Shar Sweeney: The 11th Hour Program 

Supporting patients in their final moments of life

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Shar Sweeney
  • Shar Sweeney

Shar Sweeney, the director of support services at Inspiration Hospice, has been working in health care for 15 years. She helped form the nationally recognized 11th Hour Program (, which trains volunteers to be on hand to assist and comfort individuals who are undergoing the dying process.

What do 11th Hour volunteers do?
The training to be in the 11th Hour Program is extensive for the benefit of the patient and the volunteer. Utah requires 12 hours of training but we provide 16 hours; we want to make sure there is ample support for any questions and concerns the volunteer may have throughout the process. Volunteers in the 11th Hour Program do not provide medicine or move the patients; they do not prolong life or hasten death. They create comfort for the loved ones and the patient; it’s more focused on the service of just being there.

Is being present for a death a scary thing for volunteers?
Before the official implementation of the 11th Hour Program, I used to ask hospice volunteers during training what worried them the most. One woman stated, “The thing that scares me the most is that a patient might die while I am with them.” Then it actually happened to her. Her patient was 94 and was actively dying. I called her and let her know that her goodbyes should be sooner rather than later. She was scheduled to see him close to a week later, but decided, after our phone conversation, to see him right then. She sat with him while his son ran errands. She massaged his hands as she normally did, and laid her other hand on his chest. He looked at her and said, “That feels so good.” Three minutes later, he passed away. No one expected that to happen, especially her. But what was such a terrifying idea to her before turned out to be a beautiful experience.

Do most volunteers adhere to a certain belief system?
Not at all; there are a variety of volunteers from all religions, including LDS, atheist and agnostic. I think they all have in common that they are good people who want to give something back and do something meaningful for someone else. They volunteer even though they might not yet know of the reward it will provide them. Many times they have had loved ones who have received the benefits of this program. After they have taken time to grieve, we often see that as a foundation for desire to ultimately volunteer.

How do you determine that a patient may be coming close to death?
It’s not as hard to do as one might think; it’s actually very predictable, very much like the birthing process. Though every birth might be different, the physiological preparations for that birth to occur are the same. The body just knows how to swing into action in producing life and allowing death. Typically two to three weeks out, a patient will lose interest in some of the things that were meaningful for them. Additionally, lack of food intake or lack of hunger is a big sign. I’m sure you’ve heard that no one can survive without food or water for very long; I’m here to tell you that that is not true. I’ve seen patients last up to two weeks without either. And that’s part of the digestive system shutting down. Seeing this can be difficult for the loved ones of a patient to understand; they say, “Mom, if you would just eat, or drink something you’d feel better.” We strive to instill the education that the body knows what it is doing and help them through the process of seeing their loved one’s body begin orchestrating its own death.

How are volunteers affected by their experiences with patients?
I remember a volunteer going to see her patient during springtime and there was a lilac bush in bloom in her neighbor’s yard. She asked if she could cut some, then took it into her patient. The patient grabbed the bouquet and inhaled, knowing it was the last time she would ever smell lilac, or see another spring. She just couldn’t stop inhaling the fragrance. A volunteer who took time on her way to pick those blossoms created that moment and it made all the difference to that patient. It was also so profound for the volunteer that she purchased a lilac bush and planted it in that woman’s memory. Every time it blooms she thinks of her. This is not a unique occurrence; all of the volunteers have stories like that one.

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