When the strongest start to fail.

One of the saddest things as a nurse, is seeing the proud, strong, independent, become more confused, dependent and weaker. Sometimes nothing can be done to "fix" the problem, Symptoms can (and should) be managed. Emotional support is a necessary part of the picture.
The family should be supported. Sometimes they lash out at staff, not because staff has done anything wrong, but, because they (the family) are feeling angry, helpless and just not dealing well with the guilt, stress, etc. that they are feeling. It is a time to be patient with the family, without letting them disrupt the nursing floor.
Hospice, although not essential in a skilled nursing setting (for actual care), can make the difference with emotional support and advice with symptom management. Sometimes a doctor is more willing to treat pain, nausea and other symptoms more aggressively when hospice is involved.
Staff do become emotionally involved with people they take care of day after day. They grieve, too, as a patient becomes weaker, losing their battle with chronic illness and an aging body.
It is a hard time for all.
It is a time to support each other, and to be kind to all involved.