Dr. Vanessa Little

Nov 16, 2025

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Don’t Erase Older Adults from Healthcare

“It feels like healthcare is trying to erase older adults,” a patient’s wife told me, her voice heavy with grief and fear. Her husband had relied on palliative care for years—first at home with an interdisciplinary team, then in clinic visits after home support was cut back. Now even that clinic is closing, and the couple has been told their complex needs will be left to a primary care provider already stretched thin.

This story is not unique. People living with serious illness face mounting barriers to care just as their needs grow. Functional decline, limited mobility, emotional suffering, spiritual pain, and distressing symptoms all deserve attention. Yet instead of increasing support, our system withdraws it.

Palliative care is not about giving up—it is about living as fully as possible with serious illness. As a physician specializing in hospice and palliative medicine, I have seen how this care helps families navigate impossible choices, clarify goals, and preserve dignity. Sometimes there is no cure. Sometimes more treatments or more hospitalizations offer only more suffering, not more time. In those moments, the most powerful medicine is consistent, compassionate presence.

Most people say they want to die at home. Yet the majority die in hospitals or nursing homes. Many don’t realize that a simple choice—like checking “Full Code” on a medical form—can all but guarantee a hospital death. We owe people the chance to make informed decisions and to receive the kind of care they value most.

In rural Maine, options are painfully scarce. Hancock County has no skilled nursing facilities. The nearest inpatient hospice house is two hours away in Rockport. Families are expected to shoulder the burden, even when caregivers are elderly themselves or when patients live entirely alone. We talk about “aging in place,” but in practice we make it nearly impossible.

The truth is that our health system was not built to prioritize whole-person care. It runs on procedures, medications, and tests. Shared decision-making—listening to patients’ goals and fears—is rarely reimbursed, so it is not prioritized. That is not the fault of any one doctor, nurse, or hospital; it is the consequence of the system we have created.

Communities can choose differently. We can create resources that allow people with serious illness to live and die with dignity. We turn toward suffering instead of turning away from it. When we come together as a community, we can ensure no one is left behind. We can choose to take care of each other and know that when it’s our turn, we too will be cared for with respect, dignity and grace.

I believe how we die shapes how we live and impacts the lives of the people around us. If we face aging and illness with honesty and compassion, we create a culture where every life is valued. If this vision resonates with you, I invite you to join us. Together, we can build a community where no one feels erased.

Please send your ideas to: sanctuaryhouseMDI@gmail.com.

Dr. Vanessa Little,

DO Hospice and Palliative Care Physician,

Seal Harbor Maine