# Sample Volunteer Training Agenda The BRAIN Project Sample Volunteer Training Agenda For volunteers who will work with older adults in your hospital. Training Volunteers to Work With Older Adults Volunteers can be a valuable resource to the geriatric ED. After recruiting the right candidates, the next step is onboarding and education. To support you, we’ve provided a sample volunteer training agenda. This agenda was designed specifically for a Meal Mates volunteer role, but can be adapted based on the program you are developing. Start With an Example Read the following training agenda for an idea of how to structure volunteer education. We’ve also provided a downloadable version for ease of use. Sample Volunteer Training Agenda Get started by adapting this sample document. Download Word Document Volunteer Training Agenda — Meal Mates This sample contains learning content for a volunteer who will be assisting with the Meal Mates program at a hospital. We've included it to illustrate one approach to volunteer training. Review and adapt it to suit your program, incorporating age-friendly care principles where appropriate. About Meal Mates Meal Mates is a patient-focused volunteer service aimed at providing encouragement, companionship, and feeding assistance during meal times. Making meals more pleasant for our patients is a primary goal — and the expected outcome of this program. Participating volunteers should feel a great sense of satisfaction in helping to achieve this. Volunteers interested in Meal Mates must attend a special in-service covering the materials contained in this packet. Look for the Meal Mates pin on the lapel of those volunteers who have completed the training. Assisting Patients and Enhancing Dignity Some people who are ill and hospitalized require assistance with eating and drinking. The amount and type of assistance depends on the physical and mental limitations of the patient. These limitations may involve reduced arm mobility (due to casts, surgery, paralysis, or an intravenous line in their dominant hand or arm), visual impairment, cognitive impairment, or severe physical weakness, which can affect older adults or those undergoing surgical procedures. In addition, hospitalized patients have multiple dietary needs. These stem not only from disease processes, surgical procedures, and physical health, but also cultural, religious and individual preferences. Other patients may simply be depressed, or listless from being in the hospital, and miss the social aspect that usually accompanies mealtime. Having someone with them may encourage them to eat more and help improve their nutrition. Adults who are normally able to eat independently may find assistance of any kind embarrassing and difficult to accept. They may become depressed because they need help. They may also believe that they are being a burden to busy nursing staff. It’s therefore very important to allow the patient some control over mealtime and avoid coming across as impatient or annoyed. We want to make mealtime an experience that enhances nutrition while providing a sense of normalcy and maintaining the patient’s abilities and dignity. Training for the Meal Mates program will teach you how to safely assist patients with meals while promoting independence and enhancing dignity. Criteria, Assignment, and Reporting Patient Criteria The patient will be cooperative. The patient may be confused about time and place — but able to eat. The patient can be def in a chair or bed. Nursing staff will position the patient in an appropriate way to eat, which may require adjustment of the bed, bed railings, and alarms. The patient will not be on isolation. The patient must not be identified as high aspiration risk. Patient Assignment Nursing staff will place an order in EPIC for a patient to receive services from a Meal Mates Volunteer. In some cases, they will consult with Speech and Language Pathology staff. Report to your unit secretary for your assignment. You will receive a documentation sheet with information about the patient and a place for you to record your visit. Reporting to Nursing Staff Communicate unusual or emergent situations to nursing personnel. These include: A patient having difficulty swallowing. A patient who starts spitting up food. Food or liquid coming through the nose. A patient refusing to eat or drink. A patient who appears to be choking (go to the threshold of the door and yell for help). A patient who becomes agitated or starts to yell. A patient who is trying to get out of bed or their chair. Patient need for toileting. Patient need for pain medication. *In an emergent situation, stay with the patient, stay calm, and seek assistance from the nursing staff by calling for help using the patient phone or by pushing the call bell. If you feel it is necessary, go to the threshold of the door and yell out into the hallway for help. Always ask for assistance at any time you feel it is needed. Additional Considerations Dining vs. Eating Atmosphere — Hospital versus home, loss of independence. Environment — Bed versus chair verses table, alone versus with family. Eating Habits — Food preferences, order in which foods are eaten, alternating between eating and drinking. Food Quality — Institution versus home cooked, loss of and limited choices, new textures. Why a Patient May Not Eat Abdominal or generalized pain Nausea Constipation Lack of appetite due to illness, medication, or lack of activity Depression Paranoia Left dentures at home or needs adhesive Mouth and throat pain from thrush or oral sores Dry mouth from medication or poor oral hygiene (can possibly get wet swabs for their mouth) Don’t like the food (ask the patient; ask yourself what kind of food would you want) Abnormal taste (medication side effect) Boredom Delirium Dementia Need special utensils (large handles, sippy cups) Poor vision Bad smell in area Lack of taste or smell Swallowing difficulty Pain Need to go to the bathroom Report any of the above concerns to the nurse. Special Populations Cognitively Impaired (Dementia, Depression or Delirium) Provide simple instructions Demonstrate instructions as needed Give regular reminders Distract the patient when appropriate (to redirect them from distress) Encourage independence by utilizing the patient’s abilities Offer positive reinforcement Hearing Impaired Speak clearly (not louder) Speak more slowly Face the patient Eliminate background noise Speak in a deep voice Apply hearing aids or amplifier (can leave with patient) Write to the patient Visually Impaired Avoid startling the patient Bring appropriate eyewear Position yourself and any objects appropriately Adjust lighting as needed Instructions The following procedures will guide you during mealtime assistance: Receive patient assignment and information from PAA (Unit Secretary). Wash your hands before entering the patient’s room with the hand solution outside (standard policy). Introduce yourself to the patient and ask permission to check their ID band so you can verify that you have the correct person. Explain who you are and why you have come to visit. Set the tone for a quiet, enjoyable mealtime. Minimize distractions and noise as much as possible by asking the patient's permission to shut off the television or lower the volume. You can also ask to pull the privacy screen between the beds, or close the door slightly. Take notice of any communication difficulties the patient may be exhibiting — either sensory or cognitive — and apply communication skills you have learned.  The patient may have a listening device such as a hearing amplifier or a hearing aid. Please ensure the patient is wearing their device and that it is working. If the patient needs glasses to eat, these should also be on the patient.  If the tray has not yet arrived, clear the tray table of any items that should not be present for meals, such as urinals, bed pans, and trash. Make sure the call bell is within reach. If necessary, wash the table down with soap and water. When the tray arrives, make sure that the name on the menu matches the ID band on the patient. Check that items on the tray match the menu. Refer to the tray slip and ensure the correct diet and food texture has been provided. If it is incorrect, or if you are unsure, inform the nurse or PCA before beginning the meal.  Appropriate positioning of the patient prior to eating is the responsibility of the nursing staff. Before you begin to assist with the meal, confirm with either the PCA or the RN that the patient is in the correct position to eat (in general, this is an upright position of 90 degrees). Occasionally, patients must have modified positioning for safe swallowing or physical restrictions (hip fractures, for example). However, you are not to position the patient, move the head of the bed up or down, take the patient out of bed to the chair, or adjust side rails — only nursing staff can do this. If the patient wears dentures, confirm with the nurse that the dentures are appropriately applied. Once the patient has been positioned, you may move the clean tray table into a position in front of the patient.  Before you touch the patient’s tray to begin helping with the meal, wash your own hands in the sink in the patient’s room. Use the handwashing wipe supplied on the lunch tray to give the patient an opportunity to wash their hands before eating. Place a towel or a napkin across the patient’s chest to protect their clothing. Attempt to be at eye level with the patient. This may require you to sit in a chair or stand up, depending on their height. Talk about the food choices with the patient. Ask if they would like any of the provided seasonings, dressings, or condiments applied. Open containers, unwrap utensils and prepare drinks with straws, being careful not to touch surfaces that will go into the patient’s mouth. Assist the patient as needed, but promote independence as much as possible. For example, you may need to cut the food for the patient, but they may be able to put the fork into the food, and the food into their mouth. Allow the patient to choose the order in which the food is eaten. When patients must be fed, keep the spoon or fork quantities small (spoon no more than 2/3 full, sometimes less). Offer foods in sequence according to patient's preference.  Name each food as you move from item to item. This can be done in your conversation with the patient: “Here are some mashed potatoes”, “Let’s try some squash”, or “The beef looks delicious, would you like gravy on it?” Allow the patient time to chew and swallow before offering more food or fluids. Watch for the swallow: look at the throat and make sure you see the swallow before providing the next bite or sip. If you see any signs of discomfort or difficulties, inform the nurse immediately. Adjust your pace to the patient’s and look for cues that the patient is ready for another bite of food. Utilize facial expressions and gestures to communicate non-verbally when necessary. When a patient is given nutritional supplements with a meal, they are in addition to the meal, or in place of a given beverage such as coffee or tea. These supplements provide necessary calories and nutrients in liquid form. Work them into the meal as best you can. Develop a way for the patient to indicate that they are ready for another bite. This could be verbal, or non-verbal, such as a nod of the head. Be aware that your reactions to the foods and drinks can easily be picked up by the patient. For example, if you dislike broccoli and make a face showing disgust, the patient may notice your facial expression and decide not to try it. It is important to avoid conveying your food preferences to the patient. Remember, they may enjoy foods you dislike, and these ingredients may be important contributors to nutrition and health. Ensure the patient is alert before and during feeding. Some patients may experience fatigue during the meal and doze off. Consider whether they need regular breaks. Use a napkin to wipe the patient’s mouth as needed and after the meal. Interact with the patient throughout the meal, but try not to ask questions or cause laughter during chewing or swallowing to reduce risk of choking. Learn to read your patient’s body language when they cannot talk. For example, when you offer the patient food and they close their mouth tightly or turn their head, this probably indicates a dislike, or that the patient is full. After feeding a patient for a time, you will learn to interpret their signals.  When you feel the patient has finished eating, remove the towel or napkin from their lap. Wash the patient's hands and mouth if they are unable to do this. Leave any items the patient wants in an accessible location. Record the information requested on the documentation sheet regarding your experience. Wash your hands after the meal and before leaving room. Be sure that the patient is in a safe position, and that alarms are activated if necessary. If you have any concerns about leaving the patient, let the PCA or nurse know. Otherwise, you can leave the completed form with the PAA. AREAS TO TROUBLESHOOT  If you suspect the temperature of the food is incorrect, call the PCA. Food may need to be heated, and the PCA would need to do this. If the food appears to be too hot, leave the lid off and allow it to cool down before feeding it to the patient. If you suspect the patient is pocketing the food in their mouth and not swallowing it, do not continue to feed them and notify the nursing staff. Discontinue feeding a patient who falls asleep. If a patient is non-verbal, pay attention to body language and facial expressions. For the visually impaired patient, try using numbers on a clock to help them locate food on the table or plate. Competency Checklist Volunteer Name:                                                            Preceptor Name: ___________________ Date Started: ___________________ DEMO = Demonstrates skill VERB = Verbalizes process if unable to demonstrate CONF = Confident to perform COMP = Competent to perform independently COMPETENCYDEMOVERBCONFCOMPReceives assignment    Washes hands before entering room    Introduces self to patient — identifies correct patient    Ensures patient is wearing sensory aids if needed (glasses, hearing aids/amplifiers) and dentures    Assures the correct positioning of patient has been handled by nurse/PCA    Minimizes distractions (television volume, etc.)    Clears the tray table and cleans if necessary    Washes hands at sink before touching tray items    Identifies meal tray matches patient ID band    Identifies items on tray match the menu    Moves tray table over the patient    Gives patient opportunity to wash hands with wipe    Places towel or napkin across patient’s lap or chest    Positions self at eye level with patient    Makes sure call bell is in reach    Introduce food on tray to patient    Prepares food on tray — opens containers, utensils, straw, etc. (not touching surfaces that will go in patient’s mouth)    Ensures food is correct temperature    Asks patient for preferences on seasoning and condiments    Cuts up food if needed    Utilizes numbers on clock for visually impaired patient to locate food on tray    Identify foods/liquids and allow patient to indicate what they want next    Feeds patient using a spoon no more than 2/3 full    Allows the patient time to chew and swallow before offering more food or fluids    Watches for the swallow    Develops a way for patient to indicate when they are ready for another bite     How-to-Guide Starting a Volunteer Program Preparing a volunteer program? We'll walk you through each step, so you can launch your program with confidence. View Guide Part of the BRAIN Project Creating Dementia and Delirium Friendly Hospitals BPAC sessions are a key element of the BRAIN Project. The initiative brings the Alzheimer's Association and the Geriatric ED Collaborative together with the support of the West Health Institute. Its goal is to identify high-performing hospitals, understand how their models work, and translate those lessons into practical tools for other health systems to adopt. BRAIN brings together leading hospitals to explore practical interventions for dementia and delirium in ED and inpatient settings. Successful approaches are shared through collaborative sessions and formalized. From there, health systems are equipped to transform care — translating what is already known into what is widely practiced. Explore BRAIN Project