WEBVTT - Getting Comfortable With Death 0:00:01.600 --> 0:00:05.240 Hey there, folks, this episode of our podcast is going 0:00:05.280 --> 0:00:09.920 to be all about dignity, love and joy as we 0:00:10.000 --> 0:00:15.240 talk about death, we'll explain. Stay with us here, Welcome 0:00:15.280 --> 0:00:18.240 to this episode of Amy and TJ and Robes. I 0:00:18.280 --> 0:00:21.159 say that because we are going to be focusing on 0:00:21.880 --> 0:00:26.800 end of life, which is now. It scares the heck 0:00:26.840 --> 0:00:28.680 out of anybody to think about the end of your life, 0:00:28.680 --> 0:00:30.960 and it's hard to plan for that. But there's an 0:00:31.040 --> 0:00:33.760 organization now that has been around for several years as 0:00:33.840 --> 0:00:36.599 trying to make this a part of life and not 0:00:37.520 --> 0:00:40.960 I guess as daunting of a task or a thought 0:00:41.120 --> 0:00:42.760 as most of us think it is. 0:00:42.880 --> 0:00:44.879 Yeah, well, what do we do when we're afraid of 0:00:44.880 --> 0:00:47.000 something or we don't want to think about something. We 0:00:47.040 --> 0:00:49.200 ignore it. We don't plan for it, we don't talk 0:00:49.200 --> 0:00:51.680 about it, we don't discuss it. And yet when it happens, 0:00:51.720 --> 0:00:55.680 and it is something that is inevitable, we cannot escape death, 0:00:55.920 --> 0:00:58.080 not on one of us. And yet somehow we don't 0:00:58.120 --> 0:01:00.800 talk about it and we don't plan for and you 0:01:00.920 --> 0:01:03.080 leave the burden behind for the people who love you, 0:01:03.760 --> 0:01:08.920 and you also don't take the opportunity to actually be 0:01:09.000 --> 0:01:11.120 a part of that planning and be a part of 0:01:11.160 --> 0:01:14.560 that understanding and it can be a loving, beautiful thing. 0:01:14.680 --> 0:01:17.880 But because it's scary and because we want to avoid 0:01:17.920 --> 0:01:20.080 it and we don't want to talk about it, we 0:01:20.160 --> 0:01:22.920 miss those moments that are there. And so yes, there 0:01:22.959 --> 0:01:25.120 is a group. There was an organization that's been around, 0:01:25.319 --> 0:01:28.560 a nonprofit initiative that is focused. As you say, I 0:01:28.640 --> 0:01:31.880 love this making end of life part of life. That 0:01:32.000 --> 0:01:35.479 is such a concept that I don't think most people 0:01:35.520 --> 0:01:39.080 even think about or have even considered, and yet it's 0:01:39.120 --> 0:01:39.880 so important. 0:01:40.280 --> 0:01:44.720 And the founder of the organization, doctor Joshana Ungerlighter, is 0:01:44.800 --> 0:01:46.800 going to be joining us here now she is on 0:01:46.880 --> 0:01:50.880 the podcast. But not just doctor Hungerlighter. We have with 0:01:51.000 --> 0:01:54.360 us also a name, a face, and a voice. I 0:01:54.360 --> 0:01:56.760 think Robes is familiar to a lot of people. 0:01:56.920 --> 0:02:00.440 Yes, we have Yvette Nicole Brown. You know her love 0:02:01.280 --> 0:02:03.840 she has been I don't know. There are so many 0:02:03.880 --> 0:02:06.880 different television shows and movies. You've been a part of EVET, 0:02:06.880 --> 0:02:09.280 but I think most people know you from community and 0:02:09.320 --> 0:02:11.839 I love that you are now the voice of Coach 0:02:11.960 --> 0:02:15.680 robertson Inside Out Too, one of TJ's daughter's favorite movies. 0:02:16.080 --> 0:02:18.480 So but that's just I mean I could go on 0:02:18.520 --> 0:02:20.320 and on and on naming all of your. 0:02:20.160 --> 0:02:21.640 Accolades that this is wild. 0:02:21.800 --> 0:02:22.680 I am not kidding you. 0:02:22.960 --> 0:02:25.240 I actually asked her ahead of time, can you please 0:02:25.280 --> 0:02:27.720 handle the intro to her? It's just too much, it's 0:02:27.800 --> 0:02:31.119 too much to try to get in there. But welcome, 0:02:31.240 --> 0:02:33.400 Welcome to you both. It's so good to have you 0:02:33.480 --> 0:02:36.760 both with us here on the podcast. Doctor Ungerler. How 0:02:36.800 --> 0:02:37.440 are you doing today? 0:02:38.360 --> 0:02:41.160 I'm well, thank you, Thank you so much for having 0:02:41.240 --> 0:02:44.560 both of us and for having this conversation today, and 0:02:45.080 --> 0:02:45.760 thanks for having us. 0:02:45.800 --> 0:02:48.839 Yes, yeah, And I wanted to ask you how did 0:02:48.880 --> 0:02:52.200 you get involved in this group? Because, as I mentioned, 0:02:52.240 --> 0:02:55.280 this isn't something that most people think about, and I 0:02:55.320 --> 0:02:57.840 think it's something most people don't want to think about. 0:02:58.560 --> 0:03:01.760 Yeah, you know, I'm a giver. I lost my mom 0:03:01.800 --> 0:03:04.040 three years ago, as everyone knows. And then I'm also 0:03:04.080 --> 0:03:06.800 a caregiver, so end of life has been, you know, 0:03:07.480 --> 0:03:10.440 in the forefront of my mind for a while. And Shoshana, 0:03:10.480 --> 0:03:12.200 how do we ended up working together? Did you just 0:03:12.320 --> 0:03:14.560 see me in the caregiving space and go she might 0:03:14.600 --> 0:03:17.560 be cool to host this or how did how did 0:03:17.560 --> 0:03:18.280 we get together? 0:03:19.280 --> 0:03:23.640 Exactly? We basically were like vet is incredible. She is 0:03:23.680 --> 0:03:28.000 the most dynamic person and has has walked this journey, 0:03:28.040 --> 0:03:29.959 and so we just felt like it was a perfect 0:03:30.040 --> 0:03:33.360 fit to have you come, you know, host last year 0:03:33.400 --> 0:03:36.200 and then you you smashed it, so we had to 0:03:36.200 --> 0:03:37.840 have you back this year for it for our event. 0:03:38.120 --> 0:03:40.760 And I learned so much you guys about end of life. 0:03:40.840 --> 0:03:42.640 And I mean, the thing that blew my wig back 0:03:42.680 --> 0:03:45.240 last year was death doulas because we've all heard of 0:03:45.240 --> 0:03:47.920 birth doulas. I heard for the first time about death 0:03:47.960 --> 0:03:50.120 doulas when I hosted last year, and there were just 0:03:50.160 --> 0:03:51.960 everybody that came up on the panel. It was just 0:03:52.000 --> 0:03:55.000 more information about conversations we don't want to have, but 0:03:55.040 --> 0:03:56.680 we need to have. And the thing is, you have 0:03:56.760 --> 0:03:59.080 it once you figure out what you want, what you 0:03:59.200 --> 0:04:00.720 what you people want to do and all that, and 0:04:00.760 --> 0:04:02.920 then you never have to talk about it again, you know. 0:04:03.040 --> 0:04:05.880 So it's just important to know. We talk about birth, 0:04:05.920 --> 0:04:08.920 we talk about love and relationships and life and careers, 0:04:08.960 --> 0:04:11.160 we talk about everything except the one thing that's inevitable 0:04:11.160 --> 0:04:12.520 for all of us, we all getting out of here. 0:04:12.960 --> 0:04:15.560 So we need to have a conversation about end of life. 0:04:16.680 --> 0:04:19.080 It's so interesting you just said that because right before 0:04:19.120 --> 0:04:22.040 we came on the podcast, I was talking in the 0:04:22.080 --> 0:04:26.119 studio and I said, death doula. I have never heard 0:04:26.160 --> 0:04:28.560 that term before. And to your point, yes, we've all 0:04:28.600 --> 0:04:31.599 heard about doula's there who helped women give birth. I 0:04:31.680 --> 0:04:36.279 didn't know that was a thing. Tell can doctor a ungerletter, 0:04:36.320 --> 0:04:39.279 can you tell us what a death doula actually even 0:04:39.480 --> 0:04:41.360 is and how prominent are they? 0:04:43.000 --> 0:04:47.280 Yeah? Well, so a death doula is exactly the same 0:04:47.320 --> 0:04:51.279 thing that one does for the birthing process for new 0:04:51.279 --> 0:04:54.320 moms and families. But at the end of life, it's 0:04:54.320 --> 0:04:58.640 somebody who walks beside you in a non medical fashion 0:04:58.839 --> 0:05:03.200 and supports the the dying person, supports the family, other 0:05:03.279 --> 0:05:07.760 loved ones, and death dula's usually come you know, into 0:05:07.800 --> 0:05:11.159 play in the final weeks of life, but they can 0:05:11.480 --> 0:05:14.279 month's upstream if somebody's terminally ill get involved. 0:05:14.520 --> 0:05:16.960 And even more than months upstream, I found they if 0:05:17.000 --> 0:05:18.919 you are just someone that wants to get your affairs 0:05:18.920 --> 0:05:20.960 in order, you could have a death dula even though 0:05:21.000 --> 0:05:23.400 you're perfectly healthy. And you talk to that person and 0:05:23.400 --> 0:05:25.120 you say, well, when I pass away, I want all 0:05:25.160 --> 0:05:27.400 my jewelry laid out, and I want everybody to come 0:05:27.440 --> 0:05:29.159 and pick up a string of pearls or a ring 0:05:29.240 --> 0:05:32.440 as they celebrate me, or I want this playlist playing 0:05:32.560 --> 0:05:35.360 at my homegoing like you literally just get to plan 0:05:35.400 --> 0:05:37.440 it the way you would plan a wedding, you know, 0:05:37.520 --> 0:05:40.159 and then when the time comes, everything's already laid out 0:05:40.360 --> 0:05:42.200 and everybody knows what you want. 0:05:42.640 --> 0:05:47.920 How exactly isn't this, doctor Aungerler, This is so much 0:05:48.040 --> 0:05:50.120 yes for the person who is passed it, but how 0:05:50.279 --> 0:05:52.800 critical is this for the people who are going to 0:05:52.839 --> 0:05:57.480 be left behind that this these conversations and this whole 0:05:57.600 --> 0:05:59.400 end well concept takes place. 0:06:00.560 --> 0:06:03.520 Oh, it's it's huge. I mean it's it goes well 0:06:03.560 --> 0:06:07.400 beyond the person in the bed, and certainly as it 0:06:07.440 --> 0:06:10.080 relates to the legacy and the planning as far as 0:06:10.080 --> 0:06:12.200 getting your affairs in order, which is I just lost 0:06:12.240 --> 0:06:14.760 my dad, and so I can tell you having those 0:06:14.800 --> 0:06:17.599 conversations ahead of time makes all the difference in the world. 0:06:17.920 --> 0:06:20.800 And then as you navigate the grief journey too once 0:06:20.920 --> 0:06:23.839 once your person is gone, I'm having a death duela, 0:06:24.279 --> 0:06:27.400 and thinking about these things ahead of time I think 0:06:27.480 --> 0:06:31.279 doesn't alleviate the grief, but makes it a little bit easier, 0:06:31.640 --> 0:06:33.080 you know, for everybody who. 0:06:33.000 --> 0:06:35.040 If you found, is more resistant, and maybe a vet 0:06:35.040 --> 0:06:37.680 you can speak to your personal experience, who's more hesitant 0:06:37.720 --> 0:06:40.200 to have the conversation. Like you said, doctor Ungelier, is 0:06:40.240 --> 0:06:42.240 that person in the bed or is it the family 0:06:42.279 --> 0:06:44.760 who's who's most resistant? 0:06:44.960 --> 0:06:45.120 Ends? 0:06:45.760 --> 0:06:48.839 It depends too, because you know, I'm finding with my dad, 0:06:48.839 --> 0:06:52.719 who has dementia, he's it's I feel that he's declining, 0:06:52.720 --> 0:06:54.760 and I feel like it's you know, I hope I 0:06:54.760 --> 0:06:57.000 have him for another fifty seven years, but I don't 0:06:57.040 --> 0:06:59.320 know how long it will be. But I'm noticing that 0:06:59.360 --> 0:07:02.800 he's less concerned with anything here, you know what I mean, 0:07:02.839 --> 0:07:05.080 He's more concerned. He's I feel like the veil has 0:07:05.080 --> 0:07:07.520 been lifted, and he's seeing his mother and his father, 0:07:07.600 --> 0:07:11.120 and he seeing my mom, and so he's already transitioning, 0:07:11.160 --> 0:07:14.480 I feel in a certain way. So it's definitely harder 0:07:14.520 --> 0:07:16.480 for those of us left here to imagine and to 0:07:16.480 --> 0:07:20.080 think about what the next step is for us, you know. 0:07:20.360 --> 0:07:23.040 And there's a lot of conversations that are difficult, but 0:07:23.080 --> 0:07:24.400 it only hurts when. 0:07:24.320 --> 0:07:26.960 You don't have them. You gotta have them. You gotta 0:07:27.040 --> 0:07:27.720 have the tough ones. 0:07:27.760 --> 0:07:30.520 And Doctor Underlighter, I'm curious because I know part of 0:07:30.520 --> 0:07:34.600 your mission is to, you say, challenge societal norms and 0:07:34.720 --> 0:07:38.240 to humanize the death experience, which is such an interesting 0:07:38.280 --> 0:07:41.720 way to put it. Is this something specific to our country? 0:07:41.760 --> 0:07:47.200 Do other countries? Do other people handle this better and 0:07:47.440 --> 0:07:50.920 weave it into the fabric of their lives in anticipation 0:07:50.960 --> 0:07:54.640 of what is inevitable? Or is this something that maybe 0:07:54.640 --> 0:07:58.480 perhaps universally we all avoid What would you say? 0:07:59.400 --> 0:08:01.840 I would say it is pretty universal. I mean, there 0:08:01.840 --> 0:08:06.600 are some select communities and cultures that do talk about 0:08:06.640 --> 0:08:09.560 death or have really amazing ritual around end of life. 0:08:09.600 --> 0:08:12.400 But I would say as part of the modern and 0:08:12.480 --> 0:08:17.680 certainly the Western human experience, we tend to run away 0:08:17.680 --> 0:08:20.840 from these conversations. And how that plays out is that 0:08:21.120 --> 0:08:23.560 and I see this over and over, far too many 0:08:23.600 --> 0:08:26.160 people get care in and around the end of their 0:08:26.200 --> 0:08:29.200 lives that they don't want or maybe they don't understand, 0:08:29.600 --> 0:08:33.040 and ultimately may not help them. So the more that 0:08:33.080 --> 0:08:36.120 we can be kind of talking about this, normalizing this, 0:08:36.280 --> 0:08:40.040 these discussions, or having a relationship to our own mortality, 0:08:41.240 --> 0:08:43.440 I think allows us to live better every day, but 0:08:43.520 --> 0:08:46.600 I think certainly allows us to have a better end 0:08:46.600 --> 0:08:48.840 of life experience when that time does come. 0:08:49.720 --> 0:08:49.800 And. 0:08:57.600 --> 0:08:59.840 You'll explain what it means. By the end of life experience, 0:09:00.400 --> 0:09:03.720 we assume it's a medical experience that we're exprounded by doctors, 0:09:03.720 --> 0:09:07.400 we're in hospice. You all are trying to shift that 0:09:07.520 --> 0:09:09.800 focus in that mindset. Explain that to us. 0:09:10.040 --> 0:09:13.400 Yeah, well, it's not that it's a specific time or place. 0:09:13.480 --> 0:09:16.320 We sort of broaden out the end of life experience 0:09:16.400 --> 0:09:18.640 because it can be different things for many different people, 0:09:18.640 --> 0:09:21.760 depending on if you're facing a terminal diagnosis, if you're 0:09:21.840 --> 0:09:26.000 just thinking about advanced age, or they're certainly young people 0:09:26.160 --> 0:09:29.520 you know who who become ill and pass. But it's 0:09:29.720 --> 0:09:33.640 really a continuum of time. And again, it's not about 0:09:33.679 --> 0:09:36.920 saying like you gotta you should die at home in 0:09:36.960 --> 0:09:39.480 your own home, or you should do this or do this. 0:09:39.520 --> 0:09:42.240 It's really a bigger conversation about what it is that 0:09:42.880 --> 0:09:47.319 the individual wants, and ending well is really about ensuring 0:09:47.360 --> 0:09:51.080 that people have the opportunity to live their lives fully 0:09:51.200 --> 0:09:54.480 up until the end, with dignity and purpose and connection 0:09:54.600 --> 0:09:57.960 to the things that really matter most to them. Whatever 0:09:58.040 --> 0:09:59.480 that looks like anything. 0:09:59.600 --> 0:10:02.079 And I want to may I add also, the in 0:10:02.200 --> 0:10:04.800 Well symposium is not a sad experience. 0:10:04.960 --> 0:10:05.800 It is a. 0:10:06.120 --> 0:10:10.640 Joyous life affirming experience because we hear about end of 0:10:10.640 --> 0:10:13.880 life from every different direction, from so many different types 0:10:13.880 --> 0:10:16.880 of people. Some people are doing Tignotaro did a comedy 0:10:17.520 --> 0:10:19.720 bit about it. You know what I mean, like this, 0:10:19.760 --> 0:10:21.800 you're gonna get a this was last year. Well, you're 0:10:21.800 --> 0:10:23.880 gonna get it from every direction, and there will be 0:10:23.960 --> 0:10:27.320 someone there that meets you where you are. If you're 0:10:27.520 --> 0:10:30.400 a scaredy cat, you know, if you're somebody that's like, 0:10:30.559 --> 0:10:33.160 let's go team in, well, like whatever, wherever you are 0:10:33.200 --> 0:10:35.000 on the spectrum, you're going to find someone there that's 0:10:35.000 --> 0:10:36.640 going to speak to exactly where you are, and you're 0:10:36.640 --> 0:10:37.760 going to learn a lot. One of the things I 0:10:37.840 --> 0:10:41.200 learned last year was I don't know the percentage and 0:10:41.240 --> 0:10:43.720 helped me doctor if I get this wrong. But when 0:10:44.800 --> 0:10:48.240 oncologists get a cancer diagnosis, this blew my wig back. 0:10:48.960 --> 0:10:50.560 I didn't even have one on and it blew it back. 0:10:50.880 --> 0:10:54.720 They choose if it's terminal, most of them, and I 0:10:54.720 --> 0:10:57.760 don't know what the percentage was, most of them choose hospice. 0:10:57.800 --> 0:11:02.160 Most of them do not choose the extraordinary measures, which 0:11:02.200 --> 0:11:04.320 says to me one that they understand that when you 0:11:04.360 --> 0:11:07.000 get the terminal. They know what the odds are. You know, 0:11:07.040 --> 0:11:09.600 we all wish for great things and there's miracles that 0:11:09.600 --> 0:11:10.400 happen all the time. 0:11:10.559 --> 0:11:11.120 But they know the. 0:11:11.120 --> 0:11:13.120 Statistics and they know what it looks like. And they 0:11:13.160 --> 0:11:17.080 also have decided how they want those last years, months, 0:11:17.080 --> 0:11:19.640 whatever to be, and they choose to go home and 0:11:19.679 --> 0:11:22.199 be with their families. So at the end of their life, 0:11:22.200 --> 0:11:25.280 knowing what they know, they want family time, you know 0:11:25.320 --> 0:11:27.600 what I mean. So, I mean it helped me think 0:11:27.640 --> 0:11:29.560 about what am I doing every day and how am 0:11:29.600 --> 0:11:32.200 I spending my time every day and what will be 0:11:33.280 --> 0:11:35.800 when it's time for me to face my going on 0:11:35.880 --> 0:11:36.400 to glory. 0:11:36.840 --> 0:11:38.199 I want to spend it with family too. 0:11:38.240 --> 0:11:41.080 But that's a decision I made from hearing them say 0:11:41.160 --> 0:11:42.839 how they do what they do, see what I mean. 0:11:42.920 --> 0:11:45.400 So you learn a lot of things at the symposium, 0:11:45.440 --> 0:11:46.160 A lot of things. 0:11:46.480 --> 0:11:47.960 Yeah, And I was going to ask you, this is 0:11:47.960 --> 0:11:50.880 your second time hosting event, correct this year? I was 0:11:50.920 --> 0:11:53.439 just kind of reading what you all have planned. Can 0:11:53.480 --> 0:11:56.240 you give listeners an idea? This is taking place November 0:11:56.280 --> 0:12:00.960 twenty second in Los Angeles. What are people going to 0:12:01.000 --> 0:12:03.719 see and hear at the symposium this year? Because you've 0:12:03.720 --> 0:12:06.120 got some you've got some big names, and you've got 0:12:06.120 --> 0:12:07.160 some big acts coming on. 0:12:07.920 --> 0:12:10.240 Yeah, I'm gonna I will say, from my perspective, You're 0:12:10.240 --> 0:12:13.640 gonna get great energy, a lot of empathy, a lot 0:12:13.640 --> 0:12:16.000 of compassion, and hopefully a lot of jokes. 0:12:16.240 --> 0:12:17.600 That's what I'm bringing to the table. 0:12:18.040 --> 0:12:20.040 Joshana, what are these other people bring into the table 0:12:20.080 --> 0:12:21.600 that you have lined up for everyone? 0:12:21.920 --> 0:12:24.959 Yeah, well it's it's at the Skerball Cultural Center in 0:12:25.480 --> 0:12:28.120 la And of course we're going to have Yvette back 0:12:28.200 --> 0:12:32.760 as our as our host, and some other prominent advocates 0:12:33.080 --> 0:12:38.800 will Becoming ten By Locke, who wrote From Scratch, that 0:12:38.920 --> 0:12:45.640 amazing Netflix series. Award winning writer and war correspondent Sebastian 0:12:45.720 --> 0:12:49.120 Younger will be there. We're thrilled to have a special 0:12:49.160 --> 0:12:53.319 guest performance by Miguel Servantes from the Broadway show Hamilton, 0:12:54.080 --> 0:12:58.320 and several other amazing surprise guests. But I would say 0:12:58.360 --> 0:13:02.679 that you know, this is not not a medically focused conversation. 0:13:03.320 --> 0:13:07.599 This is about, you know, the human experience, the spiritual, 0:13:07.800 --> 0:13:11.800 the social, sometimes the financial, the sort of thinking about 0:13:12.600 --> 0:13:15.960 end of life from a design perspective. I mean, it 0:13:16.000 --> 0:13:19.079 really runs the gamut and the audience is full of caregivers, 0:13:19.080 --> 0:13:22.080 of people who've been patients, of folks from the media, 0:13:22.640 --> 0:13:26.240 on policymakers, I mean, sort of faith, community leaders, you 0:13:26.320 --> 0:13:30.480 name it. So it's really about creating an experience that 0:13:30.559 --> 0:13:33.040 anybody can really find accessible and meaningful. 0:13:33.320 --> 0:13:35.959 Do you all think there's to be some policy changes, 0:13:36.679 --> 0:13:39.840 some governmental changes that would change the way we all 0:13:40.120 --> 0:13:42.719 that could help us at end of life, that could 0:13:42.760 --> 0:13:45.080 help the way we view end of life? What are 0:13:45.120 --> 0:13:52.320 we getting wrong at least from a government standpoint? Okay, 0:13:52.440 --> 0:13:53.120 sorry about that. 0:13:53.800 --> 0:13:55.199 A lot of questions. 0:13:55.440 --> 0:13:57.160 I can make a list too, because also because I'm 0:13:57.160 --> 0:13:59.000 in the caregiving space, there's a lot of things that 0:13:59.640 --> 0:14:01.280 we just don't have that we need. 0:14:01.320 --> 0:14:02.240 I love that there's that. 0:14:02.600 --> 0:14:06.440 Hopefully our future president just listed a policy about bringing 0:14:06.520 --> 0:14:10.160 Medicare home, which will help a lot of caregivers in 0:14:10.200 --> 0:14:12.760 the future, because when you think about I want to 0:14:12.760 --> 0:14:15.840 do hospice, your choices are not I'm going to do 0:14:15.840 --> 0:14:17.240 it at my house most of the time because you 0:14:17.240 --> 0:14:18.720 don't have the money to be able to do it there. 0:14:18.880 --> 0:14:22.160 So this could change things. Yeah, there's a lot. 0:14:21.960 --> 0:14:26.520 Of there's paid caregiving leave, you know, which is being 0:14:26.720 --> 0:14:29.960 is being talked about because folks who are caregivers. Family 0:14:29.960 --> 0:14:32.640 caregivers often like like you bet said, you know, can't 0:14:32.720 --> 0:14:34.720 can't go to work, and they're certainly not trained and 0:14:34.760 --> 0:14:36.360 how to be caregivers. 0:14:35.840 --> 0:14:38.200 You know, community to take care of my dad, So 0:14:38.360 --> 0:14:40.920 sometimes you got to choose your loved one over your. 0:14:40.840 --> 0:14:41.360 Job, you know. 0:14:42.280 --> 0:14:44.520 And we also have a shortage of providers, right so 0:14:44.560 --> 0:14:47.440 the field of palliative care, of which hospice is part, 0:14:48.240 --> 0:14:52.080 this is these are nurses, doctors, social workers, chaplains. There 0:14:52.080 --> 0:14:55.280 aren't enough of them and so there's actually they're underpaid. 0:14:55.360 --> 0:14:57.400 And so there's a bill right now and it's been 0:14:57.440 --> 0:15:00.600 being looked at for the last ten years to increase spending, 0:15:01.400 --> 0:15:04.840 government spending to allow more trainees to come up through 0:15:04.880 --> 0:15:07.120 the system because we just don't have enough people to 0:15:07.160 --> 0:15:10.480 take care of our aging population. So that's another huge one. 0:15:10.560 --> 0:15:11.760 Did you really say ten years? 0:15:12.680 --> 0:15:16.800 Oh yeah, just been sitting there swirling around in Congress 0:15:16.880 --> 0:15:19.320 and it's like a bill. 0:15:19.440 --> 0:15:22.000 Yeah, oh wow, yes, taking it back old school. I 0:15:22.000 --> 0:15:25.880 love that school of rock, doctor Ungerler, you know, it's 0:15:26.000 --> 0:15:28.040 I don't and I don't know the exact numbers on this, 0:15:28.120 --> 0:15:32.200 but my brother is also an internist and he has 0:15:32.280 --> 0:15:36.920 talked about this end of life decisions and making choices 0:15:37.960 --> 0:15:40.960 to my parents and to my relatives who are getting older, 0:15:41.360 --> 0:15:45.560 and he said something like the like, the largest percentage 0:15:45.600 --> 0:15:49.200 of your healthcare cost over your entire lifetime, don't compare 0:15:49.240 --> 0:15:51.480 it to the final two weeks of your life. It's 0:15:51.520 --> 0:15:54.400 like eighty percent of your health care costs are all 0:15:54.760 --> 0:15:57.320 in the last two weeks of your life. Is part 0:15:57.320 --> 0:15:59.200 of what you're trying to do to prevent that, so 0:15:59.280 --> 0:16:02.280 decisions can be made ahead of time, and oftentimes for 0:16:02.400 --> 0:16:06.480 life saving measures that that patient doesn't even necessarily want 0:16:06.840 --> 0:16:10.800 and is absolutely kind of throwing something at a situation 0:16:10.880 --> 0:16:14.440 that isn't going to change. What do you say to that. 0:16:15.400 --> 0:16:18.480 No, I mean that's accurate. I would say that in general, 0:16:18.840 --> 0:16:22.000 that's sort of an average. Yes, we spend a massive 0:16:22.000 --> 0:16:25.320 amount of money on the final weeks of people's lives, 0:16:25.720 --> 0:16:28.400 and you know, to me, it's I'm not a healthcare economist. 0:16:28.440 --> 0:16:31.640 You know, to me, the numbers are important, But the 0:16:31.760 --> 0:16:34.320 bigger issue, because I became a doctor to help people 0:16:34.440 --> 0:16:38.040 and help heal people, and that is that I really 0:16:38.080 --> 0:16:40.840 want to see people get care in and around the 0:16:40.880 --> 0:16:43.640 end of their lives that honors the life that they've 0:16:43.680 --> 0:16:46.680 lived is in line with their goals and their values. 0:16:47.040 --> 0:16:51.360 And I think that first starts with incentivizing conversations early 0:16:51.440 --> 0:16:57.479 and often within the healthcare journey about your goals, especially 0:16:57.520 --> 0:17:01.520 if you're diagnosed with a life limiting illness, a terminal illness, say, 0:17:01.920 --> 0:17:05.360 And so I think to me, that's the biggest sort 0:17:05.400 --> 0:17:08.280 of issue that comes up for people is that we're 0:17:08.320 --> 0:17:11.600 just not having these conversations. Seventy percent of doctors that 0:17:11.720 --> 0:17:15.280 seven zero aren't trained and had to break bad news 0:17:15.280 --> 0:17:18.320 to patients or talk about prognosis. So where does that 0:17:18.400 --> 0:17:21.520 leave us it, you know, in a system that values 0:17:21.600 --> 0:17:25.159 doing everything to keep people alive at all costs. That 0:17:25.640 --> 0:17:27.719 leaves us in a place where we're just on this 0:17:28.160 --> 0:17:32.320 you know, conveyor belt of aggressive invasive treatment, no matter 0:17:32.359 --> 0:17:34.240 how old you are, no matter how sick you are, 0:17:34.560 --> 0:17:37.240 and even if it won't help you very often. And 0:17:37.280 --> 0:17:38.400 so that's change. 0:17:38.800 --> 0:17:41.800 And maybe if we had the conversations earlier and we 0:17:41.840 --> 0:17:44.760 accepted that it's inevitable, we wouldn't be so afraid of 0:17:44.760 --> 0:17:48.320 it and be chasing one more I need one more summer, 0:17:48.720 --> 0:17:49.400 you know what I'm saying. 0:17:49.640 --> 0:17:53.440 Maybe if we talked about it early, enough and talk 0:17:53.520 --> 0:17:55.680 to our people and made our plans and we could 0:17:55.760 --> 0:17:57.959 just get busy living and then when we get the 0:17:58.520 --> 0:18:01.639 inevitable conversation we all get if it's a sickness that 0:18:01.720 --> 0:18:05.440 takes us out, you're not scrambling to get all the 0:18:05.480 --> 0:18:07.800 stuff in. And I'm trying to extend something that is 0:18:08.119 --> 0:18:10.639 we're not gonna make it everybody. We're not gonna make 0:18:10.680 --> 0:18:14.080 it out of your life. So everybody has an appointment, 0:18:14.600 --> 0:18:17.119 So listen, enjoy it. 0:18:17.200 --> 0:18:19.640 Why you got it prepared for when it comes? 0:18:20.320 --> 0:18:23.440 And in well, in well, I just want that one 0:18:23.440 --> 0:18:24.879 more summer in the Hamptons that. 0:18:24.920 --> 0:18:39.320 Give me one more some of that. I'm sorry, talk 0:18:39.359 --> 0:18:41.600 to people, both of you. There are folks listening to us. 0:18:41.600 --> 0:18:44.760 They are in their twenties, thirties, forties, fifties, sixties, seventies. 0:18:45.280 --> 0:18:49.080 Is there a different type of conversation based on the 0:18:49.240 --> 0:18:52.359 age or is it the same conversation and you just 0:18:52.400 --> 0:18:54.679 need to have it as early as possible. What are 0:18:54.680 --> 0:18:57.480 the recommendations you all have for the different age groups 0:18:57.520 --> 0:19:00.520 about what the conversation you should be having thing about 0:19:00.520 --> 0:19:01.359 the end of life? 0:19:01.440 --> 0:19:03.639 Well, I will tell you how I feel about this, 0:19:03.680 --> 0:19:05.760 and then I want to hear your thoughts too, you know, 0:19:05.800 --> 0:19:08.760 as somebody who works in this space. From my perspective, 0:19:08.760 --> 0:19:12.600 it's never too early to start normalizing these kinds of 0:19:12.640 --> 0:19:16.119 conversations again, because I think it can allow you to 0:19:16.200 --> 0:19:19.640 live better every single day. Recognizing that time is short 0:19:19.720 --> 0:19:22.440 gets you to ask these questions about like, well, am 0:19:22.440 --> 0:19:25.200 I living my life with the kind of you know, 0:19:25.920 --> 0:19:28.720 purpose and meaning that I want? Given that I don't 0:19:28.760 --> 0:19:31.760 know if tomorrow is promised right or is a given? 0:19:32.200 --> 0:19:34.720 So I think that that is a really you know, 0:19:34.840 --> 0:19:38.960 beautiful framing. And then you know, as time goes on, 0:19:39.480 --> 0:19:43.520 if medical diagnoses develop, you know, it's a different kind 0:19:43.520 --> 0:19:47.280 of conversation that's a little more medically nuanced maybe, and 0:19:47.359 --> 0:19:50.439 it's also psychologically speaking, and the data support this that 0:19:50.840 --> 0:19:53.720 you know, we don't we can't predict our future selves, 0:19:53.920 --> 0:19:56.240 right or what would be acceptable to us in terms 0:19:56.240 --> 0:19:59.639 of quality of life, because at twenty that's probably different 0:19:59.680 --> 0:20:01.840 than what maybe would be the case at fifty or 0:20:01.840 --> 0:20:05.159 maybe the case at ninety if we are facing you know, 0:20:05.359 --> 0:20:08.040 a terminal illness. So again, like I do, think it 0:20:08.080 --> 0:20:11.520 is important to kind of revisit this stuff throughout life 0:20:12.080 --> 0:20:15.160 and really talk to your loved ones and the people 0:20:15.200 --> 0:20:18.040 you care about about what matters, so that you know, 0:20:18.080 --> 0:20:20.280