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Honoring Madelyn’s Wish

Madelyn Shoales

In February 2017, 16-year-old Madelyn Shoales was diagnosed with a rare type of brain cancer. She underwent surgery to remove the tumor, followed by six weeks of radiation. Two weeks after her surgery, she returned to school to finish out her sophomore year. Madelyn was a student athletic trainer with aspirations of becoming a physical therapist.

One year later, when it became apparent that Madelyn would not survive her courageous battle, her last wish was to die at home. Her parents, Suzannah and Jason Shoales, and her Hospice Austin pediatric care team were determined to do everything they could to honor her wish. Bethany Miller was Madelyn’s RN case manager.

“To be a pediatric hospice nurse takes a superhero and a saint, all at the same time,” said Dr. Ann Marie Case, palliative care physician for Dell Children’s Medical Center. “Bethany has a way of connecting with families and kids. When no one else can get a child talking, she’ll pull out her silliness and connect with the child. Families come to trust her.”

Bethany helped care for Madelyn during the last six weeks of her life. Bethany soon formed a strong bond with Madelyn and her parents.

Suzannah, Thomas, Madelyn, Mary Rose and Jason Shoales

“No parent ever thinks their child will get sick and die,” said Suzannah, Madelyn’s mother. “When Bethany came, she had to show my husband and me how to do things that we’re not medically trained to do. She held our hand and taught us not to be afraid.”

Madelyn did not have a lot of symptoms when she first came on to Hospice Austin’s service, so the team tried to respect her ability to be a normal teenager. As her illness progressed, Bethany began visiting daily and then twice daily. Madelyn passed away on a Saturday, while Bethany was off work. Bethany immediately went to be with the family. She helped change Madelyn’s clothes, clipped and braided some of Madelyn’s hair for the family, and stayed until almost midnight, when the funeral home escort arrived.

“She’s truly an angel,” Suzannah said, “I don’t think we could have gotten through this without her.”

Bethany believes that much of the credit should go to Madelyn’s parents. It was astounding, she said, to watch the evolution they went through in learning to provide end-of-life care for their daughter.

“These parents were doing things they never thought they’d do in their worst nightmare,” Bethany said. “It showed the depths of love and commitment they had in honoring their daughter’s last wish. They inspire me.”


Suzannah Shoales, Dr. Ann Marie Case, Bethany Miller, Leanne Rhoades, and Katie Mason

Hospice Austin pediatric nurse Bethany Miller was one of five finalists (out of 400 nominations) to be honored at the 2nd  annual Austin American-Statesman’s Recognizing Nurses Best in Class celebration. Bethany was nominated by Dr. Ann Marie Case, Hospice Austin COO Leanne Rhoades, and Suzannah Shoales, Madelyn’s mother. Every year, Hospice Austin’s pediatric hospice team – the only one in Central Texas – helps 15 to 30 children and their families remain in the comfort of their homes while receiving skilled and compassionate end-of-life care. Generous community support from The Carl C. Anderson Sr. and Marie Jo Anderson Charitable Foundation, The Carolyn Rice Bartlett Charitable Foundation, The Donald D. Hammill Foundation, Heritage Title, Philip R. Jonsson Foundation and other generous individuals make this program possible.



Melinda Marble
Communications Coordinator

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