Yvette Lascelle has a favorite saying: “It is what it is.”

“Whatever happens, happens,” Lascelle said with a faint smile. “They try to prevent it, but you can’t always prevent it.”

The 81-year-old has been fighting multiple myeloma, or plasma cell cancer, for over a year and a half. In the past month, however, her condition has rapidly declined. Not knowing how many days she has left, she takes each one as it comes and savors the small moments – sitting with her brothers in the morning or sipping on eggnog in the afternoon.

Her room at the hospice house in Concord is rarely quiet. Nurses check on her frequently and help maintain her comfort. Her priest comes by to guide her in prayer. Family and friends fill the space. Her daughter, Karen, sometimes sets up a small makeshift office and works remotely from the red chair by the window. Her son, Dan, visits after work with his wife and son. Lascelle lays underneath her lilac quilt, watching the world unfold from her bed and cherishing this time with her loved ones while it lasts.

“Every day I’m happy to wake up,” the grandmother of four said. “You face the tomorrows. That’s it. It’s better than what I expected.”

‘The best care’: More than a place to die

Two winters ago, Lascelle’s life shifted. She arrived at her brother Ronald Girard’s house for lunch one day, and he noticed that she had lost a lot of weight. At his behest, she went to the doctor.

Even amid treatment, her cancer diagnosis did not stop her from still working as the office manager at Capital Appraisal Associates, a company she helped start back in 1982, nor did the kidney failure that led her to start dialysis. Up until a couple of months ago, Lascelle, who lived alone, was driving herself to her own dialysis appointments and still going to work.

“Actually, I never said I stopped working,” Lascelle joked wistfully.

Then a blood infection spread through her body, leading to complications that left her significantly weakened.

A recent two-week stay at Concord Hospital in mid-October delivered a grim prognosis of little time left. On the day of her 81st birthday at the end of October, she moved from Concord Hospital to the hospice house. Birthday balloons, now partially deflated, still rustle quietly in a corner of her room. Cards and flowers line the table. Family photos hang on the walls.

To her surprise and that of her family, Lascelle, who barely ate for two weeks while at the hospital, regained her appetite. She worked her way up to eating toast, eggs, and crispy bacon in the morning and credits the hospice house with getting her to this point.

With hospital-level care, combined with the comfort of a home, the 10-bedroom Granite VNA Hospice House on Pleasant Street in Concord offers an alternative to at-home hospice for patients who need a higher level of medical support. Here, the average length of stay is five days.

“How often have I been going past this building and never knew what it was all about?” Lascelle said. “It’s not a place where you should be afraid to go into. They’re more than welcoming. They give you the best care, for sure. Anything you may want, you’ll get.”

The decision to enter hospice – either at home or at a hospice house – can evoke fear for some patients and their families. Lascelle’s brother, Ronald Girard, highlighted that the care his sister has received has helped ease that fear.

“I think we’ve all had not a negative view about hospice, but it was almost an unknown. People hear of hospice and they think it’s just a place to come to die. I think it’s more than that,” Girard said, looking at his sister, who nodded in agreement.

Lascelle explained that she knew going to the hospice house was right for her.

“It wasn’t really a decision. It’s just where I was with my medical care,” she said. “It was always okay.”

Despite everything, she feels a sense of peace about what lies ahead, in part thanks to her lifelong connection to Catholicism, which has provided her with additional comfort.

“I think God was with me,” she said. “I feel like as bad as I guess this is, I feel lucky at the same time.”

With a glance at the framed photo of her and her late husband, Marcel, resting on her bedside table, Lascelle then looked at Girard, who comes to see her every day. She says they’ve always been close. They have two other brothers, Richard and Dennis, each of whom has spent time visiting Lascelle in recent weeks. The siblings, who grew up in Allenstown back when it was still known as Suncook, even brought life-size cardboard cutouts of their faces to keep Lascelle company when they couldn’t be with her. None of them are strangers to illness, having lost their youngest sister, Collette, to breast cancer two decades ago.

“We’ve always had strong family ties,” Girard said.

In a way, he’s felt those ties grow even stronger in the time Lascelle has been at the hospice house. Family members visit daily and spend hours together in her room.

“It’s just amazing how her presence here is strengthening our family even more,” he said.

Girard teared up, took a breath, then added, “She’s accomplished something in her life that she’ll never know what she’s done to help us out.”

The family tries to dwell in the present and enjoy each moment of togetherness. Sometimes this includes watching game shows, which Lascelle particularly loves.

“I feel very comfortable here,” she added. “It’s not like being in the hospital. You don’t think of it like that at all.”

Death: The ‘great unifier’

The common refrain echoed by those who work in hospice is that most people don’t understand the benefits of these end-of-life services, which increase patient comfort, offer support to families and caregivers, and create a sense of peace in the process. Last year in New Hampshire, over 7,300 patients received hospice care, with the average duration being 67 days, according to the Centers for Medicare & Medicaid Services.

To qualify for hospice, a patient with a terminal illness receives a life expectancy diagnosis of six months or less. For most patients, care happens at home, with a nurse, case manager, social worker, spiritual care counselor, and volunteer available to assist the patient and family based on their needs. Hospice services such as the ones offered through Granite VNA include bereavement support for loved ones up to 13 months after the patient’s death.

Marsha Filion, executive director of the Hospice Help Foundation, emphasized that people don’t tend to discuss matters relating to death. This sometimes prevents them from learning about hospice earlier in their journeys.

“When you’re talking to people about death, it’s such a hard conversation to bring up, but it’s inevitable, and it’s a great unifier because we’re all going to go through it,” Filion said. “We all have loved ones who are going to go through it.”

Lascelle and her family don’t necessarily sit around talking about death, but they can feel its unspoken presence around them, dwelling in the silences.

“She gives me courage,” Girard said. “We all have fears in life. She’s such a strong person. She knows her life. She knows her fate. But she still embraces each day.”

Hospice can be life-affirming through its holistic approach to care, Filion added. It helps people feel less like patients and more like full human beings.

“Once you enter hospice, you don’t give up on life. It just means that you’re really focusing on the things that make it worth living, as opposed to spending the day going from one doctor’s office to the next, or being hooked up to tubes,” Filion said. “It’s really just about pulling the things that are meaningful close to you and enjoying them with as few distractions as possible.”

Beth Slepian, president of Granite VNA, hopes that the more people who understand hospice, the more they will consider taking advantage of it as a resource. If patients choose, they can have a trained hospice volunteer come read to them, write down their memories, grocery shop for their family, sit with them outside, or spend time however the patient wishes.

“We’re really trying to reframe how people look at hospice – not as how they die but as how they live,” Slepian said. “Hospice in general is very underutilized in New Hampshire and across the country. We know that people are often referred too late, so they don’t get to benefit from hospice and all it offers. ”

Many people move to hospice when they have mere days or weeks to live. But, as different hospice care professionals underscored, even for those with months to live, the services offered can improve their quality of life.

“We’re trying to get people to consider hospice sooner rather than later because it’s so beneficial,” Filion said. “Because you’ve got a whole team of people coming in, it can be such a relief for family members and caregivers who are trying to help.”

Even from her hospice bed, Lascelle still wants to take care of those she loves. After a few nights, she told her daughter, who had been sleeping on the couch, to go home and be with her family, reassuring her that she’d be okay.

“It’s like my favorite saying: ‘It is what it is,’” she repeated.

Rachel Wachman can be reached at rwachman@cmonitor.com