Volunteer to Make Sure No One Dies Alone
The No One Dies Alone Program at University of Utah Health (UUH) is a branch of the national No One Dies Alone (NODA) organization designed by Sandra Clark with the Peace Health Organization. The goal of the NODA program is to provide compassionate companionship for patients alone at the end of their lives.
On average two to three patients die without accompaniment monthly at University of Utah Hospital. Doctors, nurses, and other hospital staff attempt to fill this void but have neither the time nor the resources to provide this service. This is where the NODA program is relevant. NODA provides the reassuring presence of a volunteer companion to patients transitioning from life to death who would otherwise pass without the caring and comfort of another human being.
University of Utah Health is proud to provide a program that offers companionship to our patients, providing one of the most valuable human gifts: a dignified death.
The University of Utah Health NODA chapter began in 2017 through the tireless efforts of Tyler Montgomery and Dr. Gretchen Case. This team initially partnered with the Imagine Perfect Care initiative at UUH which provided seed grant enabling the program founders to be trained in end of life companionship skills, as well as establishing an organizational template for the program. Since then, the NODA administrative team has constructed a volunteer training curriculum specific to the UUH policies and procedures that have been approved by the UUH administration.
Currently, the UUH NODA program has served over 30 patients and maintains a core group of over 60 amazing and devoted volunteers. The NODA program is generously funded by Imagine Perfect Care, The Keener Foundation, and the University Hospital Foundation.
Heather Smith is an LCSW at University of Utah Health. She has been involved with the NODA program since February of 2017 and was an initial member of the administrative team. Heather supports the NODA program by conducting staff and volunteer trainings, and clinical protocol improvement. Heather is a longstanding social worker passionate about end-of-life care, social work, and end-of-life conversations.
Susan Gustafson is a retired educator and part-time librarian who started with the NODA program in April 2018. The person who stuck by her close loved one during their passing inspired her work with NODA today. Susan helps coordinate vigils and quarterly meetings and loves the opportunity to volunteer for a vigil.
Nichole Robinson first stared with the NODA program in June 2017 while working as a social worker at the Huntsman Cancer Hospital where she mediated the expansion of the NODA program to cancer patients. Nichole currently works for University of Utah Hospitals and Clinics as an Organizational Development Consultant focused on support, training, and coaching of hospital staff. Nichole assists with developing clinical protocols, NODA promotion, and volunteer and staff trainings. She is passionate about end-of-life issues and compassionate patient care.
Reverend Lorie Nielson is a board certified clinical chaplain and has been involved with the NODA program since November 2017. She is a member of the University of Utah Health Palliative Care Team to help and support patients and family members with their spiritual needs. Lorie serves with the NODA program to assess and coordinate patient vigils throughout the hospital and as a volunteer trainer. Lorie is passionate about end-of-life care, patient healing, and health care provider education.
Erin Price is a professional pharmaceutical chemist. Erin started with the NODA program in December 2017 and now assists in managing and supporting NODA volunteers throughout the training, onboarding, and volunteering process. Erin is passionate about compassionate care and end-of-life care.
Diane McDermaid began volunteering with the NODA program in 2018 and moved into the administrative side of the program in February 2021. She is a commercial real estate paralegal, a two Blue-Star Mom, and a passionate scuba diver and instructor. Her spouse died by suicide in June 2015, and she finds purpose, grace, and solace at the bedside of the dying.
Cody works in the cyber security field, specializing in data analysis, behavioral analytics, machine learning, and incident response. Cody began as a NODA volunteer in May 2018. He supports the NODA program in various ways, including with technical support, training, and managing and coordinating vigils. Cody is passionate about the NODA program, end-of-life care, and the human dignity expressed in this process. Cody loves spending time with his family, sailing, gaming, and skiing.
Emergency Department Care Representative
Sariah currently works both in mental health private practice and as a Trauma Social Worker in the Emergency Department at the University of Utah Medical Center. Sariah worked as a surgical nurse in her home country of Mexico before coming to the United States for her BS in Community Health. She learned about the NODA program while getting her Master of Social Work at the University of Utah and began work with the program in 2019. The NODA program is meaningful for Sariah because of her life experiences and her reverence for human life and its infinite journey. In her free time Sariah enjoys spending time with her husband, cooking, and eating.
Huntsman Care Representative
Reverend Gerson Annunciacao started with the NODA program in 2021. He and his wife Sandra have two children and two grandchildren. Gerson was ordained as a Presbyterian minister in his home country of Brazil in 1988. He moved to the Massachusetts in 2001 and then to Salt Lake City in 2018 where he started as a chaplain at University of Utah Hospital. In 2019, he became a chaplain at the Huntsman Cancer Institute. Gerson speaks English, Spanish, and Portuguese.
Questions About Volunteering
How old do you need to be to volunteer with NODA?
The minimum age to volunteer for the NODA program is 18 years old. However, there are other volunteer opportunities at University of Utah Health that can work with eager people younger than 18 years old. Please contact the volunteer office for more information.
What is the expected NODA volunteer commitment?
We are asking for volunteers to serve during one vigil per month for one year and participate in quarterly volunteer debriefings. You take a maximum three hour shift during a vigil (i.e. you sit with a patient for a maximum three hours at a time) and we typically hold two to three vigils a month.
Are NODA volunteer shifts scheduled?
Because the dying process can be variable and sudden, NODA volunteers are not scheduled for specific times each week or month to sit with patients. NODA volunteers are “on call” and can sign up for three hour shifts to sit with patients as a vigil is activated and the volunteer shift is available.
What are the training requirements to become a NODA volunteer?
We require all NODA volunteers to attend a three hour NODA and University of Utah Health training.
How do I contact the NODA program with questions, concerns, or to sign up?
Please reach out to firstname.lastname@example.org for any further questions or concerns.
Questions About Patient Care
What is palliative care and how is NODA involved?
Palliative care provides individuals facing a life-threatening illness with relief and a healing, rather than curing, experience before their passing. A natural question that arises is "How are healing and curing different?" Curing seeks to rid an individual of illness or disease. Healing, on the other hand, is intended to provide relief from pain, a sense of companionship and connection, and an acceptance of life, to include death and dying.
Rather than solely focusing on the physical aspects of care, palliative medicine incorporates emotional, mental, and spiritual measures. Ultimately, our goal at NODA is to support palliative care and provide comfort to individuals before they pass.
What are the signs that an individual undergoing palliative care is in pain or discomfort?
Being able to assess an individual's pain or discomfort can rely on the level of communication they have. In the event that the individual can communicate, questions regarding their comfort and potential ways to relieve or manage their pain are appropriate.
Even simple questions about the lighting setting or their position in bed can lead to increased comfort for individuals in palliative care. In the case that someone is unable to communicate, there are some nonverbal signs that indicate they are experiencing pain. Such signs include grimacing or frowning, restlessness or shifting in bed, or even changes in temperature and breathing pattern.
How long does the dying process normally take?
In truth, the length of the dying process depends on each person; it may be weeks, days, or hours. An important point in palliative care is that the death and dying process is indeed a process, one that is unique to each individual.
The events and duration of such that occur during each individual’s journey are never the same. However, there are some signs to potentially expect when death is near. These signs include changes in skin color such as going pale or bruising, decreases in appetite and continence, decreases in body temperature, and changes in breathing patterns. Although only some of these may occur, they are all considered normal aspects of the dying process.
What are some of the challenges that those performing palliative care face?
There are mental and emotional impacts when providing care to an individual facing the end of their life, whether it be as a friend, family member, or professional medical team member. Due to the intense and emotional commitment that comes along with palliative care, what is referred to as "compassion fatigue" or "compassion burnout" is common to occur.
Compassion fatigue refers to the cumulative impact from consistently caring for individuals undergoing suffering or the dying process. Signs of compassion fatigue in caregivers include anxiety, difficulty sleeping, increased isolation or distance from others, and irritability. However, resources do exist to effectively cope with compassion fatigue. Having emotional boundaries, particularly in the professional setting, with individuals undergoing suffering has proven to help prevent the development of burnout.
Additionally, incorporating self-care through exercising, spending time with friends and family, openly discussing your emotions with loved ones, journaling, spiritual practices, etc. has been shown to help individuals combat the effects of compassion fatigue.
The End of Her Days
One writer's cautionary story about how his mother-in-law's stroke and fight to die on her own terms, taught him the importance–and limitations–of Advance Directives.
How do you initiate a vigil?
Healthcare providers for University of Utah Health can find vigil activation information on the institution’s internal website. (Staff access only.)
In the News
The Salt Lake Tribune
At University of Utah Hospital, a small group of volunteers pledges that no patient will die alone