Assisting at Home

01/31/2026

“Gabby, I think mom is dying.” This was a message I received from the daughter of a woman I had the pleasure of visiting with for over a year. Six months before, she was ready to die and wanted to know why it was taking so long. She was 93 years old, she had lived a good life, her family was (mostly) accepting and had said their own personal goodbyes numerous times, because for months, they thought each day was “the day,” and then it wasn’t.
This can take its toll on the family, as some of you might know.

I am asked often why it is taking so long. My answer is usually something like, “the body knows what to do and we must trust that." We can offer medications for symptom relief, we can educate you on how to provide compassionate and heart-centered care, we can even prepare you for that last breath, but we cannot tell you when it will happen. I have learned to trust that their body will let go when it is ready, and until then I will make sure both patient and those who love them are cared for and supported well.

I arrived at their home to find this beautiful woman letting go. Her body was finally ready, and she was leaning in to it with such grace. The daughter who had called me had been her primary caregiver, and we had been talking every day for the past week as I guided and supported her while she tended to her mother. She was afraid of every sound and movement, which most people are, and I relieved her of her fear. She gave the medications as ordered by the hospice team and was comforted in knowing that her mother was not suffering. Her main struggle was the disconnect between her and her siblings as they often doubted her care, which weighed heavy on her.

Her siblings were not nearly as supportive of her as I was, in fact when I let them know she was dying, their first question was whether their sister had hastened her death by giving the medication, as if to blame her for their mother’s death. I knew at that moment I had two very important things to do during my visit; prepare the family for their mother’s death, which was minutes away, and somehow bring them all together and on the same page, helping them to see the beautiful care their sister provided their mother.

When I am at the bedside of someone who is dying, I am usually sharing it with someone who is preparing to say goodbye. When there is more than one person at that bedside there can often be dynamics and disconnect that can interfere with the peace that needs to be felt at that time. As a hospice nurse I do my best to manage symptoms, educate about the medications and the dying process, and prepare those in the room for what could and might happen. As an end-of-life doula I see my role as a peace maker, using a calming voice, a gentle touch, compassionate words, and sometimes music, to change the energy in the room so that when that last breath is taken, there is a sense of peace. My goal is to combine the roles of nurse and doula so that I can ensure that the person who is dying can do it without pain, or fear, or negative energy in their space, and the person(s) saying goodbye can feel or find a sense of peace within. And if I can do that, I can also help to reduce some of the grief those at the bedside will feel.

Moments before this lovely woman took her last breath, I let them all know she was close. The daughter I had been speaking with most, took her mother’s hand and sat quietly at the bedside. Her sister came in, with energy that seemed angry, and said, “did my sister make this happen?” I looked her right in the eyes, and with a calm voice I said, “absolutely not, your sister has provided beautiful, thoughtful, and compassionate care. The amount of medication she gave your mom over the last few days is not enough to hasten her death, and this morning she only gave one small dose which gave her body the peace and permission it needed to be able to let go with ease, and grace. Your sister honored your mother on this journey quite beautifully.” She looked at her sister, with tears in her eyes, and said, “thank you.” And then their other sister came in, the one who has never said a word and has not been involved, and asked me, “can she hear us?” I proceeded to share how I came to learn that yes, they absolutely can hear us, and assured her that whatever she says to her mom, she will take with her. The other two scooted over, making space for her, and she looked at me again, “what do I say?” I took her hand, looked at all three of them, and said… “tell her you love her, that you will miss her, and say goodbye.” And she did. They all did.

When she took her last breath, there was no anger, no animosity, and no harsh words. There were just three daughters sitting at the bedside of their mother who was dying, and they were together, comforting one another, and saying goodbye. This is what I always hope for, and I see it as my role, but I am also always prepared for whatever might take place at the bedside, difficult or beautiful.

When someone is dying and others are preparing to say goodbye, those last moments at the bedside are significant in so many ways. What it comes down to, at least for me… is removing fear and uncertainty, respecting curiosity, not making it about me, considering all feelings, never pointing fingers or passing judgment, and finding a way to bring everyone together when that last breath is taken, so that when it is, that person feels peace. It doesn’t always happen, sometimes that is okay too, but I always do my best to reduce the negative energy in the room and finding peace if possible.

xo
Gabby

You can find this blog here:
https://www.thehospiceheart.net/post/at-the-bedside

01/15/2026

Please listen if you have a loved one at the “end of live” but you just aren’t sure. Your loved one is not wanting to eat or drink. It is part of the dying process. It is a part of the end of life.

01/13/2026

Is your loved one with dementia showing signs of agitation or distress and you’re not sure why?

Agitation is one of the most challenging behaviors caregivers face, and it often shows up as restlessness, pacing, yelling, or even aggression. But here’s the important part: agitation is usually a signal not just a symptom.

In this blog, Dr. Liz shares the real reasons behind agitation and how you can respond with confidence, compassion, and calm.

Discover practical tips and expert insight that can help make daily life more manageable for both you and your loved one. Read the full article here: https://drlizgeriatrics.com/dementia/agitation/

01/06/2026

This is a blog I wrote after witnessing a man take the Medical Aid in Dying (MAID) medications with his family gathered around him. I had spent days with him choregraphing his death, and then time with his family as well, learning what they needed too. All of their wishes were honored on this difficult, and yet beautiful day.

“The never-ending box of tissues”

I have been here before. The room looks different, and the faces have changed but the sounds of tears that echo in my head prepare me for what I am about to see…what I have seen before, so many times.

A playlist was created days ago, and his favorite music wafted through the house, the volume rising and lowering at just the right moments as though the poignant moments of his death had been choreographed.

His hands and fingers were turning blue, and yet the way his wife intertwined hers around them, it was as though she was being taken back to a time when they were young lovers holding hands, perhaps on a first or second date. So much love there.

His toes were also turning blue; she covered them with a blanket and whispered, “he must be cold”. No one said a thing, we just watched as she slowly tucked the blanket around him. It was a lovely gesture, and yet heartbreaking too.

When I stepped outside the room to offer them privacy, I could hear sobbing, and chairs creaking as they each reached for the never-ending box of tissue, wiping away their tears… to no avail.

Someone thanked me for being there, and then she said, “everything hurts”. I responded with, “saying goodbye to someone you love can be painful physically, emotionally, and spiritually. This pain will run deep, be gentle with yourself.” She asked me if I knew this feeling too, I said “yes,” remembering my own losses and the pain I know will reside within me forever.

I looked around, and I watched the people who love him say goodbye, and while they knew this day was coming, and they were prepared, it was as though this news was being heard for the very first time and deep sorrow filled the room.

His breaths started to slow, and they knew. They took turns touching him, resting their hands over his, kissing his cold cheeks, and gently caressing his hair as if to have one last moment with him, letting him know he was not doing this alone. Each was there for him, loving him, preparing to miss him, knowing this would be their very last goodbye.

When his last and final breath was taken, the sobs were gentler, but their hands kept reaching for the never-ending box of tissue, that kept its unsaid promise to be there for them. As if to silently say, "I've got you".

I left the room, allowing them privacy as they said their last goodbye. The volume of the music became louder, and I felt the wind blow through the open window and against the vase of days old Lillie’s…. A tear rolled down my cheek as I watched a petal slowly fall to the floor.

It is in those moments when I know not to stay, this is their private experience and while I walked alongside each of them, I also knew (and know) when it is time for me to walk away. I sat down on the couch, I took long deep breaths, and I whispered my own private goodbye to him. And I waited until they each walked out of the room, one at a time.

I went back into the room, I soaked washcloths in warm water, and I silently bathed him, as none of the family wished to participate. I dressed him, I tucked the covers around him, and I placed one of the remaining lilies in his hands.

When it was time for me to go, I hugged them each goodbye. “Take care of one another”, I said. And I walked out the door.

Each step to my car seemed to take forever. My eyes hurt. I realized I hadn’t eaten anything in hours. I stood at my car, I felt the wind brush against my face, and I took it all in, thankful to have been invited into something so private and so intimate.

xo
Gabby

You can find this blog here:
https://www.thehospiceheart.net/post/the-never-ending-box-of-tissue

You can learn more about Medical Aid in Dying in my book, "Dignity Day," which can be found on Amazon: https://a.co/d/2Qu30yD

12/29/2025

Wooden Power Lift Assist Office Chairs for Elderly, Accent Chair Lifts with Power Motor for Seniors, with Soft Fabric Cushion & Backrest, Small Sit to Stand Chair, Beige

12/14/2025

https://www.instagram.com/reel/DSJQKcIkY3k/?igsh=anQ0aWgxeW55ZGI5

12/12/2025

Doctors said dying patients needed to stay quiet and brave. She sat with them instead—and heard five truths that changed medicine forever.
In the 1960s, hospitals had an unspoken rule about dying patients: don't upset them with the truth. Don't let them express anger. Don't acknowledge fear. Keep them comfortable, keep them quiet, and above all—keep them from disturbing the efficient machinery of medical care.
Doctors made rounds. Nurses administered medications. Families waited in hallways for updates delivered in euphemisms. And dying patients lay in their beds, isolated with truths no one would speak aloud.
Elisabeth Kübler-Ross, a young Swiss-born psychiatrist working in American hospitals, watched this charade and realized medicine was hiding its deepest wound: the fact that every cure has a limit, and when that limit is reached, doctors often abandon their patients emotionally just when they need human connection most.
So she did something radical. She sat down at bedsides—not for rounds, but for conversations. Real ones. Long ones. She asked dying patients what they were actually experiencing, what they needed, what they wanted to say.
And she listened.
What she heard shattered the medical establishment's comfortable assumptions about death.
Patients weren't being "difficult" when they got angry—they were processing loss. They weren't "in denial" because they were weak—they were protecting themselves while adjusting to unbearable news. They weren't bargaining with God because they lacked faith—they were trying to make sense of mortality.
Through hundreds of interviews with dying patients, Elisabeth identified something medicine had missed: dying people move through predictable emotional stages, and understanding these stages changes everything about how we care for them.
In 1969, she published "On Death and Dying," introducing what would become known as the Five Stages of Grief: Denial, Anger, Bargaining, Depression, and Acceptance.
These weren't rigid steps every person had to follow in order. They were a map—a way to understand that the chaotic emotions dying people experienced weren't pathological. They were human. They were normal. They were worthy of acknowledgment and support.
The medical establishment reacted with outrage.
Colleagues accused Elisabeth of being "unscientific" for treating dying patients as human beings rather than medical cases. They said her empathy was unprofessional. They dismissed her work as "soft," a gendered insult meaning it lacked the hard objectivity they believed medicine required.
Some doctors argued that discussing death openly with patients was cruel—that it robbed them of hope. Hospital administrators worried her research disrupted efficient care. Academic skeptics—many of them men uncomfortable with a woman challenging medical orthodoxy—questioned her methods.
Elisabeth pushed back. Her interviews weren't anecdotal feelings—they were systematic research conducted with hundreds of patients. Her conclusions weren't sentiment—they were patterns observed across age, diagnosis, culture, and circumstance.
More importantly, she reversed the hierarchy of power that medicine had always maintained: the doctor did not speak for the patient; the patient spoke for the world.
Dying people became teachers. Their experiences became data. Their voices became evidence that medicine couldn't ignore forever.
Slowly, the resistance cracked.
Hospitals began acknowledging that the end of life is still life—with preferences, humor, unfinished conversations, relationships, and choices that deserve respect. Medical schools started teaching about death and dying, subjects that had been absent from curricula. Families gained permission to ask real questions instead of accepting vague reassurances.
Most significantly, Elisabeth's work became foundational to the modern hospice movement.
Before her research, hospitals measured success by extending breath at any cost—even when that breath came through machines, in pain, isolated from loved ones, stripped of dignity.
Elisabeth taught that dignity counts as much as pulse. That sometimes the most compassionate medical care is acknowledging limits and focusing on quality of remaining life rather than desperate attempts to extend it.
Hospice care—the philosophy that dying patients deserve comfort, connection, autonomy, and dignity—grew directly from her research. Legislation supporting hospice programs referenced her work. Training programs for end-of-life care professionals used her frameworks.
She didn't glorify death. She de-terrorized it.
She gave grief a vocabulary. She gave families permission to feel anger, sadness, and fear without shame. She gave dying people authorship over their final chapters instead of making them silent extras in someone else's medical drama.
Elisabeth Kübler-Ross died on August 24, 2004, at age 78—coincidentally, from complications that left her paralyzed and struggling, experiencing her own difficult end-of-life journey.
But her legacy lives in every hospice that honors patient autonomy. In every doctor who sits down to have honest conversations about prognosis. In every family given space to grieve without being told to "be strong." In every person who understands that anger and sadness aren't obstacles to overcome—they're human responses to loss that deserve acknowledgment.
Her Five Stages of Grief have been widely adopted, sometimes oversimplified, occasionally misapplied. Elisabeth herself later clarified that the stages weren't a rigid checklist—grief is messy, non-linear, deeply personal.
But the framework gave people language for experiences that had been private, isolating, and shameful. It normalized grief. It made space for complicated emotions in a culture that preferred everything neat and resolved.
Elisabeth Kübler-Ross refused to let medicine hide from its limits. She sat with dying patients when others walked away. She listened when silence was easier. She challenged when conformity was safer.
And she taught the world that death isn't medical failure—it's part of being human. That dying people aren't problems to manage—they're people with wisdom to share. That the conversations we avoid are often the ones that matter most.
She gave dying people their voices back. And in doing so, she gave all of us permission to be human in the face of the one thing every human eventually faces.
Not victory over death. Just honesty about it. Just dignity within it. Just acknowledgment that even at the end, we deserve to be seen, heard, and valued.
That's not just medicine. That's humanity.

12/12/2025

12/11/2025

Mary-Claire King told the medical world in the 1970s that breast cancer could be inherited and doctors feared what would happen if she was right.
Mary-Claire King stood in conference rooms explaining numbers that made people visibly uncomfortable. Her data showed that breast cancer was not always random. In certain families, the pattern was unmistakable. Daughters. Sisters. Mothers. Generation after generation. One gene. One mutation. Enormous risk.
The reaction was not curiosity. It was resistance.
At the time, cancer research leaned heavily on environment and chance. Suggesting inheritance raised dangerous implications. If a single gene could predict cancer, doctors would have to confront prevention, early surgery, and life-altering decisions for women who were still healthy. Many preferred uncertainty.
Mary-Claire King kept following the math.
Trained in mathematics and genetics at UC Berkeley, she spent the 1970s tracing family cancer histories by hand, long before modern sequencing tools existed. She analyzed thousands of cases, isolating markers passed down through bloodlines. Again and again, early-onset breast cancer clustered far beyond coincidence. The statistics narrowed to chromosome 17.
Grant funding sagged. Reviewers called the theory “too simplistic.” Colleagues warned her that tying cancer to heredity would spark panic and stigma. King ignored the noise. The data did not budge.
In 1990, after nearly 20 years of work, she published definitive proof mapping what became known as BRCA1. Women carrying the mutation faced up to an 80 percent lifetime risk of breast cancer and a dramatically higher risk of ovarian cancer. Medicine had no excuse left.
The impact was immediate and irreversible. Genetic screening transformed care. Preventive mastectomies became rational options rather than radical ideas. Early monitoring saved lives. Fear gained numbers, and numbers changed power.
King didn’t stop with medicine.
In the 1980s, she applied the same genetic precision to human rights in Argentina, helping identify children stolen during the military dictatorship. By matching DNA with surviving grandparents, her work reunited more than 130 families. Once again, the truth was politically inconvenient. Once again, the evidence won.
King testified against governments. She alarmed institutions. She accepted threats as part of the job.
In 2014, Mary-Claire King received the Lasker Award, often called America’s Nobel, for discovering BRCA1 and advancing DNA identification in human rights. Two revolutions. One method. Absolute fidelity to evidence.
Mary-Claire King didn’t change medicine by being persuasive. She changed it by being right for so long that resistance collapsed.
The gene was always there.
The courage was following it through the silence.

12/11/2025

https://m.facebook.com/story.php?story_fbid=843153591754666&id=100081800973711

Elisabeth Kübler-Ross refused to let medicine hide its deepest wound: the fact that every cure has a limit. She sat at hospital bedsides long after rounds were done, listening to patients who were told to be “brave” rather than scared, “appropriate” rather than angry, “quiet” rather than grieving. In those moments she learned what textbooks excluded—that dying people want to be seen, not managed. Her approach broke a clinical wall. She made physicians acknowledge that the end of life is still life, with preferences, humor, unfinished conversations, and choices.

Hospitals once measured success by extending breath at any cost; she taught that dignity counts as much as pulse. Her interviews with terminal patients were radical because they reversed the hierarchy of power: the doctor did not speak for the patient, the patient spoke for the world. She faced backlash, misogyny dressed as academic skepticism, and accusations that her empathy made her “unscientific.” Yet her research strengthened end-of-life ethics, informed hospice legislation, and created space for families to ask real questions instead of waiting in hallways for euphemisms. Kübler-Ross didn’t glorify death; she de-terrorized it. She gave grief vocabulary and gave dying people authorship over their final pages.