Guidelines for a Palliative Approach in Residential Aged Care

interpersonal and leadership skills [385] (Level EO). For success in this role, it is important for the
coordinator to have autonomy and authority, and for the position to be salaried [385] (Level EO).
Coordinators of volunteer services have reported that a wider range of volunteers is entering
the unpaid palliative workforce [385] (Level EO). The potential contributions of this varied group
of volunteers are valued. However, there is a notable gap in the literature related to how to
screen, train, monitor and evaluate volunteer services. Given the magnitude of the volunteer
work performed, the vulnerability of residents receiving volunteer services, and the relatively
unsupervised support provided by volunteers, greater attention to personal issues, standards of
volunteer care, and related management issues for this unpaid workforce is needed. Policies and
procedures relating to volunteer recruitment, selection, orientation and training can inform
volunteer involvement and ensure that volunteer roles are clearly defined. It is suggested that
RACFs contact organisations such as Volunteering Australia to review their standards on these
matters (see Appendix I ‘Resource List’).
The education and ongoing supervision of volunteers who may provide support to residents and
their families can help provide a service that is valued by residents and carers [384,387] (Level IV;
Level QE). Following a suitable recruitment, orientation and matching process, volunteers may
act as a companion and confidant to the resident and their family [382,384] (Level QE; Level IV).
Volunteers may also provide bereavement care if they have been trained in this area, and receive
ongoing support and supervision [388] (Level QE).
Two issues raised in the literature that need to be addressed via the orientation and ongoing
supervision of volunteers is the lack of commitment by some volunteers and volunteers
not knowing the appropriate boundary between themselves and family members after the
bereavement period [388,389] (Level QE; Level EO). These issues are paramount, particularly if
volunteers are to be involved in providing bereavement support.
Another factor that needs to be considered by the coordinator of volunteers is that a wider
range of volunteers is entering the unpaid palliative workforce; significantly, those who have
been actively serving as a volunteer for 4 years or less are more likely to be working full-time or
part-time [390,391] (Level QE; Level EO).
The following vignette illustrates the appropriate involvement of a volunteer with a resident
who was dying.
Vignette 16: Frank and Andrew
Frank had been admitted to an RACF on discharge from hospital. His condition
deteriorated rapidly and the staff contacted the local palliative service for support. As
Frank had limited family support, Frank agreed that he would like Andrew, a volunteer from
the palliative service, to sit with him. On his last visit, Andrew found that Frank was no
longer responsive, but appeared agitated and restless. Andrew sat with Frank for several
hours, playing his guitar. “I don’t know if it was any help but he seemed calmer while I was
there,” said Andrew. The staff reported that Frank did in fact settle while Andrew was with
him. Frank died peacefully several hours later.
158 Guidelines for a Palliative Approach in Residential Aged Care