Finding balance between the business of hospice and the heart of hospice.

In the past week alone, I have heard from three different families who are struggling with their hospice experience. They were promised 24/7 availability, but what they have encountered instead is delayed responses, last-minute cancellations, and inconsistent communication. Some families are feeling unheard and unsupported, and sadly, I have felt this too. Hospice should be providing heart-centered, compassionate care at one of the most sacred times in life, and yet sometimes staffing shortages and system barriers get in the way of that intention. I know there are many wonderful hospice organizations and deeply dedicated staff who do this work from their hearts, but I also know we can, and must, do better.

As a hospice liaison, I assist families with navigating the decline their loved one is experiencing, which includes not just the transition to home health, palliative care, or hospice, but also understanding about what support and resources are available to them. I help them communicate with their team, finding confidence in asking difficult questions, and speaking up if something doesn’t feel right. I have learned that most people do not know how hospice can support them, which leaves them feeling frightened and afraid. The word "hospice" is scary to most people. We cannot change the outcome but we can change how each person is held during this time.

I love being able to bridge those gaps, because when communication opens, care deepens. It brings families, patients, and hospice teams closer together, creating opportunities to celebrate the beauty of compassionate care done well.

It is important for people to remember that hospice works for you, not the other way around. They can’t fix what they don’t know is broken, which is why speaking up, asking questions, and sharing feedback matters so much. Because I was a hospice nurse for many years and now also serve as a death doula, I have learned to blend both roles to help ensure that the final landing is a softer one. When care is tender, consistent, and human, the grief that follows may not vanish, but it can be gentler. That in itself should inspire us all to do this work better.

I understand that protocols must be followed and productivity matters. But lately, it feels like those have climbed higher on the priority list than the patient and their family, and that’s where we need to speak up.

When we make promises to families, we have to keep them, they are trusting our words to be true. When they are afraid or uncertain, we need to slow down, listen, and help them feel safe and supported, not just in the care that we provide, but in the care they will continue to provide after we walk out their door. I understand the strain of short staffing, but that only deepens burnout for those carrying the load. We must find a balance between the business of hospice and the heart of hospice; both are equally as important.

To all the hospice professionals out there, the nurses, doctors, aides, chaplains, social workers, and volunteers who show up with love and intention, thank you. For all of the death doulas adding to what the hospice team brings, thank you. To the families who are providing the personal love and care, I applaud you and I want you to know that you are not alone. All of you remind me daily that this work can be beautiful, even when it’s hard. My hope is that together, we keep listening, learning, and leading with heart, so that every person’s final chapter is written with dignity, compassion, and care.

Hospice is not just protocols, it begins with heart. Hospice is a sacred offering where people can come at their most vulnerable, and their most human. How we show up in those moments can shape the difference between pain and peaceful, not just physically, but emotionally and spiritually. This work is significant. It demands presence, compassion, and heart. Every patient, every family, every team member stands in witness to the ending of a life, and that matters. It must be the priority.

It only takes one person to express a negative experience for fear to build in others. We know that there are more compliments than complaints but the complaints seem to be coming from a louder voice. Our personal care and compassion can durn the volume down.

xo

Gabby