Death is the one journey every person will eventually take, yet it remains one of the least talked about experiences in our lives.
For many families across the Fredericksburg region, the final chapter of life is often marked not only by grief, but by impossible decisions, overwhelming caregiving responsibilities, and a lack of resources that leave loved ones feeling alone during one of life’s most sacred moments.
With a mission to help individuals and families navigate the final path of life’s journey with knowledge, comfort, care and respite, Ars Moriendi Services was created.
Now, through the establishment of The Ars Moriendi Services Fund at The Community Foundation of the Rappahannock River Region, community members have a new way to help ensure that no one has to face the end of life without compassion, dignity, and support. The new fund was established with the generosity of an anonymous community donor who provided a $10,000 founding gift as a way to educate and invite others to become a part of this important mission.
More Than Hospice. Filling the Gaps Families Face
Despite serving thousands of residents across Planning District 16, the Fredericksburg region has no residential hospice home. When someone can no longer remain safely at home, families are often left with only two options: a hospital or an expensive nursing facility, neither of which is what many people hope for during their final days.
Medical hospice provides exceptional clinical care, but it does not provide around-the-clock caregivers or a place to live. Families are frequently expected to become full-time caregivers, often requiring multiple people to rotate eight-hour shifts for weeks at a time, something many simply cannot do. Omega Homes were developed nationally to bridge that gap by providing community-based, nonmedical homes that work alongside hospice agencies to offer 24/7 care in a home-like setting.
For Sara Milliken and Rachel Butler, that reality wasn’t something they read about, it was something they witnessed every day.
The two nurses first began discussing the need for a different approach in 2023 after repeatedly caring for patients whose wishes could not be honored simply because they lacked the resources or support to make them possible. Their vision became Ars Moriendi Services, which officially became a nonprofit in October 2024.
“I learned in the intensive care unit that death doesn’t have to be a negative experience,” said Sara Milliken, co-founder of Ars Moriendi Services. “People can be honored in their death. They can have dignity. But too often families don’t know what choices they have until they’re forced to make impossible decisions in the middle of a crisis.”
Giving Families the Gift of Being Family Again
Ars Moriendi Services is working toward opening the region’s first social model hospice home, an end-of-life home that partners with medical hospice providers while offering something equally essential: a place where people can spend their final days surrounded by comfort, compassion, and community.
The organization is a member of the Omega Home Network, a national nonprofit that mentors communities across the country in developing compassionate, community-supported end-of-life homes. Omega Homes are not medical hospice facilities. Instead, they complement hospice providers by offering a home-like setting, around-the-clock caregiving, volunteer support, and respite for families, ensuring no one faces the end of life alone because they lack financial resources or caregivers. Ars Moriendi Services is following this proven model as it works to bring the first Omega-style home to the Fredericksburg region.
The organization is currently raising funds to launch a pilot home while building toward a permanent residence that will serve individuals regardless of their financial circumstances. Its long-term vision includes volunteer caregivers, paid overnight staff, welcoming family spaces, accessible accommodations, and peaceful outdoor areas where loved ones can simply be together.
For Rachel Butler, the goal is about restoring something families often lose.
“We want families to have the opportunity to simply be daughters, sons, spouses, and grandchildren again,” Butler said. “At the end of life, people shouldn’t have to choose between caring for someone they love and simply being present with them. We want to give families the gift of spending meaningful time together while knowing their loved one is receiving compassionate, around-the-clock care.”
Changing the Conversation Before the Crisis
While the residential hospice home remains the organization’s long-term goal, Ars Moriendi Services is already making a profound impact across the region.
Rather than waiting until families face a medical crisis, the organization is helping people prepare long before they need these services.
Its educational programs teach individuals how to complete advance care planning documents, understand healthcare directives, discuss end-of-life wishes with loved ones, and make informed decisions about future care. The organization also hosts Death Cafés—community conversations held in welcoming spaces where people of all ages can openly discuss death, grief, caregiving, and living well.
These conversations may sound unconventional, but they are changing lives.
“I’ve fallen in love with what happens in our Death Cafés,” Butler said. “You see younger and older generations sitting together, talking honestly about something everyone experiences but few people ever discuss. People leave less afraid because they realize they’re not alone. That changes how they live today, not just how they’ll die someday.”
The organization has also launched its first Death Doula Certification Course, helping rebuild a role that once existed naturally within communities—people trained to walk alongside individuals and families through the final weeks, days, and hours of life with comfort, presence, and practical support.
A Growing Impact
Although Ars Moriendi Services is still a young organization, its reach continues to grow.
During its first full year in 2025, the organization:
- Distributed more than 500 pieces of educational literature on advance care planning and healthcare directives.
- Presented at 12 community events.
- Provided educational materials in both English and Spanish.
In just the first half of 2026, Ars Moriendi Services has already:
- Distributed 220 additional educational resources.
- Spoken at 22 community events and organizations.
- Hosted four Death Cafés.
- Launched its first Death Doula Certification Course with six students.
- Begun expanding educational materials into five additional languages through support from the Mary Washington Hospital Foundation.
The organization also provides education and outreach to underserved populations, including LGBTQ+ individuals, people experiencing homelessness, caregivers, healthcare providers, and families navigating serious illness.
A Mission That Will Touch Every Family
The name Ars Moriendi comes from a series of books written more than 600 years ago to help ordinary people understand what was then called “the art of dying well.” Their purpose was simple: make knowledge accessible so no one had to face the end of life alone or unprepared.
That mission remains unchanged.
Whether by helping someone complete an advance directive, supporting a caregiver overwhelmed by responsibility, training compassionate volunteers, or one day opening the region’s first residential hospice home, Ars Moriendi Services is building something that ultimately touches every family.
Because while death is universal, dignity should be too.
Through The Ars Moriendi Services Fund at The Community Foundation of the Rappahannock River Region, donors can help make that vision a reality, creating a future where every person in our community has access to compassionate end-of-life care, meaningful support, and the opportunity to experience life’s final chapter with peace, comfort, and grace.
To support this vision and help bring compassionate end-of-life care, education, and family-centered services to our region, donate today to The Ars Moriendi Services Fund at The Community Foundation of the Rappahannock River Region.
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About The Community Foundation
The Community Foundation is a tax-exempt public charity dedicated to enhancing the quality of life for the more than 407,000 residents of Planning District 16, including the City of Fredericksburg and the counties of Caroline, King George, Spotsylvania, and Stafford. We partner with individuals, families, businesses, and organizations united by a shared purpose—strengthening our region through thoughtful, impactful philanthropy.
Since inception, the Community Foundation has invested more than $24.8 million in grants and scholarships to support the people, programs, and initiatives that define and uplift our community. Today, we steward 226 named charitable funds established by donors to address a wide range of causes—from education and workforce development to human services, the arts, and community vitality.
Beyond grantmaking, the Foundation serves as a trusted philanthropic leader and resource. We have provided more than 8,000 hours of education and training for local nonprofits, equipping organizations with the knowledge, tools, and connections needed to maximize their impact and build long-term sustainability.
With more than $60 million in net assets under management, the Community Foundation maintains a strong financial foundation and a long-term commitment to responsible stewardship. Our strength ensures that the charitable legacies entrusted to us continue to serve this region—today and for generations to come.
For more information, please call (540) 373-9292, email info@cfrrr.org or visit www.cfrrr.org.