No One Dies Alone Program at Carl Health
“It was the afternoon of her 91st birthday, and unusually hot, part of a heat wave that had community leaders worried. Elderly volunteers had been winding through the labyrinth of footpaths, distributing leaflets on the dangers of heatstroke to the many hundreds of residents like Mrs. Ito who lived alone in 171 nearly identical white buildings. With no families or visitors to speak of, many older tenants spent weeks or months cocooned in their small apartments, offering little hint of their existence to the world outside their doors. And each year, some of them died without anyone knowing, only to be discovered after their neighbors caught the smell.”
The above paragraph is from “A Lonely Death” by 2018 Pulitzer Prize Semifinalist Norimitsu Onishi. A writer for The New York Times, Mr. Onishi features Mrs. Ito, an elderly Japanese woman who is concerned about dying alone in her home since she does not have a family. To ease her anxiety, she asks her neighbor to look at her window every morning. She tells her neighbor that if her window is not slid open, that means she has died. Mr. Onishi uses Mrs. Ito’s case to demonstrate the extreme isolation of Japanese society and its effect on elderly citizens. Known as “Kodokushi,” dying alone without being discovered for a certain period, has started to be recognized by the Japanese public since the 1970s. According to the BBC, nearly 40,000 people died alone in Japan in 2024.
Although there is no known figure of people dying alone in their homes in the U.S., according to an article titled, “Americans Face a Rising Risk of Dying Alone” in Bloomberg News published on October 9, 2017, the number is rising. The trend reflects many factors including the way many aging Americans have no close relatives, spouses, or children. This is how the concept of NODA (No One Dies Alone) originated.
In 1986, Sandra Clarke, a nurse at Sacred Heart Medical Center in Eugene, Oregon, was asked by a terminally ill patient during a night shift to stay by his side during his last moments. Barely able to speak, the patient asked her, “Will you stay with me?” Aware that the patient was under a Do Not Resuscitate (DNR) order and trying the best she could, Mrs. Clarke promised him that she would return to be with him after she checked on the other patients under her care. After an hour or so, Mrs. Clarke returned only to find that the patient had passed away with an arm stretched out as if trying to have someone hold his hand. Standing beside his bed, Mrs.Clarke felt angry with herself that she could not fulfil her patient’s one last, simple wish. From that moment on, she knew it was important for her to find a way to have someone give comfort to patients at the end of life. In 2001, No One Dies Alone (NODA) was launched at Sacred Heart Medical Center. Soon, it has spread all over the United States and overseas.
In our community, to ensure one has someone present at their final moments, Carle Methodist Hospital in downtown Peoria has launched its own No One Dies Alone program since September last year. To get better insight on the program, I sat down with Ms. Tammie Speck, the Volunteer Coordinator at Carle Health Methodist. Ms. Speck said she was in the process of having informational meetings and interviewing all the candidates. After the interview and subsequent background checks, Ms. Speck will help train the volunteers. Ms. Speck said that the NODA program is also available at Carle Methodist in Bloomington and Champaign. The Peoria NODA program preserves the same structure as the NODA programs in Bloomington and Champaign, following the original program founded by Sandra Clarke more than 20 years ago. Although each program runs separately, they also work together to improve the program. “I work with the other volunteer coordinator at another hospital to find out what worked and what didn’t work,” said Ms. Clarke.
In order to start the program in January, she hopes to recruit at least 20 volunteers. To do so, the hospital advertised the program on the news and social media. So far, thirty-five people have applied and been interviewed. “We weren’t sure what kind of reception we would get from the community, but the Peoria area has been phenomenal in terms of people who responded and came to volunteer,” noted Ms. Speck. “We want somebody with compassion and a caring heart with understanding of what a person is going through at the end of their life. Compassion is the number one thing we are looking for.”
After the volunteers are trained, the program will begin operating. First, when a nursing supervisor knows that the patient has no family or friends that are able to be with that person at the end of life, they will alert a group of NODA volunteers. The volunteers will be alerted on their phones that there is a patient for volunteers to come and sit with. An email will also be sent to the volunteers, with 36-hour time slots for them to take different times to sit with the patient. Ms. Speck said, “Since we have a large pool of volunteers, if everybody takes a turn, that person is not going to be alone. The nurses and supervisors are very receptive of NODA. They asked why we hadn’t done this sooner.”
Although volunteers need to be at least 18, high school students can also become involved with the program. Ms. Speck said that students can always make cards for other patients in the hospital. “You can cut out pictures from magazines, you can draw, write poems or verses.” However, Ms. Speck recommended that cards should not say “get well soon” because some people may not get well soon. Instead, she recommended writing “thinking of you.”
The initiative of beginning a NODA program in Peoria shows how our community takes care of one another. The amount of people who readily volunteer to sit with the patients really shows how members of our community want to support each other through this program. While Mrs. Ito in Mr. Onishi’s article was worried that no one would take notice of her existence in her apartment, critical care patients at Carle Health Methodist are rid of such worry because of the NODA program. The thought of taking one’s last breath is fearful enough, but taking that journey alone may be even more fearful. With compassion and understanding, the volunteers in the NODA program will help make sure that critical care patients at Carle Health, as members of our community, take their final journey with dignity and peace.
