The oncologist said the words you’d been dreading: “We’re running out of options.”
Or maybe it was the neurologist explaining that the disease is progressing faster than expected. Or the cardiologist saying the next hospitalization will likely be the last one.
However the bad news arrived, you’re now facing a reality you weren’t prepared for. Someone you love is dying. Not someday in the distant future. Soon.
And nobody taught you what to do next.
The Overwhelming Reality of Bad News
In the hours and days after bad news, families experience a kind of paralysis that has nothing to do with denial and everything to do with being completely overwhelmed.
There are suddenly a hundred decisions to make, and you don’t know which ones are urgent, which ones can wait, or how to even begin thinking about most of them.
Should you get a second opinion? Start hospice? Plan the funeral now or later? Update legal documents? Tell extended family? Take that trip you’ve been planning? Quit your job to be a caregiver? Move your parent into your home?
Every decision feels both crucial and impossible. You’re grieving someone who’s still alive. You’re trying to be present while also managing an avalanche of logistics. You’re attempting to make the most of limited time while also handling insurance, legal matters, medical appointments, and family dynamics.
And here’s what nobody tells you: too many families waste precious time spinning their wheels on tasks that don’t actually matter, while critical things fall through the cracks.
Not because they don’t care. Because they don’t know what they don’t know.
What Families Actually Need (And Don’t Get)
When someone receives bad news about a terminal or worsening diagnosis, the medical system provides certain types of support.
Doctors explain treatment options or the lack thereof. Nurses provide clinical care. Social workers at hospitals help with discharge planning. Eventually, hospice and palliative care teams offer comfort-focused medical support and emotional counseling.
All of these professionals are essential. But there’s a massive gap in what families actually need.
What’s missing is someone who helps with the work of dying.
Not the medical work. Not the emotional processing. The practical, logistical, decision-making work that allows families to make the most of the time they have.
Someone who can look at your entire situation holistically and help you understand:
- What needs to happen immediately versus what can wait
- Which professionals you need and how to find good ones quickly
- What questions to ask that you wouldn’t know to ask
- How to navigate family dynamics when stakes are this high
- What options exist that nobody’s told you about
- How to create the kind of death your loved one actually wants
That’s what an end-of-life coach does.
What End-of-Life Coaching Actually Looks Like
I’m an end-of-life coach, and I need to be very clear about what that means because most people have never heard this term before.
I’m not a hospice worker, though I work alongside hospice when families have it. I’m not a therapist, though the conversations we have are often deeply emotional. I’m not a medical professional, though I help families understand and navigate the medical system. I’m not a death doula, though we share some philosophy about honoring the dying process.
What I am is a quarterback.
I look at everything happening in your family’s situation holistically and help you keep the train on the tracks. I make sure all the boxes get checked. I prevent things from falling through the cracks. I help you to be deliberate and purposeful instead of reactive and panicked.
Here’s what that actually means in practice:
I Help You Understand What You’re Facing
Too often, doctors want to give you hope, or you hear only the silver linings. Family members want to stay optimistic. Nobody wants to devastate you with harsh truth.
But sometimes what families need most is someone who can help them see clearly what’s actually happening, so they can make decisions aligned with reality rather than hope.
I help families ask the questions that get to truth: What will this medical intervention actually accomplish? Will it help the person be more comfortable and present, or will it extend suffering? Are we focused on quality of life or length of life? When we look honestly at the trajectory, what does that tell us about how to spend the time we have?
This isn’t about giving up. It’s about being realistic so you can prioritize what actually matters.
I Create a Roadmap When Everything Feels Chaotic
After bad news, families often don’t know where to start. Should you handle legal documents first? Find a funeral home? Start hospice? Have difficult conversations?
I help you understand what’s urgent, what can wait, and what order makes sense for your specific situation.
We create checklists tailored to your family’s needs. We identify which professionals you need and I help connect you with vetted estate planning attorneys, financial advisors, funeral homes, and other specialists who can serve you well.
I work with these providers to ensure you’re properly cared for. I’m not just handing you a referral list and wishing you luck. I’m coordinating to make sure things actually get done.
I Shop Funeral Homes So You Don’t Have To
Most families have no idea how to choose a funeral home or what questions to ask. They’re making decisions worth thousands of dollars while grieving and overwhelmed.
You tell me what you want. What matters to your family. What your budget is. What kind of disposition you’re considering: burial, cremation, terramation (human composting, now legal in fifteen states including New York), aquamation (water cremation), entombment, or anatomical donation.
I interface with funeral homes on your behalf to find the one that best fits your needs and price point. You don’t waste precious energy touring facilities and getting sales pitches. I narrow it down to the right options, and you make a final decision from a place of clarity rather than confusion.
I Help You Navigate Hospice and Palliative Care
One of the biggest mistakes families make is waiting too long to involve hospice because they think it means giving up or because they don’t understand what hospice actually provides.
Hospice isn’t just about the final days. It’s about improving quality of life for however long someone has. It provides comfort-focused care, pain management, emotional support, spiritual counseling, and practical assistance that allows people to live as fully as possible until they die.
Palliative care can be appropriate even earlier, providing symptom management and support alongside curative treatment.
Part of my role is helping families understand how these services can help you make the most of the time you have, not just manage the end.
I Facilitate the Conversations You’re Avoiding
There are things that need to be said. Decisions that need to be made. Wishes that need to be documented.
But most families struggle to have these conversations because emotions are too high, denial is too strong, or nobody knows how to start.
I facilitate these conversations with the same skills I bring to Setting the Table dinners, but adapted for the urgency and emotional intensity of a family facing loss.
We can do an initial dinner or consultation early on to create the plan: What does the person who’s ill actually want? Where do they want to be as they decline? Who do they want present? Who needs to be kept away? What does a good end of life look like to them?
Then we do subsequent check-ins as needed as the illness progresses, as you get documents back from legal and financial professionals, as you prepare to transition someone home for their final days, or as circumstances change and plans need adjusting.
These meetings can be virtual or in person depending on what works for your family. There are no rigid packages. Everything is customized to what you need when you need it.
I Help You Plan What End of Life Actually Looks Like
Most people have never witnessed a good death. They’ve only seen medicalized hospital deaths or sudden traumatic deaths or deaths that happened when nobody was prepared.
I help families understand what the dying process looks like and how to create the experience the person actually wants.
Where do they want to be? Home in their own bed? In a facility where they feel safe and cared for? Somewhere with a view they love?
What do they want their final days to look like? What music do they want played? What do they want to eat while they still can? Who do they want reading to them? What matters most about how they spend their remaining time?
How do they want to be touched and cared for? What brings them comfort?
Understanding what hospice provides versus what family needs to arrange helps you create the death scenario someone actually wants rather than the default medicalized version.
I Support Practical Planning for Living Wakes and Life Celebrations
Some families want to celebrate the person while they’re still alive rather than waiting for a funeral they won’t attend.
A living wake or life celebration before death allows the person to hear what they meant to people, to participate in their own honoring, to have closure conversations while they still can.
I help families think through whether this fits with the person’s wishes and values, and if so, how to plan something meaningful rather than performative.
I Help Families Prepare to Go Home
One of the biggest regrets I hear from families is that they didn’t get their loved one home, or they got them home but it was only for a day or two before death occurred.
Going home to die often matters deeply to people, but families don’t know how to make it happen or they wait too long to start planning.
I help you understand what’s involved: What medical equipment do you need? What does hospice provide? What does the person need to feel comfortable and safe at home? What supports do the caregivers need? When is the right time to make the transition?
The goal is to give you enough runway that the person gets meaningful, beautiful time at home rather than arriving home actively dying, or not making it there at all.
I Help Families Actually Use Their Time Well
Here’s the hardest truth: too many families waste the precious time they have.
Not intentionally. But they spend weeks researching things that don’t matter, debating decisions that aren’t urgent, managing logistics that could be delegated, and avoiding conversations that desperately need to happen.
By the time they realize what actually mattered, it’s too late. The person has declined too much to travel, or to have deep conversations, or to enjoy the things they once loved.
My job is to help you be purposeful. To identify what will matter when you look back and ensure those things actually happen. To handle or delegate the logistics so you can be present for what’s irreplaceable.
When to Engage an End-of-Life Coach
The short answer is: as soon as you realize you’re facing a serious, terminal or significantly worsening situation.
We can often engage within twenty-four hours if that’s what you need. Usually families reach out within a week or two of bad news, once the initial shock has worn off and the overwhelm has set in.
You don’t have to wait until someone is actively dying.
In fact, the earlier you engage support, the more time we have to help you navigate well. The families who reach out when someone has months rather than weeks can accomplish so much more of what actually matters.
But even if time is very short, we can help. Even a single consultation can provide clarity and direction that prevents regret.
Who This Is For
End-of-life coaching is for families facing:
Terminal diagnoses: Cancer that’s no longer responding to treatment, ALS, advanced heart failure, end-stage COPD, or any condition where cure is no longer possible and the focus shifts to quality of remaining life.
Significantly worsening conditions: Dementia that’s progressing rapidly, Parkinson’s with increasing complications, repeated hospitalizations for chronic conditions, or any situation where it’s becoming clear the person is declining and will not get better.
Advanced aging with fragility: When an elderly person is reaching the end of their natural life span and the family recognizes it’s time to get ducks in a row, even without a specific terminal diagnosis.
This is also for families who are stuck:
Sometimes bad news arrives and family members can’t align on how to respond. Adult children want to pursue every possible treatment while the ill person is ready to stop. Or the person dying wants to plan and talk honestly while family members insist on staying optimistic.
An outside voice can sometimes say things in a way people actually hear. When I explain what quality of life versus length of life means, or what a medical intervention will realistically accomplish, families who’ve been stuck in denial or disagreement can often move forward.
What Makes This Different From Other Support
This isn’t hospice or palliative care.
Those teams provide medical care, pain management, and emotional and spiritual support. They’re essential. I work alongside them, but I’m addressing the practical work they don’t handle: estate planning, funeral shopping, family facilitation, logistical coordination.
This isn’t therapy or grief counseling.
I’m not processing your emotions about loss. I’m equipping you with knowledge and coordinating the practical pieces so you don’t have to waste energy figuring it out yourself.
This isn’t death doula work.
Death doulas often sit vigil, create rituals, provide hands-on presence during active dying. I believe that’s a delicate and private time. My goal is to educate and prepare your family so you’re confident navigating on your own without needing a stranger in your home during those final intimate hours.
What this is: practical support for all the work of dying that nobody else is handling.
The Regrets I See When Families Wait Too Long
I need to be honest about what happens when families try to handle everything themselves or wait too long to get support.
The most common regrets are:
They didn’t get their loved one home, or got them home too late. By the time they figured out the logistics and felt ready, the person had declined too much or died in the hospital. They had days or hours at home instead of weeks. Or worse, their loved one suffered during repeated medical interventions that had little if any curative hope.
They didn’t say the important things. They meant to have the deep conversations, the “I love you” conversations, the “thank you for” conversations, the “I forgive you” conversations. But they kept waiting for the right moment, and then the person couldn’t communicate anymore.
They didn’t handle legal and financial matters in time. Estate documents didn’t get updated. Accounts didn’t get joint ownership added. Powers of attorney expired or were never executed. Now there’s a legal mess on top of grief.
They wasted too much of the time they had on logistics and research. Instead of being present, they spent hours researching funeral homes, calling estate attorneys, trying to understand hospice benefits, shopping for hospital beds. All things that could have been delegated or streamlined.
They made decisions in crisis mode that they regret. Because they didn’t plan ahead, they had to make major decisions under the worst possible circumstances. They chose a funeral home in a panic and spent far more than necessary, or paid for space and services they didn’t want or need. They made medical choices based on panic rather than values. They agreed to interventions that extended suffering without improving quality of life.
Every one of these regrets is preventable with the right support at the right time.
You Don’t Have to Do This Alone
The cultural expectation is that families should be able to handle death on their own. That if you’re a good daughter or son or spouse, you should instinctively know how to navigate this.
That’s nonsense.
Most people will only navigate a terminal illness once or twice in their entire lives. You’re not supposed to be an expert. You’re not supposed to know what to do.
But there are people who do this for a living. Who’ve guided hundreds of families through what you’re facing. Who know what works and what causes regret.
Using that expertise isn’t weakness or failure. It’s wisdom.
It’s recognizing that time is the most precious resource you have right now, and spending it figuring things out yourself that an expert could handle in a fraction of the time is a terrible use of that resource.
Your job is to be present with the person you love.
My job is to make sure everything else gets handled so you can do that.
How to Get Started
If you’re facing bad news and feeling overwhelmed, reach out.
We’ll have an initial conversation about your situation, what you’re dealing with, what feels most urgent, and how I can help.
From there, we might start with a comprehensive planning dinner or consultation where we map out everything that needs to happen. Or we might address the most urgent concern first and build from there.
There’s no rigid structure. Everything is customized to what your family needs.
We can meet virtually or in person depending on what works for you. We can involve just immediate family or include extended family who need to understand the plan. We can move quickly if time is short or take a more measured pace if the illness allows.
The point is: you don’t have to figure this out alone. Resources exist to help. People who do this work exist to help.
The question is just whether you’ll use them in time to make a difference.
About Michelle
Michelle is a licensed funeral director, certified grief counselor, and end-of-life coach with over twenty years of experience helping families navigate death and dying. After watching too many families struggle alone with the overwhelming logistics and decisions that follow bad news, she expanded her practice to provide holistic end-of-life coaching that addresses all the practical work dying requires.
She serves families throughout the Hudson Valley, NYC Metro area, and Philadelphia region in person, with virtual coaching available nationwide. Her approach combines funeral industry knowledge, medical system navigation, family facilitation skills, and practical coordination to help families make the most of the time they have.
Facing a terminal or worsening diagnosis in your family? Contact Michelle to discuss how end-of-life coaching can help / Learn more about end-of-life coaching services