No One Dies Alone

Since November 2001, the No One Dies Alone program has offered companionship for dying patients who no longer have friends or family nearby to comfort them at the end-of-life. The program originated in Eugene, Oregon. After ICU nurse Sandra Clarke witnessed a patient dying alone, unable to accompany him due to her responsibilities to her other patients, she reasoned that state-of-the-art care ought to include dignity for the dying.

Sixteen years of contemplating the idea finally resulted in the creation of No One Dies Alone as a virtual department of the PeaceHealth Medical Group at Sacred Heart Medical Center.

Here’s how it works:

Volunteers — typically hospital staff, including hospital carpenters, administrative heads, maintenance workers, nurses, secretaries, and kitchen workers — sign up for on-call dates. Their incentive for joining the program varies greatly from person to person. Some come from large families and can’t imagine being alone; others are alone themselves and sympathize with a lonely patient.

A staff nurse initiates NODA, and the person who is signed up for that date is called. This “compassionate companion” is provided with materials like a CD player, CDs of soothing music, a journal, and a bible (although no religious behavior can be initiated by the companion). Upon enrolling in the program, new volunteers are given training to prepare them for this end-of-life care. They do not offer medical care to the patients; what they provide is “comfort-care”, things like holding a patient’s hand, fluffing pillows, playing music, massaging hands or feet, adjusting bed covers, reading to the patient. These measures go a long way in letting a patient know that he or she is not alone at the end-of-life, providing them with comfort and dignity in their last moments.

“I have a strong belief in human rights, particularly when a person is most vulnerable.” – Sandra Clarke, CCRN

Since the original Oregon program, NODA has spread across the country. PeaceHealth began receiving regular requests from health care organizations around the country for more information on how to start their own NODA program. In response, they have made resources and assistance available to anyone who wants to start their own program.

Two years ago, Sacramento hospital chaplain Rev. Arthur Lillicrop had a similar revelation as he was holding the hand of a dying man in Kaiser South’s intensive care unit. None of the man’s three children was present, and Lillicrop was reminded of how he had missed his own father’s death, driving from Baltimore to the hospital in Philadelphia. He decided to dedicate himself to ensuring that all patients had someone beside them at the end of their lives, so, in March 2011, he launched No One Dies Alone at Kaiser Permanente Medical Center.

The Sacramento program has 17 volunteers, mostly Kaiser staff members who are volunteering beyond their normal work hours. Local volunteers can sign up for the program at kpcares.org.

Pamela Richardson, a human resources secretary at the center, recalls her most emotional moment as a NODA volunteer:

“This particular woman was found on the street, but she was obviously cared for,” said Richardson. “She had painted nails and a key to an apartment. But nobody seemed to be able to identify her. She had passed out on the street and was brought in.”

During the couple of days the patient was comatose at the hospital, no friends or relatives surfaced. When it became apparent that she was going to die, NODA participants were called.

“I sat with her, held her hand, and told her that her family loved her and that I’m sure they were looking for her,” said Richardson. “I came in for a two-hour shift, but I couldn’t leave her, so I stayed for eight hours.”

For more information, check out our Interview with Carleen McCornack, NODA Program Coordinator with PeaceHealth.