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Mindful approaches to caring for someone close to death
Instructor: Alistair Shanks
Loretta Lowrey’s Practice As Service to Others
Thirty years is a long time to be in a relationship with anyone, let alone with an organization that you volunteer for. Loretta Lowrey arrived at Zen Caregiver Project (then known as Zen Hospice Project) as a volunteer in 1992, and while she stepped away during a few child-raising years and then again during her busy career years, Loretta has always found herself being called back to the organization in one way or another.

She came to Zen Caregiving Project (ZCP) in the middle of the AIDS epidemic when even the word ‘hospice’ was new to her.
“Suddenly, everyone in my world was talking about it—the woman who took care of my daughter, my sister, a museum curator that I worked with,” Loretta said. “When something presents itself to me three or more times, I pay attention to it.”
Paying attention is exactly what she did by volunteering at Laguna Honda Hospital as a Zen Caregiving Project caregiver. She continued in that role for five years until her second child turned two years old; she then stepped away to spend more time with her children. Because of her background in nonprofit management and development, Loretta continued to stay active with the organization by occasionally helping with events and development support. Over those years of being a full-time mom and employee, Loretta lost touch with ZCP for a while.
In 2013 when Loretta was looking forward to retirement, she decided it was time to return.

It felt like coming home,” she said. “When I returned to Laguna Honda Hospital (LHH) as a volunteer, it felt so familiar and lovely to be a part of that again. We all live in these self-created bubbles and the greatest impact for me has been meeting the range of people who have invited me into their lives and into their hearts.”
Observing the frailty and resilience of the residents is what continues to open Loretta up to becoming more compassionate and open-hearted.
“It’s given me perspective on what is truly important. Volunteering at the hospital and being with residents is so real. So many other things that seemed important before dropping away. It motivates me to live more fully by being exposed to illness and death and having it normalized,” Loretta said.
One of the residents who made an impact on Loretta was a woman who used a device to speak. The only way that she could communicate was by typing out words and since it was difficult to use her hands, it took a long time for her to have “a conversation.”
“I was so taken aback that it was such an effort to communicate, yet she would say things like ‘That’s such a pretty dress.’ We laughed and cried together while completing a legacy project that was important to her.”
During the pandemic, Loretta became a Mindful Caregiving Education (MCE) instructor for ZCP. She now teaches some of the MCE courses and still sits with residents at LHH. Through the years and through her various roles with ZCP, Loretta has become more aware of herself.
“One thing I am able to notice is when I’m acting out a role or when I have my armor on. The training we’ve had to sit at the bedside with someone has made me more aware of the power of presence,” Loretta said.
“I really think of this work as part of my practice. I think of service as seeing the wholeness in others. I thought I’d be coming to this work to give something, but in fact, I take away so much more than I give.
“Many of these residents are living fully in spite of their illness or condition,” Loretta said. “They are such a gift to me.”
And Loretta, like all our volunteers, is a gift to us at Zen Caregiving Project.
If you like what you read, please join us and enroll in one of our courses, share our work with someone you think will benefit from it, or support us through a donation.
Bob Stumpf, ZCP Volunteer since 2016
Bob Stumpf is prepared to go the distance whether it’s in a relationship with others or on a run. He’s completed 28 marathons and these days, Bob often comes in first or second in his age group. (Don’t tell anyone that at 74 years of age, Bob generally competes against only one or two others in his age category).

As a volunteer with Zen Caregiving Project (ZCP) for nearly six years, Bob sits with residents at Laguna Honda Hospital every Friday afternoon. One particular resident continues to enrich Bob’s life even though this person has since died.
“There was a resident at Laguna Honda that I visited weekly,” Bob explained. “I would save him for last because I knew it would be an uplifting experience for me at the end of my day.”
Bob explained that he loves sports and thought he knew everything there was to know until he met S, that is. “S. knew everything there was to know about sports, everything. He and I also bet on sporting events, usually hundreds of thousands of dollars at a time, with play money. I think he still owes me some money,” Bob said with a grin.
“Sports were a common bond from the beginning, and S. had also visited my hometown in Southern Indiana, so he understood where I came from,” Bob said. “It wasn’t just me taking care of him; it was S. taking care of me.”
That’s one aspect that surprised Bob about being a volunteer – how much he would get back from it.
“Not only have I gotten close to the residents I sit with, but I’ve developed close, personal relationships with other volunteers. During our shift change meetings, I find myself getting to know other volunteers who are very different from me, and yet we are kindred spirits,” Bob said.
“I didn’t expect that whatever calls people to do this work would give me the opportunity to meet so many other like-minded folks. We’re a real community.”
As a left-brained attorney for more than 40 years, Bob surprised himself by recognizing that he can also be a right-brained kind of person. When he turned 65 years old, he wanted to scale back his work and increase his volunteerism. While he had been on a number of charitable boards over the years, he found himself drawn toward volunteer work that would give him a one-to-one connection.
“I’ve always been interested in the concept of death; not in any kind of morbid way, but in the sense that we are born, we live, and then we die.”

Bob is also interested in music; specifically, he has a penchant for collecting jukeboxes. He once had 22 jukeboxes in his office that are now at home with so many others that he doesn’t divulge the total number. There’s one behind him as we talk, lit up and ready for any song to be played.
“They all work,” he explained. After he purchases them, he sends them to someone who restores and fixes them for him and then delivers them wrapped up in such a way that Bob feels like it’s Christmas morning every time one arrives.
He feels that same joy when he leaves his shift at Laguna Honda.
“I get so much more out of volunteering than I put into it,” Bob said. “When 6 p.m rolls around on Friday, I’m always at my happiest as I’ve been all week. During my shift, I’m able to get out of my own head. It’s a cleansing and nourishing experience.”
“I’m more sensitive now to the importance of having relationships with people who are really not like me at all,” Bob said.
One such resident that Bob has met could not be more different. Bob has had many advantages as a white man who attended Harvard, whereas E. had a very different life as a black man in America who for many years lived on the streets. Bob and E. have met weekly since December 2016, and they have forged a strong relationship.
“He’s important to me,” Bob explained. “ We aren’t family; we aren’t best friends, but we get together weekly, and he’s my friend. When I leave, he usually says, ‘Be safe out there.”
Bob looks off into the distance and returns to thoughts of his friend, S. who died last year.
“I saw him for almost two years,” he said, “and every time I walk by his room at Laguna Honda Hospital, I think of S. I miss him.”
Bob hasn’t just run 28 marathons. He’s running a marathon with residents at Laguna Honda, and rest assured, he’ll go the distance with them not to win any kind of medal, but to just be present on their journey. “People can have almost nothing left, and they are still living their lives,” Bob said. Yet they still have Bob, holding their hand and offering his presence. And often, at no extra charge, he offers them a few jokes.
If you like what you read, please join us and enroll in one of our courses, share our work with someone you think will benefit from it, or support us through a donation.
Heidi Hartsough’s journey from the Peace Corps to ZCP Volunteer
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.
If you like what you read, please join us and enroll in one of our courses, share our work with someone you think will benefit from it, or support us through a donation.
Webinar on The Gift of Self-Compassion for Family Caregivers
In December our Executive Director, Roy Remer, presented a webinar for the Family Caregiver Alliance called The Gift of Self-Compassion This Holiday Season. We have posted it below for anyone to access.
In the webinar, Roy talks about why we must include ourselves in the kindness and compassion we give others. In the interactive session, he shares practical ways to build compassion towards ourselves and those around us.
Supporting staff that help the most vulnerable in San Francisco
Community Forward SF is a non-profit that works with and supports the most vulnerable and underserved communities in San Francisco: adults and older adults, who are or have been chronically homeless, those who are dually or triply diagnosed, those with chronic medical conditions, substance abuse issues and mental health needs and those who are BIPOC, LGBTIQQ. Community Forward SF offers medical, emergency, and transitional shelter, supportive housing, and a large array of wrap-around services such as mental health services, case management, substance abuse treatment, and domestic violence support to meet clients where they are at when they access the service.
The nature of the work they do results in front-line and clinical staff at Community Forward SF witnessing loss, suffering, and distress on a daily basis which can lead to emotional strain, empathy fatigue, or overwhelm. This strain on the staff has only increased since the pandemic.
In response, Community Forward SF is partnering with ZCP who will deliver four monthly sessions to Community Forward SF’s clinical staff. These sessions will cover the role of mindfulness in exploring and regulating emotions, compassion for yourself and others in a caregiving role, the role of loss in caregiving, and how to approach maintaining healthy boundaries.
Suzanne Adams, PhD, the Vice President of Clinical Services at Community Forward SF explained why she approached ZCP to support her staff:
“Mindfulness is an integral part of a cultural shift I hope to impart on not only for our clients’ wellbeing but for our clinical team, as well. Our clinical staff manage the demands of difficult jobs–feelings of activation, coping with vicarious trauma, and issues of burnout–while also being called to address the essential need of self-care. I reached out to Zen Caregiving to provide the education, resources, and emotional support to my team that can help them in all areas of their experience.”
Sessions will begin in January 2022 and will run until April 2022.
If you are interested in how ZCP can support you and your team, please contact [email protected] to learn more.
If you like what you read, please join us and enroll in one of our courses, share our work with someone you think will benefit from it, or support us through a donation.
The second wave of our Family Caregiver Study is running
In April this year we ran the first wave of our Family Caregiver Study in partnership with academics at the University of California, Davis, which you can read about in our previous blog. We had a total of 140 people join that first wave, with 116 people completing the sessions and the main surveys they were sent*. Individuals joined from all across the country and even internationally.
We were encouraged by the number of caregivers that signed up and participated in this first wave, and it showed us that there was a clear desire from caregivers to attend our Mindful Family Caregiving course. We approached the Stupski Foundation, who had supported our first wave of the study, and they generously agreed to fund a second wave.
For this second wave, we changed the timing of the sessions to make it easier for caregivers on the East Coast and those outside of the USA to join. We capped our registration at 76 people and the course ran across September. As with the previous wave of our study, we asked participants to fill in four surveys, one a month before the course started, one just before the course started, one immediately after the course finished and we will ask them to fill in a final survey a month after they have finished the course.
Having this second wave of participants will provide us with more data for our analysis, will help us get greater statistical power in our analysis and will help us identify more subtle changes in the data.
Next steps
We will be compiling the data from Wave 1 and Wave 2 and examining the impact that the course had on caregivers’ emotional, psychological and physical health, their level of caregiver burden, and their wellbeing. We hope to have the results published in an academic journal in early 2022 and will then work to share our findings with our community and other caregiving organizations, as well as everyone who participated in the study. We will also be examining the feedback that caregivers provide on the format and content of our course, and using this to improve our course design.
* We had expected a greater drop-out from participants, recognizing the difficult and often rapidly changing schedules of many caregivers.
We’d like to thank the Stupski Foundation for their generous support of the study, Prof Janice Bell, Prof Phillippe Goldin, and Michael Juberg for sharing their time and knowledge so generously, and everyone who shared our study with their community, enabling us to reach such a large family caregiving audience. Anyone interested in working with ZCP on further research studies, please contact [email protected]
Companionship and Compassion: The benefits of ZCP Volunteers on a palliative care ward
Camille Tacderan is the Daytime Charge Nurse on the South Three (S3) Palliative Care Ward at Laguna Honda Hospital, where ZCP volunteers have served for over 30 years. We spoke to Camille about the value the Volunteer Program brings, her experience of working through the pandemic, and her excitement about the Volunteer Program starting up again.
You have spent many years on the ward with the volunteers. What impact do you see them having?
Residents really benefit from having volunteers on the ward to interact with. It can be as simple as them sitting and talking with a resident in the Great Room [the communal area of the ward], or for some residents who are non-verbal just being present with them or holding their hand. Also, the volunteers are on the ward weekly and often have regular visits with residents whose conditions are changing over time, so they build a relationship with them and can tailor their interaction to that resident’s current needs.
They also support the families of residents. What is special about S3 is that it allows family members to be family members. They don’t have to be medical caregivers and instead can live their own lives and visit as sons and daughters, or spouses. The volunteers are a big part of that specialness because families know that even if they can’t be there to sit with their friends or relatives, the volunteers can be. And that is really reassuring.

For staff, more than anything else, it is just knowing that there is someone to sit with a resident when they aren’t available to do so. As staff, we are looking after a number of patients and sometimes can’t sit with people as long as we would like. Especially when that person is approaching the end of their life, it is comforting to know that the volunteers are available to be with that person in their last moments.
“It is comforting to know that the volunteers are available to be with that person in their last moments.”
You worked through the pandemic when volunteers weren’t able to visit the ward in person. How was that experience for you?
The pandemic was really challenging. On a personal level, there was a lot of anxiety around safety for yourself, your family, the residents, and the other staff on the ward.
The ward closed to visitors and volunteers early in March 2019 to protect residents and stayed closed until mid-2021. During this time a lot of residents didn’t understand what happened, some didn’t recognize staff with masks on, and some clearly missed the interaction they had with volunteers and family. For staff, it was also very difficult as we were busy adapting to new protocols and keeping residents safe, and it was at this time, when we were busier than ever, that it would have been wonderful to have the support of the volunteers who could also be with the residents.
The volunteers have started to come back in person to the ward. How do you feel about that?
I’m really excited as the volunteers are such a big help. We are getting more younger residents joining the ward, who are alert and will be in the ward for a long time so have a big need for social interaction from those around them. With our workload, the staff can’t always provide that level of interaction, which is where the volunteers come in.
Some of these younger residents come to the ward having experienced a lot of social isolation. Some have been living in COVID hotels, experiencing a lack of contact and services. Some have been living alone at home or in an SRO. It is so nice to know that they can get the companionship and interaction they want, need, and deserve when they get to the ward, thanks in a big part to the volunteers.
As the hospital is run by the San Francisco Public Health Department, we are the safety net of the city. Our residents may have been living outdoors on the streets with no family or connections and it is lovely to know that they can come to this ward and spend the last few days, months, or years of their life being cared for and that they knew there were people around them who did care about them.
“What we do on the ward is give the residents love.”
What we do on the ward is give the residents love. They are warm, get three hot meals a day, and get taken care of physically and emotionally. Volunteers are a crucial part of this as they fill the gaps when the staff can’t be there. And that is what makes the ward such a special place.
If you like what you read, please join us and enroll in one of our courses, share our work with someone you think will benefit from it, or support us through a donation.
Cuidar y Cuidarse
Instructora: Teresa Bouza
Meet Sarah Bain, Zen Caregiving Project’s new Chief of Staff, and learn about her journey to us.
Sarah comes to us from the Pacific Northwest though her roots and ties to California are deep and lasting. With a background in nonprofit management, partnership management, donor development, fundraising, and grants management, Sarah is excited to join Zen Caregiving Project and lend a helping hand in our development of long-lasting partnerships and create deeper and more meaningful relationships with our donors.
She has worked in the philanthropic and nonprofit field for more than 15 years. In addition, Sarah also runs the Spokane Chapter of the MISS Foundation which offers peer-to-peer support for families whose children have died. She provides newly bereaved parents with support and comfort as they process their devastating grief. Her personal experience with grief and loss from an early age and continuing into adulthood is what draws her toward the work at ZCP.
In her spare time, Sarah enjoys walking her two Australian Shepherds with her two cats who follow behind the dogs at a safe distance while they stroll together through the neighborhood. She’s also known to just step out the door of her home and keep walking in any direction until she gets tired. Often, she’ll end up seven to ten miles away from home and she’ll need to call her husband to pick her up.

As an avid reader, Sarah reads about one book a week, and while she’s willing to read just about anything, she has a fondness for literary fiction and memoirs. In 2021, her top favorites were Klara and the Sun by Kazuo Ishiguro, Hamnet by Maggie O’Farrell, Bewilderment by Richard Powers, and Notes on Grief, by Chimamanda Ngozi Adichie. Feel free to email her with your favorite suggestions to read next.
In the late 1980s, Sarah studied Theravada Buddhism at Suan Mokkh monastery in Southern Thailand with Buddhadasa Bhikkhu. She spent a year in Asia with a backpack and a group of students who were some of the first Americans to travel again along the Silk Road by jeep, bus, and an occasional farmer’s truck from Northern Pakistan into Western China. Her experiences with meditation, grief, and the ongoing journey as a caregiver have made the transition to ZCP joyful and effortless.
Welcome, Sarah, to our family and friends.
If you like what you read, please join us and enroll in one of our courses, share our work with someone you think will benefit from it, or support us through a donation.