A Hospice Nurse’s Reflection on Financial Readiness at the End of Life
Written by Clifford Cartagena, CEO & Founder
Clifford Cartagena, RN, BSN, is a psychiatric nurse, safety trainer, and founder of Gentleway Systems LLC. Co-founder of Arizona Care Horizon Institute, he is completing his PMHNP degree at Walden University. Author of The Gentle Art of Crisis, he advances trauma-informed, dignified approaches to workplace safety.
As a hospice nurse, I have had the privilege of caring for patients and families during one of the most sacred and difficult moments of life, its final chapter.
End-of-life care is not just about managing physical symptoms. It is about preserving dignity, supporting families, and helping loved ones find peace. But there is one reality I have witnessed repeatedly, quiet, heavy, and often unspoken, the emotional devastation caused by a lack of financial preparation.
What I have seen in hospice care
When a patient is nearing the end of life, families are already overwhelmed.
They are dealing with:
Anticipatory grief
Emotional exhaustion
Difficult decisions
Saying goodbye
Then, almost suddenly, another question arises, “How are we going to pay for everything?” Funeral expenses. Final arrangements. Unexpected costs. These are not small burdens.
When grief meets financial pressure
I have seen spouses who were holding themselves together emotionally break down when finances came up. I have seen families shift from holding hands at the bedside to whispering about costs, bills, and obligations. Not because they are insensitive. But because reality demands it. Grief becomes heavier when it is combined with financial uncertainty.
The reality of being unprepared
Many families are not prepared. Not because they don’t care. Not because they were irresponsible. But because life happened, priorities shifted, and planning was postponed. Until it was too late.
Turning to emergency solutions
In recent years, I have observed a growing trend. Families are turning to crowdfunding platforms like GoFundMe. These platforms bring community support, and they help.
But the truth is, they often do not meet the full financial need. The funds raised may cover a portion, but rarely the entirety of funeral and related expenses.
So families continue to struggle while grieving, managing logistics, and while trying to stay emotionally present.
The impact on loved ones
The lack of preparation does not just create financial strain, it also undermines the quality of life.
It creates:
Emotional tension between family members
Guilt and regret
Increased stress during an already painful time
Disruption in the grieving process
Instead of focusing fully on honoring their loved one, families are forced to divide their attention.
What preparation changes
I have also seen the opposite. Families who were prepared. The difference is profound. There is still grief. There is still loss. But there is also peace, clarity, and the ability to focus on what truly matters.
Prepared families can sit with their loved one, be present in the moment, and grieve without additional pressure.
A gentle reminder
This is not about fear. This is not about pressure. This is about awareness. End of life is something we cannot avoid. But the experience for our loved ones can be very different depending on one thing, preparation.
Conclusion
As a hospice nurse, I have learned that care does not end at the bedside. It extends into families' lives, before and after loss.
Financial preparedness is not just a financial decision. It is an act of care. An act of responsibility and love. Because when the time comes, what families need most. It's not more stress. It is peace.
Read more from Clifford Cartagena
Clifford Cartagena, CEO & Founder
Clifford Cartagena, RN, BSN, is a psychiatric and medical-surgical nurse, hospice provider, safety trainer, and founder of Gentleway Systems LLC. He is also the co-founder of the Arizona Care Horizon Institute. He was authorized by the ADHS (Arizona Department of Health Services) to deliver the Memory Care Services Training in Arizona. Cliff is currently completing his Psychiatric Mental Health Nurse Practitioner (PMHNP) degree at Walden University. He is the author of The Gentle Art of Crisis. With more than 20 years of nursing and leadership experience, he developed the Gentleway System, a trauma-informed approach to preventing and managing assaultive behaviors across healthcare and beyond.
References (APA Style):
Gillen, P., Neenan, K., & O’Shea, E. (2022). Financial burden and psychological distress in end-of-life care: A systematic review. Palliative Medicine, 36(6), 1001–1012.
Disclaimer:
This article is for educational and awareness purposes only. It is not intended to promote or sell any product or service. Its goal is to share real-world observations on how financial preparedness affects families during end-of-life situations.
