WVMC Palliative and Hospice Care Program

WVMC Palliative and Hospice Care Program Contact information, map and directions, contact form, opening hours, services, ratings, photos, videos and announcements from WVMC Palliative and Hospice Care Program, Western Visayas Medical Center, Q. Abeto Street, Mandurriao.

This page was created by the WVMC Family Physicians for the enrolled Hospice Patients of WVMC-DFCM Palliative and Hospice Care Program for the purpose of providing clinical information and to connect with their patients during the new normal.

22/06/2026

Life gets busy for all of us.

Days become weeks.
Weeks become months.

And suddenly, it’s been a while.

A while since you’ve called.
A while since you’ve texted.
A while since you’ve checked in on someone who matters to you.

Maybe you’re thinking of that person right now.

If so, let this be your reminder.

Send the message.
Make the call.
Say hello.

Tomorrow has a way of becoming a month ago.

And we often underestimate the power of a few moments freely given.

Imagine the difference you might make in their day… which could quite possibly make a difference in yours as well.

xo
Gabby
www.thehospiceheart.net

21/06/2026

Many of us try to push grief aside because it feels too big to face. But grief often becomes more manageable when we acknowledge it in small, intentional ways rather than carrying it alone. [image via Grieve Leave]

20/06/2026

Grief never knocks the same way twice.
Sometimes it stands at the door like a stranger, uncertain, almost polite, and I open it anyway.

Other times it slips in without warning, like someone who has been here so many times it no longer needs permission.

And then there are the days I see it coming, and I press my back up against the door, holding my breath, wishing it would pass me by.

Grief has its own ways of entering a room;
It can be heavy and loud, or soft and familiar, curling up in the corners like it belongs there. It can feel like an unwelcome shadow or like the last link to a love I can’t bear to let go of.

Some days, I welcome it with open arms, other days, I look away pretending I don’t see it.

And still, whether I whisper “go away” or “come in,” we both know I will open the door. Because in its presence, I hear the quiet echo of a last goodbye… and so I softly whisper, “come in, you were going to anyway.”

xo
Gabby
www.thehospiceheart.net

“Death is not a secret”
18/06/2026

“Death is not a secret”

When I was a little girl, I remember watching everyone get dressed up and gather at our house. I asked where they were going. “To your grandmother’s funeral,” someone answered.
I didn’t even know she had died.

At the time, I remember feeling sad, but not fully understanding why. Children often accept what they are told because they trust the adults around them.

It wasn’t until years later that I began asking myself…
Why didn’t anyone tell me she was sick?
Why didn’t I get to say goodbye?
Why wasn’t I given the choice to attend her funeral?

The older I got, the more I realized those questions were never really about the funeral itself. They were about being left out of something important. They were about losing the opportunity to tell someone I loved them one last time.

As a hospice nurse, I encounter a different version of this same story over and over again.
Families often pull me aside and whisper, “Please don’t tell her you are from hospice.”
Or, “Don’t let him know he is dying.”

I understand where this comes from. It is rooted in love, fear, and a desperate desire to protect someone we care about. But after nearly fifteen years of sitting beside people at the end of life, I have learned something important:
Most people already know.
They may not say it out loud.
They may not use the word dying.
But they know their body is changing.
They know when they no longer have the strength they once had.
They know when treatments are no longer helping.
They know when something profound is happening within them.

Think about your own life. You know when your body is trying to tell you something. You know when something feels different. You know when you need help. Why would dying be any different?

When we avoid honest conversations about death, we don’t eliminate the reality of what is happening, we eliminate the opportunity to talk about it. And in doing so, we often lose the chance to say the things that matter most…
Thank you.
I love you.
I’m sorry.
I forgive you.
Goodbye.

These conversations are not easy, but they are sacred.

I am not suggesting that every child should be told every detail or included in every circumstance. Children need information delivered in age-appropriate ways, and every child is different. But I do believe that most children deserve honesty. Most children deserve the opportunity to know that someone they love is seriously ill.

More importantly, they deserve to be given the chance to say goodbye.

I think about my own granddaughters. They are seven and eleven now, but even when they were younger, I know they would have wanted the chance to say goodbye to me if I were dying. Maybe they would have chosen to visit. Maybe they would have chosen to write a note, draw a picture, or simply tell me they love me.

They would have had the opportunity, because they were given a choice. I would have liked to have had that choice.

When we withhold that opportunity, we sometimes leave people carrying questions for decades. Questions like the ones I still carry.

When we make death a secret, we unintentionally teach the next generation that death is something we don’t talk about. And then they grow up and repeat the same pattern with their own children because it is all they have ever known.

Death is not a secret.
It is part of living, and of loving.
It is part of being human.
And when we are honest with one another, something remarkable happens. We come closer together. We share the heartbreak. We carry the sorrow collectively instead of alone. We create space for final conversations, final hugs, final hand squeezes, and final expressions of love.

Years later, when we look back, those moments do not erase the grief, but they often soften the regret.

There is peace in knowing you had the chance to look into someone’s eyes one last time.

There is comfort in knowing they heard your voice.

There is gratitude in knowing they left this world understanding the place they held in your heart.

Sometimes the greatest gift we can give one another at the end of life is not protection from the truth, but the opportunity that truth provides, which is to be given a choice to be present if we wish, and to say the things that might otherwise be left unsaid.

xo
Gabby

You can find this blog here:
https://www.thehospiceheart.net/post/death-is-not-a-secret

16/06/2026

12/06/2026

Yesterday

Yesterday is a place we return to when today feels unbearable.

It is where things still make sense. Where voices still sound familiar. Where routines exist and love feels intact. Yesterday holds what once was, and because of that, it often becomes a refuge when the present feels too sharp, too empty, too demanding.

In grief, yesterday has weight.

It carries phone calls that used to come easily. Ordinary moments that didn’t announce their importance while they were happening. Shared laughter. Predictable rhythms. The comfort of knowing someone existed just beyond reach. Yesterday is where they still feel real. And today, today is learning how to live with their absence.

We cannot go back to yesterday. That is the ache of it. But we look there anyway, not because we are stuck, but because yesterday holds proof. Proof that love existed. That life was shared. That something meaningful happened here.

Grief pulls us backward not to punish us, but to remind us.

It reminds us of who we were when love was present in a different form. It reminds us that the pain we feel now is directly tied to the depth of what we were given then. Grief is yesterday all over again, not as it was, but as it lives inside us now.

Yesterday is not only about loss. It is also about memory. And memory is a living thing. It shapes how we carry love forward when the person we love can no longer walk beside us. Yesterday becomes the place we visit when tomorrow feels too large to imagine.

There were so many yesterdays. So many moments that felt endless while they were happening. Only later do we understand how precious they were. Only later do we realize how much meaning lived in the ordinary.

Yesterday teaches us that nothing simple is ever insignificant.

In end-of-life care, yesterday often arrives quietly. It shows up in stories told again and again. In memories repeated, not because they are forgotten, but because they matter. Yesterday becomes a way of saying, This life was full. This love was real.

To sit with yesterday is not to move backward. It is to honor what shaped us. It is to allow ourselves to remember without rushing to resolve the pain that comes with it. Remembering is not a failure to move on. It is an act of love.

Yesterday holds unfinished sentences. Things that were not said. Moments that did not get their proper ending. And still, yesterday offers us something gentle: connection. Meaning. A place where love remains intact, even when presence does not.

Today asks us to keep going. Tomorrow asks us to imagine life unfolding without what we have lost. Yesterday asks nothing of us at all. It simply opens its door and lets us sit.

And sometimes, that is exactly what we need.

Yesterday reminds us that we lived fully enough to grieve deeply. That we loved in a way that left a mark. That our ache is not emptiness, but evidence.

We will never get yesterday back. But we carry it with us, woven into who we are becoming. It informs how we love, how we remember, how we show up for others in their own moments of loss.

Yesterday is not a place to stay forever. But it is a place worth visiting.

Because in yesterday, love is still whole.

And remembering is its own kind of grace.

xo
Gabby

From my book:
When Words Have New Meaning

“When Words Have New Meaning is a beautifully written A–Z collection of reflections on life, love, friendship, grief, and everything in between. Each chapter centers on a single word, inviting readers to pause and consider how meaning deepens when words are lived, not just spoken.”
⭐️⭐️⭐️⭐️⭐️

You can find my book here:
https://www.amazon.com/dp/B0GDFT9WL3?

11/06/2026

Grief has a way of transforming ordinary objects into vessels of memory. Sometimes healing isn’t about letting go—it’s about finding comfort in the small things that help us remember. What have you held onto to remind you of a departed loved one? [image via Option B]

08/06/2026

Understanding Pain Assessment Techniques in Hospice Care

Pain is one of the most common symptoms experienced by patients receiving hospice care, affecting up to 70–90% of individuals with advanced illness depending on diagnosis and disease stage (Ferrell & Coyle, 2021). Accurate pain assessment is essential because untreated pain can lead to increased anxiety, depression, sleep disturbances, decreased mobility, reduced appetite, and diminished quality of life (National Consensus Project, 2024).

Research consistently demonstrates that the patient’s self-report is the most reliable indicator of pain whenever communication is possible (HPNA, 2023). However, many hospice patients experience dementia, delirium, stroke, or advanced illness that limits their ability to verbalize discomfort. In these situations, nurses rely on validated observational tools and clinical assessment techniques to identify pain through facial expressions, body language, vocalizations, restlessness, guarding behaviors, and changes in breathing patterns (Warden et al., 2003).

Studies show that routine pain assessment and timely intervention improve symptom control, reduce suffering, and enhance quality of life for both patients and families (National Consensus Project, 2024). Effective pain management begins with recognizing that pain is more than a number, it is a personal experience that deserves careful evaluation and compassionate treatment.

In hospice care, we do not simply treat pain scores, we treat the person behind the pain.

06/06/2026

Understanding the Palliative Performance Scale (PPS) in Hospice Care

The Palliative Performance Scale (PPS) is a tool commonly used in hospice and palliative care to help assess a patient’s functional status, disease progression, and overall decline (Victoria Hospice Society, 2022).

The PPS helps healthcare providers evaluate how illness is affecting:
• Mobility
• Activity level
• Ability to care for oneself
• Food and fluid intake
• Level of consciousness

The scale ranges from 100% to 0%. A higher PPS score reflects greater independence and function, while a lower score reflects increasing decline and dependence.

In hospice care, PPS scores often help demonstrate:
• Functional decline over time
• Increasing care needs
• Disease progression
• Hospice eligibility support
• Changes in prognosis and condition

A declining PPS score may reflect:
• Increased sleeping
• More time spent in bed or chair
• Reduced mobility
• Poor appetite and intake
• Weight loss
• Weakness and fatigue
• Cognitive decline
• Increased dependence with ADLs

It’s important to understand that the PPS is only one part of the overall clinical picture. Healthcare providers also consider:disease trajectory, symptom burden, nutritional status, cognitive changes, hospitalizations/infections, caregiver burden and overall decline trends.

The PPS is not meant to predict an exact timeline of life expectancy. Instead, it helps guide conversations, care planning, symptom management, and documentation throughout the patient’s illness journey (NHPCO, 2024).

Research shows that declining PPS scores are associated with worsening prognosis, increased symptom burden, and higher care needs in serious illness (Anderson et al., 1996; Ferrell & Coyle, 2021).

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Mandurriao

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