Hospice

by Michael Landry

She was resting in bed when I arrived, a small stuffed dog cradled in her arms. Her eyes fluttered open as I approached, hesitantly. I said good afternoon, thinking she would tell me to leave her alone. When she looked up, her face filled instantly with joy.

“I love your dog,” I said.

She smiled and told me she had been taking care of the dog for years. She said I would need to take it for a walk soon. I told her I would be happy to. She warned me that the dog liked to run away, and that if I planned to keep visiting, I would have to take responsibility for finding it when it wandered off.

Over the next visits, the dog became part of our routine. She asked where it was before she asked where she was. She held it close when unfamiliar staff entered the room, loosening her grip only once she recognized me. I learned quickly that as long as the dog remained nearby, she stayed calm—untroubled by the unfamiliar sounds, the locked doors, the quiet sense that something was wrong.

One visit, I responded that the dog had left, agreeing with her story. Her hands began to shake. I reassured her quickly, telling her the dog had only gone to a floor below and would return shortly.

The dog anchored her. As long as it remained close, she did not question where she was or why.

It was then that I realized her memory loss and cognitive decline were more advanced than I had first assumed. I chose not to correct her. 

“I would love to walk your dog, Ms. G,” I said.

The joy left her face immediately. She looked confused, then hurt.

“Don’t call me that,” she said. “You’re my son. Call me mom.”

I froze. I did not know if she was joking, testing me, or if she had ever had a son at all. I chose, again, not to correct her. I was slowly learning that the desire to fix can disguise itself as compassion. I spent the rest of the day listening as she told me stories about my “family.” 

She would return to them again and again—asking how I was able to visit so often, wondering how I could travel such a distance when her real family lived far away. She spoke about her own past, about climbing stairs and dancing in open fields. Sometimes she closed her eyes, searching for a memory she believed I would remember too.

Even in her state, she just wanted to share a memory with someone. She was reaching for human connection—something that does not always obey rules, where comfort can matter more than correctness.

But in real life, the story does not resolve into a slogan.

In real life, boundaries are not just walls; they are also forms of protection—for patients and caregivers alike. And validation is not always benign; it can deepen attachment. And attachment can soothe or harm depending on what happens next.

When I left one day, I carried two questions with me: Can comfort be ethically legitimate if it rests on something untrue? And who holds power in this interaction—the caregiver or the patient?

In medicine, this is called therapeutic validation: meeting a patient in their perceived reality when correction offers no benefit. At the time, acceptance felt easier than factual correction. If this was the end of her life, I reasoned, perhaps she was entitled to feel however she needed/chose to feel.

I had assumed power belonged to the caregiver—the one who knew the truth, who could leave, who could decide whether to correct or comply. But over time, that certainty eroded. As she assigned me roles that steadied her, my presence began to matter in ways I could not undo. The power did not disappear; it shifted. What began as my decision to validate her reality became a relationship in which both of us were constrained—she by her vulnerability, and I by the meaning my presence had acquired.

I continued to visit her. Over time, I described myself less as someone she believed was her son and more as someone who was her son. I had learned how to validate a belief that eased her fear. I had not learned how to stop a belief that asked something of me I could not give. I often left feeling unexpectedly fulfilled, only slightly unsettled by the fact that I had not truly been myself.

One afternoon, I found her eating in the dining hall. I greeted her the way I always did—“Hi, Ms. G,” or sometimes, “Hi, Mom.” This time, her response was different.

“Hey, Mr. good lookin’,” she said.

I felt the shift immediately. She rolled her wheelchair closer and reached for my hand, something she had done before. Then she leaned in further, telling me she wanted to drive off into the sunset with me. She spoke about getting married, about our future together.

On my last visit with her, she was mostly sleeping. I sat near the bed and listened to the sounds hospice teaches you to hear: the rhythm that is no longer regular, the pauses that stretch, the subtle changes that signal the body is letting go.

At one point, her eyes opened. She looked at me like she recognized me from far away, like I was a long lost stranger from years prior.

“You came,” she whispered.

“I am here,” I said.

And that was true in the only way it could be true. I was there. I was not her family. I was not her partner. I was not her salvation. I was a person in a room, offering presence, trying to hold dignity without stealing it.

She closed her eyes again.

I left later with the familiar hospice feeling: grief without the right to claim it publicly. Grief for someone I had met months ago, who I truly knew nothing about. The strange intimacy of sharing someone’s last days while knowing you will return to your normal life, and they will not. The moral residue of moments you cannot categorize cleanly.

I left that day with a different set of questions than the ones I had carried before. Is identity something we hold, or something we are given in moments of vulnerability? And when a role brings comfort to one person but unease to another, whose needs should guide our care for one another?

Maybe the right ending is that I should have drawn firmer boundaries earlier, before my presence became a lifeline. Maybe the right ending is that in a place where someone is dying, rules must bend toward humanity. Maybe the right ending is that both things are true at once: that compassion without boundaries can become indulgence, and boundaries without compassion can become abandonment.

Was I a true stranger to Ms. G? Or had I somehow built a mutual relationship with her, neither of us truly being ourselves? This story leaves questions science does not demand to be answered.