WVMC Palliative and Hospice Care Program

WVMC Palliative and Hospice Care Program Contact information, map and directions, contact form, opening hours, services, ratings, photos, videos and announcements from WVMC Palliative and Hospice Care Program, Western Visayas Medical Center, Q. Abeto Street, Mandurriao.

This page was created by the WVMC Family Physicians for the enrolled Hospice Patients of WVMC-DFCM Palliative and Hospice Care Program for the purpose of providing clinical information and to connect with their patients during the new normal.

21/05/2026

Deprescribing in Hospice Care: Why Some Medications Are Stopped

In hospice care, the goal shifts from preventing future disease to improving comfort and quality of life now.

Deprescribing is the careful process of reducing or stopping medications that may no longer help a person with advanced illness. This does not mean giving up. It means focusing on comfort and reducing unnecessary medication burden.

As the body declines, some medications may become harder to tolerate and may cause fatigue, confusion, nausea, dizziness, falls, or swallowing difficulties.

Medications commonly reviewed in hospice include:

Cholesterol medications such as atorvastatin (Lipitor) or simvastatin (Zocor)

Vitamins and supplements such as multivitamins, fish oil, calcium, or iron

Preventive heart medications such as aspirin or clopidogrel (Plavix)

Certain diabetes medications that may increase the risk of low blood sugar

Bone health medications such as alendronate (Fosamax)

Dementia medications such as donepezil (Aricept) or memantine (Namenda)

At the same time, hospice continues medications that improve comfort, including medications for pain, anxiety, shortness of breath, nausea, agitation, and secretions.

Deprescribing is not about stopping care.
It is about asking:

“What helps this patient feel best now?”

— The Hospice NP
Caregiver Support • Comfort • Clarity

References: (American Geriatrics Society, 2023), (NHPCO, 2024), (Kutner et al., 2015).

20/05/2026

Gratitude doesn’t erase pain or difficulty, but it can gently widen our perspective. When we intentionally notice moments of beauty, kindness, connection, or peace, we often discover that joy has been quietly present alongside the hard things all along. [image via The New Happy]

19/05/2026

📢Join us for the third session of our 2026 Webinar Series!

This session will focus on “Palliative Care in Chronic Kidney Disease”, exploring how supportive and palliative care can be integrated into kidney care across different healthcare settings.

🔗 Register here:
https://us02web.zoom.us/meeting/register/T9PU36QTR8uxqz9EJAI-jQ

🗓 22 June 2026 (Monday)
🕝 2:30–4:00 pm (Singapore Time)
💻 Live on Zoom | 1.5-hour session + Q&A

We are honoured to welcome:
🎤 Dr Kelly Li (St George Hospital, NSW, Australia)
🎤 Dr Malama Tafuna’i (Primary Care Physician, Apia, Samoa)

Learn from two passionate clinicians working to advance kidney supportive care and palliative care integration in both high-resource and low-resource settings.

18/05/2026

Different people imagine death in different ways, but many find comfort in the idea that we remain connected to the world around us—that nothing truly disappears, but instead changes form. Sometimes grief softens, even just a little, when we remember how deeply we belong to the larger story of life itself. [image via Holly Hatam]

17/05/2026

One of the questions I am asked more than almost any other is this: “Why do we stop food and water at the end of life?”

It is a question filled with tenderness, and often, with fear. Families struggle. Clinicians and caregivers struggle. Anyone who has ever cared for someone who is dying knows how deep the instinct is to nurture, to comfort, to give. We equate food and water with love, with survival, with doing right by someone we care about.

And so, when we are asked to stop, or when a patient begins refusing food and water, it can feel like we are participating in something harmful… or abandoning something essential. Some worry they are contributing to suffering or hastening death. Others feel a conflict with their faith, their values, or the core human urge to sustain life. All of these feelings are valid. All of them deserve to be seen.

But there is another truth, one rooted in the wisdom of the body itself. At the end of life, the body does not want food and water. As the systems begin to shut down, appetite and thirst naturally fade. The digestive system slows. The cues in the brain that tell us “I’m hungry” or “I’m thirsty,” grow quiet. The body needs less energy, less input. It begins turning inward, conserving what little is left for the final work of letting go.

When we try to give food or fluids during this time, no matter how well-intentioned, we create discomfort. The body can no longer process what we are offering. Liquids can pool in the hands, feet, and limbs. Food can sit in the mouth or throat without the strength to swallow. These are not signs of neglect. They are signs of a body transitioning, doing exactly what it is designed to do at the end of life.

This is why stopping food and water is not an act of harm. It is an act of honoring the body’s own wisdom.
It is allowing the natural process to unfold without introducing distress.
It is trusting that they are not dying because we are withholding anything, they are dying because the illness has reached its end. And when we stop giving food and fluid at this stage, we are not causing death, we are helping create the conditions for it to be more peaceful, gentler, and filled with far more grace.

The body will actually let go with a little more peace and grace when food and water is not given at the end of life. The body responds well to this. It prefers this. And when we honor the body in this way we can remove or avoid physical suffering which is inevitable when we push or force food and water.

There are ways to offer care, comfort, and presence:

• Offer, don’t force. If someone shows interest, small sips or favorite tastes like ice cream, Jell-O, or a spoonful of something familiar can be soothing. But refusal is communication, and it must be respected.

• Provide mouth care. Moist lips, a clean mouth, and gentle swabs can bring comfort without asking the body to process what it cannot.

• Watch for cues. Holding food in the cheeks, coughing, spitting out food, or drooling are signs the body is not tolerating intake.

• Honor their choices. If they have an Advance Care Directive, their decision about artificial hydration or nutrition must guide us.

• Above all, prioritize comfort. Hospice and end-of-life teams are here to help families and caregivers understand these changes, to hold space for the grief they bring, and to create care plans centered entirely on comfort and dignity.

Stopping food and water at the end of life is one of the hardest things we ask of families and care teams. It challenges our instincts. It touches our fears. It asks us to redefine what care looks like.

But the truth is simple and profound:
Their body prefers it this way.
We are not hurting them. We are easing their way.
We are meeting them with compassion, not deprivation.

This work is tender. It asks so much of our hearts. But when we allow the body to guide us, when we stop forcing what it can no longer use, we give our patients what they deserve: a death held with gentleness, respect, and deep humanity.

And that is the essence of the care we all strive to provide for the people in our care, and for the people we love.

xo
Gabby

You can find this blog here:
https://www.thehospiceheart.net/post/a-gentle-truth-about-food-water-and-the-end-of-life

15/05/2026

It’s one of the most common questions caregivers carry, and one of the heaviest. It usually comes after a decision that didn’t feel like a choice at all.

Moving someone out of the home.
Starting hospice.
Saying yes to more care.
Saying no to something you thought you would always say yes to.

And then the quiet comes… and with it, the question. Did I do the right thing?

Here’s what I gently offer to those sitting in that space:
Ask yourself… Was your person safe? Were you able to care for them without losing yourself in the process?

If the answer is no, then something had to change.

And now… Are they receiving the care they truly need? The kind of care that supports their body, their comfort, and their dignity?

If the answer is yes, then you didn’t fail them, you honored them. Even if it doesn’t feel that way.

Because here is the truth we don’t say enough:
Love doesn’t always look like keeping someone at home. Sometimes love looks like recognizing when you can’t do it alone. Sometimes love looks like making a decision that breaks your own heart.

Our homes can be beautiful, they can be filled with meaning and memories, but they are not always the safest place for someone at the end of life.

And choosing something different doesn’t mean you gave up, it means you paid attention. It means you were honest about what was needed, and it means you chose care, even when it was hard.

If you are holding that question right now…
Did I do the right thing?
Pause for a moment and remember:
You made the best decision you could with the information you had, in a moment that asked more of you than most will ever understand.

That kind of love doesn’t always feel right, but it is still love…

xo
Gabby

You can find this blog here:
https://www.thehospiceheart.net/post/did-i-do-the-right-thing

14/05/2026

When I tell people what I do, the response is almost always the same: “How can you do that, it must be so hard.” I understand why they say it, because what I do is hard.

Working in end-of-life care means bearing witness to death. I have been present for over one thousand last breaths, and for just as many last goodbyes. Many people reading this know that experience; and many others cannot imagine it. But just like any calling, any profession, any skill, we are each shaped for something unique. We all carry gifts that allow us to stand in places others may not be able to. I am not the only one.

What I want people to understand, though, is that I don’t just see death or grief. I witness culture, ritual, and faith that often leaves me in awe. I see the kind of strength people draw from belief systems I am still trying to fully understand. I see complicated family dynamics too, some tender, some painful, and I remind myself that my role is not to fix, but to honor what is present. And sometimes I see relationships so full of love that a part of me aches, because I never had that. Yet even in that ache, I am comforted by knowing such love exists.

What I see, over and over again, is love, every shade, every expression, every way a human being shows up in the face of the inevitable. I see how people react, how they lean in, how they prepare themselves for the mystery of what comes next. I am not just invited to be present for the most fragile, most intimate, and most personal part of life, I am trusted to be there, and that means everything to me.

Death opens the door to the deepest parts of who we are, our traditions, our faith, our sorrow, our tenderness, our love, and in witnessing it all, I am shown life.

So no, I don’t just see death, I see life, and I am grateful every day that I get to witness this.

xo
Gabby
Hospice/palliative care nurse, end-of-life doula

www.thehospiceheart.net

14/05/2026

Some of you may already know that I am a facilitator with the Humane Prison Hospice Project. I have been doing this work since 2023. Each time I am invited into a prison, my passion for this work evolves in ways I never quite expect.

Over the last two weeks, I spent time with incarcerated men who are providing end-of-life care to others behind bars. Last week, we talked about vigiling, what it means to sit at the bedside of someone who is dying, and the quiet power of presence. We talked about meeting people where they are, without needing to fix anything. They reminded me that presence itself is one of the most unselfish gifts we can offer another human being.

Yesterday, our conversation centered around grief.

Not just grief after death, but grief in all the ways it exists throughout a life. The loss of relationships. The loss of opportunities. The loss of the person you once were. The grief of choices made, paths not taken, and futures that will never unfold the way you imagined.

Some spoke about losing loved ones they could not say goodbye to. Others spoke about having the chance to say goodbye even if they could not attend a funeral. We talked about witnessing dying men reconnect with family after years of silence, and sometimes witnessing families still carrying anger, hurt, and regret.

What struck me most was this: grief is rarely about one thing. It is layered into our disappointments, our trauma, our regrets, our love, our humanity, and even our hope. It becomes part of the story of who we were, who we are, and who we still want to become.

I left feeling deeply humbled and incredibly grateful. This work fills my heart with purpose, but it also gently asks me to look at my own life with more honesty and compassion.

I think all of us are searching for ways to matter, ways to contribute, and ways to leave people feeling seen, valued, or less alone.

And maybe sometimes it starts simply with being willing to sit beside another human being and truly see them.

Compassion does not ask who deserves it, it simply rises from the heart of one human being and reaches toward another. And sometimes, in the most unexpected places, we witness it in its purest form.

xo
Gabby

To learn more about the Humane Prison Hospice Project click this link: https://humaneprisonhospiceproject.org/

09/05/2026

There is something I want to say…
Not because I am planning to leave anytime soon,
but because I know that one day, I will.
And so will you.

We don’t get to choose when that day comes.
But we do get to choose how prepared we are for it…
and how we love the people who will one day have to live without us.

I have taken the time to write things down.

Not just the medical decisions… although those matter deeply.
But the personal things.
The music I want playing.
What I want to wear.
Where I feel most at peace.
Who I want near me.
How I want to be cared for when my voice begins to quiet.

Because what matters to me
Is keeping my voice, even when I can no longer speak.

I have also written letters...
To my children.
To my grandchildren.
So that they will always have something to hold onto.
Something that says, in my own words,
how deeply they are loved.
And I don’t wait for those letters to do all the talking.
I say it now.
As often as I can.
Out loud.
While I’m here.
Because I have seen what happens when these conversations don’t take place.

I sit with families every day who are asked to make impossible decisions.
To become the voice for someone they love…
without ever really knowing what that person would have wanted.
And the question always comes:
“What would they want?”
And too often…
no one truly knows.

Having these conversations does not make death come sooner.
It does not invite it in.
It simply honors the truth:
that it will come… and love deserves to be prepared for that.

This is why I started my class, "Your End of Life Wishes."
Because this isn’t just about dying.
It’s about living in a way that says...
when my voice gets softer,
you will still know me.
You will still hear me.
You will still feel me.

I want my story told.
I want my name spoken.
I want my grandchildren, and theirs, to know who I was,
what I believed, and how deeply I loved.

Because when we stop saying someone’s name,
we slowly stop telling their story.
And I want mine to live on.

So today, I’ll ask you the same question I ask so many others:
Have you told them?
Have you written it down?
Do the people you love know what matters most to you?
If not…
there is no better time than now.

xo
Gabby
www.thehospiceheart.net

Link to the class:
https://www.thehospiceheart.net/your-end-of-life-wishes

Address

Western Visayas Medical Center, Q. Abeto Street
Mandurriao

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