The Relationship is the Work

For over two decades, Duke's Death & Dying service-learning course showed what's possible when students and community learn together.

For over 23 years, Professor Deborah Gold's Death & Dying course partnered with roughly 20 community sites across Durham – hospices, assisted living facilities, and adult day programs. Charles House, a day program serving people with dementia, partnered with the course for nearly a decade.  Through staff mentorship, students learned how to build relationships with participants by facilitating discussion groups, storytelling and memory-sharing activities, music, and movement. In turn, those relationships advanced a core mission at Charles House: keeping participants connected to the broader community.

Dean Fox, now executive director at Charles House, has watched this exchange unfold semester after semester. He knows what it looks like because he lived it himself—years before leading the program, Fox was a UNC student fulfilling a service-learning requirement at the same organization.

"I wouldn't be here—and I wouldn't now be our executive director—if not for a service-learning course requirement I had as a student," Fox said.

Over time, Fox has seen Death & Dying students—many of them aspiring physicians—complete placements at Charles House. Some later told him they were considering geriatrics, a specialty they hadn't previously imagined.

"That possibility—that we might be shaping future geriatricians—is something we take a lot of pride in," he said.

But the impact went both ways. Many Charles House participants are former academics who spent their lives engaged in learning. A retired political science professor, Fox recalled, once found himself surrounded by students during a group activity. He stepped naturally back into a teaching role.

"It was one of the best afternoons he'd had in a long time," Fox said. "He felt like he had students to whom he needed to offer instruction."

For Fox, this captures what Charles House is about. "The work here has always been relational and educational," he said. "Creating a space where people are known, heard, and engaged as whole people is core to what we do."

Tailoring the Experience

At Duke Hospice, Carolyn Colsher, recipient of the 2018 Betsy Alden Outstanding Service-Learning Award, took a similar approach. As volunteer manager from 2001 until her retirement in 2019, she required Death & Dying students to complete the full hospice volunteer training—16 hours over a weekend, early in the semester.

Students initially balked at giving up their weekend. But the training gave them something crucial: confidence.

"When they came out of the training, they felt empowered," said Professor Deborah T. Gold,  who collaborated with Colsher for over a decade. "They knew what to do and how to handle things."

Colsher matched students carefully to patients and families. Some brought instruments to play. One student sat with a dying patient for seven hours, talking, praying, and singing hymns.

"Understanding the value of just being present and how you can make a difference by showing up—that was the coolest thing to watch," Colsher said.

The partnerships taught students something medical school doesn't: how to be present without trying to fix. Harry Wang, a neuroscience major preparing for medical school, said the experience reframed what care means.

"As I develop technical clinical skills, the opportunity to simply sit with someone and hear their story is often treated as a luxury," Wang said. "Working through the course's community partnerships taught me that care begins with recognizing another person's struggle and choosing to meet them where they are."

Sophia Cai, a biology major who took Death & Dying as a first-year student and served as a facilitator for multiple semesters, watched the transformation happen again and again.

"Working with community partners shifted the course from something theoretical to something lived," Cai said. "As a facilitator, I saw students move from abstract discussions about death to a deeper understanding shaped by real people."

What Continuity Makes Possible

When the pandemic hit, most academic partnerships with community sites disappeared. Some never returned. But Death & Dying students continued showing up—adapting to virtual visits and even standing outside windows when that's what it took to maintain connection.

"Dr. Gold's class was the one consistent through line of service-learning participation during the pandemic," Fox said.

That continuity mattered. Many students kept volunteering after their required hours ended, becoming more skilled and comfortable with the work. The longer they stayed, the deeper the relationships became.

For Colsher, building long-term relationships with faculty made everything smoother. Over time, she could adjust what wasn't working. When a student needed extra support, she could reach out to Gold directly.

"If a student had a loss, I could contact Debby, and she would provide additional support," Colsher said. "I think that's why her class was so popular—she truly had a passion for what she was doing."

Gold's Death & Dying course ended in 2025, but Fox hopes to find new academic partners to continue the work.

"There are lots of ways to weave in what Charles House does to the fabric of what a course is doing, even if it might not be focused in aging or in health care," he said.

For Fox, whose career began with a service-learning placement in the same building where he now leads, the impact is clear: "I hope they carry with them the understanding that the relationship is the work. The showing up, the listening, the being present—that's what changes how you see the world."

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NOTE: Charles House is seeking new Duke course partners interested in relationship-based learning grounded in real community connection. Faculty interested in exploring partnerships can contact Dean Fox at Dean@charleshouse.org.