The word “hospice” is a two-syllable gut punch for anyone who knows what it means and represents, even if they’ve never had to engage with the concept head-on. A decade ago, the Antlers further bleakened the word, weaving a story that used the slow descent of cancer as a stand-in for an abusive relationship. The band made two albums prior to Hospice (though they were still a solo project of frontman Peter Silberman) and two since, but they’ve yet to grab onto the same power they tapped into here—though 2011’s Burst Apart came close.

Silberman still sings and plays a handful of instruments—guitar, accordion, keyboards, even harp and harmonica make an appearance—but he’s joined by Darby Cicci (who’s trumpet flourishes make tracks like “Sylvia” and “Bear” soar), bassist Justin Stivers and drummer Michael Lerner, all of whom help flesh out the gauzy textures of the album. Rather than forcing these songs into traditional structures, the band allows each song to take whatever form is more needed: more traditional songs like “Two” and “Shiva” coexist comfortably with others that wholly disregard those structures, like “Atrophy,” or the threadbare, Sharon Van Etten-starring “Thirteen.”

I wish that I had known in that first minute we met/ The unpayable debt that I owed you,” Silberman sings as “Kettering” begins, setting the scene for the album. He’s accompanied by an icy piano line and small, staticky squalls, his voice sounding as though it’s coming through a distant speaker. He sings this song meekly, as though fearful of the hell that telling his story will bring. As he sings the last line, the mix begins to grow and burst into a wall of noise, combined with his soft cooing. This dynamic—trembling fear and boisterous outburst—defines the landscape of Hospice, where post-rock and dream-pop flow into each other to make an album that sounded like nothing else made around it. It’s rife with grim imagery of fractured femurs and broken glass, atrophy and eulogy singers, without even the hint of a darkly comedic smile. In this space, death, as well as the abuse that flows darkly underneath lines like “Threats of castration for crimes you imagine when I miss your call,” isn’t too real to sing about, but it is far too real to ever make jokes about. The dancey, abortion-centric “Bear” is the closest we ever get to levity, an atmosphere undercut by its subject matter.

Hospice is tied together with lines designed to cut deep, with Silberman delivering each with an impressive range. From the restrained “And I didn’t believe them/ When they told me that there was no saving you” in “Kettering” to the gut-wrenching, shouted “Sylvia/ Get your head out of the oven/ Go back to sleeping, and cursing/ Remind me again how everyone betrayed you” of “Sylvia,” he manages a great range of emotions with his falsetto croon. “Atrophy” accomplishes its task without Silberman ever climbing out from a low, somnambulant tone, later mutated for the bulk of “Wake” as well, before delivering one of the album’s most potent, and still important, messages: “Don’t ever/ Let anyone/ Tell you you deserve that,” he repeats, his voice growing with each repetition. Elsewhere, on “Two,” the only song in which he lets an air of growing resentment shine through, he delivers the song rapid-fire, to the point he’s near breathless.

Hospice closes with the barren, acoustic “Epilogue,” which repeats the almost nursery rhyme-like hook from “Bear,” only instead of singing about abortion, he’s singing about the ghosts left behind by loss. It’s the most stripped-back song of the bunch, and the most tear-jerking as well, wringing dry whatever you had left in you after you’ve heard the rest of the album. “I’ve woken up, I’m in our bed, but there’s no breathing body there beside me/ Someone must have taken you while I was stuck asleep,” he sings cooly. He sounds on the verge of tears throughout the song, his gentle voice fraying at its edges as he delivers these lines. By the time we reach the album’s final repetition, one that feels like a part of the heartbreaking core of Hospice—“You’re screaming/ And cursing/ And angry/ And hurting me/ And then smiling/ And crying/ Apologizing”—his gentleness is replaced with a fever pitch of shouted lines, and as his falsetto shout and guitar strumming cuts, it’s replaced by a simple, warped synth line. It’s abrupt, but it feels like the best place for Hospice to end—not with anger or sorrow, but with a moment of peace.

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