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A Family's Gratitude: Compassionate End-of-Life Care at Home

6 minute read
The late Bill Hanafin

Sometimes the best healthcare isn't about prolonging life—it's about enabling someone to make the most of what time they have left.

For the late Bill Hanafin, who passed away at age 95, that meant being at home surrounded by loved ones. Through Mass General Brigham Healthcare at Home, Mr. Hanafin received compassionate, high-quality care in his final days that aligned with his wishes. As a result, he and his family could focus on what truly mattered: being together.

"Many members of our family were able to sit with him, hold his hand, talk to him, and pray with him," said Mary Hourihan, Mr. Hanafin's daughter. "It made for a passing that was therapeutic for the whole family."

Expert hospital-level care delivered in the home

Mr. Hanafin was a proud Marine veteran of the Korean War and a long-time resident of Boston's West Roxbury neighborhood. He and his wife, Mary, were married for 69 years and had five children, eight grandchildren, and four great-grandchildren.

Late in life, Mr. Hanafin struggled with congestive heart failure and chronic obstructive pulmonary disease (COPD). As a result, he paid many visits to the emergency room (ER) at Brigham and Women's Faulkner Hospital.

Bill with his wife, Mary

During one visit, his care team told him about Mass General Brigham Home Hospital. This program delivers expert hospital-level care in the comfort of the patient's home. The idea immediately resonated with Mr. Hanafin. From that moment on, whenever he ended up in the ER and had the option, he chose Home Hospital.

As Mr. Hanafin's health declined, his Home Hospital care team recommended Mass General Brigham Home-based Palliative Care. This service is dedicated to easing pain, managing symptoms, and providing emotional and practical support.

"Healthcare at Home was a fabulous resource for us," said his daughter Mary, a retired nurse who worked at the Faulkner for 43 years. "They took beautiful care of my dad, and we felt very secure knowing that all of his care needs were addressed. After a bit, it felt like they were part of the family."

Healthcare at Home was a fabulous resource for us. They took beautiful care of my dad, and we felt very secure knowing that all of his care needs were addressed. After a bit, it felt like they were part of the family.

Mary Hourihan, Bill's daughter

A seamless expansion of care

One day, Mr. Hanafin was admitted to the Faulkner with shortness of breath. After an overnight stay, he went home under the care of Home Hospital and Home-based Palliative Care.

But once home, it became clear that his body was struggling. His lungs kept filling with fluid, and his kidneys started to fail. Mr. Hanafin had clearly expressed his wishes—he wanted every effort made to keep him alive, short of intubation (inserting a tube into the throat to assist with breathing). Yet despite adjustments to his medications and other interventions, nothing was working.

Home Hospital nurse practitioner Kayla Quinn, NP, had a difficult conversation with his family. As she gently explained, his body was shutting down. Furthermore, continuing aggressive interventions would not change the outcome. In her opinion, the time had come to focus on comfort—relieving his symptoms and ensuring he was at peace.

Recognizing what mattered most to Mr. Hanafin, the family embraced the change in approach.

Prioritizing comfort until the end

Six days after returning home, Mr. Hanafin's condition worsened. During breakfast, he began having spasms. Kristin Wharton, CNP, a nurse practitioner with Home-based Palliative Care, arrived later that morning.

Kristin had been caring for Mr. Hanafin for about three months, so she knew him, the family, and their goals for care very well. After consulting with the family, Kristin and Home Hospital nurse practitioner Hilary Waitner, CNP, made some adjustments to Mr. Hanafin's medications. By that evening, the spasms were finally under control, and he was resting peacefully.

"That allowed him to rest through the night, which was beneficial because the spasms had been so distressing for everyone—especially my mother," Mary said. "The care teams were careful about making sure they chose the right combination of medications, which was complicated by the fact that his kidneys had shut down."

Throughout the next day, Hilary, Kristin, and others lovingly tended to Mr. Hanafin. Family members moved in and out of the room, spending quiet moments with him to say goodbye.

At 10:26 p.m., just minutes after the last of his visitors left, Mr. Hanafin passed away.

Collaboration between care teams and family

Bill surrounded by his wife, grandchildren, and great-grandchildren

Hilary, Kristin, and Kayla worked closely together to manage Mr. Hanafin's end-of-life care. They regularly consulted each other and his family to adapt his care plan as his condition changed.

"The biggest thing for his family was making sure he was home, comfortable, and surrounded by family," Hilary said. "And each time I was there in the last few days, everyone was there—his wife, children, grandchildren, nieces, and nephews. That was an important piece of the puzzle for them at the end."

"The collaboration between Home Hospital, Home-based Palliative Care, and my family allowed my dad a peaceful death," Mary added. "It was a model of how care teams should work together and with the family, and we feel blessed to have been the beneficiaries of that."

Having Healthcare at Home professionals available both in the home and by phone helped ease Mary's anxiety during a stressful and sorrowful time.

"They were wonderful about explaining everything that was happening and why they were taking the steps they did," she said. "It was so reassuring to me as a daughter that we were doing everything we could to alleviate my dad's suffering and respect his wishes. What they did for us meant more than they could ever know."

Learn more about Healthcare at Home