There's a story Abbi Henstra tells that says everything you need to know about the state of hospice care today.
At a Christmas party for a hospice agency, staff were asked to guess what you'd most likely find hidden in the supply closet. The most common answer wasn't extra gloves or paperwork. It was a crying nurse.
"It was funny," Abbi admits. "And also very sad."
That story — equal parts dark humor and genuine alarm — is what drove the creation of FireNote, an AI-powered documentation tool built specifically for hospice and home health teams.
And it's the same underlying frustration that led Cara Abbott to found Betterleave, a family engagement and bereavement platform, after losing her mother to cancer and being thrust into a system that felt fragmented, impersonal, and decades behind.
Both women joined together recently for a fireside chat on the future of connected family experience. What followed was a frank, funny, and deeply human conversation about what's broken in post-acute care — and what's finally starting to get fixed.
The Problem Nobody Talks About Out Loud
Ask any hospice leader what keeps them up at night and they'll probably mention staffing. Burnout. Turnover. The impossible caseloads that send nurses home to chart while their kids are asleep.
"No one gets paid to chart," Abbi says. "You're paying your nurses to chart, yes — but as an agency owner, that is not billable time. You have to chart to get paid, but the charting itself isn't reimbursed."
FireNote was built to attack that problem directly. The platform uses AI to reduce charting time by over 70%, bringing routine notes down to around 8 minutes and admissions under 40. The goal isn't to replace clinical staff — it's to give them their lives back.
"We're not here to cut your headcount," Abbi is quick to clarify. "We're here to create the breathing room your staff deserves. Happy staff means better retention. Better retention means better care."
On the family side, Cara saw a parallel problem. Family communication in most hospice organizations isn't a system — it's a collection of heroic individual efforts. One exceptional nurse makes three extra calls. A compassionate social worker sends a handwritten card. But when that person is out, the family on the other side of the phone feels the absence acutely.
"Family communication is not systematic," Cara says. "It's ad hoc. And that means the families who don't get that amazing nurse are not getting the same experience. What groups are really starting to ask is: how do we create a standardized level of care for family members?"
Bereavement Is Not a Checkbox
Of all the places where the hospice industry has fallen short, bereavement might be the starkest example of good intentions colliding with broken process.
Legally, it's a compliance requirement. Practically, it's been treated as an afterthought — a mail merge, a stack of envelopes, a box to check before closing the file.
"Think about what that actually involves," Cara says, with a laugh. "You print off all the family names and addresses. You stuff the envelopes. You mail them. And a stamp is 70 cents. It's expensive and it's time-consuming — and when it lands in someone's mailbox, it sits in a pile with the rest of the mail they're not reading."
She held up her own desk as evidence: a stack of unopened mailers next to her phone, which is never more than arm's reach away.
Betterleave replaces that process with conversational SMS messaging — meeting families where they actually are, in the medium they actually use, at the moments they actually need support. The platform follows families from the start of care all the way through 13 months of bereavement, providing personalized check-ins, resources, and support that adapt to each family's specific situation.
A family navigating a loved one with dementia gets dementia-specific resources. A family dealing with a sudden terminal diagnosis gets something entirely different from a family in a long, chronic decline. The difference, Cara argues, isn't just better service — it's a fundamentally different relationship between hospice organizations and the families they serve.
"Bereavement isn't just a compliance checkbox," she says. "It's the last impression you leave. And if you treat it that way — as a relationship, not a requirement — it becomes a growth function. We're seeing more Google reviews. More family referrals. Real outcomes."
"We Have to Do Better"
One of the more interesting threads in the conversation was around staff fear of technology — the worry that AI tools will eliminate jobs rather than improve them.
It's a concern both Abbi and Cara hear regularly, and both push back hard.
"When I hear someone say, 'Oh, this tool could let us cut staffing down,' I stop them immediately," Abbi says. "That is not the point. The point is breathing room. Your nurses didn't go into hospice to chart at home at 10pm. Your bereavement coordinator didn't get into this work to stuff envelopes. Give them back the time to do the thing they actually came here to do."
Cara echoes this with a story about a bereavement coordinator who, when asked what she'd do with more free time, didn't hesitate: she'd go into the assisted living facilities and nursing homes that refer patients and run grief support groups for the staff there — people who form deep bonds with residents and then lose them, over and over, with almost no support of their own.
"That's the idea that gets unlocked when you remove the administrative burden," Cara says. "That's what we're actually trying to make possible."
What's Coming Next
FireNote's 2026 roadmap is, by Abbi's own description, "heavy with AI" — with significant releases planned for Q2 through Q4. She teases one project that would allow clinicians to tell the story of a patient's decline more clearly and completely than ever before, pulling in data across benefit periods to help with both clinical documentation and compliance, without requiring staff to manually dig through charts.
For Betterleave, the focus is on deepening personalization — moving beyond a one-size-fits-all family program toward something that genuinely meets each family in their specific moment, with resources and support tailored to their diagnosis, their timeline, and their emotional reality.
And both companies are increasingly thinking about how their tools connect. FireNote patient data flows directly into Betterleave, eliminating duplicate data entry and making the handoff between clinical care and family support as seamless as possible.
It's a philosophy of partnership that Abbi says is central to FireNote's approach: rather than trying to do everything, find the best tools in each niche and integrate them.
"We want to play nice in the sandbox," she says. "Our clients deserve the best of everything — not just the best of us."
The Bottom Line
Hospice care is, at its core, one of the most human things that exists. It asks clinicians to show up, day after day, in the most tender and difficult moments of people's lives. It asks families to navigate grief while simultaneously managing logistics, information, and uncertainty. It deserves tools that are equal to that weight.
"At the base of all of it," Abbi says, "we are humans trying to solve other humans' problems. The technology is just how we do it better."
Both women closed the conversation with a version of the same challenge to the industry: it's 2026, and there are better tools available. The question is no longer whether technology can help — it's whether leaders are willing to pull the trigger and find out.
"How long," Abbi asks, "are you going to watch your nurses come in utterly exhausted before you do something about it?"
