The Impact and Importance of Hospice Volunteers: Understanding the 5% Rule

Hospice care plays a crucial role in providing comfort and support to individuals nearing the end of their lives. Volunteers have been at the heart of this movement since its inception in the United States. In order to ensure that hospices continue to make effective use of volunteers, the Medicare Hospice Conditions of Participation (CoPs) established a requirement known as the "5% rule." According to this rule, at least 5% of the total patient care hours provided by a Medicare-certified hospice must be performed by volunteers who are not administrative or managerial staff.

Volunteers contribute significantly to the quality of care provided to patients and families in hospice settings. They offer companionship, emotional support, respite care, and assistance with activities of daily living. Hospice volunteers generally serve in three areas:

Hospice volunteer programs are regulated by several entities, including Medicare Conditions of Participation, state regulations, accrediting organizations, and agency policy and procedure. These regulations ensure that volunteers are utilized effectively, meet all requirements associated with their specialty area, and are properly documented.

Volunteers can serve in various roles, from providing spiritual care to helping with household chores, shopping, transportation, and companionship. However, there are certain tasks that volunteers cannot perform, such as giving medication, giving food or drinks, assisting with moving or ambulating, driving or transporting patients or caregivers, and engaging in financial transactions.

It is crucial for volunteers to maintain professional boundaries and adhere to the range of acceptable behavior. They should be mindful of fostering dependence, managing their time appropriately, and communicating effectively with patients, families, and the interdisciplinary team.

When recruiting volunteers, it is essential to discuss the keys to a successful volunteer experience. Some critical factors include genuineness, dependability, communication, listening, confidentiality, physical contact, conflict management, and personal reactions. Addressing these aspects helps both the potential volunteer and the agency determine if the role is a good fit.

In the aftermath of the COVID-19 pandemic, it is important to address the concerns and anxieties of potential volunteers. Topics to discuss may include fears about entering certain dwellings, infection control practices, considerations for immunocompromised volunteers, and health policies required by the agency, state, or federal guidelines.