Assisting at Home

08/03/2025

“Let’s make this time matter.”

Thanks for your leadership in end of life Gabby Jimenez.

“No matter how heavy the diagnosis, no matter how long or short the time, we still get to choose what to do with the days we have left. We still get to love, to speak, to laugh, to cry, and to say goodbye in a way that matters. To say what we need to say. And if we are lucky, we get the chance to say we are sorry, to forgive, to make amends, and to find some kind of peace with all of it; the past, the present, and whatever comes after.”

In 1987, my mom was told she had a year to live.

She had lung cancer that had spread to her brain. I was twenty-three years old, living four hours away. No training in death, no roadmap for grief, no idea how to hold space for someone staring down the end of their life.

There was distance between us, not just in miles or years, but in the kind of closeness I quietly wished I could have had with my mom.

I remember sitting by her bedside, trying to wrap my head around what she was saying. A year to live. One year. That’s what they gave her. And in my innocence, or maybe my hopefulness, I said, “Then we should do something with that year. We should go somewhere, do the things you’ve always wanted to do. Make it matter.”

It made sense to me then, that we could turn that time into something beautiful. That we could squeeze joy from heartbreak.

She looked at me, and I’ll never forget the way her eyes settled on mine. “Gabby,” she said, “you’ve always seen life through rose-colored glasses.” Her voice wasn’t cruel, just tired. Honest. She explained that I had no idea what she was going through. That she was dying, really dying, and I needed to understand that. I never understood that. None if it made sense to me.

She died exactly one year later. She was 51. I’ve now lived ten years longer than she ever got the chance to.

I carried that conversation with me for decades. The memory of her words, the way she dismissed mine, and it has haunted me. I thought I’d failed her. That I’d said the wrong thing.

But now, thirty-seven years later, I sit at the bedsides of the dying every day. I am a hospice nurse and an end-of-life doula. I’ve walked with over 2,500 people to the edge of this life. I’ve listened to their stories. I’ve held their hands as they let go. And if I could go back and sit with my mom again, knowing what I know now, I would say the exact same thing.

I would still say, “Let’s make this time matter.”

No matter how heavy the diagnosis, no matter how long or short the time, we still get to choose what to do with the days we have left. We still get to love, to speak, to laugh, to cry, and to say goodbye in a way that matters. To say what we need to say. And if we are lucky, we get the chance to say we are sorry, to forgive, to make amends, and to find some kind of peace with all of it; the past, the present, and whatever comes after.

Death doesn’t wait for us to be ready. But life... life will wait for us to choose it, right until the end. So maybe I did see through rose-colored glasses, and maybe that’s not such a bad way to see someone you love, or the time they have left.

xo
Gabby

You can find this blog here:
https://www.thehospiceheart.net/post/rose-colored-glasses

08/02/2025

07/21/2025

It is in the giving the we receive!

Katharine Hepburn, in her own words:
"Once, when I was a teenager, my father and I were standing in line to buy tickets for the circus. Finally, there was only one family between us and the ticket counter. That family made a lasting impression on me.
There were eight children, all under the age of 12. From the way they were dressed, you could tell they didn’t have much money, but their clothes were clean, very clean. The children were well-behaved, standing in pairs behind their parents, holding hands.
They were so excited about the clowns, the animals, and all the acts they would see that night. From their excitement, you could tell they had never been to a circus before. It was going to be a highlight of their lives.
The father and mother stood proudly at the front of their little group. The mother was holding her husband’s hand, looking at him as if to say, 'You’re my knight in shining armor.' He was smiling, enjoying seeing his family happy.
The ticket lady asked how many tickets he wanted, and he proudly responded, 'I want eight children’s tickets and two adult tickets.' Then she announced the price.
The wife let go of her husband’s hand, her head dropped, and the man’s lip began to quiver. He leaned in closer and asked, 'How much did you say?'
The ticket lady repeated the price.
He didn’t have enough money. How was he supposed to turn around and tell his eight kids that he couldn’t afford to take them to the circus?
Seeing what was happening, my dad reached into his pocket, pulled out a $20 bill, and dropped it on the ground. We weren’t rich by any means. My father bent down, picked up the $20 bill, tapped the man on the shoulder, and said, 'Excuse me, sir, this fell out of your pocket.'
The man understood what was happening. He wasn’t being handed charity, but he gratefully accepted the help in his desperate, heartbreaking, and embarrassing situation. He looked straight into my father’s eyes, took my dad’s hand in both of his, squeezed the bill tightly, and with trembling lips and a tear streaming down his cheek, he replied, 'Thank you, sir. This really means so much to me and my family.'
My father and I went back to our car and drove home. The $20 my dad gave away was what we had planned to use for our own tickets.
Although we didn’t see the circus that night, we felt a joy inside us that was far greater than seeing the circus.
That day, I learned the true value of giving. The Giver is greater than the Receiver.
If you want to be great, greater than life itself, learn to give. Love has nothing to do with what you expect to get, only with what you expect to give—everything.
The importance of giving and blessing others cannot be overstated because there is always joy in giving. Learn to make someone happy through acts of giving."
~Katharine Hepburn

07/18/2025

Hospice takes care of people the doctors are having a difficult time fixing; people the doctors probably can’t fix. What does hospice do? Hospice helps people live with the greatest possible comfort during the limited time they have left.

It is interesting that a person who can’t be fixed, who is approaching death through disease, looks very sick and often frail in the months before their death BUT they don’t look like they are dying or at least match our idea of what a person looks like. They have probably entered the dying process in those prior months but they don’t look like they are going to die. It is only in the one to three weeks before death, that a person who is dying from a disease actually looks like they are dying.

People are generally referred to hospice in the last weeks of their life, which is way too late to help the patient and is often just crisis solving with the family.

What do you say to someone to get them to accept hospice? Well, one thing to say after explaining the services hospice offers is to ask what they think will happen if they get on hospice too soon? The answer is really a good thing---the person gets discharged from the hospice program. They have stabilized or gotten better and no longer need the guidance that hospice offers. Great! And that does happen. Not a lot, but it does happen.

Getting on the hospice program when a person’s condition is deteriorating in spite of all the treatment that is being given or has been done is accepting a different kind of medical help. It is not saying I have given up hope. It is not implying that I am dying tomorrow or next week but it is getting help that centers around family, the significant people in our circle of life that are affected. It is accepting help for ourselves as we face life with illness, often accompanied by pain, fear, and eventually death.

What is scary about that? The scary part is that everyone has to admit, on paper, that there isn’t going to be the cure everyone was praying for. People have to face the realities of life — everyone dies. Fortunately, hospice services can support and guide everyone during that scary time. Knowledge and companionship reduce fear. Hospice helps reduce the fear we all bring to end of life decisions. It takes courage to face reality and we can face reality best when we have all the facts and are not alone.

07/11/2025

To CARE for someone means something different at the City of New Bern, NC Police Department. The CARE program (Call, Answer, Respond, Empower) supports elderly citizens who may not have the ability to respond in a crisis. It provides daily check-ins by the police department to ensure the safety & well-being of participants. The program is ideal for seniors & elderly with specific medical or cognitive conditions (like dementia, mobility issues, etc.), helping them maintain their independence while providing peace of mind to their families. Need more info or want to enroll? Let us CARE for your loved one. Call (252)672-4135.

07/03/2025

About six months ago, I sat at the bedside of a woman who took her very last breath. She made me promise that I would look after her husband after she died. Once a week I meet him and we take a walk around his neighborhood. He is grieving, he is struggling, and he cries often. We talk about his wife a lot. Each week I come up with a new question that gives him the opportunity to go down memory lane and share about their life together. And I listen.

For the first five months, his dog walked with us. She was a beautiful distraction for him, and gave him purpose as he woke up each day missing his wife. About three weeks ago she started getting sick and he finally had to make the difficult decision to let her go, which broke his heart.

When I show up to his house to walk, he walks out his door, without his dog, and looks at me and cries. So now I am supporting him while he grieves his wife and his dog. His heart is just so sad. I often feel that I have a loss for words, disappointed that nothing I say will make him feel better. 

He tries to find joy in each day, he hikes with his friends, he eats well and works in his garden, but he is lonely. It is really hard to move on with your life not just grieving someone you love, but also trying to figure out who you are now that they are gone. He feels lost.

Yesterday I met him for a walk. We had moments of tears which is not abnormal, but I also felt that there was some healing happening. We laughed more than usual, and we had a wonderful conversation.

As we came around the corner to get back to his house, a neighbor was watering his garden and said hello. I was introduced, hands were shaked, and he asked my friend how he was doing. He then asked where his dog was and why she wasn’t walking with us. He told the neighbor that she had died and he started to cry.

The neighbor said this:
“Oh. Wow. I am so surprised to hear this. She was such a beautiful dog. She was like the mayor of the neighborhood and everybody loved her. I am really sorry for your loss. I know you miss her, we will all miss her. I am here if you want to talk about her. We can talk about your wife too, any time you want to.”

I could see the reaction my friend had to his kind and compassionate words. He was grateful for them, and it brought him comfort. I can’t speak for him, but it felt to me like his neighbor‘s words helped him to feel seen and acknowledged. Sometimes I wonder if he feels like he has to hide from the grief and not let anyone see that he is hurting. Adding the death of his dog to his grieving, has elevated his grief in a new way. His neighbors words were thoughtful and supportive, and something I believe my friend needed. 

Let’s all be more like his neighbor…
He saw my friend, he honored his sadness, and he offered him a safe place to talk about his wife and his dog. That was a gift, a beautiful, generous gift. 

❤️
xo
Gabby
www.thehospiceheart.net

06/25/2025

Gone From My Sight is a great resource for understanding end of life.

Most people aren’t alive one minute and dead the next when dealing with a life limiting illness. There are changes to watch for regarding eating, sleeping and interacting with others. Those changes begin months before death actually comes.

You will find all the signs of approaching death in Gone From My Sight: The Dying Experience (“the hospice blue book”). The booklet will be your guiding light through this sacred journey.

06/14/2025

A hospice team becomes extended family. They are a gift to the person who is dying and to their family. 

One of the most valuable lessons I have learned as a hospice nurse, is the importance of the team you share a patient with. Early on I didn't understand the roles of the other hospice team members, and in some ways, I felt they were encroaching on my time with a patient, perhaps even feeling threatened, as if their being there might indicate in some way that I was not capable of doing my job. I had a lot to learn.

When I first became a hospice nurse, I didn't know a lot about death, the process of dying, or what grief looked like. I put a lot on my shoulders thinking I was supposed to handle it all on my own, until I realized how truly blessed I was to have these incredible people to share each patient with. Once I became more aware, and really understood what a hospice team was all about, I found myself dependent on them to guide and teach me.

When a patient comes on to hospice, they are assigned a doctor, a nurse, a social worker, a chaplain, a home health aid (CNA/HHA), and a volunteer. Each brings something unique and valuable to the care of the patient, as well as those at the bedside. Over the years I have come to see the gifts each member of the team brings, and I have learned to rely on them. I go to them for answers, because I do not know it all. I have also gone to them for help for myself; for comfort, for support, for guidance and clarity. I need this team, as much as the patient and family does.

Many times, the family refuses additional support, which I believe stems from them not understanding the value each brings. I can appreciate this. I always take the time to explain each role, helping them to understand the benefits and encouraging them to embrace the many ways we are all here to help them navigate this time. I love the team I get to work with and have witnessed the gentle way they approach a dying patient and those grieving at the bedside. I see all of the many ways they offer support and I know that I cannot do this job without them.

The dying process, while it has many similarities, is unique and unpredictable and no one dies or grieves the same way. To navigate it in a way that allows each person to feel supported, comforted and heard, requires a team of hospice professionals who are trained to react and respond to a myriad of different symptoms and emotions.

Now when I see a member of our team at the bedside of a patient that I too am providing care for, I step back and I watch in awe of the beautiful work that they do, and I am not the least bit threatened they are there. In fact, it is just the opposite, I am thankful and honored to have shared each experience with them.

The other members of this team, the ones that don't get mentioned nearly as often, but deserve just as much credit are the 24/7 triage and after-hours nurses, the outreach and intake people who help to get our patients and families settled in with us, and everyone who works in the office making sure the the paperwork is processed and supplies are ordered and we have the tools needed to do the work we do. It takes a village.

I see the hospice team as a patchwork quilt made with a variety of different fabric squares. While they do not match, they are uniquely beautiful and when they come together they create an exquisite quilt that can wrap tightly around anyone who might feel ache, and comforts them and makes them feel safe.

That is what a hospice team means to me.
xo
Gabby

You can find this and all of my other blogs here:
www.thehospiceheart.net

06/12/2025

At a recent palliative care conference, I learned that many individuals are unclear about the differences between palliative care and hospice, and some even confuse palliative care with palliative sedation. I wanted to take a moment to clarify these distinctions, aiming to ease any fear or confusion you might have. Additionally, I hope to illustrate a path that can help you or a loved one recognize that there is a plan in place during such challenging times, offering resources, support, and compassionate care tailored to the specific needs and stages of decline.

Palliative care offers comfort-focused care with the intention of providing relief from the symptoms and physical and mental stress of a serious or life-limiting illness. This is similar to hospice care as the intention is to reduce symptoms and suffering, however they differ in their timing and objectives. Palliative care can be used at any stage of a serious illness, whether terminal or chronic, and can be stopped when no longer needed. Palliative care can transition with you, no matter where you are on your health journey. Palliative care can be provided alongside curative treatments, while hospice care is typically offered when curative treatments have been discontinued.

Hospice care focuses on comfort and quality of life for terminally ill patients and their families, emphasizing pain relief and symptom management instead of life-prolonging treatments. The intention is to make the end of life as comfortable and yes, even peaceful as possible for the patient and the people who love them.

I think it is important for you to know that palliative care is available to anyone with a serious illness, regardless of their prognosis, while hospice care requires a doctor's certification of a life expectancy of six months or less to live.

Palliative care can be provided in various settings, including hospitals, clinics, and homes, while hospice care is primarily provided in the patient's home or in a hospice facility.

Hospice care is generally well-covered by insurance, including Medicare, Medicaid, and many private plans. Palliative care can be covered by insurance as well, but the specifics vary. I encourage you to speak to your insurance provider to find out what is covered under your particular plan.

A quote I often share: "All hospice care involves palliative care, but not all palliative care takes place in hospice." (author unknown)

Palliative sedation, which I prefer to refer to as Proportionate Palliative Sedation (PPS), involves administering medication to lower a patient's consciousness just enough to alleviate unbearable suffering, ensuring their comfort while maintaining their capacity to interact with their surroundings as much as possible. This is a last-resort intervention in palliative care, mainly used for patients with terminal illnesses who are experiencing severe and untreatable symptoms.

Since I am currently employed as a pediatric palliative care nurse, I would like to provide you with a brief overview of this field. Pediatric palliative care involves specialized medical care for children facing life-threatening or life-limiting conditions, with an emphasis on enhancing their quality of life and addressing both their physical and emotional needs.

We cannot change the diagnosis or the outcome, however we can make sure that you or someone you love has a team that will support you through this process whether it takes years, months, weeks, or days, making sure to guide all involved until that last breath is taken. Both palliative care and hospice care are available for anyone who is navigating decline from age or illness. Neither are a diagnosis, they both align with the plan of care for the diagnosis.

Perhaps if people realized how accessible this information and education is, they would consider palliative care sooner and have a more graceful transition to hospice if/when it is appropriate. Increasing the education about this could end up being the difference between a distressing or peaceful death, ensuring that each person receives good care, valuable resources, and support earlier on.

xo
Gabby

I am grateful to the two doctors who read, reviewed, and provided feedback on my writing, as well as to Google for the information I researched to compile this blog. Their assistance was invaluable in helping me accurately explain the differences between hospice and palliative care.

You can find this and all of my other blogs here:
www.thehospiceheart.net

06/11/2025

Peelaways are waterproof, disposable bed sheets designed for older adults, children, and anyone needing quick and easy fresh sheet changes.

06/04/2025

This should be hung in every dementia care home and in hospitals where there are patients with dementia.

If I get dementia, I’d like my family to hang this wish list up on the wall where I live. I want them to remember these things.

And I would add one more:
Every time you enter the room announce yourself.

“Hi Mom- it’s Margaret.”
NEVER ask- Do you know who I am??? That causes anxiety.

1. If I get dementia, I want my friends and family to embrace my reality.

2. If I think my spouse is still alive, or if I think we’re visiting my parents for dinner, let me believe those things. I’ll be much happier for it.

3. If I get dementia, don’t argue with me about what is true for me versus what is true for you.

4. If I get dementia, and I am not sure who you are, do not take it personally. My timeline is confusing to me.

5. If I get dementia, and can no longer use utensils, do not start feeding me. Instead, switch me to a finger-food diet, and see if I can still feed myself.

6. If I get dementia, and I am sad or anxious, hold my hand and listen. Do not tell me that my feelings are unfounded.

7. If I get dementia, I don’t want to be treated like a child. Talk to me like the adult that I am.

8. If I get dementia, I still want to enjoy the things that I’ve always enjoyed. Help me find a way to exercise, read, and visit with friends.

9. If I get dementia, ask me to tell you a story from my past.

10. If I get dementia, and I become agitated, take the time to figure out what is bothering me.

11. If I get dementia, treat me the way that you would want to be treated.

12. If I get dementia, make sure that there are plenty of snacks for me in the house. Even now if I don’t eat I get angry, and if I have dementia, I may have trouble explaining what I need.

13. If I get dementia, don’t talk about me as if I’m not in the room.

14. If I get dementia, don’t feel guilty if you cannot care for me 24 hours a day, 7 days a week. It’s not your fault, and you’ve done your best. Find someone who can help you, or choose a great new place for me to live.

15. If I get dementia, and I live in a dementia care community, please visit me often.

16. If I get dementia, don’t act frustrated if I mix up names, events, or places. Take a deep breath. It’s not my fault.

17. If I get dementia, make sure I always have my favorite music playing within earshot.

18. If I get dementia, and I like to pick up items and carry them around, help me return those items to their original place.

19. If I get dementia, don’t exclude me from parties and family gatherings.

20. If I get dementia, know that I still like receiving hugs or handshakes.

21. If I get dementia, remember that I am still the person you know and love.”

ᴄᴏᴘʏ ᴀɴᴅ ᴘᴀsᴛᴇ in Honor of someone you know or knew who has dementia. In Honor of all those I know and love and lost who are fighting Dementia/Alzheimer’s.