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In between visits with patients and families, Loos consults with social workers, other nurses or Alix at a nursing station. In a quiet moment, she chats with a young nurse who recently sat with her husband's grandmother in her final hours. The nurse took a break to go home and feed her baby, and when she got back, it appeared that the grandmother had awaited her return. Unable to speak, the grandmother touched thumbs with her—a gesture of affection the two had shared—before dying peacefully.

Just being with a patient, known as the "nursing presence," is an important part of palliative care, says Loos. "There are so many technological interventions and so many medications. We can do all that, but sometimes rubbing someone's back is just as important as administering [the antianxiety drug] Ativan." She recalls a patient at the hospice house. "She had the meds she needed to have, we had a plan, we had had every discussion she needed to have, but at the end of the day, she was very distressed and afraid. I was sitting next to her for 15 minutes quietly, and she said, 'Don't leave me,' and I said, 'I won't leave you.' After several minutes, she said, 'You can go now. I don't want to keep you from your work.' And I said, 'This is my work.'"

For many nurses, who must act as "a funnel" for all the technology, paperwork and documentation, "just being there" with a patient is a way of getting back to the basics, says Loos. And the relationship between nurse and patient at the end of life is an intimate one. "I almost always walk away having learned something," says Loos. "It's almost like a gift."

In the past year, one of the patients who had a profound impact on her was the late Thomas Fairchild '59, the former UNH professor of animal science, dean and interim president. Although studies show that roughly 85 percent of people would prefer to die at home, 50 percent die in a hospital, often because they have intractable symptoms that require constant monitoring. Fairchild spent his final weeks in the hospital, where he was the first to use a new palliative care room designed for that purpose. "The last week of his life, we got his pain under control," recalls Loos, "and he was able to have conversations with his kids and grandkids. He gave advice. He was teaching till the last moment."

Before he died, Fairchild told his children of his desire to write a letter to the hospital about the palliative care program. Six months after his death, two of his daughters, Karen Fairchild Reed '97, '98G and Kathryn Fairchild Francoeur '87, wrote the letter on his behalf—one of many grateful letters Woolley says that the hospital has received from families over the past year. The letter ends in this way:

"Our father said that this experience was like something from a movie or last chapter of a book. Of course, the experience of dying is surreal for everyone involved, however, he meant much more than this. He was referring to unforgettable moments of sharing love and life with his wife, children, grandchildren, friends and staff. In the 'hospice bag' given to us was a camera and journal to document these moments. Again, we are immensely grateful for having been able to capture these last times together.

"Our dad was an avid hunter; he enjoyed big game and bird hunting trips. He had hoped to run his dog in the woods before the end. However, instead of being disappointed about not making his last adventure, he said, 'I thought this trip (dying) was going to be the worst, but it has ended up being the best trip ever.' Thank you for helping our father. We are blessed to have been a part of this final journey."

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