In a small open-label pilot with home-hospice patients, a single psilocybin-assisted therapy session (25 mg) was feasible and well tolerated, with no serious adverse events. Participants showed a meaningful reduction in demoralization three weeks later, even as their physical condition continued to decline. Sessions often centered on themes of grief, acceptance, and peace. The study was small and exploratory, but it suggests psilocybin therapy may be a compassionate option in end-of-life care, pending larger trials.