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Dr Jacqueline Watts
Senior Lecturer, The Open University
BSA MedSoc Conference, Chester
September 2011
Exploring the working role of hospice volunteers
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Context• Voluntary work, as uncommodified work, is
shaped by diverse motivations – altruism, community involvement & fostering sense of self in the world
• Growth of voluntary sector due to increased cost of buying in services from the formal economy (Noon & Blyton, 2007)
• Different ‘types’ of voluntary work: career/casual, formal/informal, occupational/non-occupational (Stebbins, 1996)
• Volunteering evokes different forms of commitment, identification & allegiance (Newman & Mooney, 2004)
• Partnership between voluntary sector, government & business has resulted in the professionalisation of much voluntary work
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• 716 hospices & ‘in-patient’ palliative care units in the UK, most with registered charity status (Watts, 2010)
• Services – day care, bereavement counselling, complementary therapy, day and night sitting services, respite and terminal care
• Intimacy at scale
• Multidisciplinary approach to care leads to mixed staffing profile: doctors, nurses, social workers, chaplains, physiotherapists & volunteers
• Managers from the business sector often now recruited to head up the hospice operation
Hospice services in the UK
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The Study
• Aim: to develop understanding about motivation and experience of working as a hospice volunteer
• Setting: large well-established English hospice
• Mixed methods: focus group with 8 participants and 2 semi-structured interviews
• Small-scale pilot study to inform the design of a larger research project
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Participants
• All women
• Age range: 41 to 77 years
• None in paid work
• Variety of volunteer roles represented: receptionist, coffee shop assistant, day care worker, bereavement counsellor & complementary therapist
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• Giving back – a gift to be earned & repaid (Sinclair, 2007)
• Temporal structure to weekly routines
• Socially useful work
• Opportunity to develop friendships and have social contact
• Maintain skills developed in professional role prior to retirement
• Gain experience to support application onto a qualifying social work programme at local university
Motivation to volunteer
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Training & Support
• Induction & initial training mandatory – death education, principles of palliative care, understanding grief & loss, team working, ethical principles
• Ongoing formal support from supervisor
• Informal peer support from co-volunteers greatly valued
• Regular updates including education sessions
• Deficit areas: diversity (particularly cultural and religious difference) and spirituality/spiritual care (what is it and should this just be left to the chaplain?)
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Challenges for volunteers
• Emotionally demanding work
• Increased scrutiny & accountability paralleling the paid work model
• Rise in managerialist approach
• Less flexibility
• Valued but also ‘taken for granted’
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Challenges for Voluntary Service Managers
• Volunteers who won’t leave or ’retire’ from their ‘volunteer career’ (Hamilton, 2009)
• Lack of cultural diversity in the volunteer workforce
• Constraints on budget resources for education, training and support of volunteers
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The future of hospice volunteering
• Hospices cannot continue to provide the current level and breadth of services without the ongoing contribution of volunteers
• The volunteer roles of emotional comforter, spiritual supporter, palliative caregiver & therapeutic healer represent a division of ‘healing labour’ greatly appreciated by service users
• Voluntary work in the hospice sector looks likely to increasingly draw on practices from the paid labour market including annual appraisals and satisfaction reviews (O’Brien & Wallace, 2009)
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A concluding comment
Whilst the hospice setting for this research sees volunteers as essential to service provision, Sheldon (1997) notes that in some hospices volunteers are positioned as ‘handmaidens to the professional team’ and can be resented because of the substitution of volunteers for tasks previously undertaken by professionals.