Episode 78 - End of Life Planning with a Death Doula

End of Life Planning with a Death Doula with Kelli Merriam Penick edited

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Welcome to Caregiver Relief's podcast. I'm Diane Carbo, RN. Today our topic is end of life planning with a death doula, where we'll explore the important and often overlooked topic of end of life planning. Today we have a very special guest, Kelly Merriman Penick, a compassionate death doula who brings a holistic approach to end of life care.

Kelly is a retired nurse who now dedicates her life to guiding individuals and families through one of life's most profound transitions. From the moment of diagnosis to the journey through bereavement, Kelly offers support that goes beyond traditional medical care. She helps you understand complex diagnoses.

Attends medical appointments and navigate the paperwork. Maze of POAs, power of attorneys, advanced directives, and living wills, but her support doesn't stop there. Kelly assists with every detail whether you're considering organ donation. planning a funeral, or exploring options like traditional burial, cremation, or even green burial.

She helps create meaningful experiences such as living wakes or transforming your environment to reflect your wishes, even if that means bringing the serenity of the ocean to you. Kelly's mission is to empower you to take control of how you write the end of your story.

With her on your side, this seemingly overwhelming process becomes a journey of comfort, dignity, and peace. So join us as we delve into the world of end of life planning with Kelly Merriman Pennick from keys to comfort. net. That's keys. The number two comfort dot net, whether you're planning for yourself or supporting a loved one, this conversation is full of invaluable insights and heartfelt wisdom.

So let's get started. Welcome Kelly. And I'm so glad to have the opportunity to discuss this challenging topic with you. I'm excited to be here, Diane. Thank you for inviting me. Oh, I'm excited, too. So, Kelly, can you share your journey from being a nurse to becoming a deaf doula? What inspired this transition?

Well, I have worked with dying people throughout my life, pretty much starting around the age of seven, taking care of my great grandmother, which was very comfortable and normal to me. So as I grew up, I became a home health aide and looked in that and decided to be a nurse because I thought that I would help people even more.

Yes. So I became a nurse and while nursing is wonderful, I found it very frustrating and hard to work in. Well, I've had a similar experience. Yes. And the nursing that I went into 54 years ago is no longer the nursing. That we practice today, and I too prefer to have more of a one on one individual experience with my, my clients.

Exactly. Exactly. And I was a big advocate for my patients and my families. And due to the system, I kept running into brick walls. So my frustration, yes, my frustration just grew and grew because I did not feel like Specific needs were being met that that's very true. I feel are a priority and every 1 of our lives, especially when we are sick or dying.

Yes. So, 1 day, I have a frustration and saying, I can't do this anymore. I'm done. I walked away. And started looking what to do now. Somebody gave me the advice, do what you know and do what makes you happy. Great advice. So I started looking, I'm a nurse. I have this much experience. I like taking care of people, all of that.

And I came across the word death doula one day and it piqued my interest. So I looked in, investigated research and said, this is what I was all along. So I went and became a certified death doula. Which means I am holistic. I do not do medicine. I'm not a certified therapist or an attorney, so I do not work in those capacities.

But what I do holistically through education assistance and guidance. Help you understand everything from legal documentation all the way through to bereavement. So anything that you can think of with death and dying, I try to handle. If I don't know how to do it, I pass it on. I find the person that can.

So how does your role differ from that of a hospice nurse or a palliative care team? Well, I think that hospice should be used more. Yes. And we have a nurse shortage, unfortunately, so I don't see that happening too close in the future, but the other reason why doctors don't refer to hospice as soon early as they should is a financial reasons.

Doctors don't get paid for patients coming to see them anymore because. All care is ended and , I did hospice as well. Yeah, and I can tell you it's a financial issue for doctors in this day and age and exactly. And that's the problem that I have on a huge level. Yes. When it comes to insurance. Oh, absolutely.

Absolutely. Care is about finances and not about the human being. Exactly. Exactly. So, I am a person that is human being related. I, I want that relationship. Yes. So, what I'm now able to do is do what they are not able to do, fill in that spiritual and emotional need, well, educating, assisting and guiding you and the family all the way through.

I think, you know, that's really important because, first of all, end of life is a difficult subject for people to discuss, but we have such a growing aging population that we're going to be hit head on with death and dying often.

Exactly. In fact, there is a U. S. Census Bureau reports that approximately 10, 000 people turn 65 every day in this country. Yes, in fact, the oldest of the baby boomers will hit 80 years old in 2030. Yes, and that's exactly it says a trend is expected to can continue through 2030. Yeah, we have at least five more years.

Well, that's exactly right. In fact, the youngest of the baby boomers turn 65. I don't I think it's 2020 this year. Yeah. So we have, we are overwhelmed with aging and we don't have enough youth or people to take care of our aging. So we have to be more open about the death and dying process. Exactly. For a couple of reasons.

And one is exactly what you're talking about. We have a nurse, a nurse shortage already. Yes. And it's going to just continue to intensify is the word that is being used and the statistic realm intensify. Yes. As the baby boomers age and their need for health care. Yes. That's a problem. There's not, there's not 60, 000 nurses To meet every individual need for a person retiring, let alone everybody else.

In fact, what I do, I did a whole series on caregiver robots are here. Yes. I just read an article where remote nursing, I don't know how anybody can do remote nursing. Who's going to clean them and turn them and do skin care and incontinence care and oral care. And even exactly their psychosocial needs.

Exactly. And I am actually looking into some of those. And so far, the only thing that I see that I see of any benefit is wearing a bracelet or a necklace that is not pretty, very expensive, and it does your vital signs and lets you, somebody know if you have fallen. That's it. Yeah. Oh, and it will remind you to take your medication.

Yes. That's all I'm seeing. Nothing else being addressed. That's a problem. We'll talk some horror stories as we walk. Yes, I've had horror stories. Yes, because I have some sad stories of people, but can you walk us through the services you offer from diagnosis to bereavement? Well, my biggest service is educating people on end of life documentation.

Okay. We do not discuss that in this country. Yes. It is a hush hush secret. We're taught that's between myself and my spouse or that's nobody's business. We find death scary and fearful. A lot of people believe that if you speak of it, it will happen. So you don't talk about it. We've gotten ourselves so far away from it.

We let our medical people and our funeral people handle everything to do with death and dying. Exactly. You know, what's really sad is Medicare pays for once a year for you to have a visit to discuss your end of life planning. And the Democrats many years ago when this was being proposed said it was death panels and that's not what it was at all.

So they fed into not just Democrats, the politicians in our. Yeah. Yeah. Yeah. And they were pushing. Oh, these are death panels. They were not death panels. They simply were. Let's start having And educated discussions and open discussions and open that line of communication about the most important time of your life, where you can still have control till the very end of your life, the very last breath and Medicare pays for one visit a year to do that, which is a whole 15 minutes.

I'm telling you to fill out your paperwork correctly, to make sure it is thoroughly done. To meet your needs to hold up in court to do everything. Yes, it's good. It's based on how I am doing it. We are talking 2 separate meetings. Educating and then assisting filling out the forms. Yes. Yes. It's it is time consuming, but you need to do it right.

And you also need to open the lines of communication when you use the family member to be your power of attorney. Exactly. And you need to understand that that power attorney does not have to stay on there forever. You can go back and change everything. The power of attorney needs to understand what their role is.

Their role isn't to make decisions. Their role is to support the wishes of the person who cannot speak for themselves. Do you see the difference? Oh, there's a big huge. Yes. And we need to educate. Yes. Because we don't get it. And I believe that a big part of the reason we don't understand that year besides the funeral services.

And insurance and the medical field has taken everything away and pushed into us as a fear, just like you were saying with these gentlemen and women. Yes, you know, and was it because they misread or was it because they themselves were scared and don't want to discuss the matter. Yes, you see how we so what I also have to do is I find that a lot of people are lacking a spiritual.

They don't feel that spiritual connection or missing that. So, I hope, you know, try to help address some of that family issues. Well, you know, address that. With the spiritual thing, it's funny because I have had agnostics and atheists at the end of life want to talk about God. And it's just, I don't know if they, they have a fear of, oh, maybe I, I didn't believe I don't believe what I was thinking, or just to be on the safe side.

But I have seen many at the end of life. Before they die, you know. What do you believe or can I speak to a person of faith like a pastor or a priest or whatever. And it's very enlightening to me that, you know, but if you are agnostic or you are atheist, it's okay. You know what you want to do is you want your wishes honored no matter what they are because it's about you being in control of your life up until the very end.

Yes, and making a peace with what is coming and how life was what you did and how it turned out. So you're going through all of this. You're going to go through a life review. We all do it. That's part of being a human. You're going to Possibly come across some stuff that you are concerned with or not happy with and you want to speak to somebody about that.

And there's that spiritual aspect to it. Also on understanding, you know, yes, multiple things. So what I can help you do through listening number 1 and hearing what you are saying. And then offering suggestions to reset point of spirituality or peace or forgiveness, or just sometimes we have to let go of things we just couldn't do exactly.

Yeah. Yeah. And that's just sad, but it's the way it is. One thing I do want to point out is because you are basically a stranger to them, it's easier sometimes for people to talk to a stranger about all these issues that it is their own family or friends, right? That's a really important thing that people have to consider as well because there are a lot of people. I have so many examples of where the parents did not want to talk to their children. They didn't want to burden them or the other aspect is they're very, very private and they don't want to share it. Anything with their kids, not their financial situation, nothing about their health, and it really causes issues.

So I think that somebody in your role as a death doula is so valuable because you can guide these people to the right, the right setting, like if, if they don't want a financial power of attorney and don't want to disclose their family members their financial situation. Things to their family members, you know, you can recommend some fiduciaries that can help them pay their bills and address those things.

You can introduce them to the concept of an estate planning. You can there's so many things that you bring value and knowledge to that a lot of people are not aware of and allow them to first. We honor their wishes. That we help them maintain their privacy until the very end of their life, and we honor their wishes when they feel either ashamed or protective of themselves for some reason, whatever that is.

I come across that often in my 50 some years of nursing. So I, I think that you're so valuable in so many ways. Well, I appreciate that. And I do feel that this is what I was supposed to do. And I have the sadness as everybody else does. I also grieve when a person leaves this planet.

Yes. But I also have a peace and a happiness to be able to have been able to be part of that person's life and to walk. Alongside of them in a very special moment that each individual is going to experience their own way and they have been kind enough to allow me to walk it with him. Yes, that doesn't get better than that.

No, it doesn't. I would like to go back to something you said earlier. On the wanting to talk to a stranger over a family. Yes. I think we're all like that sometimes. Oh, yeah. Absolutely. You know, you're mad at your husband or your wife or your kids. And you're just sitting there and you start up talking with somebody.

And then you just let your day go. What was going on? And you feel some relief. And they're like, I understand. Or how about this? Or have you thought of this? We all do it. Yes. I will give this piece of advice to everybody that is going into the hospital or nursing home or whatever it may be. Befriend your nurse aides.

Exactly. Befriend them. Yes. I was one for many years. They. Keep the secrets, which means exactly what you said. They're a mess in that certain way, a counselor, a priest, a spiritual and emotional sport. They do it. That is put on them. Yes. One thing, as a nurse assistant. That what we are taught besides the have to take care of things and do things correctly, as we are actually taught to listen to them, to our patients, to spend time with them if possible, to brush their hair, to hold their hand, to rub lotion on them, to have that connection.

And they will tell you stuff. Yeah, I guarantee it. And you need to the one that does not hear those things. You need to just try to learn how to respect that. And I know it's difficult because we all want, why didn't they come to me? And their daughter and their husband under this. Yes, we're, there's always that part of us that needs that outsider.

I agree. 100%. And they build a trust with those nurse aides. Yes. Like nobody's business. That's, you know, and now all we have is. Nurses, aides. We don't have, like when I started in nursing, we did the combing of the hair and we bathed the patient and we talked to them and we educated them on their Exactly.

Disease process and what they were going through. And nurses don't do that anymore. Nurses in the RNs, in the hospitals and stuff are just taught to delegate responsibilities to the aides. So, you're right, the aides are the ones that keep the secrets. Mm-hmm . Exactly. They do. And so I went to nursing school thinking that I would actually, besides learning more, be able to do better for my patients.

That's why I went and my family's I'm very big on, but it did not take me the 1st semester to realize this is going to be awful because nursing is so much more than I thought it was going to be. Motto is, and it's still very big, even though we're trying to stop that nurses eat their young. Oh, my God.

That's very true. Yes, true. So it's a very emotionally draining program. Yes, we lose a lot in our programs and they'll tell you. Next week, there will be 10 less of you. I mean, the belief is, I think, still an old school way, weeding the weak ones, whatever that may be out.

I went to nursing school, and I I'm a diploma RN. And I start, we started out with 200 in the program. By the time we graduated two and a half years later, there were only 70 of us. Yeah, and it, they just drop out like flies because they can't deal with the, the hands on approach, but I'll tell you what, nursing changed and then we'll get back on the topic of end of life planning, but nursing changed when managed care hit in the eighties and it nursing no longer was caring about the patient. It was all about the money and exactly changed. And it's really sad because we have nurses now that are getting beaten up. We get have patients that are angry because they're out of pocket. Expenses are sky high and their copays and they feel entitled to the best possible care and it's not happening.

No, not even close. That leads me to you mentioned on your website that you help with medical appointments. So how does your medical background enhance your role as a death doula during these visits? Well, my medical background, of course, teaches us diseases and the way they're treated from medications to the tests that are done, the surgeries, chemo, all of it.

So when I can attend an appointment, and of course we will have our questions beforehand because everybody should do that. Absolutely. And the one other thing I teach people is you must advocate for yourself today. It's not like it was when, well, the doctor said, and you just did what the doctor said.

You can't do that anymore because of what you said and insurance and all these people, people taking everything away. And now I've got five minutes for this, five minutes for this. I got to get you out of here. I got 10 other people behind this, this, and this. There's no more time to spend on anything else.

It's very true. Medicare only reimburses the doctor for a 15 minute visit. In that visit, they have to assess, diagnose, Treat, chart, and move on. Bye. Yeah, remember that ad pie? Did you guys do that? Yes. Yeah, just like you said. And it's really sad because, you know, most people don't go into, I too, I have actually a medical How to prepare for a medical visit office visit.

And I want you to ask, write your questions down so you don't forget. And I encourage family members to. Or even the patients to record their conversations, because you may hear something totally different than what was said. And when you get to replay it, it makes a difference. But I can see how with your medical background, because that's I'm the same way I would have questions that I would already have prepared and asked to determine, what's the next step? You know, what is the prognosis? What is the anticipated treatment plan? What are all the other options I have? If this is other options and which are Can I make a determination is which one is best for me? Exactly. And the other thing, you know, when I'm there, beforehand know what we're going in for, because you hire me after your diagnosis, so let's say you're diagnosed with stage 3 breast cancer.

I am going to go home, and I'm going to research everything that I can about breast cancer. I'm going to find All the medications that are used, the percentages of how they work, your other options, does diet do anything, has that proven anything, this, this, and this, all of it, and I will have my list, and when we go in there, and I, you know, you're going to ask your questions, and I'm going to be writing them down, or like you said, recording them.

And then I'm going to, you know, if my questions are not answered within the conversation, I'm going to ask my questions. And I will also have my phone open to look up certain things at the same time. Yes, because, you know, sometimes somebody will say something in your 3rd statement is like, this is the only way or some such.

Yes, that's rare. That that's the only way. Exactly. Exactly. Yes. Yes. Yes. So then we're going to go home. And on the way home, we're going to get a cup of coffee or have a little meal, and maybe cry a little bit in the car. If we can find some humor, we're going to do that. And then we're going to talk about it.

We're going to talk how awful this is. We're going to talk how this makes you feel. Like crying all day, like giving up, like not getting out of bed. How am I supposed to tell my children this? Oh my gosh, I can't believe this is happening. How am I going to pay for this? What am I going to do for that?

We're going to talk about it and I'm going to tell you it's going to be all right. It's going to be all right. It's not going to be perfect, but we're going to make this be all right. And we're gonna do this together. That makes a huge difference in a family's life and in a person's life. Yes. To know that there's someone that will walk their journey, their end of life journey and help them.

Right. And I will say that my business as a death doula, the client, the person passing away will always be number 1. I am their advocate. I am their death doula. I am their planner. So they are number one. Now we know that the funeral are for the living. Yes, but I'm going to do as my clients wishes, and I will, with all respect, tell the family members.

I, I understand. And I know this is hard. But this is what they want, and it's within the law, and I'm going to follow that. Funeral planning can be so emotional and challenging. Yes. So how do you support families or the person making their decisions about their funeral and their decisions? There's so many different ways right now.

There's traditional funerals. There's home funerals. There's green. Burials. Yes. Cremations. I mean, how do you help them decide what they want? I have a questionnaire. Okay. I don't just stick to only that. I'm, you know, lots of notes and lots of questions come out of that. Yes. But we go through it. And we talk about what you know, what you have thought about, what you would like, and what is available.

So, going through everything, we're going to talk about what all of it entails. And we're going to talk about the pricing. Because people should know, you can spend 500 or you can spend 12, 000. Exactly. The death industry takes advantage of people at their most vulnerable time. I know people don't want to hear that, but families feel guilt if they haven't been involved enough in the family member's life, so they think buying the best.

Most expensive coffin is going to make up for that. And that's doesn't need to be. In fact, I really, really encourage pre planning so that you and prepayment for it so that the person that is dying gets exactly what they want, and it takes the onus off the other family members to worry about it because decisions made with emotions and not logic are poor decisions.

Exactly. Exactly. And when you are in shock and distraught,

you're not going to be able to make any reasonable decisions. So they now we're not saying all we know that there is a small percentage who are just like us and are doing it because they believe that they were called to do it and they respect the human being completely different group. But these certain people know how to Take advantage of you, how the wording, whatever, to make you feel the guilt, such and such, and you will walk away thinking you've done all this and oh my gosh, it cost so much, and then, you know, everything happens, and in the end, you most likely have not got peace within you because of those decisions that you were made.

To decide on at a moment of distress. Yes, and and it's very hard and it's sad because it does happen. I've seen it over and over again. And, I just really encourage people to really pre plan the funeral. Right? I think that's really. I can tell you a couple of things, and this is part of the reason that I also do this, educate, educate, educate.

We need to change the whole system on on a couple of things. And the 1 is the funeral industry. There are other options and they are legal and you have a right to these options. Yes. And I encourage people to have to pass at home and to prepare people on how to wash the body and prepare it for burial.

We lost that. That was taken away from us. Exactly. You know what is it's I have been at the bedside of many people that have passed and I was shocked at I asked family members. Would you help me bathe your father or your mother and family members would say, Oh, no, I can't do that. And, and to me, it's just such a humbling and important thing.

It's part of the death and dying process for us as of the living to read to to care for someone right at the very end and even beyond death. Yeah, you are honoring that human being, and I don't, I don't, and I find it sad, how many times when I'm discussing with somebody what I do, they say that I think the silliest thing.

They say, Wow, that is so awesome. You're so special. It must take so much courage to do what you do. I could never do that, that me, because that's not right. That's wrong. Ladies and gentlemen. That's wrong. You can do it. Yes, you can please me. You've been told you couldn't do it. Yes, but I'm here to tell you centuries our original people from wherever we came from had certain rituals and things that were done during that process. Yes, that was, you know, not a negative or embarrassment or something to be afraid of, but, you know, a piece and a celebration or what may you. Yes. And for the people, oftentimes it's in some cultures, oftentimes when people pass, somebody opens a window, they say, you have to open this.

Yes. Yes. Yes. So let the spirit out and. In fact, I just had that experience a few weeks ago with somebody and you know, we giggled about it because, you know, whether it's true or not, we felt that it, we needed to let her spirit go. Right. It was, it was a concrete way for us. That are left behind to do something that made us feel like we were helping her pass on.

Exactly. We're releasing her. We were giving her freedom from this earth. Yes. Yes. And, you know, that's, that's hard for us to do for our loved ones. Yes, it really is. But we need to change our mentality. Yes. Of me, me, me. Yes. And back to you. community, the world. Exactly. Yes. So part of what I do, a big part of what I do is I Really, you know, explain the law what's available.

Show them all the multiple options that are out there. Encourage and, you know, let me show you how to do this. I will walk you through and educate you and then when it is time, I will be there to tell you. Yes. Yes. Yes. If you have questions or you're getting a little afraid, it's okay. Yes, it's okay. This is new for all of us.

This is a whole we are taking back what was taking from us. That's a good point. Our, our, our women used to do it. We were the ones that helped birth the babies, a birth doula. And then, we were also the same ones that knew how to treat lead. Because so many babies did not make it. So many mothers did not make it.

It was a normal part of life. It was just what it was. We accepted that we did it. We need to go back. Yes. Can you explain the concept of a living wake and why some people choose this over a traditional memorial service? You know, I think a living wake is for those people that just want to see a celebration about them.

They just want to see that party. You know what I'm saying? It's a life celebration. Yes, it's a party they don't want to miss. Yes, we, I have, I have a, a friend in England in his early 90s who had one last year and he had so much fun. And he they all all his friends bought him so much booze. He decided he wants to have one every year.

Yes, exactly. Exactly. And don't you just want to go home and when everything is done and you're the person who's passing just say what a good day. Yes, you had a good life and I had good people in it. Yes, yes, yes. And for those that were there to lay down at night and we all do it as we're or whatever. To sit there and just the realization comes over to you what I just attended.

Yeah, it was amazing. I want the same thing. Well, I'm an Irish, I'm an Irish American. Yep. Same here. Same generation. So my family, now my mom died when I was 18. And My future husband was shocked. He was from Indiana and he was a farm boy and did not have family close. So he had never seen death and dying.

Whereas the big Irish family, somebody was always dying in our family. And what we did was in Pittsburgh, I'm from Pittsburgh, Pennsylvania. They lay a person out. That's what we called it. We were laid out for three days and every day. There were certain times of visitation at the funeral home or the home, depending on what your choice was and the people would come and then everybody would come to, like When my mom died, everybody came to our house.

We had food. We had drink. We had and my future husband said to me, what is wrong with you? People were laughing and talking and sharing. And he was, he was offended by, but that's how we grieve, right? Exactly. Celebrate somebody's life. And You know, it's just the way our families did it, and you can't judge somebody for their culture, for what they, they are using, their traditions.

Exactly, and people don't, or aren't aware of, that based upon your culture in the United States, how you grieve, and how you bury your dead. Yes. It's different. And those things need to be respected. Yes. And some of the people have been able to hold on to those traditions and those rituals. Yes. But a big majority of European descent, I have come across, are struggling with that.

Towards that, they're like, you know, they attend a church or whatever, and then, you know, whatever occurred. And then you had those ones who didn't and then you had the ones that like you said and then you have these younger generations that are like, oh, I don't believe or they believe in something beautiful and wonderful.

Yes. So it's all going to change and you have to look at each individual and how they look at all of that. You can't just put them all in a box, which I feel the funeral homes have done. I, I, I've never, I've been to only celebrations that

are attended by white people for white people and

they're all the same. They're all the same. Well, I lived in Pittsburgh, so I've been to Jewish ceremonies, which are very beautiful. Yes, I was, I lived in Hoboken, New Jersey for a while and I observed. The Chinese traditions, which are is another beautiful way. Yes. So, I've been exposed to different cultures and it's just a beautiful way that people have and the prayers they say or the response to grief.

And then Yes. The old Italians, Lord have mercy, the old Italians have grievers, professional grievers. Yes. And sit in the front of the church or at the funeral home and sob for them for the day. Yes. Yes. So, you know, and, and the first time I thought that, I went, Oh my Lord, but, It was something that they were very used to.

So I'm very proud of what a great tradition from their own culture and people use as a celebration, whatever form it may be, look down in Louisiana. Beautiful. Oh, I love beautiful. That's behind the horse and the music's playing and they're all dancing. Yes. Yes. Wonderful. Yeah. Wonderful. You know, we need to go back to that.

I find that, you know, the funeral homes are basically the same. You pull into this typical same type of driveway. You go into the same type of hallway, usually with that red or gold carpet, the smells exactly the same. The casket, you really can't tell a big difference. Yeah, the chairs the way the meet everything. It's like a program. Yes. Yes. Check the boxes. Yes. I agree. That's it. No, we need to not do that anymore. We need to because I'm hoping with the death doulas that that will start to change. And with the aging populations, we are going to see more people Thank you. Look into their traditions of their families and put those funeral planning in place before they die so that they, yes, right, and know that.

And I think that part of that is educating them about it and then teaching them that, you know, you have these rights and we're going to do this, you know, and I also believe that you know, basically, I'm a, I would say around in our area and then everybody younger, their whole thought process on death, dying and funerals is not in the traditional sense at all cremation is a very.

Big thing for them. They are minimalist. Yes, less fingerprints on the planet, the better our footprints. That's the way I would think that green burials would also be important to them. A lot of that has to do with educating on a green burial, where the cemeteries are, how it's done, how to get the beautiful caskets, the wrath if you so choose to.

Yeah, you know, all of that just needs to be taught what's available. Yeah, because that's why I think your services are going to be so important in the future. They really now and in the future because the boomers are, are, are on their way out the door. I'm 1 of them. You know, I'm right soon to be 72 and you know, yes, we are living to 100 or beyond, but, you know, we still and we're living healthier.

We have many things to deal with. So I actually encourage everybody over the age of 18 to put an advanced directive in place and everybody goes, that's crazy. And then to review it, you should review it every year, but most people don't. They look at decades. So when they turn because what you want at 20, you don't want it 3040 50 and definitely not.

It's exactly. And what if you get married and then you get divorced or you have children or this or that or the other? Yeah, it'd be looked at at least on a yearly basis. And then every time you have a legal life change. Yes. Yes, you need to address that. Exactly. We will do a follow up on some of this paperwork because it was just explained to me by a hospice nurse who now has a business educating those of us that are death doers and green burials.

So she's very much in that pattern and she also knows the system. Yes. That's important. I just met this lady. Her name is Suzanne. I do not remember her last name, but she is an RN.

She worked hospice for years and she noticed that something was missing also. So she ended up becoming an advocate of dying at home and green burials. Natural barriers, natural death. She informed us the other day in her live session that an advanced directive was invented in order to protect the doctors, not the clients.

And that's why you should always fill out the other paperwork because they are actually more legal than an advanced directive. Yes, I did not know that the physician. I encourage everybody that has a terminal diagnosis or a chronic illness to encourage them to get a post a physician ordered life sustaining treatments order or called a most a medical life sustaining treatment.

They're the same thing. And the reason why is, Doctors, if something happens to you and you, 911 is called, and you don't want any life saving treatments, even if you have a DNR, they cannot honor it because they were called it is their obligation, but if you have what they call is this pulse, which the Allows them to, it's a doctor's order that they have to follow and it will say, I do not want to be intubated.

I don't want to be put on a ventilator. Do not give me IV fluids or I'll take IV fluids, but don't resuscitate me. If my heart stops, they will honor that. And that's really important that people need to know that. And I think that people become more and more aware of that.

With the aging population because it's something that has to be addressed. Yes. And with a lot of education, which is my plan. Yes. So, and I agree with you. I think that everybody wants you hit the age of 18. you need to fill out your documents. I also believe that you do make need to write down in detail what you were saying and the plans because.

You might be 18, but you get in a car accident on or you had a heart attack in your sleep and you are now meeting on a medical event in order to survive. What would you like done if these things happened? I promote the 5 wishes. Yes, net. I love that that advanced directive because it's very specific.

It's it asks you very specific questions. Yes, you wouldn't think of. And I think that those also are are thought provoking questions for the family or somebody to look at and say. Hey, Kelly, what does this mean? I mean, would I not want antibiotics at the end of life, or why would I not want fluids, or why would I not want a feeding tube?

Explain this to me, and then you can address that, and that helps them make an educated decision for when their time comes. Exactly, and a decision that they are comfortable with living. With exactly, you know, I know they're 18. I know they're 20. I understand. I was that age at one time too.

And that's the last thing on your mind. It's not going to happen. What are the chances? I don't do this or that, you know, things happen. Well, the average 18 to 24 young adult males. are prone to spinal cord injuries and head injuries. And I can't tell you how many graduates I have cared for, or young men that have had accidents that were newlyweds or just graduated from high school or college that became vegetables.

Like, you know, they became unresponsive with G tubes and all contracted up. And, you know it's forget bed source. Don't forget bed source. Oh, trust me. Yes. Yes. I have another question for you. Organ donation and body donation and donating your body to science are not the personal decisions. And yes, even asking for brain donation now for for dementia studies.

How do you help your clients explore these options? Basically through I've done a lot of research, so I have a lot of, you know, papers that to educate and show you what these are, what they are involved. And if you are even qualifying for those, a lot of people do not know, but a lot of people do not qualify for an organ donor.

Because of when they passed away, how long it was before they were found. Or other things in that area. So we have, you know, people think there's a lot of, there's not a lot of donors. There's not a lot of donors. A lot of people think, you know, oh, I don't think my religion will allow it. You'd be surprised at how many religions do allow donors donation very much.

And I have taken care of 1 gentleman. Very nice man, extremely intelligent, and he was donating his brain to our local university. We have a large university, medical university here. So I learned a little bit in that arena and, you know, he was. Very at peace about it. Had no problem with it whatsoever, you know, so I've educated myself.

And of course, I will know, you know, the latest up to date. Yes, how it's done and such and such and also the localities of where this is done, because if this is your choice, we have to make sure things are set up correctly for when the time happens, because you have to meet certain criteria and certain timing.

Or it does not work. It won't go through. Yes. And you have to take that paperwork with you at when you're being hospitalized every time. So hospitals know that's I created, I encourage my families to create a crisis packet and it has the information in it so that they grab and go. But when they leave to the hospital every single time, cause you don't know what the outcome will be at any time.

You exactly. Unexpected admission to the hospital. Yes. I also encourage people to leave one in your car. Good idea. How many times have you had an accident? If you are, if your daughter or your son takes care of you, your grandson, your niece, your nephew, somebody you pay, whatever, let them have a copy and there's also because you get in an accident and they take you, your person can run to the hospital and say, hey, hey, hey.

I've got the paperwork, you know what I'm saying, I do things might not have been met, but now you have the paperwork. So, from this point on, you know, exactly what this gentleman or female wanted at the end of life, Kelly, what you do in your field has a lot of burnout. How do you take care of your own emotional well, being while supporting others through their end of life journeys?

I've done a couple of things and one is finding that spirituality that makes you comfortable and give you peace and helps you to walk the path. That's beautiful. Yes. I also really try to find like minded people and keep a connection. Because we need that. Yes, we are in a small group still. And even with that, in that group, certain things are looked at differently.

I met a few people the other night and they are do it was, but they are also funeral director get graduates who are very much. Into traditional burials and

fixing the face as needed with injections and set up your pass away embalming all of that and they are very gung ho and that's what they well, their agenda is different from yes, a death duel. Right, even though they're saying that they're a death doula. Yeah, I understand you have to, you know, choose what you're going to be as a doctor.

Are you going to follow the holistic way or are you going to do it differently? And then. Based on your own agenda. Yes. Yes. And then you have to find the like minded people. So Kelly, what advice would you give to someone who wants to start planning their end of life care, but feels overwhelmed or unsure where to begin?

Well, the first thing I would do, I think is Just meditate on it a little bit. Maybe write down what you want. You can always reach out to me. I am more than willing to answer questions. Give your website again, please. Keys. Dash. The number two. Dash. Comfort dash care dot com. Could you say that again, please keys dash two dash comfort dash Care. com. Okay. Great. Keys to comfort care because I have the keys to your comfort care.

Awesome. I like that. And if I don't have the key, I will find out who does. Great. Well, Kelly, this has been very informative and enlightening and I just want to thank you for your time today. I end all my podcasts with, to my family caregivers out there, you are the most important part of the caregiver equation.

Without you, it all falls apart. So please practice self care every day. Be gentle with yourself because you are worth it.