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Growing with the Lowcountry: Honoring Our Promises, Expanding Our Care 

The terms hospice and palliative care are often misunderstood, yet they represent two of the most compassionate and comprehensive approaches to medical care available today. Both focus on enhancing quality of life, providing comfort, and supporting patients and families during serious illness—but they serve distinct purposes. Hospice Care The word hospice originates from the term hospitality, which dates back to medieval times when travelers who were ill or weary were offered rest and care by compassionate hosts. Over time, this concept evolved into the modern hospice philosophy—providing comfort, dignity, and support for individuals at the end of life. Today, hospice care can be provided wherever a patient calls home—whether that is a private residence, nursing facility, or inpatient hospice unit. Hospice focuses on comfort rather than cure, meaning that the goal of care is no longer to treat or reverse the underlying illness, but to manage symptoms and enhance the patient’s remaining quality of life. Hospice care is available to anyone who meets eligibility criteria, regardless of age, insurance status, or financial means. In fact, hospice is fully covered by Medicare, Medicaid, and most private insurance plans. Care is also provided to uninsured individuals through community support. Contrary to common misconceptions, a physician referral is not required to inquire about hospice services. Many physicians and families hesitate to discuss hospice due to outdated fears that choosing hospice might hasten death. In reality, research consistently shows that patients receiving hospice care often live longer and experience improved comfort because their symptoms are well-managed and they are surrounded by compassionate support. Hospice services include a full interdisciplinary team: a medical director, registered nurses, certified nursing assistants, medical social workers, chaplains, bereavement counselors, and trained volunteers. Additional services such as pet therapy, aromatherapy, and music therapy may also be offered. Medications, medical supplies (such as briefs and under pads), and durable medical equipment (including hospital beds and oxygen) are provided at no cost to the patient or family. Palliative Care The word palliative is derived from the Latin palliare, meaning “to cloak” or “to cover.” Palliative care “cloaks” or eases the symptoms, pain, and stress associated with serious illness—regardless of diagnosis or stage—while patients continue to pursue curative or life-prolonging treatments. Palliative care provides an additional layer of support for both patients and families. The care team—typically consisting of a nurse practitioner, chaplain, and medical social worker—works alongside the patient’s existing healthcare providers to ensure that symptoms such as pain, anxiety, or shortness of breath are effectively managed. This allows patients to focus their energy on what matters most to them, rather than on managing frequent medical crises or emergency visits. Care is available in the home, hospital, or other settings, and the palliative team is accessible for symptom management and support at any hour. This continuity of care reduces unnecessary hospitalizations and helps patients and families feel more in control throughout their healthcare journey. Who Can Benefit from Hospice or Palliative Care? Hospice and palliative care are appropriate for individuals facing serious illnesses such as: Chronic Obstructive Pulmonary Disease (COPD) Heart failure Alzheimer’s disease and other dementias Kidney disease Cancer Amyotrophic Lateral Sclerosis (ALS) AIDS And many other life-limiting or life-altering conditions  Our Commitment to the Community At Friends of Caroline, our mission is to ensure that every member of our community has access to compassionate care, education, and support during life’s most challenging times. Too often, individuals delay seeking help because of the stigma or misunderstanding surrounding hospice and palliative care. Our goal is to help families overcome these barriers by providing clear information, compassionate guidance, and comprehensive support. We will all need care and comfort at some point on our journey. It is reassuring to know that such care is available—right here in our community. If you have questions or would like additional information, please do not hesitate to contact us. We are here to help.

Grief is often misunderstood as something to “get over.” But what if it’s something to grow through? This article explores the purpose of grief, what healthy mourning looks like, and how we can support one another through it. The phrase “good grief” might call to mind Charlie Brown’s familiar sigh of exasperation. Yet beyond the comic strip, the words hold a deeper truth. Good grief is more than an expression — it’s a way of describing what healthy, adaptive mourning can look like. While loss is never easy, grief itself is not the enemy. When approached with honesty and compassion, it can become a process that shapes, strengthens, and deepens our capacity for life. Grief Is Not a Problem to Solve—It’s Evidence of Love Modern culture often urges people to “move on” or “stay strong,” as if grief were a weakness to overcome. But grief isn’t a flaw in the human design — it’s evidence of connection. Healthy, or good, grief doesn’t follow neat stages. It comes in waves — unpredictable, sometimes overwhelming, sometimes gentle. What matters is not how quickly it passes, but whether we allow ourselves to engage with it honestly. The Purpose of Grief Grief has a purpose: it helps us adapt to loss. It is the mind and heart’s natural way of recalibrating to a changed world. At its core, grief is love searching for where to go next. It allows us to honor what was lost, to process the rupture, and to slowly rebuild a sense of balance and meaning. The purpose of grief is not to erase pain but to transform it. Through grief, we learn: How deeply we can love. How resilient we can become. How to grow around the loss rather than away from it. Grief, in this sense, is not an interruption to life — it is one of its most profound teachers. What Good Grief Looks Like Allowing feelings to be felt — even when it hurts Good grief begins with honesty. It means acknowledging sadness, anger, confusion, or even relief without judgment. Feeling pain does not mean failing — it means allowing truth to surface. Giving time to grow — without a timeline Grief is not something to complete. It unfolds at its own pace, often circling back unexpectedly. Accepting that rhythm allows genuine change to take root. Staying connected to others Isolation can deepen sorrow. Reaching out — through conversation, shared memories, or quiet companionship — helps carry the weight of loss. Growth happens most naturally in the presence of understanding. Rediscovering moments of meaning Over time, small moments begin to shimmer again: a song, a sunrise, a familiar scent. These are signs of reorientation — reminders that life continues, carrying both love and loss within it. Letting go of self-judgment There is no “right” way to grieve. Each journey is unique. Extending compassion to oneself is essential for transformation to occur. The Four Tasks of Mourning Psychologist William Worden described four “tasks” that can help outline what healthy grieving looks like. They are guideposts, not checklists: Accept the reality of the loss – Facing what has happened, emotionally and mentally, opens the door to growth. Process the pain of grief – Pain that is expressed can evolve; pain that is denied remains stagnant. Adjust to a world without the person or situation lost – Rebuilding daily routines, identity, and purpose within the changed landscape. Find an enduring connection while moving forward – Transforming love into something ongoing: memory, meaning, or legacy. What Good Grief Support Looks Like Just as there is such a thing as good grief, there is also good grief support. Grieving people don’t need perfection — they need presence. The best support is not about fixing pain but about accompanying it. Good grief support often looks like: Listening more than speaking. Acknowledging the loss directly. Showing up consistently — especially after the first few weeks. Accepting all emotions. Offering practical help. Respecting personal pace. True support reminds the grieving that they are not alone — that their love still matters, and so do they. When to Seek Extra Support Sometimes grief becomes so heavy that it halts movement altogether. Reaching out for professional or community support is not a sign of weakness — it’s a commitment to growth. Seek extra support if: The intensity of grief does not lessen over time. Daily life feels impossible for long stretches. Numbness, guilt, or despair remain constant. Anger or avoidance dominate relationships. There are thoughts of hopelessness or self-harm. Grief counselors, therapists, and peer groups can help create space for growth and meaning when the path feels unclear. The Quiet Strength of Good Grief “Good grief” does not mean easy grief. It means real, conscious, and life-affirming grief. It honors what was lost while nurturing what remains. To grieve well is to let love reshape us — to grow through what hurts without losing what matters most. In the end, grief is not the opposite of love but its continuation. For Reflection What would it mean for you to experience good grief — not as an ending, but as an evolution? --------------------------------------------------------------------------------------------- Grief can be a difficult and isolating experience - but you don't have to go through it alone. FRIENDS of Caroline offers Grief Busters, a series of supportive group sessions for those navigating life after loss. Each group provides a compassionate, welcoming space to share your journey, connect with others who understand, and find strength as you heal. For more information about grief groups at FRIENDS of Caroline or to join a group visit: https://www.fochospice.org/copy-of-grief 

Alzheimer’s Disease is a progressive neurological condition that affects memory, thinking, and behavior. Over time, it significantly impacts an individual’s ability to manage daily life, leading families to seek additional support and care options. One important resource for families is hospice care, which provides comfort, dignity, and support for patients and their loved ones during the final stages of illness. When Does Hospice Become an Option? Hospice eligibility for Alzheimer’s Disease is based on the progression of the disease rather than a specific timeframe. The key indicator is when the individual is in the advanced stages of dementia and the focus shifts from curative treatment to comfort and quality of life. Medicare and most insurance providers use certain clinical guidelines to determine eligibility, which include: Inability to perform two or more daily activities without significant assistance such as eating, dressing, bathing, toileting, or walking. Limited verbal communication, often only a few words or phrases. Difficulty swallowing or frequent infections such as pneumonia or urinary tract infections. Unintentional weight loss or malnutrition despite support. Declining overall health, including multiple hospitalizations or frequent emergency room visits. Why Hospice Matters For families caring for someone with Alzheimer’s Disease, the journey can be long and emotionally overwhelming. Hospice provides a holistic approach to care that supports both the patient and the family. This includes: Hospice CNA: who helps patient with bathing, incontinence care, changing clothes, changing bed linens, and oral care which is often difficult for family to provide. Expert medical care: Symptom management, pain control, and close monitoring of changes along with education provided by hospice physicians, nurse practitioners, nurses, and CNAs on the changes that occur within the journey of the illness of Alzheimer’s Disease. Emotional and spiritual support: Counseling and guidance for patients and loved ones provided by hospice chaplains and social workers. Navigation of financial resources for various needs in caregiving and arrangements: Provided by hospice social worker Respite for caregivers: Relief through short-term inpatient care and volunteer support. Grief support: Continued assistance for families before and after a loved one’s passing provided by hospice chaplains or bereavement counselors. Friends of Caroline’s Commitment At Friends of Caroline, we recognize that every journey with Alzheimer’s Disease is unique. Our hospice team partners with families to ensure compassionate, individualized care. Whether in the home, our inpatient facility, nursing facilities, assisted living facilities, or through our grief support services, we honor the dignity of each patient while providing comfort and peace for their families. If you are caring for a loved one with Alzheimer’s Disease and are unsure if hospice is appropriate, we encourage you to reach out. Our team can provide guidance, answer questions, and help you understand the options available.  Since 1977, Friends of Caroline has been committed to serving our community with palliative, hospice, and grief support services. No one is ever turned away due to inability to pay.

At Friends of Caroline, we often say that no one walks alone—and I believe that with my whole heart. Each day, I have the privilege of witnessing how deeply our mission touches the lives of patients, families, and caregivers throughout the Lowcountry. But behind every comforting visit, every grief counseling session, and every moment of support is something just as important: you —our generous and compassionate community. As Director of Development, I’m often asked why fundraising is so important. The answer is simple: it’s the foundation that allows us to serve. Unlike many healthcare providers, Friends of Caroline is not fully reimbursed by insurance or government programs for much of the care we provide. Our palliative care services, grief support, and educational outreach are all offered free of charge, thanks to the community members who believe in our mission and show up—time and time again—through events, sponsorships, and donations. More Than Money Fundraising is about more than raising dollars. It’s about creating awareness, building relationships, and inviting people to walk alongside us. Events like the Clay Shoot , and our Release & Remember bring people together not just to support Friends of Caroline, but to experience our mission in action. I’ve watched someone attend their first fundraiser in memory of a loved one and become a dedicated volunteer the following year. I’ve seen corporate sponsors turn into long-term partners who support us well beyond the event itself. These moments remind me that fundraising is truly where community meets compassion. The Power of Participation Every fundraiser also helps us grow stronger and more sustainable. The funds we raise are flexible, which means we can respond to needs in real time. Whether it’s helping a family through a medical crisis or expanding our bereavement services for children, your contributions give us the ability to say “yes” when it matters most. And none of this happens without people. Our staff, board members, volunteers, and donors all play a role in planning and executing these events. Fundraising strengthens our internal culture just as much as it supports our programs—it brings us together with a shared purpose and shared pride. Walking This Journey Together Friends of Caroline exists because this community believes in comfort, dignity, and care for all—especially during life’s most vulnerable moments. As someone who works behind the scenes to help make this mission possible, I want to thank you. Whether you’ve bought a ticket, shared our events, volunteered your time, or made a donation—you are part of this story. Fundraising isn’t just something we do. It’s how we honor our commitment to be there for every patient and every family, without hesitation and without barrier. Together, we’re not just raising money. We’re raising hope. ------ For more information on ways to support Friends of Caroline and the work that we do, please click here .

One of my favorite quotes is from the great Dr. Martin Luther King Jr.: "If you can't fly, then run. If you can't run, then walk. If you can't walk, then crawl. But whatever you do, keep moving forward." My name is Shoranda Clark, and this powerful quote has helped me get through some difficult moments in my career. I've been a hospice-certified nursing assistant for 29 years—21 years actively working as a CNA and eight years in an administrative role, all with Friends of Caroline. You might be wondering how someone can stay in this field for so long. In the beginning, besides a lot of crying and prayer, I came to recognize that this work is my calling. Some may find it depressing, but I find it deeply rewarding. It was especially challenging at the start of my career, particularly after losing my first patient. But over time, I realized that my patients were giving me something as meaningful as the care I gave them. Working with terminally ill patients helped put some perspective in my life because they shared their regrets and the things they wished they had done differently; Hearing their stories helped me appreciate my own life so much more. I would go home and hug my loved ones, telling them how much I love and appreciate them. Through this work, I became a better mom and wife. I've learned to live life with no regrets, and I'm truly grateful for each day God gives me. It is a blessing to be chosen to provide physical and emotional care to someone at the end of life. I once had a patient who refused to let her family bathe her. Several of my fellow CNAs tried, but she still declined. She went almost two months without bathing. When it was my turn to visit her, we simply talked. I learned that Yahtzee was her favorite game. So, I made a deal with her: after her bed bath, we'd play a game of Yahtzee. She agreed. That became our morning ritual—a bed bath, a cup of cappuccino, and a game of Yahtzee. Week after week, we had so much fun. As her health declined and she could no longer roll the dice, I rolled them for her. We kept playing because it brought her joy. We continued this routine until her last week. I truly believe this small gesture brought light into her life. She looked forward to it, and I'm grateful I could help comfort her and her family. Not every case is like that one. Sometimes, the dying process is difficult to witness, so knowing when to take time for yourself is important. Having a healthy work-life balance is essential. Over the years, I've worked with some amazing CNAs who are passionate about their work. One of my fellow CNAs once volunteered to help a patient pull weeds from her garden—not part of her job, but she did it because the patient loved her garden. When you love what you do, it's easy to provide compassionate, hands-on care and emotional support, all while enhancing a patient's quality of life. I could tell you countless stories about how extraordinary hospice CNAs are. But great patient care takes more than just individual effort—it takes a team. Our team includes a skilled medical director, nurse practitioners, nurses, a social worker, a chaplain, and volunteers. CNAs often spend the most time with the patient, and we work closely with nurses to act as a bridge between patients, families, and the care team, ensuring everyone is aligned on the patient's needs. It's heartwarming when someone stops to thank you after learning you work in hospice. Some may view our work as sad or depressing, but I see it differently. I believe it's an honor to help someone cross over with dignity. In 29 years, I've learned so much through each case, and I often share those lessons with my fellow CNAs. If I had the chance to change anything about my career, I wouldn't. Serving our community has been both an honor and a privilege, and I look forward to the next chapter with our amazing team at Friends of Caroline.

National Nurses Week 2025 is celebrated from May 6th to May 12th. This week-long celebration recognizes and honors the contributions of nurses, who are the heart and soul of healthcare. It also serves as a time for appreciation, support, and recognition of nurses' dedication and commitment to patient care. As a recognition to our nurses, we asked a long time Hospice Nurse for a day in the life describing how valuable our nurses are.

National Healthcare Decision Day is April 16. We encourage you to take the time to review and update your Advance Directives and if you don’t have any in place we recommend Five Wishes as a tool to aid in the process.