Millions of older Americans live out their final hours alone in a hospital bed. But at some hospitals, a comforting presence at a patient’s bedside is considered essential end-of-life medicine. So, if there are no friends or loved ones to keep vigil, a volunteer might fill the void.

Americans are living longer, with more seniors living alone — and dying alone. They may be single, childless, or getting treatment long distances away from their loved ones. The U.S. Census Bureau estimates that 18 million men and women aged 65 and older move through their golden years alone, either never married, divorced or newly widowed. And the American Psychological Association estimates that more than three-quarters of Americans will die either in a hospital bed or a long-term care facility, rather than at home.

All of this means many more older adults find themselves without “someone there to advocate for them, or simply be with them in the hospital, when the time comes,” said Dr. Mohana Karlekar, Director of palliative care at Vanderbilt Hospital. The point of palliative care is to provide relief from the stress of serious illness, and improve quality of life for patients and families.  Vanderbilt Hospital in Tennessee launched its vigil volunteers program in 2016. It was modeled after a program begun 15 years earlier at Sacred Heart Medical Center in Eugene, Ore.

The Oregon program — titled No One Dies Alone — has gained a hold in various hospice and hospital settings across the country. The idea is to carefully screen and train volunteers who can befriend these solitary patients as they enter their waning hours. The program’s goal is not only to show respect, but really to help make someone’s final moments as meaningful as possible.   Volunteers engage with patients — whether they’re communicative or not — by playing soothing music or reading books or prayers.