08/05/2026
Today, I said goodbye to a client I had the privilege of serving for the past three years.
After a long battle with Parkinson's disease, she passed away peacefully in her sleep, surrounded by the comfort of compassionate caregivers and hospice. While losing a client is never easy, there is comfort in knowing she was finally at peace.
This past week reinforced some important lessons that I hope may help other families navigating the end-of-life journey.
First: Don't wait to think about hospice.
One day, my client was doing relatively well, despite showing signs of a gradual decline over the past several months. The next morning, she was unresponsive. There wasn't a long period of obvious, significant decline where we simply delayed making decisions. Her condition changed dramatically overnight.
On Friday, I found myself fighting tooth and nail to get her the care she desperately needed before the weekend. One of the biggest hurdles was that hospice required a referral from her primary care provider. When time is critical, even a short delay can mean unnecessary discomfort and added stress for everyone involved.
Although my client appeared to be resting peacefully and comfortably in her bed, she was no longer able to tell us whether she was experiencing pain or discomfort. In the final stages of life, a person's ability to communicate—or even outwardly show signs of pain—can be significantly diminished. That is why hospice care is so important. Their expertise in recognizing subtle signs of discomfort and adjusting medications accordingly helps ensure that patients remain as comfortable and peaceful as possible, even when they can no longer speak for themselves.
Thanks to the incredible advocacy and persistence of local care manager Susan Quinn, we were able to secure a same-day hospice admission. It truly felt like a miracle.
My biggest takeaway is this: having a responsive, compassionate primary care provider and a network of advocates can make all the difference. If someone has a progressive illness like Parkinson's disease, don't wait until a crisis occurs to begin the hospice conversation. Getting hospice involved as soon as your loved one qualifies can make the transition much smoother and ensure they receive the comfort and support they deserve when they need it most. We are so lucky to have multiple hospice agencies with such compassionate care in our area that go above and beyond for our elderly community.
Unfortunately, my client never met the medical eligibility criteria for hospice while she was still alert and interactive, although we did meet with a palliative care team just two weeks before her rapid decline. Looking back, that conversation proved invaluable and helped prepare us for what was to come.
Once hospice became involved and her medications were adjusted, we knew that she was comfortable, and she passed peacefully in her sleep just a few days later.
Second: If organ or tissue donation is important to you, plan early—and don't assume the logistics are already in place.
My client wanted to donate her brain for Parkinson's research. We believed we had planned ahead. Her application to the brain bank had been submitted months in advance, and at no point was it brought to our attention that there could be significant logistical hurdles to making that donation happen.
The day she was admitted to hospice, I contacted the brain bank to make sure everything was in order. It took several days to receive a response. By then, her condition had deteriorated rapidly, and there simply wasn't enough time to coordinate the specialized arrangements that were required.
We learned that she would have needed to be transported to a mortuary in the Bay Area to be closer to one of their contracted doctors. Unfortunately, by the time transportation could be arranged, the mortuary could complete its coordination, and the brain bank could assemble the necessary physician and recovery team, too much time would have passed. The brain tissue would no longer have been viable for research, making it impossible to honor her wish to contribute to Parkinson's disease research.
Fortunately, my client had gone back and forth on this decision over the past several months. After discussing it with her family, we all agreed that she would have been at peace knowing we did everything we reasonably could to honor her wishes. Had this been someone who felt more strongly about making the donation, the outcome would have been devastating.
My biggest takeaway from this experience is that, whether you are a family member or a professional, you must think several steps ahead. Be overly cautious. Ask questions. Verify the details. Consider everything that could go wrong—even if you hope it never will. The best plans aren't just made; they're tested against the unexpected. While not every obstacle can be prevented, thoughtful planning and asking difficult questions ahead of time can make all the difference in ensuring a loved one's final wishes are honored.
If you or a loved one hope to make a specialized tissue or organ donation—particularly for neurological research—start those conversations early, but don't stop there. Find out exactly who needs to be called, where the donation will take place, what transportation arrangements are required, what timeframes must be met, and make sure your family, fiduciary, healthcare agent, hospice team, and funeral home all understand the plan well before it is ever needed. Even with planning, unexpected obstacles can arise. Understanding the logistics ahead of time can make all the difference.
As a professional fiduciary, I learn something from every client I serve. This experience reminded me that planning isn't just about trust, powers of attorney, and finances. It's about ensuring that a person's wishes can be fully fulfilled when the time comes.
Today, I'm grateful that my client was comfortable, at peace, and no longer suffering. I hope that by sharing her story, another family—or another professional—may be spared some of the challenges we faced during her final days.
Rest peacefully, my dear. You will be deeply missed.
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