Volunteer Visit Program Provides Meaningful Interaction with Elderly Patients

In August, Cleveland Clinic’s Fairview Hospital began a pilot program on a 24-bed medical-surgical unit to provide social and cognitive stimulation for patients 65 years and older who express loneliness or have no or minimal visitors.

“The literature reveals the potential for decreased prevalence of delirium, improved patient mood and increased food intake with visits during mealtimes,” says Stacey Claus, MSN, RN, GCNS-BC, CNRN, Clinical Nurse Specialist in Medical-Surgical Nursing at Fairview Hospital. “We’re also hoping to meet the needs of volunteers who want more patient interaction and support nurses who feel like quality patient time is not something they can accomplish.”

Inception of the pilot program

Inspiration for the program began at an interprofessional meeting of the Nurses Improving Care for Healthsystem Elders (NICHE) Steering Committee. Tina Jacobs, Director of Volunteer Services at Fairview Hospital, indicated that some volunteers wanted to have more interaction with patients. “The volunteers were helping patients immensely by providing discharge transport, delivering specimens and so on, but that was indirect help,” says Claus. “They wanted something more.”

Claus shared this feedback at a Geriatric Resource Nurse Committee meeting. Maggie Marniella, RN, a clinical nurse and geriatric resource nurse on the 6N/6S medical-surgical unit, expressed interest in helping develop a volunteer visitation program. “A lot of times when the older population are hospitalized, they get lonely when they’re in the room alone for a long time,” says Marniella. “We felt this program would be good for the patients, as well as give volunteers more one-on-one time with patients.”

Services offered by the volunteers

Nearly a dozen volunteers signed up to participate in the “Volunteers as a Caring Presence” pilot program. At the onset of the program, they were available in four-hour shifts between 8 a.m. and 4 p.m., Monday through Friday. Nurses on 6N/6S identified patients who would benefit from visitation, then volunteers reviewed the list and began rounding on patients. The volunteers provided the following:

• Talking with patients about their lives and current events
• Offering available services, such as pet therapy, a library cart, spiritual consults and healing services
• Help with menu selection, and encouraging oral intake for patients who eat independently
• Supporting activities the patient enjoys, such as reading, making puzzles and playing cards
• Encouraging and accompanying walking as a companion for patients who ambulate independently and are a low fall risk
• Help in make follow-up appointments
• Reporting any noted change in behavior to the patient’s primary nurse

Marniella created an activity cart that volunteers can bring on their rounds. It includes coloring books, large-print spiritual publications and quilting activity blankets. It also has comfort items that patients might typically use at home, such as warm socks, tissues and reading glasses.

Prior to launching the program, the volunteers participated in a three-hour training session to discuss expectations. Marniella and Jacobs reviewed the job description, talked about safety considerations and provided education on the geriatric population, including information on dementia-friendly and aging-sensitive communication. They also conducted a role-playing activity with different scenarios the volunteers might face. Finally, the volunteers toured 6N/6S to learn the location of blankets, the ice machine, the activity cart and other supplies they might need.

Anecdotal evidence of the program’s success

Marniella, Claus and Jacobs are currently tweaking the program to achieve the best results. For example, they discovered that scheduling volunteers for four-hour blocks of time wasn’t always optimal. Sometimes there weren’t enough patients to visit to fill the time. So they are considering other options, such as sending volunteers to the unit a couple times during each shift to see if any visitors are required.

Despite some glitches, the pilot program is working well overall. Marniella says they have gotten really good feedback from patients, nurses and volunteers. “One volunteer shared that he visited with someone from his neighborhood and had a great time reminiscing with the patient,” says Claus. “A couple of retired nurses have asked to join the group because they love the idea and know how hard it is for nurses to provide the kind of time they want to with patients.”

Marniella concludes, “The program is a work in progress, but it’s been well received.”