VOLUNTEERING FOR LIFE BEFORE DEATH; HOSPICE WORKERS OFFER PATIENTS, FAMILIES A HAND TO HOLD AT THE END

Annette Trout, a Southeast Hospital Hospice volunteer, said a book called 'Hymns of Faith & Inspiration' is one of the favorites of hospice patients she visits.

Carol Keppler, coordinator of volunteers for Southeast Missouri Hospital Hospice has about 30 patients enrolled in the program.

Annette Trout learned about hospice care as her brother lay dying of cancer in Sydney, Australia.

Trout, who now lives in Cape Girardeau, worked as her brother's caregiver during that final visit.

"We had a real good week or two before he died," she said. "It made me more or less open to the hospice end of it, where the patient is allowed their choice to stay in the home or go to the hospital to die."

Trout's mother had also died in a hospice years earlier.

Now Trout is one of more than 60 volunteers who work with terminally ill patients and their families through Southeast Hospice in Cape Girardeau.

Carol Keppler, who coordinates volunteer services at the hospice, said volunteers' duties vary widely, from running errands for the family to office work to simply holding patients' hands when family members need to be away from home.

Volunteers do not provide medical care or administer medication, she said.

"It's really more of a companionship for the patient or the family," Keppler said. "They can run errands for the family. Every now and then I'll have a caregiver who can't cook a meal, and we'll do a little SOS to our volunteers and they can bring in a meal for him."

There are usually about 30 patients enrolled in the hospice program at any given time, Keppler said. Patients must have a caregiver -- either family or staff in a nursing home -- to participate in the program.

Volunteers go through 20 to 24 hours of basic training, and have to take continuing education while they remain in the program.

Trout's brother died in 1993. She had begun hospice training in Bolivar, Mo., where they had lived previously, but didn't complete the program.

Then in 1994, she and her family moved to Cape Girardeau, and that fall, she began training with the local hospice program.

"I've always felt like God had a hand in this," Trout said. "When (Keppler) asked me if I would consider taking training, I said, let me settle in first and think about it."

She thought about her brother's illness, and remembered holding his hand and singing the Psalm 25 to him.

She sang the psalm for Keppler.

"And I think she realized I could be useful in the program," Trout said.

Hospice volunteers develop a close relationship with patients and their families, said Sue Martin, who began volunteering with the local program about a year ago.

"You become so close so quickly under that situation that they welcome you as part of the family," Martin said.

The work is harder than Martin thought it would be, because of that close relationship.

"As the patient gets closer to the end, then a lot of times, they're not communicating very well, and your attention turns to the family, trying to get them through the last part and the funeral," she said.

After the patient dies, the volunteers keep in touch with the family members to help them cope with their grief. They call during holidays, anniversaries and birthdays to offer a little more support to the bereaved.

"They're in your thoughts, and they're in your prayers," Martin said. "And when I see the family members in town, it's just like seeing an old friend. They're very special."

Trout often sings for her patients.

"If you have a song in your heart, you can get through anything," she said. "It seems to be very soothing for them."

Her last patient loved hearing patriotic songs, and Trout would sing those for him, and read the histories of the songs and the biographies of their composers to him.

Another patient loved playing "500," a card game.

"I had never played it before, but that was something that she taught me how to do, and I enjoyed it," Trout said.

She spent Christmas with another patient who had no family.

"I pretty much was going out to see him on a daily basis while he was getting closer to the end," she said. "He asked me one time, I don't know why you're doing this. And I said, this is my Christmas gift to you."

For family members, staying with the dying is "an obligation," Trout said. "This isn't an obligation. If this was my father, I could think of nothing better for him."

Hospice volunteers give patients and their families a hand to hold during a difficult time, Trout said.

When she saw the film "Saving Private Ryan," it reminded her of several patients she had worked with who had served in World War II.

"I would remember them crying out for their mothers (in the film), and that brought me back to my patient. When I sang for him, he said, 'This reminds me of my mother singing to me when I was a child," Trout said. "As we go toward our last moments, we are becoming that child again. It's that child within us reaching out, and there's nothing like having a parent there. Usually it's a mother, but sometimes it's a father, holding that child and saying, 'It's all right. It's all right.' We're holding one hand, and Jesus is holding the other and leading him into the next year."