By Meghan Fitzpatrick, Hospice & Palliative Care Representative
Old Colony Hospice & Palliative Care
One of the unexpected gifts of working in hospice is the way it gently dismantles assumptions you didn’t even realize you were carrying.
Dementia is usually framed as a thief. It steals memories, language, recognition, independence. And for families walking alongside it, that framing often feels painfully accurate. There is anticipatory grief layered on top of daily loss, and it can be relentless.
But from where I sit, there is another truth living alongside that one.
Many hospice patients with dementia are blissfully unaware of their impending death. They do not know what their bodies are doing. They are not counting days. They are not rehearsing goodbyes or mourning futures that won’t happen. They are simply here.
And because they don’t know, they are not grieving in the way many people without dementia do.
I’ve sat with patients who understand their prognosis and are deeply distressed by it. They grieve the loss of independence, the loss of roles, the loss of time. Their minds race ahead to everything they will miss, and that grief can be sharp, heavy, and all-consuming.
By contrast, many patients with advanced dementia are spared that particular kind of sorrow. Their emotional world is often smaller, quieter. Not empty – just focused. A warm blanket. A familiar song. A hand to hold. The comfort of routine. The safety of now.
There is something profoundly instructive in that.
It reminds me how much our emotional suffering comes not from what is, but from what we know – or think we know – about what is coming next.
Grief is real. It is necessary. It is the price we pay for love. But it is also, at least in part, a product of our mind’s ability to time-travel. We replay the past. We anticipate the future. We live everywhere except the moment we’re actually in.
This week, I was with a support group and one of the participants said something that I think will inspire me for years to come. In speaking of his loss, he said, simply, that he’s been trying to stay in the day he’s in.
Not stay positive.
Not stay busy.
Not stay strong.
Just stay in the day he’s in.
That, I think, is the lesson dementia teaches us if we’re willing to listen. This day, too, shall pass – the good and the bad – so stay in the day you are in.
Patients with dementia don’t have the luxury – or the curse – of looking too far ahead. They live in fragments of presence. And while dementia is cruel in countless ways, presence is not nothing. Presence can be peaceful. Presence can be enough.
Of course, this doesn’t mean dementia is easy. It doesn’t erase the heartbreak families feel as they watch someone they love change before their eyes. The grief simply shifts locations. Often, it moves outward – into spouses, children, caregivers – while the person with dementia remains relatively unburdened by it.
And that contrast can be jarring.
But maybe there is something for us to borrow there.
We cannot turn off our awareness the way dementia does. Nor should we try. But we can practice loosening our grip on the future. We can notice when our suffering is coming from 10 steps ahead instead of the ground beneath our feet.
Hospice has taught me that dying is not always the hardest part. Anticipating it can be.
Staying in the day you’re in doesn’t deny loss. It doesn’t minimize grief. It simply acknowledges that right now – this breath, this moment, this ordinary day – may still hold comfort, connection, even quiet joy.
And sometimes, that is more than enough.
About the Author: Meghan Fitzpatrick is a business development representatives at Old Colony Hospice & Palliative Care. She has a strong background in assisted living and dementia care. She is also a trained support group facilitator for the Alzheimer’s Association. Her compassion and knowledge make her a vital part of Old Colony Hospice’s outreach efforts. She is a trusted resource in the community, connecting with families, providers, and community partners throughout the region and can be reached at mfitzpatrick@oldcolonyhospice.com.
