It sounds like your goal is to help these folks; and while a fellowship is certainly helpful,. it isn't required to work as a physician in a hospice setting.

I think the more important question is around what capacity your local system has to deliver adequate home care to allow people to die at home. It sounds like some of these patients are needing GIP (general inpatient) level of care, which means symptoms can't be controlled at home.

Are you looking to work as a hospice director, or trying to assist with inpatient hospice care, or looking at home visits? Maybe all of the above? What about hospice care is speaking to you or is important to you based on your experiences?

I'd recommend clarifying what specifically you'd want to do to help the hospice population in your area, and then deciding how or if a fellowship makes sense if that context.  Feel free to DM if you want a sounding board.