WVMC Palliative and Hospice Care Program

02/03/2026

The Exhale

It begins long before the last breath
Long before the room goes still
It starts in that first moment
when a diagnosis enters the air
and something inside you
quietly tightens.

From there, the waiting starts
You hold your breath without meaning to
through each update
each slow change
each “let’s see what tomorrow brings”
You learn the landscape of decline
by instinct
listening for shifts no one else hears
showing up again and again
because love holds you in place.

Caring for someone who is dying
creates its own rhythm
a steady, quiet bracing
for whatever comes next
It reshapes your days
your nights
your lungs
You try to stay ready
even when ready isn’t possible.

And then their last breath comes
Soft
Final
Not dramatic, just true.

But the breath that breaks you
isn’t theirs
It’s yours
That long, trembling exhale
you didn’t know you were holding
A release wrapped in relief
in grief
in the sharp ache
of a chapter closing.

We think the final breath
belongs to the dying.

But the truth is
the real ending is ours
the exhale that follows
the one that carries
the weight, the love, the loss
and the letting go.

That exhale…
our exhale
that’s the moment
it all becomes real.

xo
Gabby

You can find this poem here:
https://www.thehospiceheart.net/post/the-exhale

26/02/2026

When someone is sick or nearing the end of their life, we feel the urge to fix, to explain, to ease what cannot be undone. But they are not a problem to solve, they are a human being wishing to be seen.

Sometimes it is enough to simply walk through their door and sit. Let your presence be what reminds them they are not alone. There is no need to bring answers to questions that were never asked, no need for a polished performance.

And if you find yourself wondering whether you are doing enough, remember this: you do not have to arrive with solutions. You do not have to try so hard. Your presence is not small. It is not secondary. It is a gift.

You are enough. Just show up. Sometimes that is all that someone else needs.

xo
Gabby
www.thehospiceheart.net



23/02/2026

“End of Life Wishes”

When I am dying, I don’t want the last sounds I hear to be machines beeping and alarms going off telling me what I already know, which is that my body is shutting down and I am dying.

I don’t want machines keeping me alive.
I don’t want machines feeding me.
I don’t want to feel the suffocation of the blood pressure cuff as it squeezes my arm every hour on the hour.
I don’t want IV’s stuck in my arms, or tubes down my throat.
I don’t want other people making decisions for me.

I don’t want to be in a room that isn’t mine, with a view of medical charts and notes stating when I had my last bowel movement, when my medications are due, or how many times I have been turned and repositioned, which by the way is obnoxious when you are dying and I definitely do not want that.

I don’t want fluorescent lights on above my head, forcing me to keep my eyes closed so they don’t burn from the glare.

I don’t want people walking into my room as though it is theirs and not mine.

I don’t want strangers telling me what to do or how to feel or treating me like I don’t have feelings.

I don't want people to talk over or about me as if I can't hear. I can hear and I will hear you!

I don’t want my family to wait day after day in a stark hospital room knowing there is nothing else anyone can do but wait.
This is not how I want to die.
This is not how I want the people who love me to see me die.

I have written down everything that is important to me so that none of the above ever occurs.
I have listed where I want to be, who I want there, what music I want to hear, how I want to be cared for, what I want to wear, how I want my symptoms managed, and to what extent I want people to go to keep me alive.

When I am dying, I want my wishes honored, my voice heard, and my death peaceful.
I want this for you too!

Please write down your wishes and share them with the people you love.
Have the conversation.
Talk to your family and friends.
I promise you… it won’t happen sooner because you talked about it.

xo
Gabby
www.thehospiceheart.net

My book “The Conversation” is a great way to get the conversation started.
https://a.co/d/5kDTiSn

My class “Your End-of-Life Wishes”
can be found here:
https://www.thehospiceheart.net/your-end-of-life-wishes

21/02/2026

We Will Not Walk Away
By Gabby Jimenez

When someone has received a terminal diagnosis,
and they’ve been told they have less time
what this translates most to them, is that
they have been moved to the front of the line

A line no one wants to stand in
a line that can often bring fear
a line that changes everything for them
and lets them know that death is near

So many things are taken from them
most importantly, their autonomy and choice
leaving them dependent on everyone and everything
no longer having a voice

So, if given an opportunity to say goodbye to pain,
to end their suffering, and to feel free again
they need to know we support them
that we will not walk away
they need to know that whatever they choose
we are here to stay

A poem written for my book "Dignity Day," which is about Medical Aid in Dying and the decision a person might make to exercise their legal right to take end of life medications.

xo
Gabby
♥️

You can find my book here:
https://www.amazon.com/Dignity-Day-end-life-medications/dp/B0CCCJBT95/ref=pd_aw_sim_m_sccl_1_2/130-2232800-4346236?

13/02/2026

If you have a brain, you have a bias. Let people tell you who they are.

11/02/2026

I think a lot of us have learned to hold our feelings in, not because we don’t feel deeply, but because we’re afraid of how our emotions might affect someone else. We don’t want to be too much. We don’t want to burden the people we love. So we stay quiet. We downplay our pain. We tuck it away to make things easier for everyone else.

I am guilty of this.

But the truth is, that kind of silence can backfire. The more we hold in, the heavier it becomes. And while we’re trying to protect others, we end up hurting ourselves. We all deserve safe spaces to be honest about what we’re carrying. Speaking our truth isn’t a burden, it’s a release. It’s a way of making room for healing, for connection, and for being seen.

I think people often hold in their feelings because they thought they had to, maybe they feel like they were protecting us, maybe I felt like I was protecting someone else when I kept my own pain inside. That didn’t work for me and I have a feeling it didn’t work for many others as well.

I think we can change this pattern by learning to be open with how we feel, and creating a safe space for others to do the same.

So maybe the invitation is this: let’s try to be the safe place. The kind of people others don’t have to shrink around. If someone trusts us enough to share their pain, their fear, or their uncertainty, let’s meet them with softness, not solutions. Because sometimes the most powerful thing we can offer is simply the space for someone to be fully seen and heard.

xo
Gabby
www.thehospiceheart.net

09/02/2026

We know there is no "other side" to grief; it is an experience of absorption, adjustment, and long-term integration into one’s life.When a meaningful part of your life is lost, self-perceptions and your place in the world may change.

07/02/2026

"Normal"
From my book: "When Words Have New Meaning"

In healthcare, especially in end-of-life care, we often reach for the word “normal.” We say it gently, with good intentions. “This is normal.” “What you are seeing is normal.” We hope the word will soothe, that it will soften the sharp edges of fear or uncertainty. And yet, so often, it doesn’t.

I can see it in their eyes when I say it. A pause. A quiet resistance. Without words, they are asking me, “what do you mean, normal?” Because there is nothing normal about this. What they are witnessing is death and dying. What they are holding is anticipatory grief. What they are enduring is the unbearable intimacy of watching someone they love die.

Calling that normal can feel dismissive, even when it isn’t meant to be. It can sound like a closing of the door rather than an opening. Like a label placed too quickly on something that deserves reverence, not reassurance.

I also use the word “normalize.” I talk about normalizing conversations around death, dying, and grief, making space for them, making them less hidden, less feared. That kind of normalization matters deeply to me. But the word normal does not mean the same thing to each of us, and in moments like these, the distinction matters.

When I do use the word, I try to follow it with care. I might say, “how you are feeling right now, is normal,” and then I explain. Not to label the feeling, but to validate it. To say, this response makes sense. It is acceptable. It belongs. Even then, I hesitate, because normal has a way of flattening the experience, of suggesting there is a right way to feel and a wrong way to deviate.

It is not normal to witness someone die, even if it happens every day. I have seen many last breaths, more than I can count, and still, there is absolutely nothing ordinary about them. Each one is personal. Each one is intimate. Some are quiet, some are restless, some are unexpectedly tender. Sometimes they are even beautiful. But they are never the same.

To call these moments normal risks minimizing their impact on the people living them. It risks suggesting comparison, as if this moment could be measured against another, as if it could be made smaller by frequency or familiarity.

What I want the people at the bedside to know is this: what you are witnessing is significant. This is your moment. It does not belong to statistics or patterns or prior experience. It is not interchangeable with anyone else’s goodbye.

Yes, there are things that are common at the end of life. There are changes we recognize, signs we have learned to name. But common does not mean normal, and it certainly does not mean unimportant.

The conversation about death, that is what I want to normalize. The talking. The asking. The trembling honesty. I want that to feel safer, more accessible, less isolating. But the act of witnessing someone take their last breath, that should never be made ordinary.

If we are more careful with our words, especially with a word as heavy as normal, perhaps we can offer something more supportive than reassurance. Perhaps we can offer presence. Perhaps we can say, without trying to smooth it over, “this is hard, this matters, and you are not wrong for feeling exactly as you do.”

xo
Gabby

You can find my book here:
https://www.amazon.com/When-Words-Have-New-Meaning/dp/B0GDFT9WL3

04/02/2026

Grief has no set timeline, and is a deeply personal, non-linear process that everyone experiences differently. It is unpredictable and always changing.

04/02/2026

Losing a loved one can be an intensely stressful experience that can take a toll on one’s mental and physical health. The grieving process can cause physical symptoms from bodily pain and a weakened immune system, to stomach upset and fatigue.

04/02/2026

This poem is written for the person who chooses Medical Aid in Dying (MAID), and for the people who love them and stand beside them in that choice. It is also written for those who do not support this option; my intention is not to persuade or to change minds, it is simply to ask that we do not walk away from one another, that even in disagreement, even in discomfort, no one is left alone at the end.

We Will Not Walk Away

When someone has received a terminal diagnosis,
and they’ve been told they have less time
what this translates most to them, is that
they have been moved to the front of the line

A line no one wants to stand in
a line that can often bring fear
a line that changes everything for them
and lets them know that death is near

So many things are taken from them
most importantly, their autonomy and choice
leaving them dependent on everyone and everything
no longer having a voice

So, if given an opportunity to say goodbye to pain,
to end their suffering, and to feel free again
they need to know we support them
that we will not walk away
they need to know that whatever they choose
we are here to stay

by Gabrielle Elise Jimenez

You can find this poem here:
https://www.thehospiceheart.net/post/we-will-not-walk-away

This was written for my book”Dignity Day,” which is about Medical Aid in Dying.
https://www.amazon.com/dp/B0CCCJBT95?

03/02/2026

Babcia

Babcia.(pronounced bob-cha) - The Polish word for grandmother.

Each family I meet teaches me something. I am invited into moments that are intimate, sacred, and deeply human, and I never take that invitation lightly. Still, there are rare times when a family reaches me in a way that stays, when their presence settles into me quietly and permanently. This was one of those times.

It began with a text message from a woman who had been referred to me. We exchanged a few messages, enough for me to sense urgency, care, and a deep concern for doing this well. By that afternoon, we decided to meet over Zoom. That was where I first saw her. That was where I met her brother, too. And that was where I began to understand the weight she was carrying.

Her mother had just started hospice. Her mother was dying. She needed someone to tell her what she could do, what to expect, how to prepare, and how she could help her family through this.

She was holding two roles at once, daughter and caregiver, and doing both with remarkable steadiness. On Zoom, I could see the tiredness in her eyes, the kind that comes from love layered with responsibility. Even then, she wasn’t focused on herself, she was thinking about her husband, their kids, her brother, his wife, and their kids. She wanted everyone supported, especially the kids. She wanted to make sure they were cared for in this. From my perspective, she was already following in her mother’s footsteps... something I learned later.

This family is Polish, and the woman they were preparing to say goodbye to, was called Babcia. She was a grandmother to many, some were her daughter’s children, some were her son’s, she was unmistakably the center of them all. She wasn’t only the grandmother, she was also the matriarch, the one who gathered people without effort, the one around whom everything quietly organized itself.

She had lived in her home since the 70’s. This was the house, the place where holidays happened, where people returned to, and where life unfolded again and again. Family by blood, by marriage, by friendship, this home held all of it. Long before her death approached, her legacy was already living in those walls.

After that first Zoom call, her daughter and I continued to text. We talked about what the coming days might look like, about death and about saying goodbye. We talked about the kids, young adults, each of them navigating this in their own way, all of them deeply attached to their grandmother. I had agreed to come the following day to help support them, but things changed, her condition shifted more quickly than expected, and she asked if I could come that day instead. I said yes.

The moment I walked through the door, I felt it, the house was alive with emotion. I could feel the stories, and the layers of laughter, hardship, resilience, and love. There was a sense of foundation there, something strong and steady beneath the grief. I felt deeply honored to be welcomed into it.

There were many people in the house. Family in every sense of the word. Everyone had shown up, not because they felt obligated, but because they wanted to be there for her and for one another. Even the three dogs seemed to know something important was happening. They moved differently, staying close, offering comfort in the quiet, instinctual ways animals do. It felt like everyone, human and animal alike, was trying to take care of everyone else.

When I first saw her, I knew she was close, hours, maybe a day or two. And I could see how differently each person was holding that truth, especially the kids. Their love for her was clear. They were tender and brave all at once, allowing themselves to feel, to cry, to be seen, without hiding the depth of their connection to her. There was nothing performative about it. It was honest and incredibly beautiful.

I wanted to offer them something that honored both their individual relationships with her, as well as their shared love for her, so I invited them to participate in my embroidery thread ritual. If they were skeptical, I didn’t notice it, and everyone agreed to participate. I recognized immediately that they would each make this their own and I loved that about them.

I watched as they chose their colors of thread. I watched their faces as they listened, and as they imagined what this would look like. One by one, they went into her room alone. Each tied a strand of embroidery thread onto her left wrist, securing it with four knots. Each had their own private moment with her, leaving her with a private and heartfelt message to take with her. Each came out in tears. And yet, there was something grounding in it, something that allowed them to express their grief without being consumed by it.

When they were finished, they all gathered in her room to tie the remaining threads around their own left wrists, helping one another with the knots. It was symbolic and sacred, quiet and profoundly meaningful. I felt honored to witness it, and to photograph it, knowing these images would one day matter deeply.

Then they all placed their hands near the many strings tied to her wrist, holding up their own so the threads mirrored one another. I felt tears rise and held them back, this was not about me, this moment belonged entirely to them. Still, I knew I was witnessing something rare.

Later, when she became briefly agitated, we spoke gently about comfort and medication. Her family was already providing beautiful care, following the guidance of their hospice team with intention and love. My role was simply to support what was already so clearly present.

Eventually, I slipped out quietly, giving them space to be a family.
She died the next morning.

Their grief will be real and lasting. But so will her presence. She leaves behind a legacy that few do, a legacy of gathering, of deep connection, of love that multiplies rather than divides. I was with her briefly, I only spent a few hours with her and her family. But I heard the stories, and I saw their faces when they spoke her name. She lived fully. She loved attention. She gave pieces of herself so freely that each person carried something different, something uniquely theirs.

Yes, she died, and yet, she will never die. She will live on in their stories, in their laughter, in the way they continue to look out for one another. They will say her name. They will feel her presence in the rooms she once filled.

Her daughter, the woman who first reached out to me, will likely feel this loss most acutely. Balancing caregiver and daughter leaves little room for rest. She may not see it yet, but she is her mother’s reflection. Even in her hardest moments, she was watching out for everyone else. Her mother’s final gift was allowing herself to be cared for, and in doing so, she quietly passed the role of matriarch to her daughter. And what gives me hope is this: I believe this family will care for her, too. I saw it. I felt it. They know how to hold one another.

This was a house filled with people honoring their own experiences while remaining deeply attentive to everyone else’s. I don’t see that often. And perhaps that’s why this story lingers, because it surprises, and it invites a quiet kind of envy, and at the same time, a deep gratitude for knowing that this kind of love exists at all.

Babcia was unique, and what she leaves behind is extraordinarily beautiful.

xo
Gabby

You can find this story here:
https://www.thehospiceheart.net/post/babcia

I was given permission by the family to share their story and the photo.