Caring Companions: Torrance Memorial's No One Dies Alone Program
Providing a compassionate witness for patients who are alone during their final hours
In early 2024, Torrance Memorial quietly implemented a specialized program to help a rare type of patient. For its many awards and accreditations—including a CMS 5-star rating for overall hospital quality—one important service had been missing.
While most people have friends or family stay with them during their final hours of life, some patients do not have those connections. For others, their closest relatives are unable to visit them or live too far away to arrive in time.
Torrance Memorial's Caring Companions program, part of the No One Dies Alone (NODA) initiative, provides compassionate end-of-life care to terminally ill patients who may not have loved ones by their side. This unique volunteer opportunity allows individuals to provide emotional support for patients in their final moments, ensuring that no one faces death alone.
Caring Companions takes an important place in the hospital’s continuum of care.
During his rounds and through interactions and study with other hospital chaplaincies, Rev. Jan Arthur Lee, a chaplain in the Torrance Memorial spiritual care office, saw the need to provide a human presence for patients who are alone during their final days.
“It is our privilege to sit with them as they die, to be a gentle presence and offer a gesture of hospitality to the very end,” he says. “There is something sacred and beautiful about it.”
Rev. Lee and the hospital’s bioethics director, Andy Shen, MD, initiated the research and development of the program, networking with other hospitals that have NODA programs and creating an interdisciplinary team that includes the spiritual care office, palliative care, clinical education, marketing and communications and volunteer services.
The mission of Caring Companions is to ensure dignity, compassion and support for dying patients by offering bedside companionship to anyone who is alone at the end of life. Dr. Shen says Caring Companions is uplifting to the entire medical center—patients, physicians, nurses and staff members.
“Rev. Jan has said that the program is ‘good for the soul of the institution,’ and that’s a powerful statement,” he says. “After experiencing a few of the vigils myself, I felt that play out in real life.”
What is the Caring Companions Program?
The program is designated for individuals who are expected to die within 48 to 72 hours and are without family or friends to stay with them until the end. It is set in motion when a registered nurse, palliative care provider, case management provider, physician, social worker or spiritual care provider identifies a patient in need.
Then, nursing or medical staff activate Caring Companions with a phone call to the Volunteer Services office, which notifies its volunteer pool and creates a schedule of three-hour shifts. The scheduler will also share the schedule with the charge nurse of the patient’s unit. During nights and weekends, the on-call bioethics doctor will organize vigils.
“It’s very reassuring and comforting for the hospital staff, especially the nurses, when they have a dying patient—knowing if they can’t spend time at the bedside, someone else can stay with the patient,” says Dr. Shen. “And it gives the doctor comfort knowing their patient is being well loved and cared for, and not just medically. A doctor can’t be there, but they want to know someone is there for the patients when they are dying.”
The first group of volunteer companions received training in February 2024, and have been present for four patient vigils, as of October 2024. More trainings are planned. Rev. Lee says nurses and hospital staff involved in these vigils have shared their gratitude and relief.
“The nurses absorb a lot. This alleviates the caseload of a nurse to reserve their strength for other patients,” he says. “We can pick up that emotional, spiritual, existential weight.”
Mary Matson, director of service excellence, patient experience and volunteer services, says Caring Companions is evolving and growing. Each vigil has taught participants more about the needs of dying patients and the program’s potential to meet those needs.
Volunteering for the No One Dies Alone Initiative
Caring Companions volunteers are instructed on the use of personal protective equipment, isolation protocols, safety and confidentiality. They are also trained about the dying process, ways they can comfort the patient and how to care for their own feelings throughout the experience.
Any information available about the patient’s preferences or beliefs is shared with the volunteers, with related resources included in a binder for companions. “With the information we have, we are respectful of what the patient would and wouldn’t want. This is not a religious program, but we know health and healing involve all aspects of the individual,” Matson says.
Caring Companions volunteers and team members debrief after a patient’s vigil. They share what they learned, what improvements could be made to the process and how their involvement affected them.
“At first, volunteers are worried about what they should do. The beautiful thing is everyone brings their own special humanity to how they spend time with the patient,” says Dr. Shen. “Those who’ve experienced the process have universally talked about how emotionally powerful it felt to be part of these vigils.”
At present, Caring Companions are selected from Torrance Memorial’s current volunteers. “We started with our volunteers because they are known to us and can add this periodic assignment to their current weekly schedule. We’ve reached out to inform and encourage inpatient care teams to use this resource,” Matson says. “And we’ve received wonderful feedback from staff, who have always done their best to tend to patients in these circumstances before Caring Companions. They are proud and grateful we have this program.”
