Understand the basic facts about hospice and palliative care, what they have in common, and what makes them different.
In this “EOL 101” episode I explain the difference between hospice and palliative care. This is an important piece of information for people making choices around end-of-life care and an area where there are many misconceptions. We all need to be well-versed in EOL options for our own needs and also so that we can help educate others. I’ll offer additional “explainer” episodes in the future!
Join the team at Patreon.com/eoluand get access to the EOLU mug: “Mind if we talk about death?” (only Patrons can purchase it)
If you enjoy this content please share it with others and consider leaving a review on iTunes! Thanks again to all supporters on my page at Patreon.com/eolu, especially my newest Patrons: Lisa Monroe, Deb Pazderka, Debbie Henkemeyer, and Molly Byock; your contributions make all the difference!
Learn about the “dark side” of the hospice business and how to identify and support organizations that are truly patient-centered.
My guest Jeffrey Lycan has spent the last 21 years of his hospice and palliative care nursing career as an advocate for improving care and quality of life for patients at the end of life. He will discuss the recent alarming reports issued by the OIG (Office of the Inspector General) about instances of negligent care in some hospices, the worrisome trend toward profit-centered rather than patient-centered care, and how to support community-based hospices that are preserving Cicely Saunders’ legacy of end-of-life care. Learn about the Why It Matters Campaign he has started:
The two OIG reports from July 2019 that exposed fraudulent and negligent care in some hospices (see links below)
What a “deficiency” in a hospice survey actually means
Business changes in the hospice industry that have contributed to flaws in the care being offered
How some hospices now focus on profit first rather than patient care first
How profiteering harms the hospice system, patients and staff
New MedPAC proposal for lowering the annual per patient cap for hospices and why it may be a good thing
How consumers can choose the best hospice for their loved ones
How to register a complaint about hospice care
The campaign Why It Matters: Preserving the Legacy of Hospice
As originally championed by Cicely Saunders, MD, the founder of the modern hospice movement, the hospice model of care was based on providing end-of-life care with both compassion and science, and offering this care through engaged community-based, not- for-profit programs.
Join the team at Patreon.com/eoluand get access to the EOLU mug: “Mind if we talk about death?” (only Patrons can purchase it)
If you enjoy this content please share it with others and consider leaving a review on iTunes! Thanks again to all supporters on Patreon.com/eolu, especially Susan Baumhammer, your contribution means everything to me!
Learn about the power of touch to bring comfort and dignity to patients at the end of life.
My guest Elizabeth Erbrecht is a massage therapist and end-of-life doula who specializes in touch and massage for the dying. We’ll talk about the importance of touch for all of us and especially for patients at the end of life. Elizabeth shares information from her guide book Nurturing Touch for the Dying and how to get comfortable touching our dying patients. Learn more at her website:
Learn how death doula training helped this physician find more meaning and fulfillment in her end-of-life medical practice.
My guest Dr. Jackie Yeager is a hospice and palliative care physician who has also trained as a death doula in order to provide the best possible care to her patients. She discusses her passion for slow medicine, especially at the end of life, and describes a new course she is launching on medical information for caregivers and death doulas. Learn more about the Informed Caregiver Course at her website:
Join the team at Patreon.com/eoluand get access to the EOLU mug: “Mind if we talk about death?” (only Patrons can purchase it)
If you enjoy this content please share it with others and consider leaving a review on iTunes! Thanks again to all supporters on Patreon.com/eolu, especially my new Patrons: Kimberly Ogle, Linda McCarthy and Sherilee Bakken!
Learn how administrators and managers can better support their staff in providing heart-based care to hospice patients.
My guest Brenda Clarkson, with over 40 years of nursing experience in hospice, truly understands the mystery that surrounds the dying process and how best to support patients and hospice staff as they journey together through the end-of-life experience. She shares her model for returning to the roots of excellent hospice care while navigating today’s regulatory challenges as outlined in her book “The Heart of Hospice: Core Competencies for Reclaiming the Mystery.” Contact Brenda at:
Registration is now open for the 8-week online course Spiritual Journeys in Chronic Illness. Rev. Dr. Terri Daniel and I will be co-teaching the class, which is offered by the Applied Wisdom Institute in partnership with the University of Redlands. CEU’s will be available! Learn more here.
Mark your calendars now for the event of the year!!! Announcing the Beautiful Dying Expo, which will be held in San Diego CA on November 2-3, 2019. I’ll be there as a facilitator for the event and registration is open now for workshop presenters, vendors, sponsors, authors, filmmakers. Go to www.beautifuldyingexpo.com to learn more. Contact Michele Little at firstname.lastname@example.org if you are interested in being a presenter.
This interview includes:
Why honoring “the mystery” of dying and death is important
How the modern hospice movement has strayed from from the original heart of patient care
A new “mystery model” of hospice care that overcomes some of the challenges faced by hospices today
Core competencies of the hospice staff
The 4 phases of growth experienced by hospice workers
How to decrease the turnover rate of hospice workers
Tools for administrators and managers to choose the best staff for hospice work and support them emotionally and spiritually
Learn how death doulas can benefit both patients and staff when they are added to the hospice interdisciplinary team.
Today I’m sharing an interview with Sherry Majewski who is a hospice-certified LPN who went to become a Certified Death Doula and is now helping her employer create a doula program within the hospice. We talk about the benefits and challenges of adding doulas to the hospice team and why this is an important step forward as we work to improve care for the dying. Learn more about Sherry’s doula services at her website:
If you enjoy this content please share it with others and consider leaving a review on iTunes! Thanks again to all supporters on Patreon.com/eolu, especially my new patrons Joanna Lillian Brown, Karin Lindfors, Carol Marangoni, Cathy Clemens, Myra Bennett, and to Mandy Pierpont thank you for increasing your pledge!
This episode is the first of a 4-part series that introduces you to the members of a palliative care team. Today Dr. Colin Scibetta discusses his role as the physician on the team and how palliative care differs from hospice care. In future episodes you’ll hear from the team nurse, social worker and chaplain.
As this episode airs I am enjoying a trip through Spain, including cycling in the Andalucia region! I’ll be back home in a few weeks to report on the trip. Follow me on Instagram to see my photos at kwyattmd or this link: https://www.instagram.com/kwyattmd/
This interview will cover:
What palliative care consists of
The difference between palliative care and hospice
The benefits of palliative care for patients
How the whole-person approach of palliative medicine also benefits care providers
Why Providence Institute for Human Caring (et al) was awarded the Circle of Life Award from the American Hospital Association
Colin Scibetta MD is a fellowship-trained palliative medicine physician who complete his undergrad in neuroscience and biology at Wesleyan University. He then moved to Ecuador where he worked on a health initiative for indigenous communities impacted by oil development. Dr. Scibetta did his undergraduate medical training at the University of California, San Francisco School of Medicine, where he also completed an internal medicine residency and a fellowship in hospice and palliative medicine.
Remember to tune in next week for Part 2 of this palliative care series! If you enjoy this content be sure to share it with others who might find it helpful and consider leaving a review on iTunes.
Learn about the life of Cicely Saunders and what we can discover from her quest to change the way that people died.
In this episode, recorded just after the celebration of what would have been Cicely Saunder’s 100th birthday, I talk about how she became interested in caring for the dying, what inspired her to create St. Christopher’s Hospice, and what we can learn from her determination to improve care at the end of life.
Read more about the life and work of Dame Cicely Saunders at:
If you’d like to join A Year of Reading Dangerously, our online reading group for 2018, there’s still time! Check out the reading list here and start reading along with 1,000 other people around the globe!
Cicely Saunders first began working with dying patients when she was training to be a nurse in the early 1940’s in London. She went on to become an Almoner (medical social worker) and a volunteer nurse at a hospice for the dying poor where she recognized the great need for better pain management and comfort care at the end of life.
When she was told that the medical system would not be interested in her ideas because she wasn’t a physician she accepted the challenge and went to medical school. One revolutionary contribution to end-of-life care was her concept of “Total Pain,” which included emotional and spiritual pain as well as physical.
As a doctor Cicely received a research grant where she studied pain management and wrote many articles. She took “before and after” photos of each patient so that she could show the transformation that occurred when pain was alleviated. Eventually her dream of creating a hospital dedicated to care of the dying was fulfilled when St. Christopher’s Hospice opened 10 years later.
From her story we can take much inspiration for today’s ongoing struggle to improve care at the end of life:
Follow your heart – Cicely stayed true to her heart and passion throughout her career as she dedicated herself to care of the dying, even when others discouraged her.
Be willing to change course to achieve your dream – Cicely was unable to pursue her original dream of being a nurse after a back injury and shifted to medical social work as a way of continuing her work with dying patients.
Be persistent – Cicely’s determination to do whatever it took to bring her dream to fruition led her to become a doctor.
Patience is essential – Cicely had to wait for many years to see her dream of a hospice become a reality: first while she studied to be a doctor, then did several years of research, and finally raised the funds to build St. Christopher’s. Change rarely happens overnight so stay the course!
Be credible before you can be incredible – Cicely demonstrated this throughout her career as she diligently worked through her own education and her research to gain credibility in the eyes of the medical system she was trying to change
The importance of teamwork – Cicely found likeminded individuals in her community and in the U.S. to sustain her inspiration and her enthusiasm for her goal. We can accomplish more as a team than as individuals.
Flexible models are necessary for optimum care – Cicely resisted standardizing her model of hospice care and instead chose to help others create their own unique solutions for the needs of their communities.
Have a big vision but humble expectations – Cicely sought to change care of the dying across the world with her vision of hospice but was content to make a difference to just one patient at at time.
“If one man from a poor village in India dies without pain because of what I have done, it will all have been worthwhile.” – Dame Cicely Saunders
Today we would be advised to remember her Total Pain concept as we struggle to deal with an opioid crisis in the U.S. Neglecting the contribution of emotional and spiritual pain to physical pain has led to over-reliance on drugs as the answer to suffering.
Happy Birthday Dame Cicely Saunders!
Thank you for inspiring us to carry on your big vision of helping every person find comfort, peace and love at the end of life.
Tune in every Monday for a new episode! If you enjoy this content please share with others and consider leaving a review on iTunes. Until next week:
Learn how pet therapy with a trained animal companion can benefit hospice patients physically and emotionally.
In this episode I share a “legacy interview” from the archives with Magnum – a trained facility dog – and his handler Carol Mestemacher about the benefits of pet therapy for hospice patients. Magnum recently “retired” from his volunteer position so I decided to honor his work by featuring this interview today. Thank you for your service Magnum and Carol!
A huge thank you to my new supporters on Patreon.com/eolu: Susan Clark and Howard Bryant! Your contributions help me keep this podcast and the End-of-Life University Interview Series on the air. If you’d like to join us for as little as $1 a month and receive special bonuses go to Patreon.com/eolu to learn more!
Hear my far-reaching dreams and ideas for changing the way people die in the U.S. in 2018.
In this episode I talk about some of my own personal goals for the New Year and then discuss a list of ideas for ways in which we need to improve all aspects of the end of life. Get some inspiration for steps you can take within your own community and in your own personal life to “Be Good at Death.”
I’ve started a new year-long reading group called A Year of Reading Dangerously for 2018! We’ll be exploring death and the afterlife through books that hopefully will inspire us and stretch our boundaries. Sign up to receive a monthly email with the book selection for the month and a downloadable reader’s discussion guide. Join the fun!
A HUGE thank-you to my latest supporters: Claire Turner and Dr. Leslie Robinson. Your contribution is greatly appreciated as it helps defray the costs of producing and broadcasting this podcast and the End-of-Life University Interview Series, but it also provides me with much-needed emotional and spiritual support! To donate as little as $1 per month go to Patreon.com/eolu.
There is a new pledge level on Patreon-the Platinum level-where for a donation of $5 per month you’ll receive replays of ALL of the End-of-Life University Interviews for 2018. So check it out now!
What we need to do to “Be Good at Death” in 2018″:
Policy Level changes needed:
Improve reimbursement for Palliative Care
Stabilize and improve reimbursement for Hospice Care
Establish a system for paying family caregivers
Medical System changes needed
Integrate Palliative Care into Primary Care and therefore …
Increase home-based palliative services
Rank hospitals according to the quality of end-of-life care provided (based on an article by Dr. Haider Warraich from Duke University). Dr. Warraich’s criteria for this ranking include:
“percentage of patients with a documented health care proxy
percentage of patients who receive heroic measures like cardiopulmonary resuscitation or cardiac defibrillation
appropriate use of hospice and palliative care
the likelihood of a family recommending the hospital for end-of-life care
whether patients’ location of death was concordant with the place in which they had wanted to die
availability of around-the-clock spiritual resources
the training the medical team receives for dealing with the medical and psychosocial issues that arise when death is imminent” ((Thank you Dr. Warraich for this fabulous idea!))
Medical Education changes needed
Train all medical providers in palliative care (at least a one-month rotation) regardless of specialty
All medical students work with dying patients in at least one rotation
Teach better conversational and listening skills to medical providers
Help medical providers process their own fears and biases toward death and their repressed grief
Learn about my Top-10 picks for people, events and trends that have changed the end-of-life movement in 2017.
In this final episode of 2017 I take a look back at the previous year and share my thoughts on some of the events and people that I believe will have a big impact on how our society deals with the end of life.
You can support this podcast by making a small donation of $1 or $2 at Patreon.com/eolu.
Here are my picks for the 2017 Game Changers in the Death-Positive Movement:
The documentary film “Extremis” was nominated for an Academy Award for Best Documentary Short. The film was also picked up by Netflix in 2016. It is a powerful depiction of end-of-life care in the ICU staffed by Dr. Jessica Zitter, which should serve as a wake-up call to people about the need to do end-of-life planning before a healthcare crisis occurs.
Dr. Jessica Zitter’s book Extreme Measures was also released this year. In addition she wrote an article for the N.Y. Times (“First Sex Ed Then Death Ed”) calling for death education classes for all high school students. This novel idea has the potential to change our society’s perception of death and dying by introducing the subject to young people. Dr. Zitter is truly a game changer!
In March and May of 2017 the organization The Dinner Party (a movement to provide community for millennials dealing with loss) convened meetings with business leaders from some prominent US corporations to discuss loss and the workplace. They emphasized the importance of developing workplace policies and protocols for managing bereaved employees and offering them assistance. These conversations are just the first step in changing how grief is recognized and supported in the workplace rather than being ignored.
In April 2017 the 1st International Death Doula Training was held in Maui for the purpose of teaching people from around the globe to serve others as death doulas. This event was a game changer because it validated the death doula movement, increased the number of qualified doulas who can serve their communities, and provided a networking platform for death workers, which helped strengthen and expand the movement. The 2nd International training will take place in 2018!
Also in Apri the National Rx Drug Abuse and Heroin Summit was held to address the epidemic of opioid addiction in this country. Measures have been taken to limit the number of pain pills that can be prescribed and dispensed at one time. This is an important and game-changing step to deal with the overwhelming public crisis of opioid deaths but caution is necessary. We must be vigilant to ensure that all hospice and palliative care patients have access to the medications they need for pain and symptom management.
On June 27, 2017 Jon Underwood, founder of Death Cafe, died suddenly and unexpectedly at a young age. Jon has been a game changer from the beginning by creating the Death Cafe platform for conversations about death that has spread around the world. But the tragedy of his death is also a potential game changer because of the powerful legacy Jon leaves behind and because of the potential for tragedy to inspire growth, creativity and healing. The entire death-positive movement is indebted to Jon for his inspiring and gentle leadership and may his death be a catalyst for transformation.
In July a new smart phone app named WeCroak was introduced. This app is a game changer because it helps people to think about death in a positive manner by sending reminders (“You will die one day”) and quotes on their phones 5 times a day. Technology has the potential to revolutionize our approach to death and dying and this simple $.99 app is just one small step toward the change that is needed.
The film Coco was released in the US by Disney and Pixar in November. Coco tells the story of a 12-year old boy who is transported to the land of the dead on Dia de los Muertos. There he receives help from his departed great-great grandfather to return to his family in the land of the living. The film depicts joyful skeletons who dance and sing and it portrays a positive image of life after death. While it is a children’s movie Coco has a powerful message for adults and is likely to stimulate much conversation in families about death and departed ancestors. It is exciting to see Hollywood begin to address death in a positive manner and this film is a game changer that will hopefully lead to more such productions in the future.
In December the first EndWell Symposium, created by Dr. Shoshana Ungerleiderand her foundation, was held in San Francisco. This groundbreaking symposium brought together thought leaders from healthcare, design and technology to share ideas on how to improve end-of-life care. The synergy of this collaborative event will have a ripple effect across the country and should lead to innovation and creativity around death and dying in the months to come. Dr. Ungerleider is a game changer for her forward-thinking generosity and ingenuity!
Also in December the Northpoint Expeditionary Learning Academy in Prescott AZ held a class for students in grades 9-12 on “Death and the Meaning of Life.” School Director Charles Mentken taught the class, which provided a comprehensive look at death and dying from various cultural and religious perspectives. The elective class also introduced the students to options for hospice and palliative care, death doulas, home funerals, cremation, and traditional funeral and burial services. This may be the first “pilot project” course of the type Dr. Jessica Zitter called for in her NY Times article and it is definitely a game changer. The students in the course have reported that their attitudes and fears about death have been totally transformed, as well as their approach to life, as a result of what they learned in the class. (I’ll be featuring an interview with Charles Mentken and 3 of his students on the End-of-Life University Interview Series in early 2018. Sign up if you’re not already on the list!)
I hope your holiday celebrations have been filled with joy and light and that you feel ready to embark on a brand new year next week! There will be a new episode on New Year’s Day where I will share my “wish list” for 2018.
Learn about this documentary film project that examines the dying process through the eyes of nurses, directed by award-winning filmmaker Carolyn Jones.
In this episode I share an interview with Carolyn Jones, an amazing filmmaker who has turned her attention to the death and dying process here in the U.S. Through interviews with nurses all around the country and by following 4 patients on their end of life journeys Carolyn hopes to demystify the dying process and spur conversation about how to do it better.
Many thanks as usual to all of the supporters who have made donations at Patreon.com/eolu! I am forever grateful for your generosity. You can become a patron for just $1 or $2 per month by signing up at Patreon.com/eolu.
I’d also like to thank all the listeners who have written in over the past few months to express their gratitude for this podcast and for the EOL University Interview Series! I couldn’t do this without you showing up to listen in and join the conversation. Thank you to Susan O’Brien, Terry Lindsley, Don Dahlheimer, Karen Britton, Marzette Ellis, and Louise Kelly for your messages of support!
Today I welcome Carolyn Jones an award-winning filmmaker who has created the Dying in America Project. Her project consists of interviews with 50 hospice and palliative care nurses, and will follow the journeys of four hospice patients when it has been completed. Carolyn will share her inspiration for the project and the goals she has for the future.
In this interview you will learn:
How Carolyn’s past experiences led to this project
How Carolyn created the Dying in America videos
What can be learned from the Dying in America website
How Carolyn hopes this project will help change the way we die in this country
Carolyn Jones is an award-winning photographer and filmmaker who specializes in telling stories that shed light on issues of global concern. Her first book, Living Proof: Courage in the Face of AIDS, was published by Abbeville Press and accompanied by shows in Tokyo, Berlin, the USA, and at the United Nations World AIDS Conference. She directed a television series for Oxygen Media called Womenshands as well as Women… on Family, a program for PBS. Carolyn founded the non-profit 100 People Foundation which creates educational films and curricula for school children worldwide. She has spent the last two years interviewing nurses from all over the country for the book and documentary film: The American Nurse. For more information about Carolyn and Dying in America, visit the websites below. The Dying in America website, supported by a grant from the Jonas Center for Nursing and Veterans Healthcare, is the first phase of the project, which will culminate in a feature length documentary that will seek to change the way Americans confront death.
Learn how Treya Wilber’s spiritual practice helped her transcend fear and die consciously as told in Ken Wilber’s book Grace and Grit.
In this episode I share a powerful and heartfelt interview with Ken Wilber where we discuss the subject of “Conscious Dying” and how the life and death of his wife Treya so beautifully teach us to live and die consciously, as told in the book Grace and Grit.
Whether or not death and dying are issues that concern you at this time in your life, you will find value in listening to Ken’s discussion of this important subject. Each of us must come to terms with our mortality in the physical realm and be prepared for an unknown future. Each of us also must face losing those we deeply love, and caring for them through illness and adversity.
We can learn from Ken and Treya’s experiences how to love totally and consciously during our lifetimes – and how to let go of that love and life itself when that time arrives for us.
This interview will cover:
The meaning of “conscious dying” from a spiritual perspective
Ken’s caregiver journey and how it became his spiritual path
How Ken and Treya “carried one another’s pain” during the course of her illness and dying process
The Buddhist practice of tonglen and why it was important to Treya
How the term “passionate equanimity” describes Treya’s approach to living and dying
Ken Wilber is a philosopher, sage, author and integral theorist who has been called “the Einstein of Consciousness.” He is:
The most translated writer on consciousness studies in the United States
Author of 22 books on spirituality and science –
A Theory of Everything
A Brief History of Everything
Sex, Ecology and Spirituality
The Integral Vision
Creator of Integral Theory – a model for organizing different perspectives of life and consciousness
His book Grace and Grit chronicles the life and death of his second wife Treya Killam Wilber.
Learn how this program of the NHPCO is helping to change public perception of hospice.
In this episode I share an interview with Anita Brikman, VP of Strategic Communications for the National Hospice and Palliative Care Organization (NHPCO.) We will discuss the “Moments of Life” Campaign, which promotes public awareness of hospice and how choosing hospice at the end of life is not “giving up.”
Anita Brikman and I will discuss the NHPCO’s public awareness campaign Moments of Life: Made Possible by Hospice. You’ll enjoy hearing about the creation of this beautiful campaign and how it might benefit you and your community. Watch this brief video about the campaign:
In this interview you will learn:
How the Moments of Life campaign is changing misperceptions about hospice care
How cultural barriers to hospice care are being broken down by the Moments of Life videos
What tools are avaiable on the Moments of Life website for patients and providers
How you can help spread the word about this campaign in your own community
How to submit a story to the NHPCO to be part of the campaign
Anita Brikman joined NHPCO in September of 2013 as the senior vice president of strategic communications and spokesperson for the national organization, which represents 1,600 hospice and palliative care providers with 3,400 locations across the United States, and more than 60,000 individual members. NHPCO’s affiliates, the National Hospice Foundation and Hospice Action Network, promote access to this end-of-life benefit and advocate to lawmakers and regulators about its vital importance to patients and families.
I hope you’ll visit Moments of Lifeand read or watch the beautiful stories of hospice patients there!
Thanks for tuning in and remember there will be a new episode every Monday! Until next week remember:
As you listen to this broadcast I am currently in Italy–traveling and doing research for my new book on grief (also eating … a lot!) This episode has been pre-recorded (along with several others) so that there will be no interruptions in the podcast. If you want to see photos of my journey follow me on Instagram or Facebook.
This podcast is generously sponsored by donations on my page at Patreon.com/eolu. Thank you to all of my patrons–your support means everything to me!! Submit your questions for the next “Hospice Happy Hour” Q&A Sessionhere and I’ll answer them next month. You can become a patron for just $1 or $2 per month and you’ll receive access to the Q&A recordings, the Top 10 Interviews from EOLU, and the opportunity to have your work promoted on this podcast. Go to Patreon.com/eolu to learn more!
Dr. Ira Byock is a leading palliative care physician, author, and public advocate for improving care through the end of life. He is the Founder and Chief Medical Officer for the Institute for Human Caring of Providence St. Joseph Health.
Tune in every Monday for a new episode of the podcast! If you enjoy this content please take a moment to leave a review on iTunes – it will help other listeners find the podcast.
Learn how this holistic veterinarian cares for animals as they reach the end of life.
In this episode I share an interview with Ella Bittel, a holistic veterinarian who specializes in helping animal companions at the end of life. She’ll share tips for caring for our own pets when they become terminally ill.
My trip to Italy is coming up in just 2 weeks! You can check out my Pinterest board to see where I’m planning to go and then keep track of my travels by following me on Instagram or Facebook. I’ll be writing, walking, eating, biking, and tasting some wine as we work our way through Italia!
Become a patron of this podcast by making a donation of just $1 or $2 per month at Patreon.com/eolu! You’ll receive the Top 10 Interviews from EOLU, access to the exclusive Hospice Happy Hour Q&A session each month, and a chance to promote your work on this podcast. A huge THANK YOU to all my current patrons for your support! Join them if you wish at Patreon.com/eolu.
The following interview references a video named Denali that is a “must-see”! Here is the link to watch it on Vimeo:
Ella Bittel teaches us how to care for our animal companions so that they can fully live out their lives. She uses holistic and complementary medicine to keep animals comfortable at the end of life and encourages us to provide this loving care to our own pets. In this interview she discusses:
What it takes to give hospice care to an animal family member including dogs and cats
How we can create conditions to allow for a peaceful hospice assisted natural transition of our pet
How we can prepare so that giving hospice care to our animal companions becomes possible
Tips for assuring the comfort of our pets
The hotline available for questions regarding hospice care for pets on her website
Learn about 10 alternative remedies that are helpful for chronic or terminal pain.
In this episode I’ll share some insights about pain management from a recent blog I wrote in response to the opioid crisis in the U.S. I’ll cover 10 alternative remedies for pain that can be used alone or in conjunction with pain medication. Read the companion blog here (includes links to sources.)
If you missed “An Evening with Ira Byock MD” you can still sign up to listen to the replay. Just click here to submit your email address and you’ll receive the link to listen.
Thanks to all of my supporters on Patreon.com/eolu who generously contribute every month to help keep this podcast and the End-of-Life University Interview Series on the air! If you’d like to become a Patron for just $1 or $2 per month go to Patreon.com/eolu and join the fun! You’ll receive access to our monthly Hospice Happy Hour Q&A session, the Top 10 Interviews from EOLU, I’ll also promote your website, business, organization, book, etc. related to the end of life on this podcast.
In personal news, I’m busy preparing for my trip to Italy where I’ll be traveling for a month and writing a new book about grief. You can check out my travel plans on my Pinterest board and follow my journey on Instagram and Facebook.
The current opioid crisis in the U.S. has reached epidemic proportions and prescription drug-related deaths now outnumber traffic fatalities and gun deaths. This crisis has been partly fueled by the pressure placed on physicians two decades ago to do a better job of treating pain. Since that time the trend has been for doctors to hand out prescriptions for powerful and addictive opioids for relatively moderate pain when those drugs should be reserved for intractable pain from serious or terminal illness.
As a response to this epidemic I discuss 10 alternative therapies which can help with pain management that can be used alone or in combination with medications. These remedies can decrease the need for drugs and will help improve wellbeing and decrease stress as well:
Exercise and stretching
Loving relationships and sexual intimacy
Prayer and meditation
Emotional Freedom Techniques (E.F.T.)
I’ll discuss each alternative along with the science that supports its use. Hopefully we can learn to manage pain in ways that support overall health of the whole person.
Tune in next week for another episode! Until then …
Learn how a fascinating research project with hospice patients is uncovering the mysteries of deathbed experiences.
In this episode I will share an interview with hospice physician Chris Kerr MD who is conducting a research project on the dreams and visions of his patients as they near death. You’ll hear the results of his ongoing project and how this work is helping to inform medical professionals about the end-of-life experiences of their patients.
This podcast and the End-of-Life University Interview Series are supported in part through generous donations to my page at Patreon.com/eolu! This week I would like to thank Cathy Duke for her donation, along with all of the other patrons who have offered their support over the past year.
AND all patrons will now be able to take part in a monthly “hangout” called Hospice Happy Hour as a thank-you gift for donating to the cause. When you become a patron you will receive email instructions for taking part in the call. Go to Patreon.com/eolu if you would like to make a donation (just $1 or $2 per month!)
In this interview hospice physician Dr. Christopher Kerr will share his research on deathbed visions and dreams of patients at the end of life. He will enlighten us about the potential for healing that resides in these experiences and why we should encourage patients to talk about them. We’ll discuss:
how he conducts his research project,
the nature of the dreams experienced by his patients
what he has learned from this work.
Christopher W. Kerr, MD is a practicing Internist in Buffalo, NY. Dr. Kerr graduated from Medical College of Georgia School of Medicine in 1989 and has been in practice for 27 years. He currently practices at Hospice Buffalo and is affiliated with Bertrand Chaffee Hospital, Erie County Medical Center and Gates Vascular Institute.
He recently entered the public forum with his extraordinary 2015 TED talk, and is frequently interviewed in the media about his work with the dreams and visions of the dying.
Tune in every Monday for a new episode of EOLU! Until next week remember:
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SPIRITUAL CARE FOR NON-SPIRITUAL PATIENTS:
This episode was inspired by my recent attendance at the Accompanying the Dying Residential Retreat hosted by Deanna Cochran of Quality of Life Careand led by Kirsten DeLeo and Dr. Ann Allegre of the Spiritual Care Program. This retreat provided a deep dive into the task of providing spiritual care to our patients at the end of life and offered an amazing opportunity to explore our own depths of spiritual practice and presence.
In my work in hospice I have long thought about those patients who refuse all spiritual care because they are “not religious” or just not interested. But everyone has a spiritual aspect, whether or not they are aware of it or develop that part of themselves. And every dying patient is entitled to receive the presence and compassion of a spiritual care provider. But how can this care be offered without offending or intruding upon the patient’s own beliefs?
Theologian Paul Tillich has defined spirituality as one’s “ultimate concern” meaning that whatever really matters to a person at the very end of life is the expression of that person’s spiritual nature. So for some individuals the ultimate concern might be a religion or a particular practice, but for others it could be anything … even baseball.
In this episode I tell the story of a hospice patient whose “ultimate concern” was baseball and how we eventually recognized that instead of trying to get him to talk about the meaning of life or his regrets, we just needed to let him talk about baseball. Listening to his stories about his favorite team was the path that ultimately helped him heal some of old regrets and unfinished business.
This story illustrates the need for the following conditions whenever we provide spiritual care to a patient who doesn’t identify as having spiritual needs:
Listen. The importance of allowing the patient to talk about the topics of his or her choice cannot be over emphasized. Deep listening with a compassionate heart is essential for honoring the perspective of the patient.
Discover the “ultimate concern.” When patients are allowed to guide the conversation they will naturally reveal what really matters to them.
Honor the patient’s wisdom and experience. Listen with reverence as the patient talks about his or her values and priorities. Recognize what is sacred to the patient even if it seems ordinary to you.
Connect patients to their own feelings of peace and joy. The “ultimate concern” is usually the source of positive feelings and experiences for patients. Help them recall those moments of being connected with something greater by listening to stories or guiding them to re-imagine a previous happy occasion.
In the podcast you will hear how Warren’s story came to a close as an example of finding a path to healing by going through the ultimate concern of baseball. Enjoy listening!
Remember to tune in every Monday for a new episode. Until then:
What do you do when a family (your own or a patient’s) is crumbling due to unhealed resentments and irreconcilable differences? Find out now.
In today’s episode I’ll share my best tips for helping families move through conflict toward resolution during stressful times like the death of a loved one. I’ve had lots of experience with this work during my years as a hospice doctor so be prepared for a longer-than-usual episode!
My new course Step-by-Step Roadmap for End-of-Life Planning is almost ready for release (just a few days away as I record this!) The course is simple yet comprehensive and will help you examine your mindset, values, beliefs, and fears about death before you make decisions about your end-of-life healthcare. Go to eoluniversity.com/roadmap to learn more and sign up to be notified as soon as the course is released.
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Managing Family Conflict at the End of Life:
Families facing the death of a loved one are particularly prone to be divided by the resurgence of old conflicts and resentments. Over my years as a hospice doctor I have seen many families split apart by their differences at a time when they most need to be united.
Most of these families had longstanding grievances that had been buried and ignored over the years, only to rise to the surface under the stress of a loved one’s death. Sibling rivalries, parental favoritism, divorce, and competition for inheritances are the most common reasons for these resentments. In addition many families are also divided over religious and political differences, which is an especially prevalent problem right now.
One of the important functions of hospice staff members and other end-of-life workers is to assist splintered families with healing and resolution of their conflicts, whenever possible. But sometimes we are called to assist our own families when challenges arise. Here are some tips for being a peacemaker for a fractured family:
Remain neutral on the issues of conflict. As much as possible leave your own biases, preferences and beliefs at the door if you hope to help resolve a disagreement. This will be much easier if you are not emotionally entangled in the conflict. But even if you are, you need to learn to become a “Witness” to the situation (a higher state of consciousness that allows you remain detached.)
Listen to all sides of the argument. Spend time with each person involved in the conflict until you can grasp their perspective. If you are part of the disagreement then at least try to understand the point of view of the others involved in the situation. As soon as you begin to understand how and why the others feel the way they do then you have taken a huge step toward reconciliation.
Avoid trigger topics. Political and religious differences may complicate family conflicts at the end of life but are usually not reconcilable. So it is best to “agree to disagree” about these points of view and set them aside so that the focus can be on healing other issues.
Be present. By staying calm and unemotional you can prevent the conflict from escalating into an all-out war. Practice mindfulness to help strengthen your ability to be present so that your own emotions don’t flare up when you are trying to help others.
Find common ground. As you listen carefully to the stories of each opponent in the disagreement you may recognize certain common threads–areas where they actually share the same perspective without realizing it. Gather these threads so that you can remind those in conflict that are some things they have in common. Help them untie around the things that matter most (like doing what’s best for their loved one.)
Learn the wishes of the dying loved one (if possible.) If you can still communicate with the patient you may find out that she has a wish for her family to reconcile. You can use this wish to help draw the combatants together in their desire to please and comfort the one they love. Let the patient’s wishes become a “magnet” around which the rest of the family gradually comes together.
Have patience. Don’t try to force a reconciliation by rushing into a family conference or intervention. Allow for some separation initially and let the gaps between individuals gradually begin to close.
The bottom line is that families who don’t wait until the end of life to resolve their differences have a much easier time negotiating the challenges of death and dying. But that’s not the case for most families. Most are left to rehash old sibling issues, betrayals, disappointments, and wounds during the last days of their loved one’s life when they should be sitting at the bedside offering love and comfort.