When I first began volunteering in hospice care, I wasn’t sure what I would find. My interest in grief and bereavement counseling and my hope to one day offer art therapy to terminally ill individuals led me to this path—but truthfully, I didn’t have a clear understanding of what hospice was or what it really offered. I wanted to immerse myself in that world to listen, to learn, and to gently confront my own beliefs and discomfort around death and dying.

What I discovered was a space filled with paradox—both sorrow and peace, loss and love, endings and deeply human connections. Hospice is not about giving up—it’s about offering dignity, comfort, and presence in a time when those things matter most. It’s about witnessing someone as they close the final chapter of their story, and ensuring they are not alone as they do.

Different Spaces, Different Stories

Volunteering with two hospice organizations in Las Vegas, I’ve had the opportunity to visit patients in a range of settings: private homes, group homes, and long-term care facilities. The differences between these environments have been striking and, at times, heartbreaking.

Patients who receive care in their own homes—often surrounded by spouses, children, or extended family—tend to be more at peace. There is a sense of familiarity, routine, and belonging. Even in the midst of pain or decline, the presence of loved ones seems to offer emotional nourishment that no medication could replace.

Group homes offer stability and 24/7 care, but there’s often a quiet loneliness there. The staff are kind, and the rooms are well-kept, but many residents don’t receive regular visitors. Still, there’s a sense of dignity in how they are treated—a recognition that their lives still hold value, even in decline.

But the facilities… these are the spaces where care too often falters. I’ve met patients with no family, no visitors, and long histories of being systemically neglected—homelessness, incarceration, addiction, and poverty. These patients often rely on state funding, and the facilities reflect that reality: understaffed, under-resourced, and sadly, at times, uncaring. It’s here that I’ve seen the deepest need for compassionate advocacy. Not just for better medical treatment, but for basic human recognition.

One woman I visit in a facility continues to smoke despite being on oxygen. It’s easy to judge—until you realize that this is one of the only choices she has left. She doesn’t want to be in that place. She longs for independence but is bound by her health and financial limitations. Her cigarette is not just a habit—it’s her rebellion, her autonomy, her last word in a world that too often ignores her voice.

Another patient I visit lives in a group home where the cost of care exceeds $6,000 a month. He has Alzheimer’s and spends most of his days in bed watching old movies. He rarely speaks, but when I sit beside him and join him in silence, there’s a comfort in our shared presence. Sometimes, advocacy is not about changing policies—it’s about showing up. It’s about bearing witness.

And then there’s the woman who lives at home with her husband. She has congestive heart failure and can’t stand on her own anymore. When I visit, we talk for hours. She’s forgetful and foggy sometimes, but she’s warm, generous, and full of spirit. Her husband, ever attentive, once brought me lunch so I could eat with them. They are a team. And through them, I’ve seen that caregiving is not only physical—it’s deeply emotional and spiritual.

Culture, Faith, and the Language of Dying

Every patient brings their own culture, faith, and philosophy into the space of dying. These personal narratives shape how they understand death, how they seek comfort, and how they want to be remembered.

One of my patients, raised in the American South, brings a distinctly Southern sensibility to her views on life and death—rooted in tradition, family values, and a kind of grit shaped by her upbringing. Another, a Latina woman, raised Roman Catholic but now part of a non-denominational Christian church, carries deep spiritual questions about what lies beyond death. She fears the unknown, but she also trusts that God will meet her there, and that her answers will come in time.

What I’ve learned is that these cultural and spiritual beliefs aren’t separate from care—they are care. They are essential parts of the conversation when someone is preparing to say goodbye.

The Importance of Culturally Humble Care

Culturally competent (and I would argue, culturally humble) care is not a luxury in hospice—it is a necessity. People die as they lived: shaped by their identities, their beliefs, their families, their traumas. We cannot offer true comfort at the end of life without honoring the full humanity of the person in front of us.

Cultural humility asks us to approach each patient with curiosity, respect, and a willingness to learn. It’s not about knowing everything—it’s about being present, being open, and being willing to say, “Tell me about what matters to you.”

I’ve also started thinking about how creative modalities—like art therapy, storytelling, and music—could be woven into end-of-life care. Not as “extra,” but as essential. As ways of helping patients express their inner worlds, connect with their memories, and leave behind something meaningful. These tools can be especially powerful for those whose voices have long been silenced by systems of oppression.

Death as a Site of Advocacy

Death is not just a medical event—it’s a deeply personal, social, and even political experience. Who gets to die at home with loved ones, and who dies alone in a neglected facility? Who gets peace, and who gets pain? Who is remembered with ceremony, and who is quietly forgotten?

These are systemic questions. And they deserve our attention.

As a future counselor and art therapist, I want to continue advocating for culturally responsive, emotionally attuned care at the end of life. I want to help build systems that value presence over productivity, empathy over efficiency, and story over stigma.

Because everyone—no matter their background, their mistakes, or their means—deserves to die with dignity.

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If you’re reading this and work in healthcare, mental health, counseling, or community care, I urge you to ask yourself: How do we show up for people at the end of life? Are we listening to their stories? Are we honoring their culture, their grief, their rituals? Are we doing enough?

It starts with small acts: sitting beside someone in silence, asking about their faith, respecting their choices, and remembering that every life—no matter how fractured—has value until the very end.

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