Jason Roa [Courtesy photo]

When a family reaches the final chapter of a loved one’s life, the distance to care should never be part of the equation. For too many families in Southwest Florida, it has been.

For more than four decades, Avow has walked alongside patients and families in Collier County. Founded in 1983 as Hospice of Naples by volunteers who believed no one should face the end of life alone, we have grown into a nonprofit providing hospice care, palliative care, Medicare-certified home health care and grief support for children, teens and adults. What has not changed is the promise at the center of it: we care for everyone, regardless of ability to pay.

But a promise bound by a county line is an incomplete promise. Southwest Florida is one of the fastest-growing regions in the country, and it is aging quickly. In 2025, the state of Florida determined that the providers already operating in Glades, Hendry and Lee counties were not meeting the need, and through the Florida Agency for Health Care Administration’s Certificate of Need process, prospective new providers were able to apply. Nearly a dozen organizations competed for entry. Three were selected, and Avow was one of them, chosen for our proven track record, for well-established programs already running in a neighboring county and for detailed plans to serve the new counties. The gap we were asked to help close is substantial: projections showed the existing provider landscape falling short by more than 1,875 patients.

That is not an abstraction. Behind that number are caregivers piecing together medication schedules alone at 2 a.m., adult children driving an hour each way to sit with a parent, and families absorbing the financial burden of unmanaged symptoms, avoidable emergency room visits and missed work. When care is not available close to home, families are left to navigate fear, guilt and confusion at precisely the moment they have the least capacity to absorb it.

In practice, that means a hospice team that arrives wherever home happens to be: a house in Lehigh Acres, an apartment in Cape Coral, a room in a skilled nursing center, a family farm outside Moore Haven. It means integrative therapies such as music, massage and pet therapy are woven into the care model rather than offered as an extra.  And it means grief support that belongs to the whole community, not only to the families we have cared for. Our adult bereavement programs and Avow Kids grief and loss support programs are open at no cost to anyone carrying a loss.

It means something specific for Veterans, too. Avow is a five-star We Honor Veterans partner, and roughly a quarter of the patients we serve have served. Military service shapes how a person approaches the end of life, sometimes surfacing memories held quietly for decades. Meeting that moment well takes training, and it takes Veterans willing to sit with fellow Veterans.

Growth like this only works if it is built to last. A single campus in Naples cannot reach a region this large, so this expansion comes with local footing. Avow now has offices in Fort Myers and LaBelle, giving our teams a base within the communities they serve rather than an hour or more away. Care itself is delivered wherever home is, and these offices put our nurses, aides, social workers and chaplains closer to patients’ doorsteps. We are also hiring local clinicians and forming partnerships with area health systems, senior living communities and faith congregations that local families already trust.

Let me be direct about why this matters to a nonprofit. When end-of-life decisions are shaped primarily by margin, patients become a calculation. We do not select whom to serve based on who carries better insurance. Our palliative care program operates at a financial loss every year because the mission requires it and because, for people managing chronic conditions in communities without a hospital or urgent care center nearby, it is a lifeline. That is not a policy. It is a culture built over decades by caregivers who chose this work as a calling.

This is a beginning, not a finish line, and we cannot do it alone. If you live in Lee, Hendry or Glades counties, there is a role for you. We need volunteers who can sit at a bedside, give a caregiver a few hours of relief or share a talent. We need physicians, discharge planners and social workers to understand that a hospice referral is not giving up but ensuring goals of care include comfort, dignity and time that belongs to the family. And we need neighbors to talk about this before a crisis forces the conversation.

Every family deserves access to the highest quality hospice care close to home. After 43 years of keeping that promise in Collier County, we are ready to keep it across Southwest Florida.

About the Author

Jaysen Roa is president and CEO of Avow, Southwest Florida’s original nonprofit hospice, founded in 1983. Avow provides hospice care, palliative care, Medicare-certified home health care and no-cost grief support services for children and adults. To learn more or to explore volunteer opportunities, call 239-261-4404 or visit avowcares.org.