299: Viewing Death Through the Eyes of a Hospice Nurse with Liz Keller

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Liz Keller is a registered nurse with 25 years of experience. She has practiced in all specialties from birth through end of life. Her true passion lies in hospice care where she acts as a midwife on the journey for those transitioning out of the earthly world (at the end of their lives). Her goal is to eliminate the stigma around hospice care. She hopes to be part of the movement to start the conversation about having an end of life plan with the focus being on hospice care. She believes that empowering people to make choices about how they want their last days to look is very empowering. This should be done while they are still in good health and is the key to facilitating a good death. She lives in Milwaukee Wisconsin with her husband, three children, and chocolate lab Leo! She loves the lake and spending every possible minute outside during Wisconsin summers!!

>>> Connect with Betsy on IG @betsypake

TRANSCRIPT

Welcome to the Art of Living big podcast. My name is Betsy pake. I’m an author, a speaker, and a trainer of NLP and hypnotherapy. And I’m focused on helping you understand and design your life with the power of the subconscious. This podcast is designed to help you think differently about what could be possible for your life. Now, let’s go live big. Hello, everyone, welcome fellow adventurers, welcome to the show today, I have, I actually have a really good friend of mine on today. And this conversation I think, is going to be fascinating. I’m super excited. And I’m super excited, she agreed to come on and talk to me because I think I had to convince her a little bit. But Liz Keller is on she is a registered nurse, she’s got 25 years experience in the nursing profession. And she’s practiced in all specialties from birth, all the way to the end of life, which is where I’m going with this. So her real passion lies in hospice care where she acts as a midwife on the journey to those transitioning out of this earthly world at the end of their lives. So her goal is to really eliminate the stigma around hospice care. So we’re going to dive into all of that into talking about death into what happens into like, the actual, like, physical side of like, what she sees and how she experiences death in different instances. So thank you so much for agreeing to come on, Liz. Thank you,

Betsy. I’m very excited to be here with you talking about something that I think a lot of people would never choose to talk about, you know,

why? Why is it that we’re so afraid to talk about death?

I wish I knew, I think a lot of is cultural. Because I know that I’ve experienced in working with some other cultures that there’s a special reference to it. But I think in the American culture, overall, people, there’s just a lot of fear. And when you think about the way things that we don’t know, or that are unknown to us, can create fear. So yeah, it’s surprising, but I’m kind of on a mission to, you know, eliminate that and do what I can through my work. Yeah. And help people not be so afraid.

Yeah. Well, I love that maybe my work could help expand your work. And we could do this together today. As we co create, we co create. So okay, so, you know, it’s interesting, because I remember when my grandmother died, she, she wasn’t in hospice, but she was in the hospital, like, we knew she was going to die. And she and I had talked off and on about death, I think part of her wanted to talk about death when my mom died, but part of her was afraid to talk about it. But we talked a lot about having signs and that she would send me signs. And we agreed, although she sort of like laughingly agreed that she would send me certain signs, and I was very serious about it like this is, this is what’s gonna happen if I die first, I’m gonna send you these signs. And so when she was in the hospital, I started having these conversations with her again, and I knew it was making everybody really uncomfortable. But I was like, are we in denial? Like, she’s gonna die? Why aren’t we just talking about it was so interesting to me. And then as it got closer to her death, to that moment, she said to me, I’m so brave, aren’t I so brave. And I thought that is so like, talk about the biggest adventure into the unknown, you have to be brave. And you have to be courageous. And I think that what we’re going to talk about today, I think what you’re saying too, is, it’s so helpful if people surrounding you help you in that bravery and help you support you in being courageous.

Absolutely. And wow, what a amazing individual your grandma was, I don’t think I’ve ever heard anybody tell a story like that where the person going through that journey says that they’re brave, I think most people who are dying, are literally trying to keep it together for their loved ones. So you know, what we talk about is a physical transition, a spiritual transition, and that spiritual transition can be very hard on not only the person laying there, undergoing it, but the people around them. So there’s just so many layers. It’s a very, you know, layered type of thing.

Let’s we talk quite, let’s talk, start by talking about hospice, like what is hospice? So I know I’ve heard like, Oh, they’re in hospice care, and then I know enough to go Oh, I’m sorry to hear that. Right. Like, what is that? Yeah, there’s

a lot of confusion about it. And it is one of those words that a lot of people whisper you know, oh, hospice Hi. Yes. Oh, Um, so the definition of someone who is receiving a hospice benefit, it’s an actual benefit through Medicare. So, okay, age, we opt into Medicare and they keep pushing it age back further and further, unfortunately, for you and I, but you know, once you get to opt into Medicare, part of your benefit is, if it’s deemed by a physician that you if your process of disease or whatever goes along the normal course, and you have six months or less to live, you can elect to take hospice care, okay? And it’s a total voluntary thing, okay. You don’t have to do it. And what that means is that once you’re on hospice care, it’s it’s more about comfort and less about cure. Okay. So, everything is geared towards your comfort. There’s no,

can you Yeah, hospice and not be at home? Yes, you can. Okay, you can, okay. Are you okay? All right. So it’s not just like when they’re home and making somebody comfortable so that they can die. It’s, it’s even if there isn’t any, like, okay, so thinking about my grandmother is possible, then that she was in hospice care, in that they were just trying to keep her comfortable,

right. So it’s a little bit can be confusing for people. Because when I worked in the hospital, before I worked in hospice, you know, if we had someone on our unit that was nearing the end of life, we would put them on what was called comfort care, okay? And change the way they elect their benefits, it just means it’s just a signal to us that if they would code, you know, or whatever, we’re not going to run in there with all of our or try to resuscitate them might have been what your grandma was on. Usually hospice, it’s it’s a more thorough discussion with family that the patient has started, the person has to sign paperwork, that they’re electing this benefit. Okay. So it’s an actual thing. It’s an actual thing.

It’s not just Yeah, yeah. Right.

Right. So in my experience is just, I’ve worked both in homes with people, you know, when they elect home hospice, and they’re the family members take on the role of caregiver. I’ve worked in a facility that might be like a senior living community and assisted living, where we bring the services to them. And then, most recently, I’ve worked in an inpatient hospice facility, where all we do is hospice care. So it’s a freestanding building, where people go at end of life. And sometimes there’s the reason they end up there is there’s maybe a complex family dynamic. Maybe their symptoms have been hard to control, whether that be pain or breathing. So they come somewhere where they get 24/7 nursing care,

okay, yeah, yeah. Okay. So, so people that go into hospice, then there, they are aware that this is the end that this is like the last six months or so

they should be aware, but I’ll tell you what, it’s one of the most challenging things I’ve dealt with and being a hospice nurse is there are sometimes families that don’t want their loved one to know that they’re on hospice care. And then they asked us to not tell that person that they’re receiving hospice care. So that’s really tricky, because I always believe in any person, I’m caring for that. You need to kind of meet them where they’re at. But when the family is involved, and there’s a complex dynamic, it’s hard as the practitioner to choose, you know what to do, and you have to act with integrity. So it can be complex, but most of the time people know they’re on hospice, because they’ve opted in and signed, signed paperwork, and that is the benefit to them.

So tell me, okay, so this is, I have a lot of questions about this, because this is actually a really good discussion of, if I’m, let’s say, I get sick, God forbid, let’s imagine I’m 98. And I get sick and I go into hospice. If I’m told I’m in hospice, and I know what that means, then isn’t it possible that I could create my ending quicker because of my beliefs around what that is?

100%? I think so. I mean, I think so. I actually had a personal experience where a family member of mine recently was put on hospice and she battled for a very long time and her family was hesitant to to actually do it, put her on hospice, and I did the best I could to kind of educate and they had been involved in palliative care which is a whole nother that’s that isn’t confusing in itself, but they finally chose how hospice for their loved one. And I’ve seen this so many times, within less than a week.

She passed away, right? Yes.

It’s almost like she finally was given permission.

Right? I was just going to use that word to permission. Yes, it’s,

it’s remarkable. I mean, you know, I get a very pretty universal reaction. When I tell people I do hospice care, most people say, Oh, my gosh, how can you do that? Or if they’ve had a personal experience with it? Most people will say, Wow, that is really remarkable that you’re able to do right,

right? Yes, because they know all that it entails. Yeah.

But I’ve always seen it as a gift to be able to be involved with people right. At that stage very, it almost moves me to tears to think about some of the experiences and relationships and things I’ve witnessed over my 25 year career.

So I want to talk about some of those things. And I want to circle back to like, do I tell my loved one or not tell my loved one? Because if it does speed, your acceptance, and then death? Does it serve a purpose for the patient? To not know, so that they stay healthier? Longer? Like I’m wondering like, does it if it leads to your demise? Do you not want to tell like, does it make sense to not tell somebody? And is it just better to talk about what’s true? And like, if there’s no hope, you know what I mean, if like, that’s the way it’s going, right? And

that’s super complex, because I think what you were kind of getting at with your scenario, you were providing it, almost like a spiritual contract. Right. So like, once we’ve been put on hospice, but as hospice practitioners, we do not like basically one of the tenants of hospice care is that death is neither hastened nor prolonged. And what that Yeah, we don’t do anything to rush it. We don’t any, you know, we don’t do anything to help them pass quicker. Right? You don’t anything to keep them here longer. It all every journey looks different. Yeah. So, you know, I think what you’re getting at is, is it possible 100%. But as far as the physical things that happen with someone who’s on hospice, the medical type things hospice, is there’s never going to be a case where someone who works in hospice is going to do something too. Quick, and someone’s death of that.

Right. Thanks to you. Yeah, yeah, no, that makes sense. I just wonder if as people think about it, if they think Oh, my God, this is really the end than it is. But then I guess if it is, it is like there is a physical body. Right, that that may be deteriorating, or they may be suffering. So anyway, that could probably be a whole philosophical conversation. But it is interesting, right? Because like if a family member comes to you and says, I don’t want them to know, is that just their own fear? A lot

of it is yeah, I think they think that their loved one believes that. Everybody’s giving up on them. When they put Oh,

I see. I see. I see. I get it. I get it. Yeah, yeah. Yeah.

There’s another side to that coin, when you talk about like, Is someone going to get there quicker. I’ve also been the witness to people who get placed on hospice, and almost all their physical organ systems shut down, and they’re comatose. And they still hang on. Right? Yeah, that’s a result of what we kind of, you know, nobody can really guarantee this, but it can be because of like, spiritual distress. Right. So they have unresolved issues with forgiveness with someone in their life. Right. Yeah. Anger that hasn’t been aired out.

You know? I do. Yeah. Yeah. Feeling. Yeah, he was one more reason why all of our healing is so important. It’s not just important in our lifetimes. It’s important in our death to under percent. Yeah. Yeah. What do you think this is a personal question, and you don’t have to answer it. But what do you think happens? What do you think happens in the moment when people die?

You know, I, I’ve read a lot and watched a lot of things about this. And, and I, the things that I’ve witnessed kind of, for me, solidified when I believe is that I believe that there’s people who they’ve lost in the past, that kind of surround them. Okay, and the reason I say that is because I’ve been with people as they’re dying. And usually it’s before they slip into that kind of comatose or unconsciously. They’ll report seeing their mom or their grandma. Yeah. What are their bad

Betty White was talking to her husband. Yeah, that was their

remarkable Yeah, it really is. So that I think so. That’s what I think happens. And I think, I believe, you know, the soul leaves the body. The body is just a physical you know, I’m so yeah, that’s cool. Thank you, vessel vessel for our souls and I believe the soul leaves the body. And I believe, you know, I like to believe in people being really reunited with people that they’ve lost. And in you know, it’s, I don’t have fear around it. I mean, I often think about this because I care for people of all ages. You know, what would I do? You know, like you were saying earlier, like, what would I do if say, tomorrow? I got a terminal diagnosis, you know, yeah, I’m sure I’d be afraid. I’m sure I would, you know, I’ve read stories about hospice practitioners who have to go through that on their own or have to put their husband or wife on hospice, and yeah, it’s all different when it’s you going through it, right. Yeah, be very different.

So totally. What kinds of things have you seen over your years doing this, that kind of stand out to you?

Um, well, you know, kind of along the same vein of talking about people coming, or people seeing people that they’ve lost the facility I currently work in, it’s just the most beautiful place as far as its design. And each room has like, French doors that open to a patio and the family can all gather, in what we’ve seen multiple times very consistently is it’s kind of in a wooded area, deer will come up to the patio. Oh, really? When someone is close to dying?

That’s fascinating. I love this. This feeling brings me comfort.

Yes. So it was almost without fail. Like when I worked. I’ve worked there one time before, and then had a gap. And now I’m back there now. But in the past, you know, when we would be there in the evenings, and someone, one of the staff member would be tending to a patient and they’d see the deer would always be like, Oh, okay.

Yes, yeah. I gotta get prepped. Yeah.

So that’s, that’s really, that’s really fascinating. And I, I have a special connection myself to the bird, the cardinal, they say, cardinals are very, like spiritual birds. And I’ve lost some people in my life. And I always see cardinals, either right around the time they’re passing or so I’ve seen Cardinals a lot in my hospice care. I always kind of think I’m on the lookout for those always to kind of Yeah, if they’re around. Yeah, those so the animal thing is really interesting. Yeah. In the birds and stuff that kind of create, like a sense it.

Yeah. And I think like, I don’t know, I think we’re all Well, I do think we’re all so connected. But I think that includes any sentient being right. And as you are moving into that transition, which I want to talk about a little bit more about that like movement and what that’s like, but I would suspect you start going up to those higher realms, right? Where we’re all connected in like, touching base with what is like the oneness of things? Absolutely. Yeah. What do you find, like with people as they move closer to this, like, from a spiritual perspective? Have you ever? Like, do you have any insight on that? So you’ve been listening to my podcast, and you’ve been hearing me talk about ways to master your subconscious. Maybe you’ve been really curious about how you can learn this too, and maybe even create a business of your own to help other people transform their lives as well. If you’d like to become board certified in six different certifications, we have it all for you inside the alchemy Institute. You can go at your own pace with our on demand training, or you can attend live events. Find out more over at our website, the alchemy institute.co. That’s the alchemy Institute, dot C. O, I’ll see you over there.

Yeah, I’ve seen it. You know, it all look, it looks all different ways. You know, like I always there’s so many parallels, and we can continue to talk about this. But there’s a lot of parallels between birth and death. And that were word midwife. I very much relate to the fact that I’m a midwife on the other side of the journey, you know, yeah, but every death looks differently. But, you know, I would say that some of the most interesting things is not interesting, but like, you see, and it can be distressing for family members there’s there’s a certain amount of restlessness that can happen towards the end. So it’s not always pretty unpeaceful

what it How does that show up? What do you mean by wrestling? Like visibly restless? restless? Yeah.

So it can be someone is just real like fidgety in the bed and they can’t seem to get comfortable. Or they’re sometimes they they talk and they say things that are kind of nonsensical. And that’s when you really as a provider, hospice nurse, you have to really shift into this mode of being there to support the family because

that also yes You know what I know, right? Yeah, you’re wearing two

hats. So when the when the person is entering that transition where there may be no longer in a conscious state, then you literally in your care have to shift to watching the family and how they’re experiencing it. Yeah, right to kind of try to make, you know, I don’t know if making them comfortable is the right way to say it, but try to unravel what, what’s happening for them, because you don’t know what they’re thinking and how they’re seeing it. But there’s a lot of challenges when that comes along to families who want to continue to feed their loved one or want to continue, you know, have certain thoughts about how their pain should be controlled, or any of those things. And that that’s can be a major challenge. When you’re, you know, you’re there to make sure the patient’s comfortable. So it’s always it’s always very interesting, for sure,

yeah. Well, I think that’s a really good point, because the patient is absolutely going through something. And, and I’m gonna guess that I’m right, in that everybody’s experience is a little bit different. Like, I’m sure there’s similarities, and there’s things you know, they’re going through the death process. But just like, everybody’s birth story is a little bit different, right? Their death stories a little different. But then you also have families that are also going through a transition in that same moment. So that’s a lot of like, energy moving and doesn’t get really like, I’m going to use the word heavy, but I don’t know that heavy is the right word. But

no, I would say heavy. That was the word that was coming from me. Yes. 100%. Good, heavy. And I think it depends on the length of time you’ve been with the family to obviously, you know, like the people that I’ve taken care of, for a longer length of time, I can learn about the family and try to you try to as much as you can work on some of that energy stuff prior to the very end, because when it gets it gets a real hard to work on it. Yeah.

I love that your dog is like scratching himself. My dog. My dog does that all the time when I’m recording? So it makes me happy. That is your dog, everybody, everybody. That’s her dog? Jingle jingle.

I thought he would be all set.

No, it’s totally fine. We do things real life on this show. Yeah, so I real real death today.

But ya know, the energy can be heavy. And a lot of times it’s it’s to me, it stems from, you know, like, just, for example, if you have, you know, the person who’s dying has three children that are surrounding them at the bedside. And we all have our own story, right, we all carry our own weight. And so, you know, you really have to queue in to see, you know, who who’s the who’s the leader in that group, who’s the point person as far as the children growing, who seems to be the most wounded and who, you know, where they are on their own personal journey. So navigate that energy. I think when people talk about, you know, hospice nurses, and a lot of my colleagues even in nursing, say, oh, my gosh, I could never do hospice. And you know, it’s important, you know that about yourself. But for me, I feel like, one of my skills is my ability to intuitively almost determine where people are under they need Yeah, and what they need in the way they need to be supported. So it’s every day is different every day is exciting for me. And it’s it sounds very strange to say exciting when you talk about hospice because, you know, if you’re the loved one who’s going through it, you would never describe it as exciting. It’s just ever changing. You know, believe it or not, I used to do labor and delivery, and I was a labor and delivery nurse for about four years and as many parallels as there are, I would much rather work hospice than work labor and delivery.

Yeah, yeah. Really? Yeah, I

think I think for me, I had a high stress level when I was doing labor delivery, because I just always would think about, you know, there, there are things that can go wrong in the labor and it is a process of unknown and fear. Right, right. Sure. Right. When someone’s dying, you know, what the end results gonna be? Right. Right. matter of getting them to that point at

that place? Yeah. Yeah. How do you see the birth and death? How do you see those being similar?

Well, I think that, you know, I think that it’s the whole thing about unknown, right? We know with birth, we know at the end we’re gonna most most of the time that everybody’s happy. But my Yeah, you know, you’re gonna have, you know, there’s going to be a birth there’s going to be a new new life, but it is unknown on how it’s gonna get there. And there’s a lot of fear involved. And a lot of people will equate, like the transition stage when you’re giving birth now, it I laugh because I have three children, but I never gave birth naturally, I always had very good pain control. But when I would help women who were giving birth in that transition, that’s the point where you’re almost like, I can’t do this. Right? Like, I can do this. It’s almost like a distress. Yes. Yeah. You see that a lot in depth that with that restlessness I was talking about.

Yeah, like that, like turning point. Yeah.

So coming back from this kind of Yes. Yeah. So yeah, and that, you know, I’m trying to think of other parallels to it, you know, usually you’re surrounded, you know,

yeah, by people

who are supporting you. Same with when you’re dying. And, you know, we always announce a new birth, when you think about a death, you know, you’re always remembering the person who died and talking about all the great things that you the memories you had. There are a lot of parallels, I think I see a very similar.

Yeah, yeah. What do you think is the hardest thing for people going through the transition to death? What do you think is like the hardest? And I know, it might be hard to say, because you don’t know what’s going on in their mind. But has anybody said anything to you? Or?

I think the you know, I think for most people, it’s the two things, I think, the fear around not knowing exactly what it’s going to look like, yeah, you have to be brave and courageous is right, like your grandma be brave. You know, like, it depends on what kind of, they’ve gone through up until that point, because you think about pain, too. And I think a lot of people feel death is going to be painful, right? Yeah. But the goal, always when you’re caring for someone at end of life, is to optimize their comfort. And we can do that through medication. We can do that through, you know, other things like, you know, providing them oxygen in the thing that a lot of people wouldn’t you know, you you think dependent and it’s all based on your previous experiences. You personally like what you’ve seen, you know, now you’re laying in the bed, have you maybe seen your grandfather go through this horrific ordeal, or, you know, you lose someone tragically, or quickly, where you didn’t have a time to grieve? So we all come to where, to this point with everything we’ve experienced previously? Yeah. So I think that, you know, the fear the worry about pain. And I think also families, you know, worried about leaving your family, especially say it’s, you know, an 82 year old who’s been married for 60 years and right,

worried about leaving their partner.

You know, they’re their partner. And so yeah, so I don’t think it’s universal. I think there’s some overarching themes to what I’ve seen people go through. Yeah. Yeah, it’s just, like I said, Every story is different. Everybody’s story is different. So

how do you think people could prepare for death? I think the key

because what I’ve witnessed with what I’ve witnessed in my career, and hospice is trying as much as you can to have open conversation. You know, when you told the story at the beginning about your grandma, I mean, she was really brave in the fact that she was trying to discuss it prior to the Act actually happening. Yeah, it’s very unusual for someone to do that. She was

extra. She was super cool. Yes. I always feel I don’t feel my mom around very much. Which Trish, my friend Trish from Episode 208. Trish said it’s because my mom has a lot of pain, seeing how hard it was for me without her. Right. But my grandmother, I guess she’s fine with me struggling without. So like, I don’t feel her around all the time. That her sign for me was pennies. And I find pennies. People weighed on me with their name Penny. Like, I mean, I mean, every weird thing of the like, ways you could get to Penny without it being an actual Penny is fascinating to me.

And I think more people, that makes me so happy and brings me such joy. I really think that more people need to when they feel comfortable enough to have that conversation with their loved one. Because I 100% believe in science and I believe in Yeah, when I, when I’m thinking about someone that I’ve lost that I love, I almost often get a sign, you know, in mind for Yeah, horrible thing. Like, I’ll see, I’ll see or hear a cardinal I you know, and that that means so much to me, but I think I think the best thing someone can do is to try to like have an open conversation with their family about it. What they want, you know, I mean, we were just at a family funeral. And, you know, we were of course that always brings up topics, you know, and my dad was like, you know, I have Want to be cremated? And I want my ashes to be spread near the lake that we have been going to since I’ve been seven years old? And, you know, I said, I do too, I want to be cremated or I don’t want to be buried in the ground, you know. And that’s one thing to talk about. And a lot of people have wills and they have not a lot, I think, less than we would imagine, do. Right, right. What about talking about what their journey is gonna look like? You know, I think it’s so instrumental or not instrumental, but important to have open conversations with your loved ones, you know, when they’re when they’re going through treatment for something when they’re hospitalized for something, it would be great to do it before then, but especially then, most people

and I think if you do it before, then it’s not sad. It’s more like, matter of fact, like it takes some emotion out of it, if you do it before it’s necessary. I know I have like a whole plan, I have mapped out my entire funeral. Like I’ve told everybody what flavor macaroons I want served, because it it’s gonna be like a cocktail party. So everyone’s getting a gift bag with troll items, like, I have a whole thing, then it made it less like when it happens, really, they’ll know exactly what to do. And one of the things that I want is I want to be cremated. And I want to be put into like one of the coral reefs, you know, you can be made into like a coral reef, which I love the ocean, I think it’d be so cool. So whenever my husband and I get in a disagreement, he’s like, I’m gonna bring you to a pond in

Vermont.

Like, you can’t do that. Yeah. But I have a plan. And I do think that talking about the plan, or like, talking about it openly when it’s not a thing, right. Don’t be so helpful.

Well, let me ask you a question about that. Do you think your personal life experience of losing your mom and the way you lost her? Maybe was the impetus to you having a plan?

Yeah, that could be? Yeah, it could be. And I think that, I think because I’m, let me say it this way. I know. I’m sure that when I get to that moment, there will be times where a moment where I will have to be courageous. But I’m not afraid. I’m really not. I’m not just saying this, but I’m really not afraid of what’s next. I’m almost excited. I don’t want to be in pain. I don’t want to get hurt. But I’m almost excited about what’s next. And I do have a belief that when I cross over and I get into oneness again, and I feel so good. I’m going to be so excited to come back. And that thought makes me stay really alive right now.

Yeah, no. So you believe in that’s you, but I believe people come back. Yeah,

I believe that. Yeah. spiritually. I think we come back to grow. Yeah. Yeah, for sure. I do. Yeah. There was this movie that I watched on the airplane on my way home from London, and it was called Nine days. And it was about this guy. That’s okay. Have you heard of this? I think so. Yeah. Yeah. So basically, he has to choose a soul to go and have a real life. Okay. And they all interview and it’s nine days of them interviewing. What would you do for this? What would you do if this happened? No wrong answers. But he’s trying to figure out the right person to take over this or to live this life. They all want it so bad. Like, that’s what I took from this movie is that they want it so bad. And unlike sometimes, just like anybody listening, sometimes I’m like, What the fuck? Like, this life is harder than I thought it was gonna be like, Oh, why is it so hard? But then I watched that movie, it really made me go, like, if I wasn’t here, I would want it so bad. And if that’s true, I’m gonna get it so bad right now. You know what I mean? Yeah. And I would think seeing people go through that transition would have like, a similar effect. Right. Do you feel that? Yeah, I mean,

definitely, it gives you a whole new perspective, you know, to your life and what it all means. And, yeah, I mean, I think being a nurse in general, in all the areas I’ve worked in, you know, aside from maybe labor and delivery, because that, like I said, that is 90% Happy outcomes, right. But yeah, you know, working in, I used to work in an intensive care unit. And so, you know, every day I would go to work, I would see some pretty awful things. You know, and that was one of the things early in my career where I thought it would be great to work hospice because all the decisions at that point had been made. Okay. There’s not any more, you know, Hail Mary passes being thrown to try to save somebody. Yeah, that to me, is a beautiful thing. I mean, there’s almost like a peacefulness to it. It is it is it. I mean, ideally, you would love it to be peaceful. You know, there’s a lot of things that can make it not peaceful, but I’m always kind of on a mission to make it as peaceful as possible, you know, just you run into things along the way. You know, like, when I was talking earlier about some spiritual distress that you see people in a lot of times that can be unresolved relationship issues. Yeah. And one of the most moving things that I experienced was, I worked somewhere and we had a patient who was fairly young, I think he’s probably in his late 50s, early 60s. And the older I get the younger that is, right. I mean, he had pancreatic cancer, he was very sick for a long time. And if you ever have known anybody who’s gone through that, it’s just horrendous. And he, you know, he was comatose for a long time. And we couldn’t figure out where like something is holding him back. Like there’s something going on. And I don’t even know how we got this information. But we learned that he had a sister that he was estranged from, and they hadn’t spoken in years and years and years. And we, the challenging thing about that is we were gonna get her there. But she was deaf. So we had to get a American Sign Language interpreter in DICOM, to help them communicate, because he didn’t sign. And sure enough, we, you know, we made it happen. That was the amazing thing is when we work as a team, we made this to happen. Yeah, within less than a day, I want to say 1218 hours after she left, he passed away, and he had the most amazing look of peace across him. And it was. So you know, there’s there, you know, we try as much as we can to bring people peace and peace can look different. You know, that was one of the the examples that sticks with me after and that probably happened 15 years ago, you know, yeah,

that’s an amazing story. Yeah,

it was really amazing. So

I think one of the lessons here is like, heal your stuff. Like don’t wait, because it’s not gonna you’re you’re gonna have to deal with it at some moment. Right? Absolutely. Yeah. Heal it now. Yeah.

Yeah. Yeah. Kill it. When it’s, I mean, a little. It’s healing is always challenging, obviously, you know, and it’s something we’re constantly working on. But healing it, like you said, when you when you have 100%, control over Yeah, and

you can benefit from it. Absolutely. Like you can live in peace and freedom for longer of your actual life. Yeah. So as we wrap up here, what would you like people to know about hospice?

I would love for people to know that it doesn’t have this. No, it can mean this sometimes. But hospice does not always mean the person is going to die in 24 hours, okay. People can be on hospice for months, right? Instead, a gentleman that was on hospice for like a year and a half, because he a very bad lung disease. And he was still considered terminal. But he wasn’t going to die tomorrow, right? Yes. So, you know, there’s this misconception that, and I did tell a story about someone who, once they learned they were on hospice, it was just a matter of days. And that’s true. But it was a lot that comes with the hospice benefit. As far as you know, the provider, you know, you get certain types of care provided to you. It’s a benefit that you, you know, if you’re Medicare, and you have it, you know, it’s it gets a little more murky with people who are not Medicare eligible, you know, yeah, then it’s looks different, but I just want people to not be afraid about it. And I want people to talk with their family members about what they want their death to look like, you know, yeah, we have those conversations, right, we have a birth plan, you know, when we go, you know, when people go in and give birth, and I think this generations come up, they’re more in tune to that and husbands get in on it and planning how the birth is gonna look. Yeah, we should have something similar for death. You know, you know, different things. We want that different people we want there, you know, a lot of times towards end of life, we play music for people, they actually have music therapist that can come in and they have pet therapy.

Oh, I want that. Add that to my pet therapy. Line dog better be waiting, like my dog better be the one standing at the bottom of my bed or I’m going to be angry.

Yeah, so just, you know, put putting some thought into it, talking to your loved ones about it. You know, just it’s hard, but at the same time, it’s necessary, you know, something to be feared.

Right. So yeah, well, thank you so much for coming on having me and Liz doesn’t have because she’s just here out of the friendship and The, you know, the idea of sharing this information, but I have been trying to get her to get a tick tock and so when she gets a tick tock, I will share it. I will share on the show and I will share all the things as we go forward. So, Liz, you just keep me posted and I will immoral know, for sure. Thank

you, Betsy. Thanks for having me.

Thanks so much for being on. Yeah. Hey, thanks so much for listening to today’s show. And thank you for sharing the show with your friends. I love when you guys do that. I appreciate it so much. And thank you for leaving me a review on iTunes. I know that it matters because when I go to find a podcast, I always look to see what the reviews are. So it really means a lot to me that you take a minute to like figure out how to even make that happen. Now, if you want to find me find me on social media, I’m usually on Instagram, starting out on tic toc. It’s just my name. Betsy pake and that’s my website to Betsy pake.com. And you can find out all about the work that I do having me speak for an event that you might be hoping to plan or getting trained inside my alchemy Institute. But to make it really easy, if you want me just shoot me a DM shoot me a direct message on Instagram and I will be at your service. Thanks again for listening. And I will see you all next week.

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