Sarah Knee joined Ashgate Hospice as a volunteer counsellor three years ago. Here, she shares some reflections on her work supporting patients and the people important to them facing palliative care and bereavement.  

Sarah, who is openly autistic and ADHD (AuDHD), emphasises the importance of compassion and empathy in hospice care and her own experiences with loved ones underpin her passion for her role.  

Through her work, she strives to create a safe space where individuals feel heard and supported during some of life’s most challenging moments. 

My journey to Ashgate 

I started my journey with Ashgate in January 2022 as a placement counsellor. I loved it so much I stayed on as a Volunteer Counsellor once I qualified. The work can be challenging but is deeply rewarding. I feel honoured to be with people as they face the complex emotions surrounding palliative care, death and bereavement. My own experiences of loss and bereavement have influenced how I’m able to connect with the people I support, during some of their most vulnerable moments. 

My connection to death and dying 

I’ve had a complicated relationship with death from a young age, facing various losses that led to fear, frustration, and fascination. My experiences deepened my belief in the need for better end of life experiences and bereavement support. This prompted me to pursue Death Doula training and then instinctively I knew I wanted to do a placement in a hospice when I was training to be a counsellor. I felt a strong connection to Ashgate from our initial contact and was eager to join the team. Being part of Ashgate gives me immense pride, knowing our work positively affects so many lives. 

How I support patients and families 

As a volunteer counsellor, my primary responsibility is to provide 1:1 support to patients and the people important to them. It’s not just about having conversations – it’s about ensuring people feel heard, understood and accompanied. As a counsellor who is openly Autistic and ADHD (AuDHD), I bring a different perspective to the work, being able to talk openly about more confronting topics in a sensitive way. By creating a safe space, I aim to support people as they navigate the most difficult of times, valuing what matters most to them and honouring their experiences with life and death.  

I have huge respect for every one of the patients and families we support, and feel humbled, privileged and often in awe at the love they show for each other. They all have unique life stories that shape their experiences with diagnosis and loss. My background in family support – including working with parents, children, and teenage parents – has shown me how crucial support can be during challenging times. I bring the experience from my ‘pre-therapist life’ with me, allowing me to be a more relevant and supportive counsellor for the range of clients I work with.   

‘We are different, NOT less!’

Navigating challenges with ADHD and autism 

Being Autistic and ADHD comes with its own set of challenges.  There is a misconception that autistic people don’t feel empathy – in fact the very opposite is true! Most autistic people are highly sensitive.  This means I often feel things very deeply and it can take me a while to process things emotionally. Being a counsellor means holding a lot for others, so having good support systems and practicing self care is essential.  

ADHD complicates my ability to manage admin, requiring me to use various techniques to stay organised. This for me is more challenging than client work, and I often feel shame about needing a process for basic tasks like responding to emails.  

Ashgate is an inclusive environment, and whilst there is always work to do to improve understanding, you can be a part of that development. If you know what your challenges are that’s a great start to working out how to manage them. Being neurodivergent doesn’t exclude you from having vital skills and qualities that can make a real difference – and remember too that some of our service users are also neurodivergent! We are different, NOT less! 

Why I’m proud to volunteer at Ashgate 

Volunteering at Ashgate has been instrumental in building my self-confidence, both as a practitioner and as an individual. The role allows me to embrace my strengths while acknowledging my challenges. Moments of vulnerability shared by patients, such as when someone says: “I’ve never told anyone this”, outline the importance of providing a safe space where people feel comfortable expressing themselves. 

At Ashgate, compassion underpins everything. We don’t shy away from death – we face it with honesty and care. Not every death happens in the way we’d hope, but we do everything we can to make it as good as it can be. We don’t hide in the shadows and avoid the topic; we face it, we name it and we do the best we can to take away the fear and help families make the most of the time they have. I hope that by being open about my neurodiversity others will feel safe to be themselves too. When we meet people in a meaningful and inclusive way, we have great opportunity to serve our community better.