03/02/2026
Those of us who work in end-of-life care speak often about hearing, reminding families and loved ones that it is the last sense to go and that words still matter, even when someone appears unresponsive. I know this to be true not only professionally, but personally.
When my brother briefly woke near the end of his life, he repeated something I had said to him, confirming what I already believed in my heart: awareness remains. I don’t believe people magically regain hearing after years of loss, but I do believe awareness is heightened. They know who is at the bedside, they know what is being said, and they feel the emotional weight of the space around them.
What we talk about far less is the sense of smell, and how powerful, and often overwhelming it becomes as the body begins to decline. Smells that feel comforting or neutral to us can trigger headaches, nausea, or deep discomfort for someone whose system is shutting down. Flowers, burning sage, essential oil diffusers, perfume, lotions, shampoo, laundry detergent, even our own lingering scents, can fill a room in ways we don’t intend. Many people are too kind, or too unwell, to say anything.
Knowing that I might have unintentionally caused discomfort is something that stays with me, and it has changed how I enter and leave someone’s space.
This is why these conversations matter, and why they need to happen as early as possible. As an example, I cannot tolerate star gazer lilies, they give me an immediate headache, so if I ever receive flowers, (which does not happen enough, I remove the stargazer lilies immediately. In my own end-of-life wishes, I have been clear: peonies, freesias, and sweet peas are welcome; roses, though I love them, are not.
These details may seem small, but when the body is vulnerable, small things can feel very big.
At the heart of all of this is honoring the person in the bed. It is about giving them autonomy when so much has already been taken, and turning up the volume on their voice by paying attention to what truly matters to them.
So often, without realizing it, we bring into their room what we would want; flowers, scents, rituals, because it comforts us, not always because it comforts them. When we have conversations early enough, we can create the opportunity to do better. We can honor their wishes in meaningful, tangible ways, even in the smallest details, like what we place at their bedside.
Sometimes, the greatest act of care is not what we bring in, but what we choose to leave out.
xo
Gabby
www.thehospiceheart.net
