End of life · Los Angeles
Living with knowing.
End of life counseling for older adults across Los Angeles — for the diagnosis you're carrying, the people you love who are watching, and the conversations that don't have to make anyone feel small. Medicare accepted, telehealth, in-home arrangements considered.
What this can feel like
Most people don't say "I'm dying." They say something like this.
"I don't want to scare them."
The kids ask how the appointment went. You give them the easy answer. You haven't said the hard sentence out loud.
"I'm tired of being brave."
Everyone tells you you're handling it well. You don't always feel like you're handling it. You feel like you're holding it.
"I want to say a thing while I can."
To your spouse. To a son who's been distant. To an old friend. The thing has been waiting in your chest for years. Now there's a clock.
"I'm grieving him already."
Your husband is still sitting next to you. You miss him. The grief has started before the loss, and you don't know what to do with it.
"I don't know what kind of ending I want."
The conversation about what you want — at home, in hospice, with whom, with what music. It's heavier than people prepare you for.
"I still want some good days."
Not heroic days. Real days — coffee on the porch, a phone call, the smell of rain. The diagnosis doesn't get to take all of them.
How therapy can help
A place to talk about what's true without making the people you love feel small.
End of life work is some of the most meaningful work we do. We meet you where you are. For some clients, that means working through the practical and emotional knots of a recent terminal diagnosis. For others, it means slow, careful conversations about meaning, regret, gratitude, and what you want to leave with the people who'll keep going.
We draw on meaning-centered psychotherapy and dignity therapy — two approaches developed specifically for adults living with serious illness. Both of them treat you as a whole person with a whole life, not as a diagnosis. We also use CBT for older adults when anxiety or depression is louder than it should be.
We work alongside hospice and palliative teams when you have them. We don't replace them. Many of our clients see us simply because they want a place to think out loud about a hard, real situation, with someone who isn't going to flinch.
Read more about grief and bereavement counseling, or about CBT for older adults when anxiety is part of the picture.
"I came in because I needed somewhere to be honest without breaking my wife. We did good work. The next time she asked how I was, I had a real answer that didn't ask her to carry it alone."
A specific moment
It's the dinner table.
End of life moments often live at the dinner table. The grandkids are being funny. Your daughter passes the bread. Your wife laughs at something the youngest said. You watch them — really watch them — and the room is more full and more breakable than you expected. You think about how many of these dinners are left, and you don't say anything, because it would change the meal, and the meal is good.
If that's been your dinner lately, you're not morbid and you're not failing. You're paying attention. There's a way to keep paying attention without it costing you the meal.
Common questions
Quick answers about end of life counseling.
Is end of life counseling for me, or for my family?
Both, depending on what you need. We work with people who are living with a terminal diagnosis, with their partners, and with adult children walking alongside. Sometimes we see one person, sometimes a couple, sometimes the family in pieces.
What is anticipatory grief?
Grief that begins before the loss. It's the work of grieving someone you still have. It can include sadness, anger, fatigue, guilt, and surprising moments of joy. It's a normal response, and therapy can help you stay close instead of pulling away.
How do I talk about this without making people I love feel small?
This is one of the most common and most important questions in this work. There are ways to be honest without overwhelming the people around you, and ways to invite real conversation that doesn't end in everyone pretending. We help you find your own version of those words.
Do you coordinate with hospice or palliative care?
Yes, when you'd like us to. We work alongside hospice and palliative teams, and we don't replace them. Many clients also see us before hospice is part of the picture, simply because they want a place to think out loud about a hard, real situation.
Does Medicare cover end of life counseling?
Yes. Medicare Part B covers outpatient psychotherapy with licensed clinicians, and Medicare also covers advance care planning and hospice mental health services through their own programs. Call (626) 354-6440 and we'll help you understand what's covered.
Related
Things that often travel alongside.
You don't have to carry this alone.
The first session is often quieter than people expect. There's no script. We start where you are.