Ep. 356 What Keeps Me Up at Night (about Hospice and Palliative Care) with Ira Byock MD

Dr. Ira Byock takes an honest and challenging look at worrisome issues within the hospice and palliative care field.

My guest today is Dr. Ira Byock who 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. He is a frequent guest on this podcast and the author of Dying Well, The Four Things that Matter Most, and The Best Care Possible. Today he shares some of the concerns he has about current issues in hospice and palliative care. Learn more about his books and his work at the website:


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Listen here:

This episode includes:

  • The history of hospice programs and how and why they began
  • For-profit hospices now outnumber non-profit hospices by nearly 3 to 1
  • Problems with for-profit hospices include poor staffing, patients are less likely to see a doctor or social worker, 10% fewer nursing visits
  • For-profits extract up to 20% margin from patient care and make it hard for non-profits to stay in business
  • Concerns about sending patients home for hospice care without providing training to family members
  • Staff are burning out because of moral distress and because of excessive case loads which are being imposed for the sake of profit
  • For-profit hospices are being traded on Wall Street and private equity firms are also buying up hospices
  • How a focus on marketing and “branding” is causing palliative care to distance itself from hospice and from death and dying
  • Why we have to be brave enough to talk about and deal with the things that people in our society are afraid of
  • Why the palliative care “brand” should be providing the best care possible through the end of life (instead of “at the end of life”)
  • What to do:
    • Don’t trust blindly – ask questions and be discerning
    • Don’t lose your outrage – speak up when you see poor care being given
    • Be strong advocates for one another
    • Support community-based non-profit hospices

Links mentioned in this episode:

  • Pre-order All the Flowers of the Mountain by Christina Holbrook here (and thank you!)

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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 to my newest donor Mary E. Moriarty! Your contributions make all the difference.

End of Life, EOLPodcast

Ep. 217 Living a Death-Aware Life: How to Practice What We Preach

Learn why and how to intentionally develop your personal death-awareness in order to live your best life.


If you are a death-worker in any field you probably feel that you are highly aware of death and its many facets. But did you know that the human brain has a primal mechanism to protect us from thinking about and acknowledging our own personal death? Yes it’s true. We can be advanced teachers of death for other people and still be in denial that we ourselves are going to die. In this solo episode I’ll talk about how and why we need to strengthen our own death-awareness for the betterment of our lives and our work.

Listen here:


This episode includes:

  • A study that shows the defenses against death-awareness that exist in the primitive human brain
  • Why personal death-awareness must be intentionally cultivated
  • How death-awareness can expand and transform our lives
  • Why daily death contemplation is essential to our growth
    • Think about the fleeting nature of life
    • Acknowledge fears of death and dying
    • Recognize barriers to awareness
  • Benefits of increased death-awareness:
    • Enjoy the present moment
    • Find comfort in stillness
    • Experience authentic gratitude for life
    • Experience awe
    • Become less attached to material things
    • Be more inclusive and less exclusive
    • See everything as sacred

Good night Wesley. Good work. Sleep well. I shall likely kill you in the morning.

-from The Princess Bride

Links mentioned in this episode:


FREE webinar (REPLAY provided if you can’t attend live):

The Loneliness Epidemic

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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/eoluespecially my newest Patrons Kathryn Mattes, Kristy Lynn, and Astrid Raffinpeyloz, your contributions mean everything to me!

Aging, End of Life, EOLPodcast

Ep. 47 How to Shift Our Mindset About the End-of-Life


In this episode Dr. Wyatt addresses the Western tendency to deny and avoid the subjects of aging and death. But first she announced the upcoming release of her latest book “The Tao of Death” – an adaptation of Lao Tzu’s Tao Te Ching through the perspective of death (it’s awesome!) The book should be available for sale as an ebook by the end of this month so stay tuned. If you’d like to be notified when the book goes on sale sign up for the email list at www.eoluniversity.com and you’ll get an email notification (and a significant discount!)

Next she thanks her newest Patreon sponsor, Holly Randall, for her support of EOLU. If you would like to be mentioned on the podcast go to www.Patreon.com/eolu and make a $1 or $2 per month donation to say “Thank you” for EOLU and help defray the expense of creating the interview series and this podcast.

Today’s episode is sponsored by Irina Jordan and Artisurn.com. Irina has a free gift for everyone of a special coloring ebook called “Coloring Through Grief.” You can download and print the coloring pages (they’re beautiful, by the way!) at http://tinyurl.com/artisurn or go to: http://www.artisurn.com/pages/coloring-through-grief-free-coloring-ebook. These coloring pages are FREE and when you download them you’ll also receive a special promo code for a 10% discount on a handmade cremation urn from Artisurn. Get the coloring pages now – it’s really fun and relaxing to color!

In today’s chat Dr. Wyatt talks about some steps we can all take to help shift our own and our society’s mindset about aging and death. She will talk about:

  • Seeing through the false messages of youthfulness and anti-aging that are prevalent in advertising and marketing
  • How to see the beauty in aging
  • How to embrace your own mortality with grace and dignity
  • Three pillars of a new mindset about death:
    • Every living thing ultimately dies
    • Life is precious because it is fleeting
    • Each of us must find our own meaning in life and death

If you enjoy this episode you probably know someone else who would like it too so please share! Also remember to go to Patreon.com to check out the EOLU donation page, stay tuned for “The Tao of Death” and listen in every Monday for a new episode!

Until the next time, remember:

Face Your Fears.         BE Ready.        Love Your Life.