HANGZHOU — In the presence of a warm aromatherapy lamp and soothing music, Hong Dandan sat beside the bed and slowly massaged a patient's hands to relieve his pain. As a hospice nurse, Hong, 28, has provided end-of-life care for dozens of people, accompanying patients on their last journey.

In China, the development of hospice care has been on the upswing. In 2017, the former National Health and Family Planning Commission issued a trial guideline for hospice practices, defining hospice care as efforts including pain and other symptom relief, comforting and psychological, spiritual and social support.

Nurses are indispensable in hospice care. "Patients at the end of life often have many symptoms, including pain, vomiting, aphasia and mobility difficulties," says 44-year-old Xiang Qiaozhen, head nurse of the hospice ward at Zhejiang Hospital. Aphasia is difficulty talking, understanding speech, reading or writing.

"The significance of our work lies in minimizing their discomfort and addressing their needs and feelings," Xiang adds. The hospital has 26 hospice nurses after six years of development.

In one ward in early May, the faint sound of opera singing broke the quiet. "He loved singing but had not been able to sing for a long time after getting sick," says Li Lizhen, 76, as she watched her husband humming his favorite opera in the hospital bed. Tears flowed at this remarkable development.

The days of Hu Rongxiu, Li's longtime partner, are numbered due to the spread of stomach cancer. When Xiang and other nurses came to talk with Hu at his bedside, he took the initiative to mention, "I used to sing very well. Let me sing for you."

"The nurses treat us like family, and I could see the light in his eyes again when he offered to sing," Li says.

In March, an 87-year-old retired professor named Liang, who has since died, was admitted to the hospice ward where Xiang works. He had been grappling with malignant tumors for months, and at that point, his expected survival period was assessed at less than three weeks.

Liang was a calligraphy lover who was quite fond of a portion of verse in calligraphy that was presented to him by an old friend. After finding out about the gift, Xiang went looking for the calligraphy and hung it on the wall in front of Liang's bed so that he could see it. "When you feel better, we can take a photo of you with the calligraphy and send it to your friend," Xiang suggested.

Liang was too weak to answer, but a glimmer of hope flashed in his eyes. On the morning of the third day of his stay, Liang, whose pain was under control, suddenly said to his caregiver, "I want to sit up," and pointed his finger toward the calligraphy.

Hearing the news, Xiang understood his thoughts immediately. With Xiang's help, Liang put on his clothes and managed to leave the bed. "Bring me a comb and the scarf," Liang whispered as he tried to open his eyes and smiled. "Being happy to live and leaving no regrets to die," Liang read the verse aloud and gave a thumbs-up.

There is a special room in the hospice ward — the farewell room. "After the patient passes away, we hold a small farewell ceremony here following the family's wishes to work through their grief," Hong says, adding that she once applied makeup to an elderly woman before a farewell ceremony.

"These tasks are not supposed to be part of the nurses' job, but all that they did made me feel that my mother was respected, and her life cherished," says the woman's son, who visited the hospital afterward to express his gratitude to the nurses.

Taking care of these end-of-life patients is not as depressing as many people might think, nurses say. Hospice nurse Li Yanfang, 40, says her work is interesting and vibrant. Hong described her work as similar to witnessing the beauty of golden ginkgo leaves before they fall to the ground.

"The elderly are like a book. In the process of taking care of them, we look back together at the highlights of their lives and share their happiness and sadness. It makes the nurse-patient relationship here much more harmonious," Hong says, attributing this warmth and recognition to the pride she derives from her career.

In addition to the strength transmitted by patients and their families, the nurses are always supporting each other. "Sometimes when we are tired of work or in a bad mood, we will encourage and comfort each other," Li Yanfang says.

Medical treatment may have boundaries and limits, but comfort is where hospice nurses often excel. Li says these "angels" do their best to see that pain and suffering are relieved to the extent humanly possible.