Nina de Cocq, EOLD, RMT

10/13/2026

Yep

As the week wraps up, let’s get a little bit of wisdom from newly minted Nobel Prize in Literature winner Anne Carson. I love this reminder that we are all mortal. That at the end of the day, we are truly all the same.

10/13/2026

💗

I work in pediatric palliative care, and I am often asked questions most people don’t know how to ask. Recently, a high school student reached out, wanting to understand why children die from cancer. He wasn’t asking from a place of shock or disbelief, he and his classmates wanted to help, through fundraising, awareness, advocacy, or maybe one day by becoming the kind of doctors who can change outcomes for children altogether. I agreed to meet in person with him and three of his classmates.

I told him the truth, which is that I don’t know why children die. No one does, not in a way that ever feels complete or satisfying. But I do know what we do when cure is no longer possible. I know how we care for children and families when the focus shifts from prolonging life to protecting its quality.

That answer didn’t end the conversation, it opened it.
They asked me questions many adults are too afraid to voice:
Is it different when a child dies compared to an adult?
Does it look different? Feel different?
Do children know they are dying?
Do they think about death the same way adults do?

From my experience, the answer to that last question is no.
Adults come to the end of life carrying a lifetime of memories, regrets, responsibilities, and an awareness of what they will miss and who they will leave behind. There is often a reckoning with a long story that suddenly feels unfinished.

The children we care for do not come to us carrying that same weight.
They don’t arrive burdened by decades of memories or regret for a future they never had the chance to imagine. Many of them cannot speak, so I cannot claim certainty, but from where I stand, they are profoundly rooted in this moment. In comfort. In presence. In what is happening right now.

Their world may be smaller, but it is also deeply honest.

What struck me just as much as the wisdom of the children in our care was the openness of these high school students. They were not guarded. They hadn’t yet been taught to look away from death or to soften their curiosity out of fear of discomfort. They asked boldly, and authentically, without armor.

One of them asked me if I think about dying.
I told him I do, every single day.
He asked if I was afraid to die. I said no, that I just don’t want it to happen anytime soon.
So I asked him the same question.
He thought for a moment and said, “No. Because when it’s time, it’ll happen.”
I asked if believing that changed how he planned to live his life.
He said no, that he isn’t going to waste time overthinking what he should or shouldn’t do, he’s just going to do what feels right in the moment that he is given.

Standing there, shaped by years of walking alongside those who are dying, I thought: This is what we forget as we age. Somewhere along the way, we learn to fear these conversations. We are taught that death is something to whisper about or avoid altogether. We build armor around grief, around love, around truth. And around death.

But children, and sometimes teenagers standing right at the edge of adulthood, remind us of something essential: talking about death does not steal life from us, it clarifies what matters, it sharpens our attention, and it teaches us how to love more honestly and grieve more openly.

Working in palliative care and hospice has taught me again and again, that meaning is not found in the length of a life, but in the depth of presence within it. That love does not require a lifetime to be real, and that being here, fully and courageously, matters.

Maybe the question isn’t why children die, maybe the deeper invitation is to notice how much they, and those brave enough to learn from them, can teach us about how to live.

xo
Gabby

You can find this and all of my other blogs on my website.

10/10/2026

This

Over the years, I have been asked by families to “please don’t tell them they are dying.” I have sat at bedsides where family members pleaded with me not to say the word “hospice” or acknowledge death out loud. I always hold that request with respect. I know that the reasons are deeply personal, woven from culture, tradition, history, and love. I would never dismiss those choices. Still, what I have witnessed time and again is that the person who is dying almost always already knows. Their bodies tell them. Their hearts know. Their awareness deepens, even if no one around them dares to name it.

What stays with me are the moments lost when the truth is withheld. I have seen people leave without the chance to say goodbye, without being given the opening to speak words they have held close for years, words of forgiveness, apology, or gratitude. I believe those conversations, as painful as they might feel, are among the most sacred parts of dying. When we avoid them, we sometimes protect ourselves more than we protect the person we love.

This is not simple, and I don’t pretend there is only one way. There are situations where speaking directly isn’t possible or appropriate. But from what I have witnessed, I believe that naming what is real gives people the chance to meet the end of life on their own terms, with dignity, honesty, and peace. And to me, that is one of the greatest gifts we can offer.

In the end, this will always be your choice as a family. But if it were up to me, I would encourage honesty. Not harsh or unkind, but gentle and loving, meeting your person right where they are. In doing so, you not only support them in one of the most tender chapters of their life, but you also allow them the chance to feel truly seen, heard, and held as well as giving them the opportunity to say goodbye, which would be taken from them if the honest conversations were not had.

xo
Gabby

You can find this and all of my other blogs on my website.

10/10/2026

Beautiful

There are moments in life that will forever change the way you enter another person's space. I want to share one of mine with you.

Several months ago, I had the privilege of being asked to start supporting a woman as she prepared for the end of her life. During one of our conversations, I shared that I had begun studying sound healing. She asked if I would bring my singing bowls the next time I visited.

What began as practice soon became something neither of us expected. As the sounds filled her room, something within her began to soften. It was as though layers were slowly being loosened, giving her permission to release what had been held tightly inside. Conversations became deeper. Emotions surfaced with surprising ease. Stories that had never been spoken found their way into the space between us.

Neither of us anticipated that.
I don't know whether it was the sound itself, the vibrations moving gently through her body, or simply what became possible when she felt completely safe. Perhaps it was all of those things together.

As her illness progressed, she made the deeply personal decision to choose Medical Aid in Dying (MAID). Together, we prepared for the day she had chosen. Along with that decision came one final request. She asked me to do my sound healing from the moment she took the medications until after her last breath.

That morning, I brought my singing bowls, a few chimes, and my wave drum. I chose each one with intention, wanting every sound, and every pause between the sounds, to gently accompany her through those final moments.

She said goodbye to each of us, one a time with love and gratitude, she swallowed the medications, and I began playing the sounds she had requested.

As I played, I watched her soften into the experience.
I watched her family and friends soften too.

Some closed their eyes.
Some held one another's hands.
Some simply breathed.

It was as though the sounds met each of us differently, offering every person in the room exactly what they needed without asking any of us to experience the moment in the same way.

When she took her last breath, I didn't stop playing. The notes became quieter... farther apart... allowing the room to settle gently into the silence instead of being suddenly overtaken by it.

When the moment felt complete, I offered one final tone.
Clear.
Gentle.
Lingering just long enough to be felt before it slowly disappeared into stillness.

No one moved. No one reached for words.
We simply remained together, each of us holding the moment in our own way and yet somehow sharing the very same silence.

After a few minutes I quietly stepped out of the room, leaving her family to be together in those first tender moments that now belonged only to them.

I stood at a window overlooking her garden and allowed myself to take in all that had just unfolded. It was there that I realized the most meaningful part of that day had never been the music, it was witnessing what becomes possible when each person brings the very best of themselves to another human being.

Some offered their voices.
Some offered their tears.
Some offered quiet acceptance.
I offered sound.

Different gifts. One shared act of love.

Some moments become part of who we are, I know this will always be one of them for me.

Perhaps none of us are here to offer the same thing. Perhaps our greatest offering is discovering what is uniquely ours to give... and placing it, with tenderness and intention, into the life of another.

Sometimes that offering is a conversation.
Sometimes it is a hand to hold.
Sometimes it is silence.
Sometimes it is music.

Whatever it is... may we offer it generously, because when we do, we create something far greater than any one of us could create alone.

And long after the last breath has been taken, what still remains? The music remains, the silence remains, the courage remains, the love remains, the room remains, the garden remains, and the memories remain.

xo
Gabby

You can find this and all of my blogs on my website.

10/05/2026

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 a patient begins taking in less, refusing food or water, or showing signs that their body can no longer tolerate it, 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 begins to change in ways that are natural and expected. Appetite and thirst often 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 intake, less work. It begins turning inward, conserving what little is left for the final work of letting go.

This is not something we are doing to the person. It is something the body is showing us.

When we continue to push food or fluids during this time, no matter how well-intentioned, we can create discomfort. The body may no longer be able to process what we are offering. Liquids can pool in the hands, feet, and limbs. Food can sit in the mouth or throat when there is no longer enough strength to chew or swallow safely. A person may cough, choke, drool, hold food in their cheeks, or spit it out. 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.

We do not think of it as “stopping” food and water, we think of it as gently aligning our care with what the body is already telling us.

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 food or fluid is no longer being pushed. They are dying because the illness has reached its end.

And when we follow the body’s lead at this stage, we are not causing death. We are helping create the conditions for death to be more peaceful, gentler, and filled with far more grace.

The body often lets go with more peace when food and water are no longer forced at the end of life. The body responds to this. It is safer. It is gentler. And when we honor the body in this way, we can reduce or avoid physical suffering that can happen when we push food and fluids the body can no longer use.

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, drooling, or turning away are signs the body is not tolerating intake safely.

• 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.

Allowing food and water to naturally decrease at the end of life is one of the hardest things we ask families and care teams to understand. 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 is guiding us.

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 no longer force what it can no longer safely 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 and all of my other blogs on my website.

10/03/2026

💗

I think about death a lot.

After all these years working in end-of-life care, you might assume I would have become completely comfortable with the idea of dying. And in many ways, I have. I am not afraid to die; I just don't want to die yet.

There was a time when I was afraid of death. I was afraid there would be pain. I was afraid it would be frightening or tragic. I even carried a deep fear of drowning for most of my life. I couldn't be in water if I couldn't touch the bottom.

But then I began witnessing people take their last breaths. And over and over again, I saw something I had never understood before. Peace.

I have witnessed so many last breaths that I no longer believe that the final moment has to be something to fear. And I have learned enough about pain management to know that even when there is discomfort, we have so many ways to ease it. That has given me tremendous comfort.

But something happened recently that made me realize something else. I was caring for a gentleman who had just turned 97. One evening, his caregiver called and asked me to come over because he was asking for me. He looked different. He told me he didn't think he would make it through the night.

I thought I was there to say goodbye. I started to cry because suddenly the only thing I wanted him to know was that I loved him. So, I told him.

I asked him how he felt about dying, and he said something that stayed with me…
He didn't want to die yet.
He wasn't afraid.
He wasn't in pain.
He simply wanted more time.

He woke up the next morning feeling better. And I understood something about myself that I think I had already known but hadn't quite said out loud: I want more time, too.

Not because I have unfinished business. Not because I am carrying around regrets or a long list of things I need to accomplish before I can die. I have spent years letting things go. I feel grateful for the life I have lived. If this were all there was, I think I could make peace with that. But there is still so much I want to experience.

I want to watch my grandchildren grow up.
I want to see my daughter get married and have a baby.
I want to fall in love.
I want more ordinary mornings.
More conversations.
More laughter.
More time.

I am not going to make myself a list of everything I must accomplish before I die. I am going to do something much simpler; I am going to take better care of the body that is carrying me through this life.

I always say, “the body knows how to die,” it knows when to let go, and it knows what to do.

But I am realizing something else: The body also knows how to live.
It tells us when it needs rest.
It tells us when it needs movement.
It tells us when it needs nourishment.
It tells us when something isn't right.

For a very long time, I didn't listen, but I am listening now. I am exercising, I am eating better, I am drinking more water, I am sleeping better, and I am paying attention. Not because I am trying to outrun death, but because I want to be here.

I don't know how much time I have left. None of us do. And maybe that's the point. We spend so much of our lives trying to get somewhere. When we are young, we can't wait to be older. We can't wait for the next birthday, the next freedom, the next thing we are finally allowed to do.

And then we grow up, and somehow, we keep doing it.
The next goal.
The next accomplishment.
The next place we want to go.
The next thing we think we need to become.
Always reaching for something just a little farther ahead.

And now, at this place in my life, I find myself wanting something entirely different.

I want to stand still.

I want to stop rushing toward what is next and soak in what is already here.
The people I love.
The sound of their voices.
The ordinary mornings.
The laughter.
The conversations.
The quiet.
The privilege of opening my eyes to another day.

Maybe that's one of the things getting older is teaching me. Life was never asking me to get somewhere. It was asking me to be here.

So yes, I want more time. But I don't want more time so I can fill it, I want more time so I can feel it.

I am not afraid to die. I just finally understand how much I want to live. And for however long I get to do that, I think I will stand still a little longer, and soak it all in.

xo
Gabby

You can find this blog on my website

09/30/2026

We need to remember this.

There are moments in life that don’t look important while they are happening.
They only become heavy later.

Almost thirty years ago, my dad came to my house for Thanksgiving. We did not have an easy or healthy relationship, so when he asked to come, I was surprised. He lived about an hour away, so I picked him up and brought him home to be with me, my kids, and my friends. It was… unexpectedly nice.

At dinner, when we went around the table saying what we were thankful for, he said he was thankful for me. He said he was proud of me, that I was a good mother, and that I worked hard. He also said that I was kind, which mattered to me. He had never said those words to me in my entire childhood. I held them like something fragile.

When I brought him back home, he asked if I could stay a little longer. Maybe have lunch. Maybe just sit. But I had things to do, life felt busy and loud and urgent. I said no.

I could tell he was disappointed, I felt it the entire drive home.

That night, I called him and left a message on his answering machine. I told him I was sorry, and that I would make it up to him. I offered to come the following weekend and we could spend the day together. The next morning, I left another message. That evening, another. This was before cell phones. He never picked up.

The following day, my aunt called. He was in the hospital with pneumonia.
My dad had lived for years with Guillain-Barré syndrome, something not well understood at the time. His body was weakened by it, though I didn’t know he was sick when he stayed with me. I went to the hospital. He died that night. I watched him die. I didn’t sit next to his bed, I didn’t hold his hand, I didn’t say goodbye, I didn't say anything at all.

A few days later, we gathered to clean out his apartment. I noticed the answering machine light blinking, there were three messages. I pushed "play," they were all from me. He had never heard my voice telling him I was sorry, telling him that I would come back.

I went home and sat in my sadness for hours. Guilt settled into my body. Regret. And the ache of knowing that whatever might have been between us was now impossible.

So I did something instinctive. I sat at my coffee table and lit a small tea light candle. I spoke to it. I told it everything. I apologized for not staying. I apologized for anything I might have done as a child that made him treat me the way he did. I forgave him for what he could never give me. I accepted the apologies he never spoke. I said everything I needed to say.

When I blew out the candle, the smoke rose slowly toward the ceiling, and I remember thinking, "message received." And whether that was true in any literal way didn’t matter, what mattered was this: my body felt lighter, I felt peace, and I gave myself permission, real permission, to let it go.

I still feel sadness when I think about that day, but I no longer carry the weight of punishment. That candle taught me something I didn’t yet have language for. Years later, working in end-of-life care, I would come to understand ritual and ceremony as medicine for the living.

So I want to offer this to you...
If you are carrying guilt. If you missed a moment. If there are words that never got spoken. If someone died before you were ready...

Light a candle, say it all, out loud or in a whisper. Apologize. Forgive. Rage. Grieve. Love. Let yourself say the things that have nowhere else to go.

When you are finished, blow out the candle, and watch the smoke rise. Let that be the moment you know in your heart that your message has been received.

We are human. We do the best we can with what we know at the time. And sometimes, healing doesn’t come from fixing the past, but from honoring it and letting it rest.

You are allowed to let it go. Give yourself permission to let it go.

xo
Gabby

09/19/2026

Yes

I was asked recently, “What is the difference between a natural death and a death with Medical Aid in Dying?”

Having been present for 350 people who have chosen this option, and more than two thousand last breaths altogether, I have witnessed many ways of dying. What I have come to understand is that the difference is not always in the death itself, but in how the person who is dying meets it.

A natural death, for lack of a better word, is what most of us are familiar with. A diagnosis is given, or age takes its toll, and the body begins to decline. There are symptoms. There is caregiving. There is the long stretch of watching and waiting. And when the last breath comes, it is a loss, and it is heavy.

A death with Medical Aid in Dying unfolds along that similar path. The diagnosis has already been spoken. The body is already changing. Treatments have been tried. This person is dying, and the reality of limited time has already settled into the room. The difference is not whether or not someone is dying, they are dying. The difference is that with Medical Aid in Dying, they are given a choice within that reality.

I advocate for this option because I have witnessed the waiting. I have sat beside people whose bodies were not going to recover, whose strength was fading, whose suffering, physical, emotional, or quiet and internal, continued long after acceptance had arrived.

We always want more time, of course we do. Loving someone means wanting one more conversation, one more hug, one more memory to make, and one more day. But when someone you love is already dying and suffering in ways you cannot fix, love can also mean not holding them back from peace.

Medical Aid in Dying does not change the outcome. It does not create death, death is already happening. It offers autonomy at a time when so much has already been taken from this person. It allows someone to say, “I am ready now,” and to be met with respect rather than resistance.

Death is hard. Watching someone you love die is hard. But watching someone suffer while they wait can be harder still. No one should have to suffer when they are dying. We treat our animals more humanely than our humans, and I struggle with this.

If this choice matters to the person in the bed, it should matter to us. My hope is always that they are offered dignity, autonomy, and the freedom to make their final decision without it being overshadowed by our own fear or judgment.

It is still goodbye. It is still death. It is still love. And it is still hard. But sometimes, it can also be mercy.

xo
Gabby
The Hospice Heart

09/12/2026