Guadalupe Regional Hospice

04/29/2026

Many families ask about this, as their understanding comes from everything that has worked in the past, for treatment and recovery. When a person is on hospice the focus changes, and what worked once before, has shifted to what will bring comfort.

A great explanation from the The Hospice NP:

Understanding Why IV Fluids Are Not Necessary at the End of Life in Hospice Care
At the end of life, the body naturally begins to slow down, and with that comes a decreased need for food and fluids. This is a normal physiologic process, not starvation or neglect. As organ systems decline, especially the kidneys and cardiovascular system, the body is no longer able to process and distribute fluids effectively (NHPCO, 2023).
In hospice care, the focus shifts from prolonging life to promoting comfort and quality of life. While IV fluids may seem like a basic need, they do not provide the benefit many assume at this stage. Instead, they can lead to complications such as fluid overload, swelling, increased respiratory secretions, and worsening shortness of breath due to pulmonary congestion (Bruera et al., 2013; HPNA, 2021).
Dehydration at the end of life is also not typically associated with suffering. In fact, mild dehydration may contribute to a more peaceful state through the release of endogenous endorphins, and patients often do not experience thirst in the same way as healthy individuals (McCann et al., 1994). When dry mouth occurs, it is best managed with frequent oral care, ice chips, and lip moisturizers rather than IV hydration.
Additionally, IV fluids can increase the burden of care. They may require invasive access, monitoring, and equipment that can disrupt a calm and dignified environment. Studies have shown that medically assisted hydration does not significantly improve survival or symptom burden in patients who are actively dying (Bruera et al., 2013).
In hospice, every intervention is evaluated based on one question: does this improve comfort? If the answer is no, it may do more harm than good. Choosing not to use IV fluids at the end of life is not about withholding care, it is about providing the right care.
Helping families understand this shift is essential. At the end of life, comfort, presence, and dignity matter more than interventions.
Follow for clarity, comfort, and evidence-based education

04/28/2026

A beautiful gift of Thanks from one of our families 💙❤️

04/28/2026

Great information from The Hospice NP

Understanding Terminal Secretions or the “Death Rattle” in Hospice
Terminal secretions, often called the “death rattle,” are a common and natural part of the dying process. They occur when a person is no longer able to swallow or clear saliva and respiratory secretions, leading to a buildup of fluid in the throat and upper airways. This creates a gurgling or rattling sound with breathing that can be distressing for families to hear.
It is important to understand that this sound is usually not uncomfortable for the patient. At this stage, most patients are minimally responsive or unconscious, and there is no evidence that the presence of these secretions causes suffering (HPNA, 2021). What families hear is often more distressing to them than it is to their loved one.
As the body naturally shuts down, swallowing and coughing reflexes weaken, and muscles relax. This allows secretions to collect. This is not choking or drowning, and it is not a sign that something is being done wrong. It is a normal physiologic change at the end of life.
In hospice care, management focuses on comfort. Repositioning the patient can help secretions drain, and medications such as glycopyrrolate or scopolamine may be used to reduce secretion production. Deep suctioning is generally avoided, as it can cause discomfort without improving the situation.
Helping families understand what is happening is one of the most important parts of care. The goal is not to eliminate every sound, but to ensure the patient remains peaceful and comfortable.
At the end of life, comfort, dignity, and presence matter most.
The Hospice NP
Follow for clarity, comfort, and evidence-based education

04/27/2026

April is Volunteer Month! We are fortunate to have wonderful volunteers that show up, are present and helpful with our patients and families 💙 The article below is from author, Barbara Karnes, RN, who explains how volunteers are an essential part of our our hospice team!

What do hospice volunteers do, and why are they such an important part of end-of-life care?

I've worked in hospice for quite a long time. I started out as a hospice volunteer in 1982. It was the very beginning of hospice care in the US. In those days, I volunteered much of my time -- I gave 20 hours a week as a supportive nurse to the one newly hired RN.

Why did I want to be involved in hospice care? Why did I give so much of my time? I really don’t know. I just knew I was drawn to end of life work, that I felt I had something to offer, and that I really, really wanted to do this work. I’ve since learned that most of us who volunteer or did volunteer for hospice are drawn to it and are doing it because we are almost compelled to it — to help, to guide, to support.

What do hospice volunteers do that makes it so soul-driven? I think there is a desire to help, to be of service. BUT I think deeper than that is something within the person themselves. Something, maybe from a past experience with death, maybe they are curious or even fearful about death.

Because there is generally something strongly encouraging us to pursue the end of life field, we first need to know why we want to be a volunteer working with the dying. We need to know the why because we will bring our personality, our beliefs, our experiences and yes, our fears with us as we reach out to help others. Those “whys” will influence the care and help we offer. We cannot help others at the end of life until we understand what we bring to it.

So, the first part of volunteer training needs to be, “why are you here?” Follow that question and discussion with, “what are your previous experiences with dying and death?” The premise of starting training with these questions and discussions is that we clean our own houses before we can effectively help and be of service to others. (Particularly in this little-understood and often much-feared part of living).

With those questions explored, the volunteer training staff can proceed to teaching the hospice concept, what is expected of volunteers, signs of approaching death, communication and listening skills, grief dynamics, and what the role of the volunteer is in this process of care.

Hospices cannot give comprehensive quality care without well-trained volunteers. Why? Because volunteers offer what few on the team have enough of: time and presence. Time is a precious commodity for most hospice professionals. Volunteers offer listening time, companionship time, and supportive time. Volunteers offer what few on the team have enough of: time and presence.

Hospice volunteers are an essential part of a quality hospice.

04/24/2026

Understanding Why Talking to an Unresponsive Loved One Is Still Important.
Even when a loved one appears unresponsive, your voice still matters more than you think.
In end-of-life care, decreased responsiveness is common. Patients may no longer speak, open their eyes, or respond in ways we recognize, but this does not mean they cannot hear or feel your presence.
Hearing is believed to be one of the last senses to decline. While we cannot measure it perfectly, research and clinical experience suggest that patients may still process familiar voices, tone, and emotional connection, even in the final stages of life.
Talking to your loved one provides comfort in ways that go beyond words. A calm, familiar voice can reduce anxiety, promote a sense of safety, and create a peaceful environment. Even silence filled with presence, soft words, gentle reassurance, or shared memories can be deeply meaningful.
This is also important for families. Speaking allows you to express what may have been left unsaid:” such as, “I love you,” Thank you”, or “It’s okay to rest.”
These moments can bring a sense of closure, connection, and peace that carries forward into grief and healing.
In hospice, we often remind families that the goal is not to get a response but to provide presence.
So talk to them. Hold their hand. Share stories. Play their favorite music. Because even in silence, connection remains.
Don’t walk this journey alone… Follow me for clarity, comfort, and evidence-based education.-
The Hospice NP

04/24/2026

https://www.facebook.com/share/p/1BTQwKoM1R/

Death vs. Dying — What’s the Difference?

Many families hear these words and think they mean the same thing… but they don’t.

Understanding the difference can bring clarity, peace, and preparedness.

👉Dying (The Process)
This is the body slowly shutting down over time.
It can happen over days, weeks, or months.

Common signs of dying:
• Increased sleeping
• Less interest in food or fluids
• More confusion or withdrawal
• Changes in breathing
• Weakness and needing more help
This is the body preparing.

👉 Death (The Moment)
This is the exact moment life ends.

It is when:
• The heart stops
• Breathing stops
• There is no response

This is the final moment.

❤️ Why this matters:
When families understand dying vs. death,
they are less afraid of what they’re seeing.

They can shift from “something is wrong”
to “This is part of the natural process.”

As a hospice provider, I always say: We don’t just care for the moment of death… We walk with families through the process of dying.

Don’t walk this journey alone. Follow me for clarity, comfort, and evidence-based education.
📘 Facebook: The Hospice NP
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💙 Please like, follow, and share to expand this education.

04/22/2026

To say Debra Kay keeps things running smoothly in our department is an understatement!
She is professional, efficient, positive, considerate of others, takes care of all of the plants in our office and is an amazing cook! We are so happy to have you on our team!

04/22/2026

What a beautiful creation God has made for all of us!

04/20/2026

What as sweet to way to honor her mother, on her heavenly birthday by bestowing upon our team a sweet treat!

We are always honored and humbled to have an ongoing relationship with our past patients and their families. This confirms that we are doing it right! Serving with our hearts, that make an impact on their hearts, forever.
Thank you sweet Brenda for the love you show us!

04/17/2026

What a wonderful attendance, information provided, engagement and presentation by Rev. Dr. Carla Cheatham!

She discussed the importance for caregivers to have self-care and reminding them that they are all worthy to care for themselves! This is a must to be effective and compassionate when caregiving for those we love. We are needing reminders of "why" we are caregiving, but taking needed breaks and time-outs, are essential for the balance. Great tips for coping mechanisms, focusing on gratitude and regaining energy to care for your loved one.

THANK YOU to all who were able to attend!

04/17/2026

"Thank you for the sweet, tender care you gave during his final weeks. Everyone I met was amazing. All of you were a Godsend, a life line during a very sad and difficult time. There are not words to adequately express how much your love and care meant to me. It is something I'll never forget! With love and appreciation"- Hospice family

What a testimony to the wonderful group of folks we have at GRMC hospice! Cindi Kincaid is a seasoned RN, with years of serving the community, and her compassion still shows! To our newest team members, Alexis Garcia, LMSW and Chaplain Chris Barrera, kudos to your attentiveness, availability to be present with patient and their family to provide the support needed! Great job!

04/15/2026

As March swiftly passed, we realized we've overlooked a most important appreciation - our Social Worker Month. We're deeply thankful for Carmen, Donna, and Alexis, whose distinctive talents and dedication make them invaluable to our team, colleagues, and the families and patients we serve, making our workplace truly blessed ❤️.