CANADIAN HOSPICE PALLIATIVE CARE VOLUNTEER TRAINING SURVEY (SPRING 2016) - SUMMARY OF RESULTS

Stephen Claxton-Oldfield, PhD & Willa McCaffrey-Noviss

INTRODUCTION

In hospice palliative care programs across Canada, volunteers are important and valued members of the caregiving team. Training is absolutely essential to prepare volunteers for their interactions with dying persons and their families. In 2012, the Canadian Hospice Palliative Care Association (CHPCA) developed a standardized training program for hospice palliative care volunteers, with the intention of it being used across the country to “ensure that volunteers receive the consistent training and information they need to provide high quality services.” Some provinces (e.g., British Columbia, Ontario, Nova Scotia) have previously developed their own hospice palliative care volunteer training manuals.

In the United States, national and regional surveys have been conducted regarding hospice volunteer training (e.g., Lavenburg & Bernt, 2012; Wittenberg-Lyles, Schneider, & Oliver, 2010). In Canada, as far as we know, no national surveys have specifically focused on hospice palliative care volunteer training. Therefore, a survey was developed to gather information from across the country about the selection, training, and support of hospice palliative care volunteers. A summary of the survey results appears below. Note. Only aggregate data are reported in this summary.

SURVEY OVERVIEW

An online survey was developed using the Canadian-hosted web survey tool FluidSurveys.com to collect information about the following:

  • type of volunteer program (e.g., community-based, hospital-based, residential hospice)
  • number of volunteers (direct patient/family contact, administrative, grief and bereavement) in the program
  • selection, training, and support of direct patient/family contact volunteers 
  • types of support that direct patient/family contact volunteers can provide 
  • suggestions for additional training topics 
  • the volunteer coordinators’ background, roles, and responsibilities. Note. This data will not be reported in this summary.

An invitation to participate in the study was sent (via email) to the volunteer coordinators/managers of hospice palliative care volunteer programs listed in the CHPCA’s Directory of Services; it was also sent (via email) to the volunteer coordinators/managers of 121 hospice palliative care volunteer programs listed in the Canadian Virtual Hospice’s listing of programs and services. The invitation described the purpose of the study and included a link to a Web-based version of the survey (FluidSurveys). Note. Some volunteer programs may have received the email invitation twice.

RESPONDENTS

Fifty individuals fully completed the survey; 8 individuals partially completed the survey.  The overwhelming majority of the respondents were female (96.5%). The mean age of the respondents was 52.2 years (SD = 11.5), with ages ranging from 25 to 70 years. The majority (76.4%) of the respondents were married and nearly all (96.3%) had attended university or college. Although the survey was intended for volunteer coordinators/managers, five of the respondents identified themselves as something else (e.g., executive director, volunteer). Note.  Valid percentages are reported throughout this summary (not all respondents answered every question).

SURVEY RESULTS

Responses were received from seven provinces and one territory, with the most (24, 41.4%) coming from Ontario.

Type of Program:

  • community-based (26, 44.8%)
  • residential hospice and community-based (15, 25.9%)
  • hospital-based (5, 8.6%)
  • residential hospice (4, 6.9%)
  • other (e.g., hospital- and community-based, hospice unit attached to long-term care facility) (8, 13.8%)

Number of Volunteers:

  • direct patient/family contact volunteers. Total = 3,398 (female = 2,776 and male = 370); range = 4 to 350 volunteers
  • administrative volunteers. Total = 1,774 (female = 1,408 and male = 264); range = 0 to 329 volunteers
  • grief and bereavement volunteers. Total = 602 (female 478 and male = 59); range = 0 to 52 volunteers

Note. Not all respondents could provide a breakdown of their programs’ volunteers by gender.

Training for Non-direct Patient/Family Contact Volunteers:

  • 42 (72.4%) respondents indicated that their administrative volunteers do not undergo the same training as their direct patient/family contact volunteers; 12 (20.7%) indicated that they do and 4 (6.9%) indicated “not applicable.”
  • 45 (78.9%) of the respondents indicated that their grief and bereavement volunteers receive extra training; 4 (7.0%) indicated that they do not and 8 (14%) indicated “not applicable.”

Note. The following questions relate to direct patient/family contact volunteers only.

Screening:

  • 56 of the programs (96.6%) require completion of a volunteer application form; 2 (3.4%) do not
  • all of the programs (100%) interview prospective volunteers 
  • all of the programs (100%) require reference checks and police/criminal record checks

Training for Direct Patient Family Contact Volunteers

  • offered, on average, 1.9 times per year (SD = 1.1); range = 0 to 6 times
  • average length of training = 27.9 hours (SD = 8.6)
  • 29 (50%) of the programs pay for the costs of training; in 17 (29.3%) of the programs, the volunteer pays the costs and, in 12 (20.7%) of the programs, the costs of training are covered by “other”
  • 35 (60.3%) of the respondents indicated that there is a minimum required volunteer commitment; 23 (39.7%) indicated there is not
  • average volunteer shift = 2.7 hours (SD = 1.1)
  • 15 programs use the CHPCA training manual, often with their own additions (i.e., other manuals, resources and materials)

Training Topics Covered (the following topics were listed on the survey):

  • history, philosophy, and goals of hospice palliative care - Yes = 57 (100%)
  • role of the volunteer and other members of the hospice palliative care team - Yes = 57 (100%)
  • effective communication skills (e.g., active listening and empathy) - Yes = 55 (98.2%); No = 1 (1.8%)
  • family and family dynamics - Yes = 56 (98.2%); No = 1 (1.8%)
  • emotional/psychological issues and support - Yes = 56 (100%)
  • spiritual issues and support - Yes = 57 (100%)
  • multicultural issues and support - Yes = 50 (90.9%); No = 5 (9.1%)
  • physical issues and support, including pain and symptom management - Yes = 54 (94.7%); No = 3 (5.3%)
  • caring for people at home or in a hospice - Yes = 50 (90.9%); No = 5 (9.1%)
  • grief and bereavement - Yes = 57 (100%)
  • self care - Yes = 56 (98.2%); No = 1 (1.8%)

Note. All of the listed training topics received mean perceived importance ratings of 4.1 or higher on a 5-point scale, where 1 = “not at all important” to 5 = “very important.”

Other Training Topics Covered:

Other training topics mentioned by at least 5 respondents (number of respondents in parenthesis):

  • policies and procedures/orientation to organization (8)
  • volunteer boundaries (6)
  • funeral home visits/funeral planning (5)

Suggestions for Additional Training Topics:

  • 14 of the respondents (26.4%) indicated that they would like to see additional topics covered in their training (i.e., circled “Yes”); 39 respondents (73.6%) circled “No.”

Suggestions for additional training topics mentioned by at least 2 respondents (number of respondents in parentheses):

  • physician-assisted death (3)
  • legacy work (e.g., story telling) (3)
  • information about complementary therapies (3)
  • more information about grief and bereavement (2)
  • information about dementia, cognitive impairment (2)
  • information about advance care planning (2)

Training Tools Used (the following tools were listed on the survey):

  • guest speakers - Yes = 50 (89.3%); No = 6 (10.7%)
  • topic handouts - Yes = 56 (98.2%); No = 1 (1.8%)
  • case studies - Yes = 52 (91.2%); No = 5 (8.8%)
  • films (e.g., DVDs, VHS) - Yes = 50 (87.7%); No = 7 (12.3%)
  • icebreakers - Yes = 47 (82.5%); No = 10 (18.5%)
  • role play - Yes = 43 (75.4%); No = 14 (24.6%)

Type of Support Volunteers Can Provide (the following types of support were listed on the survey):

  • social (e.g., provide friendship and companionship, share hobbies and interests, play card or board games, read to patient) - Yes = 58 (100%)
  • emotional (e.g., sensitive listening and non-judgemental discussion, holding a hand, being a quite presence) - Yes = 58 (100%)
  • practical (e.g., drives to medical appointments, running errands, provide respite for family caregivers) - Yes = 44 (75.9%); No = 14 (24.1%)
  • household duties/housework (e.g., preparing food, doing laundry, washing dishes) - Yes = 15 (25.9%); 43 (74.1%)
  • personal shopping (e.g., groceries, alcohol, cigarettes, and banking) - Yes = 14 (24.1%); No = 44 (75.9%)
  • physical (e.g., helping patients get in and out of bed, lifting, turning) - Yes = 14 (24.1%); No = 44 (75.9%)
  • personal care (e.g., helping with toileting, bathing, hair washing, shaving) - Yes = 12 (20.7%); No = 46 (79.3%)
  • preparing and administering medications - No = 58 (100%)
  • informational (e.g., providing information – explanations, books, DVDs – to patients/families, informing patients/families about other resources/services that might be helpful to them) - Yes = 42 (72.4%); No = 16 (27.6%)
  • religious/spiritual (if this is what the patient/family want) - Yes = 47 (81.0%); No = 11 (19.0%)
  • grief and bereavement (e.g., support to family after a death) - Yes = 53 (91.4%); No = 5 (8.6%)
  • nutritional (e.g., assist with feeding and drinking) - Yes = 32 (56.1%); No = 25 (43.9%)
  • complementary therapies (e.g., therapeutic touch, Reiki, massage) - Yes = 39 (67.2%); No = 19 (32.8%)

Are Volunteers Formally Evaluated on a Regular Basis?

  • Yes = 31 (53.4%); No = 27 (46.6%)

Ongoing Organization-sponsored Events for Direct Patient/Family Contact Volunteers (the following events were listed on the survey):

  • volunteer appreciation lunches/dinners - Yes = 55 (94.8%); No = 3 (5.2%)
  • continuing education workshops - Yes = 55 (94.8%); No = 3 (5.2%)
  • roundtable discussions with fellow volunteers - Yes = 46 (80.7%); No = 11 (19.3%)
  • volunteer support services - Yes = 54 (93.1%); No = 4 (6.9%)
  • advanced training sessions - Yes = 42 (72.4%); No = 16 (27.6%)
  • refresher training sessions - Yes = 48 (82.8%); No = 10 (17.2%)

Is Lack of Referrals/Late Referrals a Problem? 

  • Yes = 27 (48.2%); No = 29 (51.8%)

Is Volunteer Retention an Issue?

  • Yes = 10 (17.2%); No = 48 (82.8%)

Note. Comparisons between different types of program were not undertaken in this study because of the small number of respondents from some programs