In some ways, volunteers for Hudson Hospice are helping dying people make their way home.

Few things are more frightening than death.

Experts tell us that people who are in the final stages of dying often face dual dynamics: the shut down of the body and the emotional, even spiritual impact of death.

While doctors and other medical professionals do as much for a patient with a prognosis of death, often the patient and family has other needs, from someone to talk to at the bedside to going to the store.

Hudson Hospice volunteers often provide these services.

Hospice is a program that involves the caring for the physical and emotional needs of the terminally ill.

Working with the terminally ill is not an easy task, but it can be rewarding at times, said Sister Carol Van Billiard, who serves as volunteer trainer at Hudson Hospice.

Sometimes patients are angry even demanding, yet at times they are also grateful for the company that allows them to pass their final hours with someone who is willing to listen and the share time.

Sister Carol, who will appear on the Mike and The Coach show in Bayonne, said volunteers often provide a terminally ill patient and or the family with necessary additional support that makes dying process easier.

Volunteer roles include companionship for the patients, emotional support for patient and family, errands, telephone reassurance and transportation. Patients are cared for in their homes. Hour vary according to the needs of the patient and family, and the availability of the volunteer.

Volunteers receive free training and ongoing support. In fact, training is a requirement under Medicaid laws

"It needs careful preparation," Sister Carol said, "and volunteers must be 18 or older and emotionally mature."

The need varies. At times, Hudson Hospice has four or five volunteers working, at other times, there can be as many as 20.

Some patients are in nursing homes, some in private residents. Some volunteers prefer to nursing homes over private homes, although often patients are less cognitive in nursing homes.

"Even then, they like to know someone is there with them, someone touching and holding them," Sister Carol said.

Hospice movement is a relatively new concept for the healthcare industry with roots back to the 1940s when the first modern hospice opened in London. The first hospice in America opened in Connecticut in 1974 and quickly spread to various parts of the county. In the early 1980s, Congress created legislation establishing Medicare coverage for hospice care. The Medicare Hospice Benefit was made permanent in 1986.

Sister Carol said hospices were not needed until the second half of the 20th century because most people still had an extended care system.

"Women didn't work. Neighborhoods were willing to help. Family members lived close together," she said. "Hospice tries to fill that need."

Training volunteers

Sister Carol holds training classes at the Jersey City hospice at 93 Clerk Street, although volunteers can request to assist patients all over Hudson County or a particular part.

"In the first class I talk about the hospice philosophy," Sister Carol said.

This philosophy affirms life, and agrees to provide care and support for people in the last phases of incurable disease so that they might live as fully and comfortably as possible.

"Hospice recognizes dying as a normal process whether or not resulting from disease," the philosophy says. "Hospice neither hastens nor postpones death. Hospice exists in the hope and belief that, through appropriate care and the promotion of a caring community sensitive to their needs, patients and families may be free to attain a degree of mental and spiritual preparation for death that is satisfactory to them."

The lessons talk about various aspects of hospice care, how it is carried out, and what roles volunteers play in the process.

"This means to be there to provide for the needs of the patient or the family," Sister Carol said. "We describe it as being good friends and neighbors."

Matching people up

Part of Sister Carol's job is to assign particular volunteers to particular patients, looking for aspects of character that will work well together. Assigning volunteers depends on the needs of the patient and the availability of the volunteer.

Sometimes, patients and volunteers find common ground and share truly powerful emotional experiences together. Many times, this does not happen.

"I tell volunteers not to count on it," Sister Carol said. "Patients are sometimes out of it, or they are angry and sullen."

Dealing with the anger is also part of the training.

"They are not angry at you, they are angry at the situation," Sister Carol tells the volunteers. "The important thing is not to return the anger. If possible, the volunteer can leave. But if there is no one else there, because the caregiver had to go out, then I tell the volunteer to be unobtrusive."

Sister Carol came to this position after decades of teaching more traditional schools. But she has also had her share of service at the bedside of the dying.

"I like to go out when I haven't been with a patient in a long time," she said, saying that she has memories of special moments, deep conversations even friendships with those she has assisted. "But it doesn't always happen. "I tell people everything is not always hunky dory with every patient."

Volunteers come from every walk of life, some older, some younger, some are married, some are single.

"Some of the people have had an experience at home and saw how difficult it was for the family," Sister Carol said. "Those are older people mostly. But we also get volunteers that some call yuppies who had no terrible experience of illness and just feel blessed that things are good in their lives and want to help."

Hudson Hospice offers services throughout Hudson County.

"I hold two classes a year, in the fall and in the spring. I recruit prior to them," she said.

Her next class is scheduled for sometime in April. She will likely begin recruiting via cable TV, newspaper and church bulletins in March.

"People need to have compassion and want to help people," she said. "They need to be emotional mature, in good - but not perfect health, and should not be currently grieving. I suggest that someone wait at least a year after the death of someone very close before they volunteer."

Sister Carol will be featured on Mike and The Coach on Bayonne Cablevision, Channel 19 on Monday, Nov. 27 and Dec. 4 at 8:30 and 11 p.m., then again on Nov. 29 and Dec. 6 at 5 p.m.

Those seeking to volunteer can contact St. Carol at the Hudson Hospice office 93 Clerk St., Jersey City. For information, call Sister Carol at (201) 433-6225 or the volunteer line at (201) 433-3303.