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ATTLEBORO - In her many years of volunteering and working in hospice care, Cecilia Rose has never actually been at a bedside when a patient has died.

But she would be comfortable being there, and is now more likely to be there as part of her extended volunteer role with the hospice program at Community VNA in Attleboro.

Rose and eight other hospice volunteers recently became the first team at Community VNA to complete training for an even deeper level of care. They are now Vigil Volunteers who are available to be with a dying person as death occurs.

"This is another need, another aspect of hospice," said Rose, a Plainville resident who has been affiliated with various hospice agencies since the 1980s.

What drew her to volunteer for hospice, she said, is its philosophy of caring for people with dignity and respect at the end of their lives. What drew her to join the vigil program is that it extends the mission by providing a presence during the transition from life to death. "Sometimes being alone is what people fear most," Rose said.

Vigil volunteer programs are not new, but are being revived more and more as hospice workers see the need.

The intent, said Community VNA hospice manager Judith Gordon, is to make sure the dying have someone there.

"They are so afraid to be alone as they take the last breath," she said.

That possibility is more likely in today's society because families are so spread out, she said, and sometimes the dying person has very few, if any, relatives living nearby, and may have only a spouse caring for them.

"So many people are totally alone or have just one person in the house," she said. "It's very hard for someone to be alone. That's why a vigil is so important."

The nine new vigil volunteers were already experienced hospice volunteers with up to 20 hours of training who provided various hospice support such as respite for caregivers, transportation for patients or assistance like running errands.

For the vigil program, they were given an additional two hours of training and are now available to report to volunteer coordinator Carolyn Woodruff, who is notified when a patient is hours away from death and wants someone there. Woodruff then schedules volunteers based on the times they are available and tries to fill the hours of need.

Hospice serves patients in their own homes, or in nursing or assisted living facilities. Either the patient or a family member can request the services of a vigil volunteer.

The role of the volunteer, Gordon said, is to simply be present in the last hours of life. "The best thing they can do is to do nothing," she said.

They do not give hands-on care or offer advice, but they do offer comfort, support, companionship, information and guidance. Mostly, they are a calming, peaceful presence for the patient and family.

The key, Gordon said, is to focus on the person and the family, because they are all that matters.

To prepare, volunteers are told to take care of themselves physically and mentally, to clear their minds of any clutter, and to leave their own issues at the door.

"They need to be in that moment and to leave all the personal stuff behind," Woodruff said. "It's a big commitment."

The volunteers are trained to be aware of the signs of approaching death, and are guided in how they can help by sitting at the bedside, being open to conversation, listening and allowing the person to share their thoughts and feelings.

When death occurs, they call a hospice nurse, who responds and certifies that the person has died.

Volunteers also can call a nurse at any point in the dying process if they feel uncomfortable or uncertain about anything that occurs.

"They are never, never alone," Gordon said. "They can always pick up a phone and talk to a nurse. They are only there as a presence - just to be."

As often happens at the end of a life, patients or family members may want to talk about their religious beliefs and their hopes for an afterlife. Gordon said volunteers can encourage them to talk, but are advised to not express their own opinions or make any judgments.

"It's important to go where the family is," she said.

Gretchen Robinson of Attleboro, spiritual care coordinator for the hospice program, said volunteers can bring their own spirituality to their work without imposing it on the people they serve.

Hospice views dying as a family event, a private event, she said, but for families that have never been through it before, "it can be overwhelming to watch a loved one die."

That's why the vigil program is so important, she said, and is actually a return to the ancient practice of sitting with people who are dying.

"The volunteers are amazing," she said. "I can't believe they do this work."

Rose said she was drawn to hospice work when she was living in Virginia in the mid-1980s and saw an ad for volunteers in her church bulletin. She signed up, then did volunteer work there and in her home state of Pennsylvania after relocating there. Later she became the coordinator of volunteers, and then after moving to Plainville in 1995, she took a similar job as coordinator at New Hope in Attleboro, an agency that serves victims of domestic violence and sexual assault.

Then when she switched to a career in teaching, she began volunteering for hospice at Community VNA.

The primary draw for her is the hospice philosophy, but also the hope that what she is doing for others may someday be done for her.

"If I help people, maybe when my turn comes, someone will be there for me," Rose said.

She also has no apprehension about being with a person who is dying, and no fear of witnessing death, even though she has not yet experienced it either in her personal life or in hospice work.

"If someone dies while I am there, I'm not concerned," she said. "I have had people describe it as a gift, a blessing, to be there."

Gordon said a key requirement for vigil volunteers is that they feel very comfortable around the dying, since the expectation is that the person will die within hours, or in a day or so.

"They know the outcome," she said. "That is the reason for doing this."

It's a kind of acceptance of the reality of death that is not always present in society at large, Gordon said.

"We live in such a roller coaster world that people do not even take time to start the bereavement process," she said.

Rose said death is too often a topic that people try to avoid or sugarcoat.

"Death is a part of life," she said. "It's the end part. It's there. It happens. We need to help people through that."

Her children used to ask her how much she gets paid for what she does, and were surprised to hear that she does it for free.

But she doesn't do it for nothing.

"It's the feeling you get," she said. "You feel good being able to help someone. That's your payment."

GLORIA LaBOUNTY can be reached at 508-236-0333 or at glabounty@thesunchronicle.com.