12 lessons from a year working in hospice
What I learned about life, love, and meaning from a year with the dying at the Lily House on Cape Cod.
I’ve always said hospice has a branding problem.
That’s because we tend to think of it as a place you go to die. Whenever I tell someone that I opened a hospice and enjoy sitting with people on their deathbeds, I get one of two reactions: they either look at me like I have two heads, or they dive into a story about a loved one’s hospice experience—sometimes good, sometimes bad. Either way, they’re often surprised when I explain that the experience isn’t as dark or depressing as they might think. In fact, I've never laughed or felt more love in a workplace.
For many, choosing hospice can feel like surrender—a letting go of curative treatments and a turning away from hope. But in my experience, instead of marking the end, hospice offers the beginning of something new—a chance to embrace a different kind of hope, one that isn’t about resisting death but about truly honoring the time that remains.
This vision comes to life at the Lily House, a social model hospice home nestled in the quaint town of Wellfleet on Cape Cod, MA. At the Lily House, hospice isn’t just a place where people go to die—it’s a place where people continue to live, sometimes more fully than ever. With candle-lit altars, garden views, walls filled with art, and the laughter of community echoing through each room, it feels like a real home—because it is. It’s a space where one can live fully awake to each moment, embracing both joy and sorrow. At the Lily House, hospice offers the freedom to spend one’s final days free from pain, surrounded by beauty and love, and with a surprising depth of presence.
Supporting Lily House’s residents—in a hybrid role as the Director of Operations and a care provider—through their end-of-life transitions has been an honor, and I’m deeply grateful for it. And I’m also full of gratitude for the lessons I've learned about how to live a meaningful life in the face of impermanence. Countless moments at the Lily House have shown me that living fully often comes from slowing down and being present.
Our very first resident, Janice, was a perfect example of this. Small in stature but immense in spirit, she was still full of life, even with her prognosis of being non-verbal, bedridden, small appetite, and blind.
However, after just a few days under our care, we realized that Janice wasn’t non-verbal after all. She had so much to share, along with a remarkable appetite—especially for sweet potatoes, which reminded her of the farm where she grew up. She regaled us with stories of family suppers and childhood games and hummed along to music ranging from Elvis to doo-wop to classical hymns. At The Lily House, the round-the-clock care we provide allows us to truly see and support residents in ways that go beyond the limits of traditional hospice or nursing homes. I cared for Janice in deeply personal ways: cooking her meals, feeding her, bathing her, changing her clothes and sheets, administering medication, reading aloud to her, and often simply being by her side—sharing in her presence and her stories.
My time at Lily House gives me hope for the future—one where we embrace our shared humanity and support each other through life’s most vulnerable moments.
In honor of the Lily House’s one-year anniversary, I’ve gathered 12 of the most profound insights from my time there.
Death is not an emergency. One of the privileges of hospice care is the chance to slow down. When someone is dying, there’s no rush—no need to call 911, no need to move on too quickly after death. Instead, we create moments of pause, rituals (like cleansing the body) that allow people to process, grieve, and honor. This slower pace is incredibly healing, a reminder that life’s sacred transitions deserve our full attention.
Something happens at the moment of death. In the moment of transition, there is a subtle energy shift—as though the soul has left the body yet still lingers near. I’ve seen something, almost like a soft breath, rise from the head, though I can’t fully explain what it is. But it has convinced me that death isn’t the end, and that our loved ones remain close by in ways we might not be aware of.
Our real regrets are about what we don’t do. The most profound regrets I hear aren’t about mistakes made but rather the things left undone—the conversations unspoken, the dreams not pursued, the time not spent with loved ones. I remember one woman who, in her last days, spoke often about a man she’d loved deeply in her youth. “I was too afraid of what my family might think,” she confided. “I never told him how I felt. He married someone else, and so did I. I loved my family, but I always wondered what life might’ve been like if I’d had the courage to follow my heart.” Listening to her, I felt the weight of a life not fully lived. It reminded me that real regrets often lie in the risks we didn’t take, the love we didn’t express. Her story has taught me to live boldly, speak my truth, and not wait for the “right” time to reach out.
Sacred moments unfold in stillness. Most people in our culture feel pressured to stay productive in every moment; to be constantly doing. The pace of life urges us to keep moving and keep ticking items off our never-ending to-do lists. But in hospice, life operates at a different pace. And I’ve learned that some of the most profound experiences unfold in the quiet, still spaces.
Feeling worn down one afternoon, I sank onto a couch to rest for a moment. In the quiet, I watched a lily in a vase tremble slightly, then release its last petal. Just like that, the flower’s life reached its final moment, and I was there to witness it. I realized that if I hadn’t paused, I would have missed this small yet breathtaking reminder of impermanence.
Moments like these reveal the beauty that is only available to us when we slow down and allow ourselves to simply be—witnessing life as it naturally unfolds. The richness of these still moments often holds more meaning than anything we could achieve by staying busy.
Ritual is a powerful form of connection. In our hectic, multitasking world, this is something most of us don’t take the time to do. But even small shared acts—lighting a candle, cooking a meal, gathering on a Sunday morning—can be deeply grounding and nourishing. Rituals don’t need to be elaborate; what gives them power is the intention behind them. At the Lily House, we’d light a candle in the hallway whenever someone was actively dying, a quiet signal for staff, volunteers, and family to pause in reverence. We’d also create a simple altar with items meaningful to the person—a favorite book, photos, small tokens of their life—to honor their unique presence.
Don’t avoid hard conversations: I often noticed non-hospice staff and family members tip-toe around the reality that our residents were dying, sidestepping the truth out of discomfort. But avoiding the obvious only heightens tension and makes things feel more strained. Facing death requires a kind of radical honesty that, surprisingly, brings levity, liberation, and even joy. When we openly talk about death, it invites connection, meaning, and a shared sense of relief—for everyone involved.
There is room for laughter, even in loss. Even in the face of death, humor is necessary. I’ve shared lighthearted moments with residents and their families, sparked by the surprising things people say when they know time is short (let’s just say, they tend to hold back less!). Once, while helping a resident fill out her funeral preferences, she told me she didn’t care what she’d be wearing when she was buried ('I’ll be dead anyway!') and we laughed until tears blurred my vision. Humor didn’t erase the gravity of the situation, but in that moment, it lifted us both, leaving the room a little lighter and a little more alive.
We are so much more than our accomplishments and goals. Some of the most meaningful journeys in life are the ones we don’t plan—and I see this over and over in hospice. The residents who come through our doors carry a lifetime of stories, yet in their final days, it’s rarely careers or achievements they mention. Instead, it’s the unexpected moments that matter: the warmth of a connection, a stranger’s kindness, a shared laugh. I’ll never forget one resident, John, who had been homeless before coming to Lily House. As we sat at lunch one day, he complimented my sweater. Without a second thought, I draped it over his shoulders. He had few clothes of his own, and though he was frail, the sweater—originally made for a man—fit him perfectly. He wore it every day until he died, just two weeks later, and the sweater found its way back to me. It was a small gesture, but one that formed a bond and left a memory far more profound than any planned achievement.
Loss is a great teacher. When my mom died, my world shifted in ways I couldn’t have prepared for (and still continues to do so). In those early years, I found myself struggling against reality, enraged that I couldn't bring her back. Working in hospice at Lily House deepened my ability to accept things outside my control, whether it's a loss, a breakup, or simply facing the unknown. Watching residents come to terms with their own mortality and anticipatory grief, I’ve seen how letting go of resistance opens a path to something else—gratitude.
Live with death as a companion, not a foe. A fear of death won’t stop you from dying, but it will keep you from truly living. When we acknowledge the reality of death rather than avoid it, we often discover a clarity and courage that transforms the way we engage with our time, our relationships, and our choices. Death isn’t a failure; it’s a reminder to live more fully, to savor the present, and to let go of what doesn’t truly matter. Because when we befriend death, we befriend life.
Death with Dignity is controversial but crucial. One of the most challenging truths I’ve faced is that, in Massachusetts, terminally-ill residents who are ready to die can’t access Medical Aid in Dying (MAID) when they need it most. I’ve sat beside those who were ready to go but didn’t have the option to leave peacefully on their own terms. All I could do was provide information about the few choices they did have. Now, living in Colorado, where MAID is legal, I’ve come to hear meaningful, firsthand stories about how empowering patients with choice and a measure of control brings peace and a sense of dignity. It’s a delicate and deeply emotional topic, one that deserves a broader, open conversation. I firmly believe that the right for those in hospice to choose a dignified end—on one’s own terms—is a decision we must continue to advocate for, not just as caregivers, but as fellow human beings.
Presence is the most powerful gift. When words fall short—as they often do in intense moments—our presence speaks the loudest. In life’s most vulnerable moments, just being with someone—even holding their hand or sitting close—can bring immense comfort. Through my experience as a death doula, I’ve learned that hearing is often the last sense to fade, and even if someone seems unresponsive, they can often still sense when someone is near. In these moments, a simple “I’m right here” or “you are safe” can make all the difference, easing anxiety and offering peace to both the person dying and those who remain.
Reflecting on my experience at the Lily House, I’m reminded that Hospice isn’t just a place, it’s a philosophy of care that teaches us to embrace life’s fragility and find beauty in each moment. We don’t have to wait until the end or on hospice to heed this wisdom. In a world that often rushes past life’s sacred transitions, may we all find the courage to slow down, be present, and love deeply right now. Because in the end, it’s not just about how much time we have—it’s about how we choose to spend the precious moments we have, each and every day.
– Maura
Moni and I both loved this piece! Thanks for sharing these gems.
I really loved this, Maura.