Pediatric Palliative and Hospice Care is a partnership between you, your child, your existing physicians and treatment team, and our Four Seasons Riversong team. Our goal is to provide life-enhancing care, so that your child can focus on being a child.
When we meet with you the first question we ask is “What’s Most Important to You?” We listen to your goals, your child’s wishes and work with your existing treatment teams to provide additional care that can make a positive impact on quality of life. Our care not only helps your child be more comfortable physically, but also provides emotional and spiritual care. We also support the caregiver(s) and family with training and resources.


Why Choose Four Seasons Riversong?
We Make House Calls!
Our services are provided to your child, wherever they call home, by our highly trained Physicians, Nurse practitioners, Physician Assistants, Nurses, CNAs, Social Workers, Spiritual Counselors, and Volunteers.
We are Experienced and Honored
Riversong is part of Four Seasons, an award-winning organization that has been serving Western North Carolina since 1979. Our organization achieved Deemed Status by the Joint Commission, received Hospice Honors, the Circle of Life Award and others.
We Offer Innovative Therapy
Our whole-person care includes Music Therapy and Pet Therapy in addition to grief counseling.
We Provide QUALITY Care
Our quality outcome scores rank above the national average scoring 24 out of 24 regarding the experience of care.

Palliative Care can enhance your child’s quality of life, helping them to concentrate on being a child.
Pediatric Palliative Care helps parents have more peace of mind, and allows children to have more moments to concentrate on being a child. This specialized care is a key part of care for children living with a serious illness. We help your child manage pain and provide relief from symptoms like trouble breathing, difficulty sleeping, depression, loss of appetite, and others that may accompany their serious illness. We also provide support to the caregiver and whole family. We collaborate with your providers, giving you that extra layer of support, timely response, and help in navigating your child’s care options.
WHEN is it Time to Call Palliative Care?
Pediatric Palliative Care is for children up to age 21 who are living with a serious illness including cancer, genetic disorders, neurologic disorders, heart and lung conditions, and others. Unlike hospice, your child can still receive curative, life-prolonging treatment while in Palliative Care. We suggest calling as soon as a diagnosis is received.
WHO is the Palliative Care Team?
Our Palliative Care Team consists of a Provider (Physician, Physician Assistant, or Nurse Practitioner), Healthcare Social Worker, and other specialists. We partner with your child, family, and your existing healthcare team. We listen to what’s important to you and work with you to create a plan. Additionally, we can assist in moving to and from hospitals if your child’s illness requires, providing consistent care during these difficult transitions.
WHERE is Palliative Care Provided?
We provide care wherever your child calls home, whether that is in a private home, hospital, or other environment. Palliative Care is provided in all thirteen counties we serve.
HOW is Palliative Care Paid For?
Palliative Care is paid for by Commercial Insurance, Medicaid, Private Pay, and Four Seasons Foundation.

Hospice Care provides comfort and support so that you can make the most of your moments together.
Pediatric Hospice Care is focused on providing comfort to your child, and support to your family so that you can spend quality time together truly living during this season of life. Our priority is to provide care that aligns with your wishes, while enabling your child to stay in their own home if possible. In addition to pain relief and symptom management, we incorporate supportive measures such as music therapy and pet therapy, along with care for both you and your child’s emotional wellbeing.
WHEN is it Time to Call Hospice Care?
Pediatric Hospice Care is for children up to age 21 with a life expectancy of 6 months or less and who may or may not be receiving curative (concurrent) treatment.
WHO is the Hospice Care Team?
Each Hospice Care Team consists of a Provider (Physician, Physician Assistant, or Nurse Practitioner), Healthcare Social Worker, Chaplain, Music Therapist, and other specialists who work together to manage the physical, emotional and spiritual needs of the your child, siblings and other family members.
WHERE is Hospice Care Provided?
We provide care wherever your child calls home, whether that is a private home or hospital, and, if symptoms cannot be managed elsewhere, at the Four Seasons Inpatient facility, Elizabeth House. Hospice Care is provided in all thirteen counties we serve.
HOW is Hospice Care Paid For?
Hospice Care is paid for by Commercial Insurance, Medicaid, Private Pay, and Four Seasons Foundation.
In addition to our Hospice Care services, Four Seasons offers Grief Services for siblings, parents and family. Our services include group and individual counseling, with special emphasis on adolescent grief counseling through our Compass Program. These services are provided at no cost to you because of support from our Foundation.
HOW are Pediatric Palliative Care and Hospice Care Different?
Palliative Care is available to your child at any time during a serious illness, while Hospice Care focuses on care during a person’s final months of life. Some children receive Palliative Care for many years and then no longer require it.
HOW does Four Seasons Riversong Support Families and Caregivers?
When a child has a serious illness the impact isn’t only on the child but also is felt by siblings, parents, caretakers and other family members. Four Seasons Riversong provides emotional support for families, as well as caregiver resources and training. Grief Services and other support services are also available to anyone impacted by your child’s illness.