We had a hospice referral on a patient where the adult child was known to be verbally abusive and difficult to direct. The patient wanted to come home to die and this adult child was the only caregiver. During the admission the caregiver was difficult and verbally abusive to the nurse. This nurse did her best to redirect the caregiver and try to instruct her on her parent’s care. The nurse recognized that the caregiver was really frightened at the prospect of being the primary caregiver. The hospice nurse realized the patient had very little time left and did her best to instruct on end-of-life care before she left the home. A few hours later, she called the caregiver to follow up and reinforce the teaching that she had done. The caregiver yelled at her the whole time. At night the CG called and requested an on-call visit. During the visit, the caregiver was so verbally abusive that a note was put in the chart that all future visits be done with security. The next morning the patient expired. The admitting nurse volunteered to go back and pronounce. She was offered additional staff or a security escort, but she declined both, citing that it would only inflame the caregiver more. She pronounced the patient and stayed with the caregiver until the funeral home arrived. I truly think this was a heroic effort to try to understand the caregiver and to honor the patient’s wishes to die in her own home.