Kathleen Medeiros was still in nursing school, working a late shift as a hospital aide, when a quiet request from a patient changed everything. He wasn’t supposed to be dying — not that night — but he felt like something was going to happen to him. He asked her to stay and she did, sitting there with a man she barely knew, giving him what he’d asked for: comfort.
“That doesn’t usually happen,” she said. “But it did. And I never forgot it.”
At the time, Medeiros had no interest in hospice care. Like many nurses-in-training, she imagined a career helping people heal and go home—not one that involved helping them let go. But something about that night stayed with her, when her presence helped someone at the end of their life.
Years later, Medeiros became a hospice nurse. And what she found wasn’t what she expected.
“Out of my entire nursing career, I feel like the most fulfilling part is hospice.”
Hospice is often misunderstood. For many families, the word alone is terrifying. It feels like giving up, like admitting there’s nothing more to be done. But those who work in hospices or who have benefited from hospice care know better. Hospice isn’t about giving up — it’s about focusing on living comfortably when life is ending.
Hospice care begins when curative treatments are no longer the focus and the goal shifts to comfort and quality of life. It’s a Medicare benefit that provides medical care, pain management, emotional and spiritual support, and guidance for families. And most importantly, it meets people where they are—often in the place they want to be most: home.
As the hospice director for Community Nurse in Fairhaven, an independent, not-for-profit home care and hospice agency, Ashlee Santos would like to help people understand hospice care better. There are several misconceptions about hospice that exist, she said, especially the idea that hospice is a place — a building or institution — where you go to die.
It’s not like that, she said, adding that most of Community Nurse’s hospice patients live in the community, either at home or sometimes in facilities, like nursing homes.
A second misconception, according to Santos, is that hospice care means being confined to a bed or so sick that death is imminent.
Sometimes, Santos said, the introduction of hospice and shifting care from curing the disease to managing symptoms, can help the person feel better, improving their quality of life.
“There’s this idea that you probably only have days left and it’s not like that at all,” Santos said. “I think people come to hospice and they can really thrive for a little bit because we really focus on managing their symptoms. We get the pain under control.”
Medeiros, who now works for Coastline Elderly Services, describes this shift in care as not trying to fix everything.
Instead, she said, you’re asking, “What can I do to make you feel better?…How can we make this easier for you?”
For people familiar with some aspects of hospice, one of the bigger misconceptions can be that hospice provides daily home care for the patient. That’s not the case, Santos said.
As a person’s health declines, the hospice team is usually in the home more often, providing more regular care, but that’s still different from providing daily care, an expectation some families have.
“As far as home health aides go, we don’t move in,” Santos said. “We’re kind of like a supplement to the care. So, you might get an hour a day with a home health aide, but it really is not enough. It’s a supplement.”
Hospice teams communicate with families about what care is going to be needed as a person’s health changes, she said.
“You try to start a conversation really early on about what it’s going to look like as you or your loved one declines and really try to get people to plan,” Santos said.
Even though they don’t take over care for a person, hospice is always there supporting the care that’s given. In addition to overseeing medications and providing medical equipment, regular nurse consultations help families administer medication and monitor when prescriptions or doses need to be adjusted.
All hospices work with families to determine if hospice care is right for them. To qualify a physician must certify the person as having six months or less to live.
Physicians “take their best educated guess,” Santos said. “It’s not set in stone and it’s not like you only have six months and once you hit that six months, you have to come off.”
Medeiros remembers one patient with advanced respiratory failure whose breathing was so labored that each moment was frightening for him and his family. She visited him daily, sometimes twice a day, adjusting medications and easing fears. The daughters were scared to administer morphine, worried it would hasten death.
“I had to tell them, ‘You’re not going to kill him. He’s already in the process. You’re just going to make it easier for him.’ That’s what people really need to hear,” Medeiros said.
She was there when he passed. And when she attended his wake, the family embraced her in gratitude.
“They gave me the biggest hug and said, ‘Thank you so much for what you did.’ I didn’t even know what to say. I just kept thinking, I wish I could have done more.”
Medeiros remembers sitting with patients who were truly ready and had made peace with dying. They didn’t talk about the things many people prioritize like work responsibilities or missed promotions, she said.
“They never tell you, ‘Oh, I wish I worked 50 more hours or I wish that I spent more time or money or whatever on this,” she said. “They always, always, said the same thing. I wish I had spent more time with my family. Or, I wish I had spent more time on the things that I wanted to do.”
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