(Photo by Kathy Ritchie - KJZZ)

Hospice of the Valley's office.

Dying is a process we will all experience. For some, death comes quickly, for others it can be days. Families often don’t know what to expect.

But there is a small army of volunteers who sit at the bedside of those about to die. Hospice of the Valley refers to this group as the 11th Hour Companions. Their work is solemn, but essential — especially for those they serve.

Lynn Tolmachoff manages the 11th Hour Companion program at Hospice of the Valley (HOV). The program started in 2005 and over the years has served thousands of patients and their families.

"That’s our No. 1 goal, is to not have anybody die alone, unless they want to," Tolmachoff said. "So however you do your life is how you do your death. If you’re a real private person, you won’t be able to go with anyone with you. So the volunteers have been instructed that sometime during their four-hour shift to step out of the room, let the patient know they are stepping out and give them that opportunity."

Tolmachoff’s office receives anywhere between four and five referrals a day. Once a referral comes in, Tolmachoff’s staff starts making phone calls to volunteers like Katherine Behr.

"The last weeks and days of someone life are just very special times and moments," she said.

Behr has been an 11th hour companion for two years and she has sat at the bedside of more than a dozen patients. Every volunteer is different. Some sit, some pray silently, some play music and some simply hold the person’s hand. Their job is to be a presence and to be present. Like every companion, Behr volunteered with Hospice of the Valley for six months before joining the 11th Hour program.

"That gives us time to understand HOV policies and procedures … and them to get to know us and our temperament and be certain we would be a good candidate for an activity such as 11th Hour," Behr said.

Because when it comes to watching someone die, it takes a certain kind of person to do what Behr and the others do.

It took two weeks for Tina Van Sky’s father to pass away. During that time, she was alone, so she sought support from a volunteer named Maryanne.

"She treated my dad with dignity and with care. She showed him love," Van Sky said. "I couldn’t have stayed 24 hours a day, there’s just no way to know she was there and dad knew someone was there, was such an amazing help."

For Van Sky, watching a parent pass away wasn’t a new experience. She had lost her mother years before. To a degree, she knew what to expect. But Tolmachoff said many caregivers walk into a loved one’s room not knowing what the dying process looks like.  

"Usually the eyes closed, the mouth is open, sometimes the breathing is really loud and gurgling," she said. "Sometimes it’s so shallow that you can’t even tell they’re breathing unless you’re really paying attention. They get mottling, which is the extremities are no longer getting oxygenated."

Besides alleviating any fear, companions are educating families at the bedside who may not understand what happens when the body shuts down.

"And the main thing they seem to struggle with is the eating," said Tolmachoff. "They want to keep feeding or giving their loved one something to drink and they can’t swallow anymore so they’ll choke if you try to force them."

Tolmachoff calls the 11th Hour Companion program a gift. She means that from a human standpoint, as well as a financial one. The program is funded using donations.

For Van Sky, having someone like Maryanne by her side allowed her to be in the present moment. She felt supported and wasn’t consumed by fear or the unknown. And when it came time, Van Sky leaned over her father and whispered that it was OK and that there were people waiting to see him in heaven. Then, he stopped breathing.  

"She put her arms around me and gave me a hug and said he’s at peace, and asked me if I need anything if I wanted her to stay with me, and I liked that, we just sat there and talked for a while afterwards," Van Sky said.

EDITOR'S NOTE: This story has been updated to reflect the correct spelling of the term mottling.

Updated 8/25/2015 at 11:51 a.m.