individual carers and carers organisations to provide similar training for existing carers. This is outside our current brief, but we may consider a pilot scheme.

    Using the service

    The initial outreach in Oxford targeted both potential users and potential volunteers. We hoped to appeal to users in the most direct and flexible way, so that the scheme would be perceived as outside the normal channels of 'referral' and 'service provision'. However we soon realised that we needed not only to advertise the availability of the service, but to ensure that recommenders understand and trust it. We needed to meet and talk to people in the various agencies who might suggest having a befriender to one of their users.

    We had instant responses from the carers organisations throughout Oxfordshire. They have publicised us through newsletters, put us on their databases, and invited us to speak at open days and as part of their 'Caring for Carers' programme. We had equally immediate responses from voluntary caring organisations, such as Crossroads, and the Elmore Team which has responsibility for recently homeless people with multiple problems. Both organisations stated that they could instantly identify clients who would benefit from the support a Befriender could offer.

    We have talked to social services care teams throughout the city and in North Oxfordshire, getting the most enthusiastic response from the disability teams. We have been invited to talk to Hospital Care Managers at the Oxford Radcliffe NHS Trust, with the view to appropriate patients being offered Befriending as part of their discharge package. This is an exciting development as the feasibility study for the Network revealed that terminally ill people generally get offered too much support too late. Offering a befriender very soon after the diagnosis of a possibly life threatening condition gives the ill person additional support in taking control over their own situation, time to plan, time to build a relationship.

    Another exciting possibility is to work in partnership with GPs, with befrienders attached to individual practices. This is a suggestion from Doctor Elisabeth Lee (author of A Good Death ) who has also advised us on ways of reaching GPs. We now have invitations to speak to members of the GP practice in Blackbird Lees, with the possibility of an attachment there, and to GPs throughout the city, through the post-graduate seminars held at the John Radcliffe Hospital.

    Further developments

    At present our main aim is to establish thriving model pilot projects in Oxfordshire and North London. We believe that if these are successful the Network will grow in response to demand. Meanwhile we are aware of the need for a services of this kind throughout Britain.

    We have requests for befrienders from all over the country. These often come through hospice or palliative care organisations in areas where there is no home visiting service. (Most, numerically, come from the Wirral and Northumberland.) Currently we offer information and advice on possible support, eg through organisations supporting particular illnesses or the Ananda Network. Very occasionally we are able to match the request with an untrained volunteer in the area who is willing to be contacted.

    Groups and individuals in Bristol and Edinburgh are interested in setting up branches of the Befriending Network in these cities, with plans quite advanced in Edinburgh, so we are considering helping to support these developments with resources and small initial funding.

    The Befriending Network, 11 St Bernards Road, Oxford OX2 6EH (tel 01865 512405).


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