Heidi Hartsough lights up a room when she steps into it. Her smile, even when talking about grief and loss, is ever present, and when she talks about her volunteer work with Zen Caregiving Project (ZCP), an easiness and lightness appear. In many ways, Heidi has been called to ZCP as a volunteer at Laguna Honda Hospital where she offers her presence five hours a week sitting with residents and families.
As a registered nurse at UCSF Medical Center, Heidi understands what happens in the medical system as a patient, but her roles as an RN and a volunteer are vastly different.
“When I start my 13-hour shift at the hospital, I just jump in, doing, doing, doing, and there is no check-in or space to just be. My job is doing all the time.”
“At ZCP it’s simply about being. I love when I put on my lanyard that says Volunteer, and I can enter a room and offer my presence. These experiences complement one another, and I have grown from being a nurse and a volunteer,” Heidi continues.
Her journey to ZCP started at a young age with parents who instilled in her the value of giving back to her community. The daughter of Quaker parents, Heidi grew up in San Francisco.
“I know that my childhood and how I was raised were hugely influenced by service. My parents saw everyone as equal, and I learned early that a person should show up to be all that they can be,” she explained.
Indeed, Heidi showed up early for service when she followed in her mother’s footsteps and joined the Peace Corps after studying public health in college. She spent three and a half years in Kouloumi, Togo in Western Africa, a small village located between Ghana and Nigeria. It was there, living with a midwife and working with the villagers, that she felt called to be a nurse with a focus on women and maternal health.
“The traditional way in which death and birth were held in Togo and how death was so accepted as a part of existence made a huge impression on me. We don’t talk about stillbirth, neonatal loss, or infant birth in America,” she explained.
In Africa, when asked the question, “ ‘How many children do you have?’ The answer was always followed by, “Oh, I have eight children and three are living.”
That was an answer she’d never heard before in America. “The traditional way in which death and birth were held and how death was so accepted as a part of existence made a huge impression on me,” she said.
Like many professionals with children, Heidi began to find a few extra hours available each week as her children grew older. She knew she wanted to do meaningful volunteer work, and that’s how she came across the Zen Caregiving Project.
“My parents were getting older, and I wanted to explore how I could gain more experience and knowledge as a mother and a daughter,” she said. “It felt amazingly natural as a labor and delivery nurse and my desire for service to volunteer with an organization like ZCP.”
At Laguna Honda Hospital (LHH) in their palliative care ward, Heidi was struck by the fact that we are all just human beings sitting together with stories to tell.
“To be in community with one another, to be in the presence of someone else even when we don’t communicate, is powerful,” she explained. “We are meant to practice loving kindness with one another, and this work has made me a much more grounded person and keen to sit with curiosity and patience to see what unfolds in everyday interactions.”
“As volunteers, we are present at our most vulnerable with those who are at their most vulnerable; we should not shy away from that,” she continues.
Heidi surprised herself early on after leaving her volunteer shift at LHH. “Each time I left my shift at Laguna Honda, I felt energized and connected even when someone had just died. The way death was framed in my Peace Corps days influenced this,” she said.
“We need to talk about death more often,” Heidi said. And at Zen Caregiving Project that’s exactly what she does.
On the wall behind Heidi, there is a painting of four blue hands with white dots on them. They appear to be hands raised as if waiting their turn to be next. “Come Heidi, sit with me. Be with me,” the art suggests.
May we all be fortunate enough to have a Heidi by our side when our time comes.
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The streets of San Francisco’s Tenderloin district can appear to be a cacophony of poverty and human suffering: crowded, dirty streets, the occasional smell of urine and feces, a barefoot person huddled on the sidewalk, their meager belongings strewn about them, tents, open drug use. For some, with nowhere else to go, the street is their home; they live their lives in public.
For others, who inhabit small, cramped rooms in single room occupancy hotels—SROs—the street may be their living room, a meeting place, a hang out, a social center, the hub of their social life.
On a crowded block of Eddy Street, across from the Tenderloin Police Station, stands San Francisco Historical Building #176, home of the Cadillac Hotel.
For the past year, Zen Caregiving Project (ZCP) volunteers have been going to the Cadillac every Friday to provide emotional and social support for the residents living there. The intention is to be able to provide palliative support for residents who are ill and wish to die at home in their room. The first step, however, is getting to know the residents, gaining their trust, and becoming familiar with the culture of the hotel.
The resident population is diverse. Of the 150 rooms, 75% of the population is over the age of 55, 43% are Spanish speaking. Some work regular jobs and go out every day and some rarely leave their rooms. Some are disabled, some show no physical indication of poor health but bear the scars of trauma, addiction, and mental health struggles. And they all have stories, colorful, astounding, heartbreaking stories. ZCP volunteers listen; we are witnesses to whatever the residents want to share about themselves, their lives.
One of our volunteer caregivers, John Ungvarsky said, “We’ve been able to connect with many of the residents at the Cadillac Hotel and provide a presence for them. Just by being present and being able to listen to them, we are building relationships.” At Zen Caregiving Project we embrace the notion of the mutuality of service, so that witnessing and companioning become a mutual process that serves the needs of both residents and volunteers.
John Ungvarsky is a thoughtful, contemplative environmental scientist who retired from the Environmental Protection Agency in August 2022, and in October 2022 he began his training at Zen Caregiving Project to become a volunteer caregiver at the Cadillac Hotel in the Tenderloin.
“Anybody who has spent time in San Francisco is aware of the Tenderloin,” John said. “It doesn’t have a good reputation. It’s not the kind of place where people want to spend a lot of time. It’s in the news about fentanyl deaths, homelessness, and more.”
While John knew he wanted to serve in the capacity as a volunteer caregiver, he wasn’t sure what to expect at the Cadillac Hotel. But John also knew that there was a great need to serve there because of all of the people who are suffering, and he was open to seeing how his service would unfold.
John spends up to five hours a week at the Cadillac Hotel meeting with residents, listening to their stories and finding ways to connect with them.
In 2006, John was present with his mother when she died, and in 2016, he found himself sitting with his brother, an alcoholic, as he passed away. He discovered in both situations that being present with them as they died were some of the most powerful moments in his life. So he knew, when he retired, he’d want to find ways to sit with others in times of need.
At the Cadillac Hotel, there are elderly sick people but also a great number of middle-aged and young people. Many of the residents have been affected by poverty, homelessness, drugs, alcohol, and/or mental illness and have a desire to stay off of the streets.
They’ve been through some very difficult periods of their life that have led them to live there. They are isolated, and some don’t get out much. They feel safer being in the Cadillac.
At first, John explained, the residents wondered what the volunteers wanted from them. They were certain that there must be some kind of transactional relationship. But given time and consistent presence, John explained that they have been very successful at building trust.
“We are welcomed each Friday, and we are having a very positive impact on the residents,” he said. “It is a gift because it is teaching me so much about myself. We are touching their lives and they are touching ours.”
John acknowledges that it has been a surprise for him at how comfortable he feels being around the residents.
“Zen Caregiving Project offers us an opportunity to connect with people in need, and the most important quality for us as caregivers is being vulnerable with the residents, and in turn, they can be vulnerable with us.”
Table of Content
Meaning Behind Mindfulness
Created by meditation teacher Dr. Danny Penman, and Clinical Psychology Professor Mark Williams, this website gives a simple overview of mindfulness and provides resources and apps for those who want to explore further.
With Nonviolent Communication (NVC) we learn to hear our own deeper needs and those of others. Through its emphasis on deep listening—to ourselves as well as others—NVC helps us discover the depth of our own compassion. This language reveals the awareness that all human beings are only trying to honor universal values and needs, every minute, every day.
NVC can be seen as both a spiritual practice that helps us see our common humanity, using our power in a way that honors everyone’s needs and a concrete set of skills that help us create life-serving families and communities. The form is simple, yet powerfully transformative. https://www.cnvc.org/
A website that explores the latest scientific research into mindfulness and meditation, and how they can be used in our daily lives. The site also shares interviews with leading researchers in the field of mindfulness, meditation, and compassion.
Guided Meditations (pre-recorded)
Begin or maintain your meditation practice by following our pre-recorded guided meditations.
Weekly Guided Meditations (live sessions)
Morning meditations can be a moment of respite before the rush of the day. One of our four experienced facilitators will be guiding each 45-minute sessions every Tuesday morning.
The East Bay Meditation Center welcomes everyone seeking to end suffering and cultivate happiness. Their mission is to foster liberation, personal and interpersonal healing, social action, and inclusive community building.
Insight Meditation Center
The Insight Meditation Center is a community-based, urban refuge for the teachings and practice of insight meditation, also known as mindfulness or vipassana meditation. We offer Buddhist teachings in clear, accessible and open-handed ways.
The San Francisco Dharma Collective is a welcoming and inclusive space for meditation, community, and awakening through diverse teachings and practices.
The SF Zen Center has in-person beginner’s introductions to meditation while also sharing videos of talks and teachings online.
SF Zen Center Branching Streams Affiliate Directory
The nonprofit also offers a statewide and international directory of meditation centers.
Spirit Rock offers the spaciousness and stillness as well as caring teachers, staff and volunteers to create a supportive environment for turning inward and letting go of the struggles that get in the way of experiencing the freedom and joy that are inherent in every moment of life.
Upaya Zen Center in Santa Fe, New Mexico offers daily Zen meditation, weekly dharma talks, and programs on Buddhist teachings, art, neuroscience, and social engagement. The center also provides professional training for end-of-life-care and Buddhist chaplaincy.
Tend is a mindfulness platform designed to bring your life into focus, manage your day-to-day, and help you chart a path toward a more meaningful life.
This free app has guided meditations, a timer, and the option to show who else across the globe is meditating at the same time as you are.
This meditation app offers a free 10-day beginner’s course that guides you through the essentials of meditation and mindfulness.
Table of Content
A website to support families. The site has an active online forum where caregivers can share their experience and learn from others by asking questions, giving answers, or participating in a group discussion.
CAN (the National Family Caregivers Association) provides articles, videos, and peer support to family caregivers across the country free of charge. They cover a broad range of topics from practicalities such as medication and nutrition management, to caregiver self-care to navigation of the medical system.
This non-profit’s mission is to improve the quality of life for caregivers and the people who receive their care. Their website has an online learning center and links to many other resources such as in-person support groups.
For those caring for loved ones with Alzheimer’s, this website has clear and easy to access information on practical and emotional elements of caregiving.
The caregiver page of the website has an interactive caregiver resource guide, articles, and videos on cancer-related caregiver topics, online communities, and links to other support groups.
Companioa from the Institute on Aging
A paid-for service, to support caregivers of loved ones with dementia. This service pairs you with a personal “Care Coach”, a trained dementia expert. The Care Coach helps assess your loved one’s needs, map out a care plan and meet with you bi-monthly to discuss the plan and your needs.
Life-affirming care and comfort for children with illnesses and their families.
Imerman Angels support cancer fighters, survivors, previvors and caregivers by matching them with a “Mentor Angel” – a cancer survivor or caregiver who has faced the same type of cancer and who can answer questions and provide one-to-one support.
Lorenzo’s House focuses on younger-onset dementia and revolutionize care in an industry where existing practices need profound reimagining.
Planning Guides & Tools
This useful list and accompanying templates were kindly shared with us by Donna Woodward, a Hospice Volunteer and Dementia-care Volunteer. They will be particularly useful for friends or family in a caring role.
AARP has put together local resource guides showing what support is available for family caregivers in different states and different cities.
A list of links to guides and toolkits for creating your Advance Care Directives.
Next Step In Care provides written guides and videos for family caregivers that help them through any medical treatment – from visiting the family doctor, trips to ER, hospitalization and discharge and Homecare.
The staff and board members of Zen Caregiving Project held a virtual town hall gathering on May 24th to share what we’ve been up to and where we are headed. If you missed it or want to rewatch it, you can view the recording.
Table of Content
- Conversations Around Death & Dying
- End of Life Care Directives
- Hospices Network and Directories
- Spiritual Counselors
Conversations Around Death & Dying
This resource shares conversation tools for advance care planning, advance directives, and answers to your frequently asked questions.
A short documentary following the stories of three visionary medical providers, one of which is Zen Hospice Project, caring for and supporting those approaching the end of their lives.
A blog by Zen Caregiving Project sharing mindfulness and compassion-based approaches to managing loss and grief.
In this ZCP webinar we explore ways that mindfulness can help us truly experience the grief that is present for us, allowing us to accept more and suffer less.
In this podcast, our Executive Director, Roy Remer, speaks about death and dying in the Zen tradition.
End of Life Care Directives
The Coalition for Compassionate Care of California (CCCC) provides advance instructions and information on advance directives in different languages.
This interactive site provides templates, resources, and toolkits to help you with planning for your future care. Spanish versions of all site documents are also available.
A program of Aging with Dignity, Five Wishes is a booklet ( paper or online) that guides you through planning for end of life. It also facilitates conversations with family and friends about your future medical, spiritual, emotional, and physical needs. It is America’s most popular living will, with more than 35 million copies in circulation.
The Prepare for Your Care website caters to people with minimal to no computer experience. They walk visitors through basic advance care planning steps with prompts and videos to help people get started. The website is also available in Spanish.
A workbook designed by Ariadne Labs with The Conversation Project to help people with a serious illness get ready to talk to their health care team about what is most important to them.
Hospices Network and Directories
By the Bay Health works closely with community physicians to ensure the highest quality end-of-life care for their patients, regardless of what service they choose.
A directory of certified end-of-life doulas thoroughly trained in all three phases of end-of-life care.
Sponsored by the Hospice Foundation of America, HospiceDirectory.org provides a national database to locate hospices by location and/or name, as well as links to additional information for both caregivers and patients.
Part of the NHPCO’s website, the Patient and Caregiver pages provide free resources on a range of topics, including deciding palliative care, hospice care, advance care planning, caregiving, and loss. Their resources are practical, clear, and easy to read.
A list of spiritual directors with interfaith understanding and practice.
A directory of faith-based therapists and other mental health professionals around the country.
The bathing ritual, in which a body is bathed after the person has died, has been a part of Zen Caregiving Project’s rituals since it was founded. This blog explains its significance as a grief ritual.
A company offering interactive and collaborative remote memorial services enabling five to 500 family and friends to memorialize, eulogize, and celebrate a deceased loved one. From afar, family, friends, and community will virtually attend your loved one’s end-of-life celebration.
A page with advice on grief and loss and how to navigate it. This guide also offers links to other useful information in the “resources” section.
A non-profit that offers a wealth of resources and services to support children, teens, families, and adults in the grieving process.
Last/ing Letters began as a service provided through hospice, healing circles, chaplains and palliative care doctors and has grown to include anyone who has a lasting letter they wish to write to a loved one.
Table of Content
In April and October 2021, Zen Caregiving Project ran a research study in partnership with Dr Janice Bell and Dr Philippe Goldin from University of California, Davis. The study explored the impacts of our Mindful Family Caregiving Online Course on those caring for friends and family.
This report pulls from multiple sources to profile who family caregivers are and the challenges they face and includes several first-person accounts of the experience. It takes a detailed look at recent developments and promising federal and state policies that support family caregivers, as well as promising practices in the public and private sectors, including the positive representation of caregivers in popular media. It concludes with specific recommendations.
On September 22, 2021, the Recognize, Assist, Include, Support, and Engage (RAISE) Act Family Caregiving Advisory Council delivered its initial report to Congress. It includes a comprehensive review of the current state of family caregiving and 26 recommendations for how the federal government, states, tribes, territories, and communities—in partnership with the private sector—can better Recognize, Assist, Include, Support, and Engage family caregivers.
To learn more about how the council developed this report, check out the Implementing the RAISE Family Caregivers Act factsheet.
Written by BJ Miller (a previous Zen Hospice Project Executive Director) and Shoshana Berger, Director at IDEO, this book is a practical guide to approaching the end of life. It includes instructions on everything from navigating the health care system, to talking to your children about your will, to writing a great eulogy.
Written by Jon Kabat-Zinn, this book offers a step-by-step introduction to the practice of mindfulness and how to cultivate mindfulness in the face of stress, pain, and illness. You can find videos of Kabat-Zinn’s meditation teachings on his website.
Caregiving for Caregivers
If you’re caring for a loved one with dementia, you know firsthand the challenge of providing care while maintaining your own well-being. Caring for a Loved One with Dementia written by Marguerite Manteau-Rao, LCSW offers a compassionate and effective mindfulness-based dementia care (MBDC) guide to help you reduce stress, stay balanced, and bring ease into your interactions with the person with dementia.
His eye-opening book challenges all care providers working with individuals with dementia to undertake a true operational change within residential care settings while reducing the administration of psychotropic drugs in the symptomatic treatment of dementia.
Patti Davis draws on a welter of experiences to provide a singular account of battling Alzheimer’s. Eloquently woven with personal anecdotes and helpful advice tailored specifically for the overlooked caregiver, this essential guide covers every potential stage of the disease from the initial diagnosis through the ultimate passing and beyond.
In this practical, step-by-step guide, geriatrician Leslie Kernisan, MD and Paula Spencer Scott, walks you through what to do and what to say in order to offer respectful assistance and intervention to a declining elderly parent.
Death & Dying
Breathing Wind is a podcast about grief, parent loss, change, and healing. Founded by Sarah Davis, this podcast began as a collection of stories highlighting the shared experience of losing parents at a young(er) age. Season Two’s focus is on healing.
A book by Frank Ostaseski, the cofounder of the Zen Hospice Project and Metta Institute, who has sat on the precipice of death with more than a thousand people. He has trained countless clinicians and caregivers in the art of mindful and compassionate care. In The Five Invitations, he distills the lessons gleaned over decades of selfless service offering an evocative and stirring guide that points to a radical path to transformation.
In this book, mortician Caitlin Doughty embarks on a global expedition to discover how other cultures care for the dead.
A website created by David Kessler, one of the world’s foremost expert on grief and loss. Using comforting and touching stories in his book Needs Of the Dying, Kessler provides information to help us meet the needs of a loved one at this important time in our lives.
In this book, the psychologist and Buddhist Sameet M. Kumar offers an alternative approach to grief: accepting and feeling it, and then using it as opportunity for growth and finding meaning.
By the New York Times bestselling artist, Wendy MacNaughton’s book combines drawings she drew from life while serving as the artist-in-residence at Zen Hospice Project’s The Guest House with words of hospice caregivers she interviewed.
A short documentary following the stories of three visionary medical providers, one of which is Zen Hospice Project, caring for and supporting those approaching the end of their lives.
In this book The Wild Edge of Sorrow: Rituals of Renewal and the Sacred Work of Grief, psychotherapist Francis Weller provides an essential guide for navigating the deep waters of sorrow and loss in a lyrical yet practical handbook.
A book by long-time hospice volunteer, Jennie Dear, who uses the latest medical findings and sensitive human insights to offer answers to questions that affect us all like Does dying hurt? and Is there a better way to cope with dying?