November 2, 2018, started like any other morning in my work as a hospice registered nurse. I walked into my patient’s room, and their face lit up with that familiar, beautiful smile. We talked about the upcoming days, and I shared something honest—that when they passed, I would feel both happy and sad. Happy because they would be free from suffering, but sad because I would miss them deeply.
This patient had a gift for brightening every room they entered. Their cheerful personality touched everyone who knew them. On this particular morning, they showed me their latest painting—Three Wishes. The image showed red-seeded dandelions, the kind we all picked as children and blew into the wind, watching the seeds dance away into different directions. My patient asked me not to cry when they passed, but to be happy for them. I told them the truth: I couldn’t promise not to cry, because I would genuinely miss them.
That painting became more than art. It became a powerful reminder of life’s fleeting nature and the lessons we can learn from those walking their final journey. Being a hospice nurse is a blessing—I’m invited to witness someone’s last chapter, to walk alongside them and their families during the most sacred time of life. How else would I have met this remarkable person unless God brought us together so I could help them find comfort, provide education to their family, and bear witness to their courage?
The Gift of Presence in Hospice Care
Being invited into someone’s final days is an extraordinary privilege. Most people keep their dying moments private, shared only with those closest to them. As a hospice nurse, I’m welcomed into that intimate space, trusted to provide comfort and support during life’s most vulnerable time.
Every day, hospice nurses witness both profound joy and deep sorrow. We see families come together, old wounds healed, and love expressed in ways people never managed before. We also see fear, pain, and the weight of approaching loss. My patient with the cheerful personality taught me that dying doesn’t have to be all sadness—there can be smiles, laughter, and even art created right up until the end.
Their request for happiness rather than tears reminded me that death, while difficult for those left behind, can represent peace and freedom for the person who’s suffered. This perspective shift—seeing death through the dying person’s eyes rather than only through our own grief—is one of hospice care’s greatest lessons.
A Powerful Reminder: We All Will Die
Here’s an uncomfortable truth we often avoid: every single person reading this will die. Not someday in the distant future we can ignore, but potentially today, tomorrow, or next week. Death isn’t something that only happens to other people or only when we’re elderly and “ready”.
My patient reminded me that we can die “in the twinkling of an eye”—suddenly, without warning, before we’ve said what needs saying or done what matters most. Heart attacks, strokes, accidents, and sudden illnesses claim lives every day, regardless of age, health status, or plans for tomorrow. Young parents die. Healthy adults die—people with everything to live for die.
This reality should change how we live today, not tomorrow. When we truly understand that our time is limited and uncertain, we start asking different questions: How am I spending my days? Who do I love, and do they know it? What am I doing with the precious time I have left? These aren’t morbid questions—they’re the most important ones we can ask ourselves.
Living a Life of Least Regrets
Living with fewer regrets means aligning your daily actions with what truly matters to you. It means not waiting for “someday” to tell people you love them, to pursue meaningful experiences, or to heal broken relationships. Research on end-of-life regrets shows us exactly what matters most when time runs out.
People facing death consistently express these common regrets:
I wish I had spent more time with the people I love.
I worked too much and missed out on life experiences.
I let fear dictate my choices and didn’t take risks.
I wish I’d had the courage to express my feelings honestly.
I focused too much on the future and lost sight of the present.
Notice what’s not on this list: regrets about not working more, not buying more things, or not achieving a higher status. When facing death, people want connection, authenticity, and meaningful relationships—nothing else truly matters.
Actionable ways to reduce future regrets include:
Schedule regular time with loved ones and protect that time as you would an important work meeting.
Express your feelings now—tell people you love them, apologize for past hurts, and say thank you while you can.
Choose experiences over possessions when deciding how to spend time and money.
Take calculated risks to pursue what gives your life meaning, rather than playing it safe.
Practice presence—put down your phone, turn off distractions, and truly engage with people in front of you.
My patient’s Three Wishes painting beautifully represents this wisdom. Like dandelion seeds, our wishes and moments scatter quickly on life’s wind. We can’t hold onto them forever, but we can make them count while we have them.
Why Advance Directives Matter More Than You Think
An advance directive is a legal document that explains what medical treatments you want (or don’t want) if you become too sick to speak for yourself. It typically includes a living will (your treatment preferences) and a healthcare power of attorney (the person who makes decisions for you if you can’t).
Most people think advance directives are only for the elderly or seriously ill. This is dangerously wrong. Because death can happen suddenly at any age, every adult needs advance directives in place—ideally by age 18. Car accidents, sudden illnesses, and unexpected medical emergencies does not discriminate based on age or health status before striking.
Advance directives provide peace of mind to families facing the worst moments of their lives. When your loved ones know exactly what you want, they don’t have to guess or argue about your care while grieving and terrified. They can focus on being present with you rather than making agonizing decisions they’re unprepared to make.
The consequences of not having advance directives include:
Family members making decisions you wouldn’t have wanted.
Conflicts between family members about your care can create lasting damage to relationships.
Receiving aggressive medical treatments you wouldn’t have chosen.
Financial burden from unwanted interventions.
Lost opportunities for meaningful final experiences and conversations.
Family members carry guilt and uncertainty for years afterward.
Despite the critical importance of advance directives, completion rates remain surprisingly low. Recent data show that only about 30-40% of U.S. adults have completed advance directives, though rates vary significantly by country—Germany reports completion rates of 64.7%, while Sweden and France report rates as low as 5%. This means millions of people are leaving their families unprepared for medical crises that could happen at any moment.
How Life Transition Coaches Can Help
A life transition coach is a professional who helps people navigate significant health and life changes with practical support, education, and coordination. Unlike end-of-life doulas, who primarily focus on non-medical emotional and spiritual support during active dying, life transition coaches offer broader services throughout illness journeys and significant life changes.
Life transition coaches provide several essential services:
Illness navigation: They act as project managers for your healthcare journey, coordinating care between different doctors and specialists, attending appointments with you, and ensuring all aspects of your treatment plan work together smoothly. This coordination prevents essential details from falling through the cracks in our complex healthcare system.
Medication review: Life transition coaches with nursing backgrounds can review your medications for safety concerns, potential interactions, and appropriateness. They help you understand what each medication does and ensure your medication regimen aligns with your goals.
Education and guidance: They explain medical information in understandable language, help you ask the right questions at appointments, and ensure you understand your options for care. This education empowers you to make informed decisions aligned with your values.
Grief recovery support: Life transition coaches help individuals and families process grief related to illness, loss of independence, and approaching death. They provide emotional support throughout transitions and help families cope with anticipatory grief before loss occurs.
One of the most valuable roles life transition coaches play is facilitating early adoption of palliative care and hospice care when appropriate. Many people wait too long to access these beneficial services because they don’t understand them or fear they mean “giving up.” Life transition coaches educate families about how palliative and hospice care improve quality of life and help determine the right timing for these services.
Cost-effectiveness makes life transition coaches accessible to many families. While attorneys typically charge $300-$1,000 or more to create advance directives, life transition coaches often assist with advance directive completion at significantly lower costs as part of comprehensive support services. They can guide you through free online tools, help you think through your values and preferences, and ensure your documents accurately reflect your wishes. For families needing ongoing support beyond just document creation, life transition coaches provide exceptional value.
Taking Action Today
Don’t wait until a crisis strikes to prepare. Start or update your advance directives today—not next week, not after your next birthday, but today. Remember my patient’s Three Wishes painting and the truth it represents: like dandelion seeds, our time scatters quickly. We don’t know how many moments we have left.
You have three practical pathways to complete your advance directives:
Work with a life transition coach who can guide you through the process, help you think through your values and preferences, and ensure your documents accurately reflect your wishes. Life transition coaches provide personalized support at accessible costs and can assist with advance directives as part of comprehensive illness navigation and health transition support.
Attend free legal clinics offered by hospitals, senior centers, community organizations, and legal aid societies. Many communities provide regular advance directive workshops where attorneys volunteer their time to help people complete these essential documents at no cost.
Hire an attorney specializing in elder law or estate planning if you have complex family situations, significant assets, or exceptional circumstances requiring detailed legal guidance.
Beyond advance directives, consider connecting with a life transition coach for comprehensive support through health transitions. Whether you’re facing a new diagnosis, managing chronic illness, caring for a seriously ill loved one, or preparing for end-of-life, these professionals provide continuity and coordination throughout your journey. They ensure nothing falls through the cracks and advocate for your wishes to be honored.
Take the first step today. Research life transition coaches in your area, call your local hospital about free advance directive clinics, or contact an elder law attorney. Choose whichever pathway feels right for you, but choose one now. Your future self and your family will thank you for this gift of preparation.
Conclusion
My patient’s Three Wishes painting still reminds me daily of life’s precious, fleeting nature. Those dandelion seeds dancing on the wind represent our moments, our relationships, and our opportunities to live meaningfully. Once they’re gone, scattered to places we can’t retrieve them from, we can’t call them back.
Like dandelion seeds, our time is fleeting—here one moment and gone the next. We don’t get to know in advance when our final moment will come. This uncertainty isn’t meant to frighten us but to awaken us to what truly matters right now.
I encourage you to reflect on three essential questions: How are you living? Are your daily actions aligned with what matters most to you, or are you postponing meaningful experiences and relationships until “someday”? Who do you love? More importantly, do they know it? Have you told them, specifically and honestly, recently? What are you doing with your remaining time? Are you building a life of purpose and connection, or drifting through days you can’t get back?.
I’m deeply grateful for the lessons my hospice patients continue to teach me. They show me what matters at life’s end: love expressed, relationships cherished, courage shown, and peace found. My patient, with their cheerful personality and their Three Wishes painting, gave me a gift that morning—the reminder to live fully, love openly, and prepare wisely.
Take their lesson to heart. Complete your advance directives. Tell the people you love exactly how you feel. Choose presence over distraction. Live in ways that honor the fleeting, precious nature of the time you’ve been given. Don’t wait for “someday,” that may never come.
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At present, no official organization oversees end-of-life doulas (EOLDs). Remember that some EOLDs listed in directories may no longer be practicing, so it’s important to verify their current status.
End-of-Life Doula Schools
The following are end-of-life (aka death doula) schools for those interested in becoming an end-of-life doula:
Remember that there is currently no official accrediting body for end-of-life doula programs. It’s advisable to conduct discovery sessions with any doula school you’re considering—whether or not it’s listed here—to verify that it meets your needs. Also, ask questions and contact references, such as former students, to assess whether the school offered a solid foundation for launching your own death doula practice.
