Assisting at Home

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.

12/09/2025

I realize this is kind of lengthy, but I wanted to share with you what I have learned while providing end of life care… these are my lessons.

xo
Gabby

I went to nursing school in my late forties because I felt called to hospice work. While caring for a dying friend, I felt a sense of peace at his bedside, as though I had finally found the place I was meant to be. This work is intimate, personal, powerful, and always new. No matter how many last breaths I witness, it always feels like the first. It is an honor to sit with someone who is dying and with those who love them.

Each first hello and final goodbye reminds me how fragile and unpredictable life is. I want to be the last kind word someone hears. I want to ease fears, offer comfort, and remind people they are not alone. Seeing patients early in their diagnosis allows me to learn who they are, what they want, and how they wish to be cared for. If I’m fortunate, I meet their families and hear their stories.

I have learned that human beings deserve to be cared for well when they are dying; heard, validated, and respected. Listening is the foundation of this work. If we lean in and truly hear what people need, we can honor their wishes. Every person I meet teaches me something about life, love, and compassion.

One of the greatest lessons has been understanding what it means to meet people where they are. Their journey is not about me. It is not my place to tell them what they should feel or decide. Meeting someone where they are requires listening without judgment, asking honest questions, and honoring their humanity. It asks us to set aside our own wishes so we can truly see and support them.

I’ve also learned that I don’t have to be there for the very last breath. What matters is showing up with intention and giving value to the time I am there. End-of-life work places us on an emotional seesaw, sad they are gone, grateful they let go. Attachment happens. And when it does, self-care becomes essential. If we ever stop feeling the weight and beauty of this work, that’s when we should question whether we should continue doing it.

Our presence at the bedside is not only for the patient, it is for those preparing to say goodbye. The caregiver, often a partner, child, or close friend, slides into a role they never asked for. They need support the moment that shift happens. Offering a meal, running an errand, or giving them a break can make a profound difference.

Providing care creates a bond, and with that bond comes grief. When the time comes to say goodbye, the loss is real. You cannot hold that alone. Reach out. Ask for support. Vulnerability is not weakness; it is a sign of being human in work that asks so much of our hearts.

Every day I ask myself, What did I do well? What could I have done differently? What did I learn? This helps me stay grounded in what matters most: that a human being was cared for well. Death reminds me to pay closer attention to life. Each last breath shocks me with its finality and its fragility.

Working in this field while navigating personal losses creates its own tension, between standing still and rushing past your grief. Neither is healthy. Facing those feelings head-on, naming them, and tending to them allows the “sticky” parts of grief to soften. Self-care is not optional; it is the anchor that lets us hold space for others. Journaling, movement, cooking, time with loved ones, these keep us centered. This work is beautiful, but it cannot be everything.

I cry easily, and early in my career I thought I had to hold it in. A hospice doctor once looked me in the eyes and told me to feel what I was feeling. He reminded me that we are witnessing the end of a life, and if I ever stop feeling sadness, that is when I should worry. Their experience is not about us, and projecting what we think they need is not helpful. Listening is.

One thing I know for certain: this is not about us. We are not here to judge someone’s life, their choices, or relationships. Whether or not they have a voice near the end, their wishes matter.

People often ask why someone is taking so long to let go, or why they have to die at all. The truth is, there is no answer. Life happens, and then death happens, and the space in between is where memories live. When time is cut short, we are reminded to ask:
Did I live well? Did I make memories that mattered? Do the people I love know it?

What matters most is that every human being is cared for with respect at the end of life, regardless of any choices we may not understand or agree with.

I often think of this quote by Colin Powell:
“Don’t just show kindness in passing or to be courteous. Show it in depth, show it with passion, and expect nothing in return.”

If you are providing end-of-life care, please know the difference you make. Your presence offers peace and trust, sometimes more than anyone else in the patient’s life. People often share fears or unfinished thoughts with us because they do not want to add to their family’s pain. Listening, not fixing, builds trust, and trust is a gift.

When you meet someone who is dying, remember what this moment means for them. Time suddenly becomes precious. There may be regret, anger, sadness, or spiritual pain. Your presence may be the safe place where they can lay some of that down.

Being with someone who is dying is an honor. When you first meet them, instead of asking how they are, because we know how they are, simply tell them, “It is an honor to meet you.” Let the relationship begin there. You are going to make a difference in their life, and I love you for that.

xo
Gabby

You can find this blog here:
https://www.thehospiceheart.net/post/what-i-have-learned-from-providing-end-of-life-care

11/20/2025

11/19/2025

EXCELLENT explanation!

11/10/2025

It can be hard to discuss these things with your grown children.

11/03/2025

https://m.facebook.com/story.php?story_fbid=820739393389331&id=100063598335849

It is not about us.
If a patient were to ask outright "What do you believe spiritually?" you should respond: "This is not about me and what I believe. Can you share with me what you think happens? What do you believe?"
A conversation is started as they sort out their beliefs and you listen. You do not add "Have you ever thought about this?" That is the job of clergy. That is the time you suggest that perhaps they are having questions and thoughts that a chaplain could help them with. Ask "Can I help make the contact?"
End of life work is sacred work. Everyone's belief is sacred. Yes, as end of life approaches we will have many life questions to consider: life’s meaning, purpose, and our beliefs. And yes, the patient may ask anyone who happens to be close by and who they feel comfortable with what they think.
Our job is to gently redirect the question back to them and their thoughts, not share ours, AND to offer to bring in someone more trained than we are.

10/22/2025

https://dailycaring.com/how-long-does-medicare-pay-for-nursing-home-care/

Medicare covers skilled nursing facility care for a short time after a qualifying hospital stay. Learn what’s covered, what isn’t, and how to appeal if Medicare ends coverage sooner than expected.

09/16/2025

Thank you Adrian for the words of wisdom.

Even when we know logically that it is not deserved, guilt still finds its way into grief. It is our mind’s way of trying to change the unchangeable, as if by taking the blame we could somehow make things different. We go over every detail, searching for the one moment we could have done better, the one choice that could have kept them here.
This guilt is one of the cruelest parts of grief. It sneaks in when we are already broken and makes us feel even more alone. But here is the truth: guilt is not proof that we failed somehow, it is proof that we love, desperately. We love so deeply that we cannot accept their death without trying to take responsibility for it.
If you feel this, you are not alone. Every grieving person I have met has carried guilt in some form. It is normal, even if it is painful. And while it may never disappear entirely, over time it eases. The love remains, the memories remain, but the sharp bite of guilt does not stay forever.
Be gentle with yourself in the meantime. You did the best you could with what you knew then. Love is still what ties you to your person, not guilt. And love is the part that lasts.