Speaker 1: Life is a gift, and we have a gift of time,
Speaker 1: and how are we going to use that in our life?
Speaker 1: Welcome to the one you feed throughout time. Great thinkers
Speaker 1: have recognized the importance of the thoughts we have. Quotes
Speaker 1: like garbage in, garbage out, or you are what you
Speaker 1: think ring true. And yet for many of us, our
Speaker 1: thoughts don't strengthen or empower us. We tend toward negativity,
Speaker 1: self pity, jealousy, or fear. We see what we don't
Speaker 1: have instead of what we do. We think things that
Speaker 1: hold us back and dampen our spirit. But it's not
Speaker 1: just about thinking. Our actions matter. It takes conscious, consistent,
Speaker 1: and creative effort to make a life worth living. This
Speaker 1: podcast is about how other people keep themselves moving in
Speaker 1: the right direction, how they feed their good wolf. Thanks
Speaker 1: for joining us. Our guest on this episode is Barbara
Speaker 1: Carnes are In. She's an internationally respected speaker, educator, author,
Speaker 1: and thought leader on matters of death and dying. Barbara
Speaker 1: is a renowned authority on the explanation of the dying
Speaker 1: process to families, healthcare professionals, and the community at large.
Speaker 1: She has held both clinical and leadership positions including staff nurse,
Speaker 1: clinical supervisor and executive director. Barbara has also won numerous awards,
Speaker 1: including the International Humanitarian Woman of the Year two thousand
Speaker 1: fifteen from the World Humanitarian Awards. Here's the interview. Hi, Barbara,
Speaker 1: welcome to the show. I'm excited to talk with you.
Speaker 1: This interview is a little bit different than a lot
Speaker 1: of them that we do because it's a very specialized topic.
Speaker 1: We will be talking about death in the dying process
Speaker 1: today A and so it'll be a little different than
Speaker 1: most of our interviews, which are very directed at everyone.
Speaker 1: What I'm hoping for listeners is that either A you
Speaker 1: need this information now. I think you'll find it interesting regardless,
Speaker 1: and be that you know that it's here for the
Speaker 1: time that comes when you need it, because we all
Speaker 1: will at some point or the other. So Barbara, let's
Speaker 1: start like we always do, by reading the parable. There's
Speaker 1: a grandfather who's talking with his grandson. He says, in life,
Speaker 1: there are two wolves inside of us that are always
Speaker 1: at battle. What is a good wolf, which represents things
Speaker 1: like kindness and bravery and love, and the other is
Speaker 1: a bad wolf, which represents things like greed and hatred
Speaker 1: and fear and the grandson stops and he thinks about
Speaker 1: it for a second and he looks up at his
Speaker 1: grandfather and he says, well, grandfather, which one wins? And
Speaker 1: the grandfather says, the one you feed. So I'd like
Speaker 1: to start off by asking you what that parable means
Speaker 1: to you in your life and in the work that
Speaker 1: you do. Well. Um, I think the key word for
Speaker 1: the bad wolf is fear, and there is so much
Speaker 1: fear surrounding end of life. You know. You mentioned everyone
Speaker 1: needs this material, and that's true, and that's where the
Speaker 1: good wolf comes in because knowledge reduces fear. Knowledge contradicts
Speaker 1: the fear that the bad wolf is is um portraying
Speaker 1: or presenting to us. And so my work with end
Speaker 1: of life education is that knowledge reduces fear, and that
Speaker 1: because everybody dies, if we understand that there's a normal,
Speaker 1: natural process to dying, then it isn't going to be
Speaker 1: so scary when someone close to us is dying or
Speaker 1: when we ourselves are in that position of having to
Speaker 1: deal with end of life. Right. Yeah, you do talk
Speaker 1: a lot about how knowledge neutralizes fear and how important
Speaker 1: that is. Before we get into specific questions about the
Speaker 1: death process, I want to ask you how the work
Speaker 1: that you've done with the dyeing all these years influences
Speaker 1: the way that you live. It shows me that life
Speaker 1: is a gift, and that we have a gift of time,
Speaker 1: and how are we going to use that in our life?
Speaker 1: Because really life is a terminal illness from the home
Speaker 1: what we're born, we begin to die. And so it
Speaker 1: gives me a constant reminder two live each day um
Speaker 1: as as special and literally when I go to bed
Speaker 1: at night, what I say before I go to sleep is, Barbara,
Speaker 1: what did you do today that you traded a day
Speaker 1: of your life for? And I look at that each
Speaker 1: day and say, what have I done that I'm feel
Speaker 1: good about, you know, because I'm never going to have
Speaker 1: this day back again. What have I done? Yeah? That's
Speaker 1: a great That's a great way to live. And I
Speaker 1: think there's certainly spiritual traditions that emphasize the idea of
Speaker 1: thinking uh and reflecting on your own death as a
Speaker 1: way to be more intentional in your life today. And
Speaker 1: it sounds like that's a pretty natural part of what
Speaker 1: you do. You're kind of you're exposed to that reminder
Speaker 1: on a regular basis every day because that's the work
Speaker 1: I do. And so often when we've been told by
Speaker 1: a physician that we can't be fixed, um, you know,
Speaker 1: we go home, we sit down in our favorite recliner,
Speaker 1: and we might as well have died that moment, because
Speaker 1: oftentimes we stop living and our life centers around the illness.
Speaker 1: It centers around the fact that I'm going to die,
Speaker 1: instead of thinking that really there is no such thing
Speaker 1: as dying. You know, from the moment we're born, we
Speaker 1: begin to die. Um, And so as long as we're breathing,
Speaker 1: it is an act of living. And I think we
Speaker 1: tend to forget that when we've been told we can't
Speaker 1: be fixed. There's a line in one of your readings
Speaker 1: that I really liked to said, do we want the
Speaker 1: next months or years of our lives consumed with disease?
Speaker 1: Or can we find a balance between living and dying?
Speaker 1: Exactly exactly? So, the way I thought we might structure
Speaker 1: this conversation is to start kind of where we are
Speaker 1: with you get the news that perhaps you have a
Speaker 1: terminal illness, and then I thought we would then go
Speaker 1: from there talk a little bit about the dying process itself,
Speaker 1: and then maybe talk a little bit about what's on
Speaker 1: the other end of it for the people who are
Speaker 1: remaining and surviving. So you know, one of the things
Speaker 1: we're talking about here is, Okay, I've received a terminal
Speaker 1: diagnosis and I want to focus on living versus being
Speaker 1: obsessed or consumed with my disease. What are some of
Speaker 1: the things that you recommend we be doing as part
Speaker 1: of that living in that time frame. Well, first off,
Speaker 1: you want to research your disease, and you want to
Speaker 1: really be knowledgeable about the treatment or not treatment that
Speaker 1: your doctor is offering. We tend to accept what our
Speaker 1: physician says and don't question it. And I would say,
Speaker 1: first off, get to know your disease and the treatment
Speaker 1: and the goals and the expectations be really part of
Speaker 1: those decision making kinds. Just don't leave it up to
Speaker 1: your physician. Um, it's a partnership. That's number one. And
Speaker 1: then you're going to look at what you want to
Speaker 1: accomplish in your life and in your time because none
Speaker 1: of us know really when we're going to die. It's
Speaker 1: that this person that's been told i'm having trouble fixing
Speaker 1: you or I can't fix you, have given you this
Speaker 1: gift and so you look at are their relationships that
Speaker 1: I want to fix, that I want to mend. You know.
Speaker 1: You you learn to do and say that what you
Speaker 1: want to do and say every day. You know, so
Speaker 1: look a look at what do I want to do today?
Speaker 1: And so often people who have an illness think to themselves, well,
Speaker 1: I'd really like to go visit my aunt, but I
Speaker 1: don't feel so good today, so maybe i'll feel better
Speaker 1: next week. What you want to do is remember that
Speaker 1: each day would be as good as it gets, and
Speaker 1: so you don't put off to next week. Um, you
Speaker 1: do and say anything each day, each day you're talking
Speaker 1: about for the person who is dying, you say, it
Speaker 1: will never be okay to die, so don't expect acceptance.
Speaker 1: We can, however, reach an understanding and that applies to
Speaker 1: family as well as the patient. You know. I also
Speaker 1: don't let me forget to mention advance directives, so because
Speaker 1: that's important. But um, because all of us, whether we
Speaker 1: have an illness or not, need to have advanced directives
Speaker 1: in place. But it's even more important for someone who's
Speaker 1: The doctors are having a difficult time fixing because if
Speaker 1: we don't tell our physician how we want to live
Speaker 1: until we die, then we will live the way our
Speaker 1: physician and the medical profession wants us to live until
Speaker 1: we die, and there comes a point where we aren't
Speaker 1: going to be able to be fixed because everybody dies,
Speaker 1: and so it's really important to have in writing how
Speaker 1: you want to spend the last weeks or days and
Speaker 1: even months of your life. Yes, I think that is
Speaker 1: something that we should all look at a little bit more,
Speaker 1: myself included. You know, most of us want to be
Speaker 1: home in our own bed, with the cat in the
Speaker 1: bed with us. And yet if we don't have an
Speaker 1: advanced directive, where you're going to end up is in
Speaker 1: an ICU on a ventilator with probably some broken ribs
Speaker 1: because your heart stopped and they tried to start it again.
Speaker 1: And you know it's not it's not what most people want. No,
Speaker 1: that does not sound good. All. You refer to the
Speaker 1: process of dying for the person as they go into
Speaker 1: labor as they die, similar in some ways to the
Speaker 1: labor of giving birth. Can you talk a little bit
Speaker 1: about maybe the process you know, what we see in
Speaker 1: people for a couple of months out to a couple
Speaker 1: of weeks out to a couple of hours out Because
Speaker 1: you say there's a very clear process of dying that
Speaker 1: everybody goes through. Can we walk through that real quick? Sure?
Speaker 1: First off, there are only two ways to die. You
Speaker 1: either die fast where you get hit by a truck
Speaker 1: and you're dead, or heart attack or suicide, or you
Speaker 1: die gradually. And gradual death is either old age or disease.
Speaker 1: And gradual death has a process. If it didn't have
Speaker 1: a process, it would be fast death. So that process
Speaker 1: begins months before death comes two to three to four months,
Speaker 1: and three things are going to start happening when you've
Speaker 1: entered that gradual dying process. You're gonna stop eating gradually,
Speaker 1: starting with meats and fruits and vegetables, and then it
Speaker 1: progresses over these months to the point you're not eating
Speaker 1: at all. And it's really important to understand this concept
Speaker 1: because most of us, you know, we associate food with living.
Speaker 1: If you don't eat, you don't live. While the body
Speaker 1: is preparing to die, and so it doesn't want the
Speaker 1: grounding or the energy that food brings, and so the
Speaker 1: natural process is it stops eating. It also stops drinking.
Speaker 1: It starts sleeping more and more again months before death,
Speaker 1: right up to the point where the person is asleep
Speaker 1: all the time, and then months before death they start
Speaker 1: withdrawing from the world around them. They're not interested in
Speaker 1: the Olympics, and then they're not interested in the church ladies,
Speaker 1: and eventually they're not interested or interacting with family or
Speaker 1: those that they care the most about. Then one to
Speaker 1: three weeks before death there are significant changes and that's
Speaker 1: when what I call labor begins. And and at this point,
Speaker 1: the person's eating almost nothing. You're doing good if you
Speaker 1: can get some protein supplement down them in some water,
Speaker 1: and they're sleeping almost all the time. You can wake
Speaker 1: them up, you can talk to them. They're going to
Speaker 1: go back to sleep and not know if they dreamt
Speaker 1: your visit or if you were really there. They've gone
Speaker 1: totally within. They're not interested in anything that's going on
Speaker 1: in the world around them. The key thing that tells
Speaker 1: me labor has begun is a person starts sleeping with
Speaker 1: their eyelids partially open, their mouth is open, their eyelids
Speaker 1: are open partially and they're sound asleep. They'll start picking
Speaker 1: at the air. There's a restlessness that goes with this time.
Speaker 1: You just can't get them settled. They're talking to and
Speaker 1: about things that don't make any sense because their world
Speaker 1: is a dream world. It's not this world anymore. Then
Speaker 1: there are other changes that say a person is minutes
Speaker 1: to hours from death, And there's really two things there.
Speaker 1: One is that a person is breathing changes, um, and
Speaker 1: I'm doing like an hour workshop here. Um. There, breathing
Speaker 1: changes and it gets slower and slower, and they start
Speaker 1: breathing kind of like a fish breeze, their mouth open
Speaker 1: and closes. That's in the minutes hours before death. And
Speaker 1: they're non responsive. They can be moving, they can be talking,
Speaker 1: but they don't respond to to the world around them.
Speaker 1: You can hold them, you can touch them, call them
Speaker 1: by name, but they're not going to respond to you.
Speaker 1: I think that we have most of us sleep through,
Speaker 1: you know. It's almost like we have an anesthetic. We
Speaker 1: sleep through our change from this world to the next. Um.
Speaker 1: It's it. Dying is not painful. Disease causes pain. But
Speaker 1: for us the watchers, it looks like the labor hurts.
Speaker 1: It looks like the person's uncomfortable. But what you need
Speaker 1: to know is they're so removed from their physical body
Speaker 1: that they aren't experiencing it in the same way as
Speaker 1: if that spirit were totally connected. They're like that little
Speaker 1: chicken trying to get out of a shell and they're
Speaker 1: working really, really hard. Um, but it's not painful. Disease
Speaker 1: causes pain, and so if a person has a disease
Speaker 1: history of pain, you're going to treat them with whatever
Speaker 1: it takes to keep them comfortable. But if pain isn't
Speaker 1: part of their disease, then you don't have to bring
Speaker 1: in the narcotics or the big guns just because they
Speaker 1: look uncomfortable. You have to really assess that and have
Speaker 1: someone who understands end of life to make that assessment.
Speaker 1: How do we know dying people aren't uncomfortable in that phase?
Speaker 1: Is that just lots of observation. I'm just kind of
Speaker 1: curious how we know that we know it from observation.
Speaker 1: I guess I've been at the bedside of soul many
Speaker 1: people at the moment and of death plus months two
Speaker 1: weeks before death that I'm totally convinced that it is us,
Speaker 1: the watchers that have that that perception of discomfort because
Speaker 1: we're identifying with a healthy body d and from us,
Speaker 1: I'm gonna jump in here on as from a spiritual perspective, Um,
Speaker 1: there is a driver to this physical body, and that
Speaker 1: is I call it a spiritual driver, but you know,
Speaker 1: we'll we'll call it driver. And that driver is releasing
Speaker 1: its hold on the physical body. And as it with draws,
Speaker 1: the physical sensations that go with that body, um are
Speaker 1: different because they're not totally connected. So I guess I'm
Speaker 1: going to have to say I don't know about research,
Speaker 1: but I know I have taken this knowledge from all
Speaker 1: the world religions on spirituality and esoterics and ended up
Speaker 1: with the religion according to Barbara. But all of the
Speaker 1: wisdom that I've been able to pull has really made
Speaker 1: me believe that dying is not painful. Um, that you're
Speaker 1: non responsive. You sleep through it and you wake up
Speaker 1: on the other side. And you say that as someone
Speaker 1: is dying, that it can be helpful to let them
Speaker 1: know that you understand that they have to go. You
Speaker 1: say not that it's you know, not that it's okay again,
Speaker 1: because it doesn't feel okay, but that you understand it's
Speaker 1: time for them to go, and and that can be helpful.
Speaker 1: And then the other thing you say is that the
Speaker 1: key to getting out of the body is to relax.
Speaker 1: Tension creates a tightness that locks us in our body
Speaker 1: and makes our labor longer. Right, there are dynamics to
Speaker 1: dye from disease or old age. We die the way
Speaker 1: we've lived. We die according to our personality, and we
Speaker 1: have limited control over the time that we die. And
Speaker 1: so if we talk to the person that's dying and
Speaker 1: we say to them, I understand, you have to leave,
Speaker 1: it's never gonna be okay for someone we know and
Speaker 1: love to die. So we don't say it's okay, but
Speaker 1: we can understand that this is going to happen, and
Speaker 1: someone who's dying is going to their their ambivalent. That
Speaker 1: driver is ambivalent. It's like they don't want to leave
Speaker 1: that which they know, and yet they know that they
Speaker 1: have to leave, so they're going to try and stay
Speaker 1: here for the people they care about. And that's why
Speaker 1: telling them I understand you have to go, why that's
Speaker 1: so helpful for the person that's dying. The physical pain
Speaker 1: creates attention that locks us in our body and will
Speaker 1: make our labor longer a right. So the key is
Speaker 1: relaxing and then you can slide out of your body. Well,
Speaker 1: if you've got unfinished business, something that that you think
Speaker 1: needs to be addressed before you die. That's attention, and
Speaker 1: that's gonna hold you here longer if you're afraid, if
Speaker 1: you're really really afraid, that creates attention, and that's gonna
Speaker 1: lock you and make your labor longer also, And so
Speaker 1: we try to address unfinished business, We try to address pain,
Speaker 1: and we try to address fear within a person that's
Speaker 1: dying so that their labor and their transition from this
Speaker 1: world to the next will be gentle and easier for them.
Speaker 1: In your books, you talk a lot about ways to
Speaker 1: care for the dying person, for comfort, for different things,
Speaker 1: and so I think that we don't have time to
Speaker 1: go into all that there, but you definitely have very
Speaker 1: specific instructions and ideas for helping that person to relax
Speaker 1: and to be more comfortable. You know, I used to
Speaker 1: walk into a hospital room and I would see the
Speaker 1: family standing around the bed. They're they're literally holding onto
Speaker 1: their own hands, and they're just standing there watching this
Speaker 1: person that's in bed, non responsive and is minutes to
Speaker 1: hours from death, and their family they don't know what
Speaker 1: they can do and they don't want to hurt anyone,
Speaker 1: so they stand there and watch, when in reality, if
Speaker 1: you ask them what would you really like to do.
Speaker 1: I would like to get in bed with mom and
Speaker 1: just hold her in my arms. You know. Then let's
Speaker 1: do that. You get in bed with mom and you
Speaker 1: hold her, you know, talk to her, love her, um,
Speaker 1: cry with her. You can do all of those things.
Speaker 1: It's just that people don't know that it's okay to
Speaker 1: do it. So I tell them it's okay. So let's
Speaker 1: transition now to the grieving process. So the death has
Speaker 1: happened and now we're we're standing on the other side
Speaker 1: of it and we're going through the grief. What things
Speaker 1: can you tell me about how to work through that? Um?
Speaker 1: You know, I don't I don't even know what word
Speaker 1: to use as to make it easier better or but
Speaker 1: what are some things that we can be doing, UM
Speaker 1: to help ourselves as we go through grief. Oh that's
Speaker 1: such a huge question, because each individual person is going
Speaker 1: to deal with their loss in their own unique way.
Speaker 1: I would say, just some things off the top of
Speaker 1: my head is remember that there's no perfect relationship, that
Speaker 1: there are difficult times and there are great times. And
Speaker 1: in our grieving, we hnd to elevate the person that
Speaker 1: died to immediate sainthood and they were perfect. Well, that
Speaker 1: distorts and makes our grieving more difficult. We need to
Speaker 1: recognize the positive um as well as the challenging times
Speaker 1: in a relationship. I also think it's very helpful to
Speaker 1: write a letter to the person that has died. Just
Speaker 1: you know, if if Mom died twenty years ago, you
Speaker 1: can still write her a letter, or if she died
Speaker 1: two days ago. What I'd like to suggest is is
Speaker 1: to write a letter, put whatever you want to say
Speaker 1: in that letter, no one else is going to see it,
Speaker 1: and then put it in the coffin with mom, you know,
Speaker 1: put it in her hands, put it in her pocket,
Speaker 1: wherever you want, under the pillow, but say from your
Speaker 1: heart about the good and the challenging times and how
Speaker 1: your going to um go on living. You know, we,
Speaker 1: if we think about it, grief is about us, the living.
Speaker 1: We believe that the person that has died is in
Speaker 1: a better place. Most religions teach that, and so our
Speaker 1: feelings aren't really for the person that's dead. Where our
Speaker 1: feelings are about us and not having that person in
Speaker 1: our life. And so we have to figure out how
Speaker 1: to go on living. And I think what I hope
Speaker 1: people can do is show in their grief how well
Speaker 1: they can go on living. Let that be the testament
Speaker 1: of the love that they have for the person that died.
Speaker 1: It isn't how many tears you cry or how sad
Speaker 1: you look that says how much you love someone. You know.
Speaker 1: You say that in the book. It says our inability
Speaker 1: to further enjoy life does not measure our loss. The
Speaker 1: quality of our relationship with the person who has died
Speaker 1: is found in our strength, our resilience, and our ability
Speaker 1: to create a new and meaningful life. Yeah, that's that's
Speaker 1: what I believe about grief. There isn't any healing, you know.
Speaker 1: There isn't any magical three hundred and sixty sixth day
Speaker 1: that Okay, I'm over it now. You don't heal from grief.
Speaker 1: You don't recover from grief. You learn how to live
Speaker 1: with it and grad The only thing that helps grief
Speaker 1: is time. You know, there aren't any words that are
Speaker 1: going to make someone feel better. There aren't any pills
Speaker 1: that are going to make them feel better. It's only time.
Speaker 1: Time fills in the space between the pain. But we
Speaker 1: have to learn how to live with One of the
Speaker 1: things you talk about is how when someone dies, we
Speaker 1: can go into a little bit of shock, which creates numbness,
Speaker 1: and you know, there's a lot to do after somebody dies.
Speaker 1: There's there's there's a funeral arrangements to make, and there's
Speaker 1: people to notify, and there's all that stuff, and we
Speaker 1: go through that process and then we kind of get
Speaker 1: past all that and everything quiets down and people stops
Speaker 1: sending their condolences and people stop bringing food, and people
Speaker 1: have a tendency to really start to feel it then
Speaker 1: but think that that's wrong because they're thinking that, well,
Speaker 1: I was better at the funeral than I am now,
Speaker 1: and and sort of recognizing that this isn't really a
Speaker 1: linear thing, they often really think, I guess I better
Speaker 1: go to a counselor because there's something seriously wrong with me.
Speaker 1: I was better at the funeral than I am right now.
Speaker 1: And yet when that numbness wears off, when that's when
Speaker 1: the grief really really smacks you in the face and
Speaker 1: you figure everyone else has returned to their normal life
Speaker 1: and their activities, and you realize that you don't have
Speaker 1: a normal life anymore, that you have to rebuild restructure
Speaker 1: your life without this person that you love in it anymore.
Speaker 1: You're the one that has to change, and we all
Speaker 1: resist change, none of us want to change. This is
Speaker 1: what the death of someone close to us forces us
Speaker 1: to do. It forces us to change. And it's when
Speaker 1: that numbness wears off, that that realization sinks in and
Speaker 1: then we've got to figure it out and we're hurting,
Speaker 1: we're lost. It can be a month after the death,
Speaker 1: that can be six weeks, it can be three months
Speaker 1: after the death. But it's some point that numbness wears off.
Speaker 1: I've heard you talk about hospice before. Obviously, um a
Speaker 1: lot of your career was in hospice. I'm interested in
Speaker 1: how does somebody go about finding the right hospice environment
Speaker 1: for themselves. What's that process look like and what should
Speaker 1: somebody be looking for. Oh, that's a big question to hospice,
Speaker 1: you know, they're When I started out, there weren't very
Speaker 1: many and so you didn't have to make choices. Um uh.
Speaker 1: And today almost every city has will Depending upon the
Speaker 1: size of the city, you can have twenty thirty hospices
Speaker 1: to choose from. Oftentimes you get referred to a hospice
Speaker 1: because of your physician, because of your palliative care team
Speaker 1: because of the hospital you're involved in, UM make some
Speaker 1: phone calls. Don't just accept that which is recommended. You
Speaker 1: want to know if they have primary care nursing. I
Speaker 1: think that to me is the most important aspect of
Speaker 1: hospice care. And when I say primary care nursing, I
Speaker 1: mean that you will have the same nurse and the
Speaker 1: same social worker and the same home health aid for
Speaker 1: every visit. Now that doesn't count on call because those
Speaker 1: people you know don't do on call. But you don't
Speaker 1: want to have a different caregiver every time someone comes
Speaker 1: to visit. You want the same because then you can
Speaker 1: bond with them, because then you're getting consistent education because
Speaker 1: those caregivers know and have built a relationship with you.
Speaker 1: So to me, that's the key thing. Also, know that
Speaker 1: if you have come on a hospice and you're dissatisfied,
Speaker 1: first call the hospice and talk to the director and
Speaker 1: say I'm dissatisfied and here's why, and if they can
Speaker 1: give him a chance to fix it. But if they
Speaker 1: don't fix it, find another hospice, call another hospice and
Speaker 1: and ask tell them your situation and ask your questions.
Speaker 1: So I think primary caregiving is my key recommendation for
Speaker 1: a hospice okay, And is hospice something that is paid
Speaker 1: for by insurance or how does all that work? I mean,
Speaker 1: I know there's lots of variations, so I'm not you know,
Speaker 1: saying like for everybody, but in general, is that usually
Speaker 1: something that's paid entirely by the person in the family
Speaker 1: or is insurance help if your Medicare age. Medicare has
Speaker 1: a hospice benefit. And as long as you have a
Speaker 1: physician that says I can't fix you, and I believe
Speaker 1: that you have six months or less to live and
Speaker 1: no one can put a number on it, that's another thing,
Speaker 1: be aware of numbers. But Medicare asks the doctor to
Speaker 1: put their name on the dotted line saying they have
Speaker 1: six months or less to live and that you will
Speaker 1: not have any treatment to try and fix this disease.
Speaker 1: That the physician says, there, you know, we're beyond treatment.
Speaker 1: There's nothing more we can do but keep you comfortable
Speaker 1: and we can help you live the best you can
Speaker 1: within the confines that your body and disease has put
Speaker 1: you in. So that's that is the hospice criteria. Medicare
Speaker 1: will then pay for all of the medications that are
Speaker 1: related to the life threatening illness. They will pay for
Speaker 1: all the medical equipment hospital beds, wheelchairs, whatever, oxygen, all
Speaker 1: everything that's needed in relationship to the life threatening illness
Speaker 1: and for our ends, home health aides, social workers, chaplains
Speaker 1: all to come and help the family as well as
Speaker 1: the patients. Most insurance policies for people that are not
Speaker 1: Medicare age will also have hospice benefits. Each individual insurance
Speaker 1: company may do it differently as far as reimbursement UM.
Speaker 1: Where hospice on Medicare it's not going to cost to
Speaker 1: anything at all. UM insurance I, you know, they're also
Speaker 1: different with co pays and all that. I don't know. Excellent. Well,
Speaker 1: I think we're near the end of wrapping up, but
Speaker 1: I would like to kind of go back to what
Speaker 1: I feel like was a core theme that that was
Speaker 1: running through everything that you talked about, and I thought
Speaker 1: it was really useful and important. And you talk about
Speaker 1: how the death the processes is a very sad process
Speaker 1: and there's no getting around that process, but you also
Speaker 1: talk about how normal and natural it is, and you
Speaker 1: actually say at one point, you know, there's nothing happening here.
Speaker 1: That's bad. There's nothing pathological happening here, And I just
Speaker 1: found that a really useful way to look at it. Overall,
Speaker 1: taking care of someone at end of life is different
Speaker 1: than taking care of someone who's going to get better.
Speaker 1: But most people don't know there's a difference, and so
Speaker 1: when they're watching end of life, they think something pathological
Speaker 1: is happening, and they think that the care is not
Speaker 1: being as it should be because they're comparing it to
Speaker 1: someone who's going to get better. There is a normal,
Speaker 1: natural way that a person dies from disease or old age,
Speaker 1: and if you learn that process or are taught that process,
Speaker 1: you can see that it's normal and natural moms doing
Speaker 1: what she's supposed to be doing. This is how we die.
Speaker 1: Nothing bad. It's very very sad. But what I hope
Speaker 1: I can get people to understand is that there is
Speaker 1: a normal, natural way that a person dies and that's
Speaker 1: not bad. It's sad, but it's not bad. You talk
Speaker 1: about how we is a society of view death as
Speaker 1: a failure, and so you know that that ability to
Speaker 1: kind of give up and stop trying to make it better.
Speaker 1: Um sounds like it's a very hard one very big decision.
Speaker 1: It's very hard, and it takes honesty from the physician
Speaker 1: and the medical professionals to help us realize. You know
Speaker 1: that we've we've given it our best shot. This is
Speaker 1: the best we can do, and it's not working. Everybody dies.
Speaker 1: And now I you know it's Dad's time. We can't
Speaker 1: fix him. And then let's shift gears and look at
Speaker 1: how we can make Dad's time the best quality time
Speaker 1: of not the suffering, painful, one unnecessary treatment after another. Um.
Speaker 1: So many of our people die in hospital. I see
Speaker 1: use that because they haven't had the advanced directive written,
Speaker 1: because no one recognizes that everybody dies. That is one
Speaker 1: thing we can be sure of. Well, Barbara, thank you
Speaker 1: so much for taking the time to come on. Certainly
Speaker 1: a sort of sobering or somber subject, but I really
Speaker 1: think the information you're providing is so helpful in navigating
Speaker 1: this process that so many of us aren't familiar with,
Speaker 1: but all of us will have encounters with. So thank
Speaker 1: you so much for taking the time. Thanks for talking
Speaker 1: with me. Eric, Okay, take care, Okay, byeyeye, you can
Speaker 1: learn more about this podcast and Barbara Carnes at one
Speaker 1: You Feed dot net slash Barbara