Caring House: Creating Comfort in the Final Days

Jill McClennen hosts a conversation with David Zartman and Joanna Franco from Caring House, a nonprofit hospice home in Torrance, California. They explain that Caring House serves people in the final days or weeks of a hospice journey, staffed 24/7 by caregivers, and works with many hospice agencies because it is a non-medical residential care facility. 

Families can visit freely, often stay overnight in reclining chairs, and may bring pets; volunteers include chefs, death doulas, and therapy dogs. The guests describe funding through pay-what-you-can fees, donations, grants, and fundraisers, with no one turned away for inability to pay. They discuss rituals, honoring residents after death, flexible time for families to stay, and staff debriefing and grief.

00:00 What Caring House Is

00:15 Meet the Host

01:25 Meet David and Joanna

02:35 Why Caring House Is Different

03:37 Who It Serves

04:25 Working With Hospices

06:43 Life at End of Life

08:39 Food and Volunteers

09:34 Staffing and Overnight Family

12:50 Admissions and Waitlist

13:59 Nonprofit Funding Model

16:14 Hospice Coverage Reality

18:57 Death Doulas in House

20:09 Facing Death and Control

23:53 Grief Lessons From Work

25:27 Losing Sandra Young

26:11 Lessons From Grief

26:49 Staff Facing Death Daily

29:41 Honoring Residents After Death

30:58 Family Time After Passing

33:57 Rituals Music And Goodbyes

35:51 Pets And Therapy Dogs

38:10 Why Caring Houses Matter

43:46 Support Donate And Connect

45:39 Final Thanks And Planning Help

https://www.yourcaringhouse.org/

https://www.instagram.com/yourcaringhouse/

https://www.facebook.com/YourCaringHouse/

Transcript

David Zartman: [00:00:00] Caring House is a place of respite and refuge on a lot of different levels for family members as well as people who are on hospice care. That refuge lets families connect in a way that they might not have been able to do as easily in a hospital room or somewhere else. 

Jill: Welcome back to Seeing Death Clearly.

I'm your host, Jill McClennen, a death doula and funeral celebrant. Here on my show, I have conversations with guests that explore death, dying, grief, and life itself. My goal is to create an inviting space where you can challenge the ideas you might already have about these subjects. In this episode, I talk with David Zartman, executive director, and Joana Franco, director of programs, from Caring House, a non-profit hospice home in Torrance, California.

David and Joanna share what makes Caring House so special. Families are welcome to stay, and even beloved family pets may be part of those final days together. The house is fully staffed by people who [00:01:00] understand that end-of-life care needs tenderness, patience, and flexibility. Volunteers are also an important part of Caring House, including professional chefs, death doulas, and therapy dogs.

We also talk about how Caring House is funded, why no one is turned away because they cannot pay, and how they honor both the person who is dying and the family who will continue living after the death. Thank you for joining us for this conversation. Welcome, David and Joana, to the podcast. Thank you for coming on today.

Can you start us off, just tell us a little bit about who you are. I'm 

David Zartman: David Zartman. I'm the executive director of Caring House. I've been with Caring House now about two and a half years. The first six months were as director of development, and then in January of 2024 I started as executive director. I came here from the private sector.

I was an entrepreneur, had my own company for 18 years and had ran that successfully. Decided to get more into community centric and human facing kind of realm. I went back to school, got an MBA at [00:02:00] USC, and ended up at, here at Caring House. 

Joanna Franco: Hi, my name's Joanna Franco and I'm the director of programs here at Caring House.

I've been here now five years in June of this year, and I have three daughters. My background is in senior care, like assisted living, and then during pandemic I was doing senior care in homes. I was in a agency that provided care for seniors in their homes. And during the pandemic I felt stuck and wasn't sure what my next move was gonna be, and I fell into the Caring House and I've been here now for five years.

Jill: Can you tell me where Caring House is and a little bit about Caring House and why it's different than any other place that I've ever been to? 

David Zartman: Caring House is in Torrance, California, the South Bay. So we've got Palos Verdes around us, and Lomita, and Redondo Beach, and all that. We're in the South Bay. We opened our doors in 2016, so we have been open for 10 years now.

It's our anniversary. We're super excited about that. It was started by a [00:03:00] gentleman by the name of Ed Long, who was a local elder law attorney who saw a need for this and wanted to build this. He was the one who got the ball rolling with licensing and getting funding and getting a house built to spec for licensing and all that.

Joanna Franco: That's a question we often get is, what makes us different? We are licensed under residential care facility, so there's hundreds, if not thousands, of boarding cares. And even in this area there's plenty, but I feel like what makes us different is the team that we have here. Also, we are very specific to end-of-life care.

So we train and get experience with end of life. 

Jill: And so do people live there if somebody was just aging and they were like, "I'm gonna move in there," and then just literally live there for the rest of my life? We- Or is it more somebody's nearing the end of life, they're on hospice, then they would move in?

How's that part work? So yes, 

Joanna Franco: we're very specific to the very end of their hospice journey. So someone [00:04:00] moving into the Caring House has maybe been already on hospice for quite some time, and now they're starting their transitional time, and that's when they would come to us. We care for them, if not weeks, days to end.

And how many people can you have at one time? We have a total of six rooms, so we can have six residents at one time. And our team is about 10 caregivers. 

Jill: And is there nurses on staff? 'Cause when I think of hospice, I think there's nurses, and there's doctors, and there's social workers, and there's chaplains.

There's all those different people that work through hospice. So do you have all of that on staff, or can people come from different hospices and come there just for the end? 

Joanna Franco: Yes, so that's the way... Because we're licensed as a non-medical residential care facility, we don't have nurses on staff. So our extension of that would be the hospice team.

We're not affiliated with one specific hospice, so we may have up to six different hospices [00:05:00] in the house at one time. And so then we help the families utilize all of those service, contacting the social worker, having the nurses, the bath aides come into the Caring House and provide that service to them through their hospice.

Jill: That's really neat. So it's just the physical space itself, but you work with all different hospices. Yes. That is really cool, 'cause yeah, I don't think there's any place like that in New Jersey. I've not been to any place like that. Even at this point, there's not many hospice- places for people to go to.

There's one that I know of, and it's part of a hospital, and I think there's only a couple rooms. So there's not a lot of access to that. If you wanna use hospice in New Jersey, you really have to just do it at home. 

David Zartman: Mm-hmm. It's interesting because I know in New York the, I believe, quite certain that the regulations are that in New York it's only two residents per facility is permitted.

I wonder if it's the same thing in New Jersey, although I recognize it's separate states. I don't know. It's an interesting when you said that the only ones you know of were with [00:06:00] two. Yeah. Mm-hmm. Interesting. 

Jill: Yeah, I don't know if there's any rule around how many. Mm. I just know that there is one, and there's- Mm

not a lot of space for people, so. Yeah. And it's a specific hospice. Mm-hmm. If you're using any other hospice company- Right ... you don't have anywhere to go. And I'd actually thought about this, that I would love to open a house, like it sounds like your place is, to allow people to have some place to go, especially because medical aid in dying is legal in New Jersey.

Yeah. And you can't utilize it in most assisted livings, so people have to find somewhere to go. We don't have places where people can use medical aid in dying that isn't their own home. 

David Zartman: Mm-hmm. Right. Yeah. 

Joanna Franco: What we find here is even the hospitals, a lot of people think when the time comes and you're gonna die, you go into a hospital and you pass away there.

And the reality is that once the hospital's not able to care for you anymore, they can't do any interventions, they wanna discharge [00:07:00] you home or somewhere. And so this is the idea of having Caring House for families that can't go home, don't wanna go home, they're scared of that process and don't know how to care for someone, so they would come into our home.

David Zartman: And it goes back to what sets us apart a- and what makes us unique that you brought up, is we're partially... Our mission statement is peace at the end of life for all persons. That is true. That sort of focuses on the physical act of passing away, of transitioning, dying, whatever word you choose. But at the same time, what sets us apart is the life at the end of life.

Something just happened yesterday. One of our residents in room two, a relative or some such, was in there just reading some chapters of Harry Potter. I was sitting in the kitchen like, "Wait, what?" And I could hear these characters. And so I poked my head in, and it was just so nice. She was sitting on the edge of the bed and her friend was sitting next to her, and they're reading together like this.

And so- That's another thing that we're trying to focus on is life at the end of life. It is a good thing to have a [00:08:00] good death, but I want there to be life there, whether it's reading. Another thing we do is we'll cook at any time whatever they want. So it's not just 8:00, noon, and 5:00, for example. So we cook on demand as much as is reasonable, and this means 99% of the time we take their request.

Mm-hmm. If they want some special ice cream or they want sunny side up eggs, whatever it may be, we're gonna do that. We want the life to be there, not just for them at the end, but for their families, so they can come in and have that connection, have it feel like they're in a home, just not their home, and let someone else be taking care of them.

And I think that's something that really is unique and sets us apart from a lot of typical board and cares. 

Jill: That's beautiful. I love that so much. Do you have a cook on staff? Or, like, how's that part... 'Cause my background is food service, so I'm like- Oh ... "Oh, that's really interesting, actually." 

David Zartman: All of our, I really mean this, all of our caregivers are excellent cooks in and of themselves.

I like to cook, although I've almost never cooked for a resident, but almost everyone can cook. We had a worker who we lost actually, Sandra, who was just a [00:09:00] brilliant cook. So basically we all just pitch in. Mm. The caregivers is really what I mean by that. They just pitch in and cook, and any given time there might be oatmeal, grilled cheese sandwich, a burrito, soup.

A lot of our people make homemade soups that are really good, and do that. Hamburgers. I've pretty much seen just about everything. What do you think, Joanna? Anything? 

Joanna Franco: I was gonna add we have a few volunteers who are chefs- Yeah ... in their own careers. Mm-hmm. They'll come in and make a meal for the house 

Jill: occasionally.

Yeah. Mm-hmm. Oh, that's neat. And I love that it sounds like a home. It sounds like you're just going to stay in somebody's home. But I'm assuming the caregivers are there 24 hours a day, so do they take shifts? Are they sleeping there? Like how's that part work? 

Joanna Franco: So yes, we have, like I mentioned earlier, I said about 10 caregivers.

Most of them have been here ... I have two that have been here 10 years, so since day one that opened up. And then everyone has been here for a few years already. There's three shifts, 7:00 AM to 3:00 [00:10:00] PM, 3:00 to 11:00, and 11:00 to 7:00. There's no sleeping at our home because of our license, and because we only do hospice care.

Everyone has to be awake, paid staff. 

Jill: How about family members? Is there a way for a family member to spend the night? 'Cause that's one thing. When people are dying, you can say it's probably gonna be a day. It's probably gonna be a few hours. But we don't know for sure, and so for some people they might not wanna leave.

So is there a way that they can- Be comfortable enough to get some rest if they had to? 

Joanna Franco: We are very big on allowing family to be here as much as they can and want to be. It can get a little tricky with six families, and sometimes we'll have three transitioning at the same time, so the house gets pretty busy.

But everyone's always very respectful. We always tell them that as long as it doesn't cause someone else to be upset or it's too noisy, we will work with them. [00:11:00] So there is a reclining chair in the room that we recently updated where the loved one can spend the night pretty comfortably. We have a couple reclining chairs in the living room.

I've seen family members sleep in there. And we're very accommodating. The house gets pretty quiet after hours, and so they'll spend the night, for sure, and make themselves at home. 

David Zartman: We try to say yes more than we say no. Long as it fits in with our licensing, not to overplay that, but if we can, we're gonna say yes.

We want them to be there as much as they can be, and we're happy to cook for them. We're gonna take care of them. And in a small way, what we always have on hand is fresh coffee pods, so not even just the old classic coffee pot where it gets all old and stale, but we have coffee pods. And to the right of that is our pastry section.

So our volunteers are always baking up pastries, so there's gonna be cookies or brownies or muffins or that sort of thing, so some basic stuff. And then of course, if they need to, they can dive in and have a bowl of cereal or what have you. So what you said, Jill, is totally right. It is literally a home.

Caring House is a house. [00:12:00] If you passed it on the street, it blends in with all the rest. There's no signage. It's just a home with a driveway and a, literally a white picket fence, and then it's just a little bit different when you get inside, but it is a home. And that's another reason we love working there too, is you walk in and there's the hallway, and we go down and say hi to residents and families, and to the left is the living room, and there's a fireplace, and then to the left of that's the kitchen.

So it really is working in a home, up to and including where I work in the garage. Which I love, by the way. Absolutely love working in there. Me too. And so does Matthew. 

Jill: Yeah, it sounds like a really cool place. I wish I was closer. I would totally bake muffins and brownies- Oh ... 'cause that's what... I'm a pastry chef, and so- Oh, wow

um, I actually do teach baking still. Ooh. So I'm like, oh man, that would be so cool to be able to do that. I would love that. I 

David Zartman: need a freshly baked muffin in my life right now. Sounds so good. Oh my gosh. 

Jill: And when people want to stay at your house, how's that process work? Do you have an application process?

'Cause I can imagine with only having six rooms, it [00:13:00] probably fluctuates where sometimes you have all six filled, and people might wanna stay, but they can't. I've been here 

Joanna Franco: five years now. We still are trying to see how we can best serve the most residents. Sometimes we can be full, sometimes we can go up to three.

residents, but there's many times where we have a waiting list. Because we're very specific and we're the only one here in the South Bay, people come from all over the areas, from even an hour, two hours away, when they're looking for a hospice home. The other aspect of it is that we are a non-profit. Okay.

So we will work with the families that don't have the financial means to care for their loved one at home, and don't have the money to go into a regular facility, so they wanna come here. And so we get into these waiting lists. I would say that our... We see about 10 admissions and eight passings per month right now.

Jill: Oh. Yeah, that's a decent amount, though, to have people be able to move through. [00:14:00] And so you're a non-profit. What does that look like as far as... 'Cause actually, I also work for a non-profit that is food service. But so what does that look like for you as far as a non-profit? Do people pay you to stay there, or do you get people that will donate money to help cover the cost of the house?

Does Medicaid cover it? 

David Zartman: At its core, we ask people to pay what they can afford. That being said, no one is turned away based on their inability to pay. We do some basic due diligence. So when we first started, we just said, "Hey, just come on in. We want to serve you." Obviously, after a certain amount of time, just the reality of this is an expensive world.

Yeah. Medicines and mortgage payments and salaries and everything else. So we started to ask to pay what you could. And we do some due diligence now of asking people to supply some financial information so we know where they stand. We don't wanna make anyone else indigent, and we won't do that. We're not gonna bankrupt anybody.

But without being funny, and I'm not being funny, [00:15:00] we've had people pull up in brand new Mercedes cars and things like that, claiming that they can't afford a penny. At a certain point, that's just, that's just unethical and unfair- Mm-hmm ... to the people who really need that spot, right? If there really is someone who can't afford it, I don't wanna go down that road.

It's just touchy. Besides that, obviously we do, we pay for things. And obviously, a lot of that's picked up by individual donations by people who have loved ones there in memory of, and of course foundations and grants, and then a couple of fundraisers we do. So that helps to take up the slack, but we're always fundraising.

And if anyone out there believes in hospice and non-profit, you can always go to yourcaringhouse.org and donate there and support us. So there's my quick little pitch for supporting this non-profit that we're in. 

Joanna Franco: I was just gonna add, as far as the insurance, a lot of families because they're being discharged from the hospital, they assume that it's covered through insurance.

Non-medical, no medical insurance will cover boarding care. It's considered a luxury or you would have to pay out of [00:16:00] pocket. So that's another reason why insurance wouldn't cover it. But we do work with the families basically based on what they're able to pay towards the cost. And we get families that are able to pay the full cost, and we get families that are not.

Jill: Yeah, and I guess their hospice is not being provided by Caring House, so they're getting that through Medicaid or... I guess it's Medicaid that covers hospice. Medicare, Medicaid. I always get them backwards. 

Joanna Franco: It- it is Medicaid and Medicare. Depending on their age as well, it would- Okay ... kick in one or the other.

Jill: Okay. So that is covered anyway because that's covered for the person, whether they're in a home or they go to a facility. The 

Joanna Franco: service of the hospice agency, that they do cover. 

Jill: Yeah. 

Joanna Franco: But they don't cover the board and care. They don't cover help at home, right? They're only coming in a couple hours a day, if that.

But they can provide 24-hour care for the person that's in hospice. 

Jill: Yeah. And that is so difficult, and I don't think most [00:17:00] people realize that. I didn't realize that when I first had my grandmother go on hospice. Yeah. I think in your head you think, "Oh, that means there's gonna be somebody here with her 24 hours a day."

And then reality hits and you're like, "Oh, it's maybe an hour a day." And that is- Right ... not very helpful when sometimes people require a lot of not necessarily always physical care that is so exhausting, even though there's that. It's emotionally draining- Yeah ... for somebody when your loved one's dying.

Yeah. So having a house where you can be with people that... Even just having somebody to talk to. There was days I was just at home by myself with a six-month-old and my grandmother, who was dying. So being somewhere where I could just talk to somebody else would've been completely life-changing during that time period for me.

Yes. Yes. 

Joanna Franco: I think a lot of what Keisa's going is seeing the relief in the families that come in, and just after a few moments or a couple hours of being here, just them taking that [00:18:00] deep breath and feeling like, "Okay, we're gonna be okay." Because a lot of times it gets so overwhelming that they feel like they're gonna hit a wall and lose control of the whole situation.

Jill: Yeah. And that is one thing we have to let go of at the end of life is control, because there is not a lot of controlling the end of life. Mm-hmm. Whether we want to or not. But- Yeah ... I love that point, going back to what you said earlier, David, about it also just being how somebody's living the rest of their life.

It's not just about their death. I feel like for me as a death doula, that's one of the biggest misconceptions that I hear from people. Mm-hmm. They're like, "Oh, when do we call you? Just, like, when somebody's dying?" And I'm like, "Sure, you could call me then." But really, the earlier that you talk to a death doula, the more that we can help you live the rest of your life- Mm.

Yes ... in a way that reflects your values, reflects what you care about. Yeah. It's like that level of support. Yeah. And actually, I guess that's a question that I [00:19:00] have is, would it ever be something that you would bring a death doula on staff to maybe help support people and their families? 'Cause it's not just for the person that's dying.

It really is also supporting the family members. 

David Zartman: Yeah. I think we would. We're actually really lucky in that we have several volunteers who are death doulas, and one of them's on our board of directors. Oh. Really lucky. Her name is Anne. So she's a death doula, and then we have a couple others who are volunteers who can do that when called upon.

And we do let people know, I, I don't wanna say service, but just that person is there. It's a service. That person, that skill set, that knowledge, that empathy, all of that comes with being a death doula. That is available in the house, whether it's a specific day or just we need to call someone in right now, we can do that.

Yeah. Okay. We know the value of that. 

Joanna Franco: It's a very personal moment to read the room, read the family, see if that's something they're open to. Sometimes the residents are not ready to face death, so bringing a death doula, they're like, "Oh, I don't [00:20:00] wanna talk to them. I'm not ready to talk about dying." But when we see someone that can...

we feel like they're gonna benefit from them, we do introduce them to the volunteers. We have a few. 

Jill: And I just find that still so shocking that somebody even moving into your house is like, "No, I'm not ready to deal with death yet." Oh, no. You're literally moving into a house for you to die in, and you're still not ready to talk about death.

David Zartman: Thoughts. 

Jill: That's just, it's so interesting to me that we as humans fight death and fight thinking about it and talking about it and doing any processing of the fact that we're dying, 'cause in the long run, we're all dying, right? We're all heading towards our death. We're not heading towards birth. Yeah. So yeah, that's actually really interesting that you still have people even in your house that are like, "Nope, not ready to talk about it."

Oh, yeah. It's so 

David Zartman: true. I've, I've lived it. My own father just died in November. You mentioned earlier, Jill, people hope that they [00:21:00] can have control over this whole thing, and if anything you don't have control over really, typically, is death and dying. And he was very much that sort of way. He did not wanna die.

I don't know if he was afraid of it or not, he just didn't want to. And he did everything he could to forestall it until he couldn't, right? And that was interesting because finally he looked up and he goes, "I just wanna go to sleep and disappear." And I'll tell you, that was a powerful moment for me, knowing that he'd spent the last 87 years of his life determined to live to be 150, and to finally see that loss of...

that, that willingness to lose some control and just go, "Okay, my time has come." And really, the only reason that happened was 'cause my mother had just died 12 days before that. He didn't wanna... He really didn't wanna be without her, right? So yeah, I've seen it, and it's different for everyone, and it's powerful and really profound for every single person how that happens.

Jill: I'm sorry to hear about your father. 

David Zartman: Thank you And your mother Yeah, thank you I mean, really, you 

Jill: lost 

David Zartman: both 

Jill: of them so 

David Zartman: close 

Jill: together I did. [00:22:00] 

David Zartman: Yeah, 

Jill: yeah. 

David Zartman: Yeah. 

Joanna Franco: We find it interesting ourselves, our team, when we talk about it, because it's not always the resident, too. Sometimes it's the families that are not ready to accept that.

Even though they're coming into the caring house, even though they're coming into hospice, it takes them a lot to... Some leave without accepting the fact that the person was gonna die and they had this diagnosis. And they won't speak about it. So we just have to respect that and go with them where they are in their grief process and not push it and say, "Maybe it'd be better if you talked about it."

We just, if they don't wanna talk about it, we just respect it. 

Jill: It's so hard, too, because you're right. We can't push people. We really don't even want to push people. But at the same time, there's times when I'm just like, "If you would face this, you would have a better experience. You would have an easier experience.

You would be more present with your loved one as they were nearing the end versus in denial that this is the end." Mm-hmm. But we can't [00:23:00] change people, especially in that moment, right? That's partially why I started a podcast and I talk to so many people and I try to go and educate earlier on, so that maybe we can all be a little bit more okay with the fact that one day we're gonna die and our loved ones are gonna die.

Still gonna be sad, but at least if we can work with death earlier, I have found even in my own personal life, my grief is different now. Mm. That I have really learned to be okay with the fact that people I love are going to die. And I'm still sad. I still grieve them, but it doesn't feel that same way that it felt when I was younger and I was, like, overwhelmed by it.

Yeah. So it definitely changed the way that I grieved and the way that I live. 

David Zartman: I agree. 

Joanna Franco: And I know me, for myself working here, it's definitely changed the way that I live. I'm still learning as [00:24:00] we go. We lost someone really close to us here in the house who was a big part of the caring house, and to see her going through her process, even though we know all of this, it was still shocking and very difficult for myself going through the anticipatory grief and then grief after she passed, and still not accepting the fact that she passed.

I work in this field and I see it every day, and I talk to families about how it's gonna be okay or you're gonna get through this. But I couldn't apply that to myself. So I think once you go through it yourself, it changes everything. It's not everything you read or you say. You deal with it completely different Yeah.

Jill: Yeah. Yeah. I recently had a loved one die, and he was older, right? So it wasn't a surprise, but I found myself doing the thing that I'd seen other people do, which was like my aunt saying, "We're gonna try these treatments. The hospital wants to try these things." [00:25:00] Even though in my head I'm like, "Given his age, given what's going on," I'm like, "He's gonna die.

I know he's gonna die." Mm-hmm. But there was still that little part of me that's, "But maybe not. Maybe he won't. Maybe he'll try the treatment and it'll work." And so I found that fascinating how even in my own head I could be having two totally different experiences. Yeah. And it was very bizarre. They- Yeah.

It's 

Joanna Franco: so weird ... she knew her diagnosis. She knew what was gonna come next, and she was still very positive. And I kept saying, "Yeah, you're right. We're gonna get through this. Let's keep doing the surgeries." We knew what the outcome was gonna be at the end, and we did not accept it through the whole... It was about six months from the time she was diagnosed till her passing.

Mm-hmm. Maybe less, maybe four months. 

David Zartman: Yeah. Yeah. 

Joanna Franco: And 

Jill: early 50s is young. Yeah. 

David Zartman: Yeah. And we all wanted her desperately to survive. It was just hard to accept. She herself, her name was Sandra, d- did not [00:26:00] want to die. But mostly, she had kids and things like that would make anyone not want to leave this place early.

Mm-hmm. But in the end, like Sandra and I... Or like Joanna and I say, she's still teaching us lessons even now. 

Jill: Yeah. 

David Zartman: So yeah. Sometimes you have to live right through. It's like until you truly feel it firsthand, whether it's the dear friend like Sandra, or your parents or a loved one, uh, you don't even realize that you're missing that 1% or 5% or some number of really knowing what this journey is like and knowing what it's like to talk to someone who is facing their own passing and how they might feel about it, acceptance or denial and all the other things, anger and grief and everything else.

And boy, until we do it... But it also teaches us, doesn't it? Only later do we realize how much teaching comes out of it. It's the most painful type of teaching there probably is, but maybe the most profound, too. 

Jill: Yeah. That's so true. 

David Zartman: Yeah. 

Jill: Ken, you said you have about eight people a month that come in, and they live in your facility for a couple days, maybe a couple weeks, and they die.

Do you [00:27:00] do anything as staff to work with the fact that somebody that you were caring for has died? Because you're still in a very emotional situation, and you're still working with families that are very emotional. And even if it's only a couple days, you still get attached to somebody. Mm-hmm. So is there something that the staff does either individually or maybe together to honor the- Mm

work that you're doing there? Uh, 

Joanna Franco: I was sharing with Matthew earlier today that you have to be very special to work here because they do see death daily. It is just part of our job. So to work here, it's not for everyone and it's not just somewhere where you come in and clock out, because it would be impossible not to take home the grieving daughter or the grieving- Mm-hmm

spouse. Children, our ages range between 34 to [00:28:00] 104, so we get different types of families, and we see their pain, and we hear them crying in the hallways, and we have to just be the strong ones for them. So even though they're not our family members, many times we will tap out and go cry in a corner for a minute, and then get back together and say, "Okay, let me go back and take care of that family member."

And so we do a lot of talking, a lot of debriefing, supportive of each other, making sure that everyone's taking care of themselves, making sure everyone feels well when they come into work. And so we just know it's part of what we do here. It's not a labor of a newborn, but it's a labor of, now, a passing.

So we see it as if no one else is gonna do it, we are responsible for this journey of the last few days or hours of this person. Right. 

Jill: Yeah. 

Joanna Franco: And all of our... Our whole team feels the same way. Yeah. So yes, they... We cry a lot, and they get connected. We've had residents, we [00:29:00] just a few days ago had someone here that literally passed away as they were being brought in.

Oh, wow. So they weren't even here five minutes, and it made such an impact to the family that we were able to take him in, and they were able to just gather here with him after his passing, that the girls feel honored to be able to do that, and feel good about being able to provide that service to that family.

We didn't even get to care for him. Mm. But we were able to care for that sister and brother that were caring for him at home, and they were so overwhelmed because they had to start medicating him, so they just wanted to get him here. Yeah. But he was actually already transitioning. 

David Zartman: And one other thing that's not strictly speaking for or by the caregivers, but it's still an important part of it, is we're not an organization, a residence where we're trying to just churn people in and out, right?

We're not trying to put bodies in beds kind of thing. That's [00:30:00] not it. And so when someone does pass away and die, that room is left empty for a couple of days, and their name goes on either the door or on the pillow to remember who they are, and we write up a rest in peace message on the dry erase wall with their name, so that when we go in and we just remember that Jennifer was there, Todd was there, and whatever they gave to us- We take a day or two to let the spirit of that person be free as well.

I'm trying to convey a religious thing, but just the embodiment, the echo maybe, whatever's the comfortable word for someone, the spirit, to be free of that place as well. And I think that also is important for all of us, just to remember that this is not just whip 'em in, whip 'em out kind of thing. They've honored us with their presence and their passing, and we're gonna take a moment to remember them when they're gone as well, as best we can before someone else comes in.

Yeah. 

Jill: And after [00:31:00] somebody dies, I know if you are in the hospital, they'll let you sit for a little bit, but again, they need the bed, right? So they're, they're moving people out. Do you have a way to let families stay for a couple hours, or do you ever do, like where people can, at home at least, you can use ice packs and things to allow somebody to stay with a person for a few days if they really wanted to.

What's your policy around how long people can stay with a family member? 

Joanna Franco: Yeah, we have a policy in place which is four hours. After passing, we need to have a plan in place for the mortuary to have been contacted, and they come and pick up the body. That's the house policy. But we are very flexible, so we will never pressure or rush someone because there's that timeframe.

We have waited up to 12 hours so that the family can come if maybe they're... I've had families driving from Las [00:32:00] Vegas that just wanted to come see them here before they picked up the body. They wanted to be the ones who dress the body. Mm-hmm. So we will wait and make those accommodations, and then release the body once the family is ready.

There's a rule here. No one releases the body except the next of kin, not even me or the hospice agency. Unless the family and the, or the next of kin said yes, that is when we make that call. 

David Zartman: That was another one of those I didn't know moments until my own parents had passed. Mm-hmm. I never had any kind of horse in the race, but I, I certainly wouldn't have ever said no to anyone.

But I didn't until I lived it, which was my mother died, and there she is in bed. And, like we were there and we grieved, my sister and I, and then we left. But then separately and together, we both came back to sit with her again and maybe we said a few things. With my mom, actually, was almost inadvertently like a 12-hour thing because there was actually some sort of communication breakdown and they [00:33:00] just didn't come.

But that was okay. I was able to sit with her. And then same thing with my father. I was literally holding his hand when he breathed his last breath, and was able to stay with him after that for quite some time. In my own way, I felt like that was something his spirit would've wanted. Mm-hmm. Not to take that final step alone through his own fears and things.

So it was important to be there for quite a while and let whatever he was go wherever he was going. So once I experienced that, it really what Joanna was saying, that we have a policy, but we know that the family comes first, and we're gonna make every reasonable accommodation for that. It's very important.

And plus, it could be cultural as well. 

Joanna Franco: Sometimes they want... They have to wait a certain amount of time or their priest or any religious, they wanna come in and pray a rosary with them. So we will allow that and make it very comfortable for them and not feel like they're stepping on our toes or anything.

We'll allow it and make the accommodations for them. 

David Zartman: Yes. 

Joanna Franco: Yeah. 

Jill: Do you ever have families that wanna [00:34:00] do some type of, like a ritual or something nearing the end of somebody's life? Is that something you see regularly where people say, "I wanna, I don't know, play music or I wanna spread rose petals around," or like whatever it is that they want to do.

Or is it more, when I think of like my family, again, like most of the time people weren't really around anyway when somebody died, but if they were, we're all just like sitting there, right? Like, 'cause nobody knows what else to do. We do have a lot 

Joanna Franco: of families sitting for hours from the moment our visiting hours open till late at night.

We'll allow immediate family members to stay here in the house or at bedside while they're waiting for the passing of their loved one. As far as rituals, yes. I think it's depending on their religion or their culture. I've seen them put up a Buddhist altar, and they'll play some type of music next to their loved one.

I've seen rituals after passing, so they'll bathe the body, they'll [00:35:00] dress the body. They'll dress them in a certain color based on what their beliefs are. So we do see that. And also I've seen them have parties or have a party for the loved one in the room, and they'll laugh and sing and reminisce before the passing.

Jill: That's how I wanna die. I want everybody to be around me, hanging out. Mm. Having as good of a time as they can. Yeah. I just... I don't know. I just feel like it, even if the person is not totally aware, I feel like there is some awareness up until the moment they die. Mm-hmm. Sure. Who knows, maybe even afterwards.

Maybe our soul does leave the body and hang out. I don't know for sure. Sure. But I like the idea of my family members- I don't know, trying at least Gathering and having- That's true ... a good time. Yeah. Yeah. Yeah, sure. 

David Zartman: Love that idea too. The post wake. Why not? Let's have some smiles in there too. Yeah. 

Joanna Franco: Yeah. So bring their pets into the house to say goodbye.

Oh. We see a lot of that. 

Jill: Mm-hmm. Actually, yeah. I hadn't thought about that. Mm-hmm. Is that something where [00:36:00] people can bring a cat, a dog? 'Cause we are very connected to our pets, and I know that pets also will grieve the death of somebody. Yeah. And so I've heard of people saying that especially after somebody has died, they'll make sure the pet comes and is able to see them.

So yeah, do you see a lot of- We see that ... people bringing...? Yeah, for sure. Happens 

David Zartman: right now in one of our rooms. A gentleman is there, and his wife brings in their dog, I think its name is Daisy. Her name's Daisy, and Daisy loves it and hangs out with him and comforts him very much. 

Jill: Have you ever seen anybody bring something weird like a bird or a snake?

I'm like, "Uh-" I know with the cat- ... people might show up with weird stuff ... it's a big deal 

Joanna Franco: because the cat could only stay in the room because we have a staff member that's allergic to cats. So we would bring it, sneak him in. Yeah. He would have to go in the room and not open the door until the cat left.

But no, nothing weird yet. I'm sure it'll happen. 

David Zartman: Yeah. The allergy thing is true. I've always thought some kind of pet cat or something similar would be nice for all the [00:37:00] reasons that have been established for many years of just calmness and comfort- Mm-hmm ... and that sort of thing. And of course, have to be cognizant of people's allergies and that sort of thing.

Or even a mellow, I don't wanna say therapy dog, but just some kind of presence of a friendly dog. Mm-hmm. And Matthew brings in a dog sometimes. Even I bring in a French bulldog sometimes that likes to cuddle. So we have adopted therapy dogs- Mm-hmm ... that come in on occasion. Yeah. 

Joanna Franco: And, and it's not only... I always tell everyone that it's not just for the residents, the staff too gets very excited when there's a puppy in the house or a cute dog.

So it just helps everyone feel good- Yeah ... in the house. 

David Zartman: Yeah. 

Jill: Yeah. Yeah. Right. Who doesn't love a nice visit- Yeah ... with a dog, you know? Yeah. Because some people don't. Some people don't like dogs, but- Right ... I know whenever I go anywhere, if there's a dog, I'm very excited. Yeah. And I have seen some assisted livings that, yeah, maybe the dog doesn't live there, but it's maybe like- Like a family

like a house dog. Yeah. Yeah, I've seen that too. Mm-hmm. Yeah. Oh, that definitely makes sense. Yeah. But yeah, you're right. With allergies though, what do you do with that? Yeah. [00:38:00] I guess it must be fine because I've seen it in more than one place. Mm-hmm. And I think it does bring a lot of joy to people to have pets around.

David Zartman: Yep. I can't help but say just how important the houses like this are around the world, United States, as a community partner, as something that is here for the community by the community. Myself and Joanna, we all live here. We all live within 10 minutes, 15 minutes of Caring House. And we work very much as community partners.

That's just one thing that I would love to convey amongst all the other things, is that for the people who are experiencing death and dying in the family or, or whatnot, that there are places you can go. And I encourage your viewers and listeners to even in their darkest hour to remember that there's possibly a place that can help them, can comfort them locally, hopefully in some form like that, whether it's just palliative care, end of life hospice, a hospice residence, et cetera.

[00:39:00] And just encourage everyone to learn about that and see if that's something that makes sense for them. Of course, I totally understand that if you live in a small town somewhere, that probably isn't gonna be an easy thing to find. But nevertheless, just remember that we're all community partners in this, and we want to make life at the end of life better for people.

We've had too many people come in who are so glad they've come to Caring House because their grandfather or someone they knew just had the terrible experience at the whatever, hospital or it doesn't matter where. And we work with hospitals literally every day. Kaiser and Torrance and Little Company of Mary, et cetera.

We work together to make sure that the people that come from there are gonna get just as good of care as they did at the hospital. It's just their end of life. So I just wanna convey that out to people. And if you wanna support us, we would love your support to keep this going at yourcaringhouse.org.

Joanna Franco: We've been open 10 years now, and we've served over 800 residents- 

David Zartman: Yeah ... 

Joanna Franco: that have walked through the house, families- Right ... loved ones. And so it, it may seem like a little small house, but we've made a [00:40:00] big impact in the community as well. 

Jill: That is a big impact. Yeah. That's a lot of people. And I wonder why there isn't more of them around.

Especially if it's a non-profit, I'm just surprised the more that I think about it, there's not a lot of places like yours that I've heard of. So I wonder why there isn't more of them. Maybe people just haven't thought of it yet. So anybody listening, if you wanna open one, especially in New Jersey, I think that would be pretty cool.

Yes. There you go. But yeah. I hope to see more places like this with time because- I think 

Joanna Franco: things are changing, too, because more people are having more conversations about death. Otherwise, we don't wanna talk about it because we're not dying, and so we're not gonna talk about death, but I feel like now it's being talked about more.

And it's true. Most of our families that come here lived here in the South Bay their whole life. They've been part of the hospitals here in the area, and it's the first time they've heard of something like this. Oh. And they're shocked that we're [00:41:00] even here and what an amazing thing to call. Yeah. We can't go home, but we can come somewhere where we can feel at home.

And so it's the first time they've heard of it. 

David Zartman: Yeah. It's respite for both the families and the person. Mm-hmm. And I'm sure you understand that very well. But it really is respite. It's emotional respite. It's physical with the caring side. It's obviously financial possibly, right? So Caring House- is a place of refuge on a lot of different levels for family members as well as people who are on hospice care.

It really is. It's a place of respite and refuge, and that refuge in turn lets families connect in a way that they might not have been able to do as easily or as warmly as in a hospital room or somewhere else. They can just be, sitting, holding their hand, whispering, talking, laughing, whatever it may be.

That's The Caring House right there. It's just letting them just be with the family, and we will take care of the other worries as best we can. Uh, that's a powerful thing. 

Jill: Yeah. [00:42:00] That is a powerful thing because it's, it's so hard to be with somebody at the end of life. Mm. And just having a space where you can feel safe to feel whatever it is that you're feeling.

Yeah. And it's hard 'cause some people die in hospitals, some people maybe are in a nursing home or they're in their own home. But I know at least in the hospitals, things are still so loud and it's so busy. I would assume a nursing home, the same thing, where there's still the regular day-to-day life going on.

Mm-hmm. And so there is this feeling of almost disconnect when you're with somebody that's dying. Mm-hmm. And the rest of the world around you is still moving on like nothing's different. Yeah. It's jarring in a way. So it just seems like that house is such a beautiful energy- Mm ... for supporting people and holding them during a time when we really can use, like you said, community, right?

We need community. Yeah. And unfortunately, in our culture, we've lost a lot of community aspect- Yeah ... [00:43:00] for these really important times in our life. Yeah. 

David Zartman: You're exactly right. Yeah. 

Jill: Yeah. Beautiful. 

David Zartman: Well, 1% a day. Hopefully we can all work together. Especially with podcasts like yours, helping spread the word.

Thank you for doing what you do. I mean it. Thank you so much for having us, but also just doing your general work and as a death doula, the people that you touch as well, so thank you for that. 

Jill: It feels like it's my life's purpose. It feels like this is what I was put here to do. Yes. Even though pastry and food service- Yeah

has been 30 years of my life. Mm-hmm. And I still do it, right, 'cause that's the thing that makes me some money, but this feels like my life's purpose. Yeah. I'm really so happy that I found the work and that I'm able- Nice ... to help people through this experience. 

David Zartman: Very nice. Good for you. 

Jill: Thank you. Yeah. Yeah.

And so you mentioned your website already, which is great if anybody wants to donate to help support a nonprofit. Mm-hmm. I know how hard nonprofits work to keep their doors open and to pay their staff and to do all the things that [00:44:00] they need to do. So for sure, if anybody's listening, go to the website.

But also, is there any other places people can find you? Do you use social media? Do you have a newsletter? Like, where can people find out more? 

David Zartman: We have the socials. We're on Instagram. We're on YouTube Facebook. We even have an events Instagram for our separate fundraising events and that sort of thing that Matthew's helped create.

Our website again is www.yourcaringhouse.org. You- Yeah. And- And I'll put links to all of it in 

Jill: the show notes so people can just go to the show notes, find the websites, and check them out there. But I think this is amazing. I really do wish I was closer. Oh. You could open up a satellite one in New Jersey because We're 

David Zartman: trying.

We want to so much. It's part of our vision is to scale up and have other Caring Houses out there kind of thing. Oh. Yeah, we would love to. We'd love to come to New Jersey. In fact, we were more or less around the corner from you just last year because the Omega Home Network had their conference in Buffalo, New York.

So [00:45:00] if not around the corner, close enough. And really love the vibe of the East Coast. And really, there's some real roots, as you must know, for some real early hospice care houses like this on the East Coast in New York and this sort of thing. I don't know if they were the first, but certainly there's some history there for some of these houses on the Eastern Seaboard and that kind of thing.

So yeah. Mm-hmm. Come on out, visit us. The coffee's on. Yeah. You can see how our pastries stack up to yours. Hmm. I don't 

Jill: know. I make a good muffin. Oh 

David Zartman: my 

Jill: gosh. But yeah, if I do make it back to California, I will for sure come visit, come hang. Well, thanks. Yeah. Lovely. Yeah. But I love California. It's a beautiful place.

Oh, good. Yeah. Yeah. Lovely. All right. Well, thank you both. I really appreciate you taking the time today. 

David Zartman: Likewise. Thanks for 

Jill: having us. 

David Zartman: Thank you for having us on so much, Jill. Thank you for what you do. 

Jill: If you've been listening to my podcast for a while and you hear me and my guests talk over and over about how important it is to create a plan for the end of life and to have the conversations with your loved ones about what's important to you, and you're thinking, [00:46:00] "Okay, maybe it's time.

Maybe I should actually sit down and figure this out instead of just hoping it all works out later," I get it. These conversations can feel overwhelming or scary or just like something you'll deal with another day, but you don't have to do it alone. If you want help creating an end of life care plan for yourself or for someone you love, maybe it's your aging parents, a spouse, whoever it is in your life, you can book a complimentary 30-minute call with me, and we'll just talk.

We'll get clear on what's going on for you and what the next right steps might be. There's no pressure, just support. The link's in the show notes whenever you're ready. And if this episode made you think of someone, a sibling, a friend, or another caregiver, feel free to share it with them. Sometimes these conversations are easier to start when someone else opens the door first.

Thank you for being here. The fact that you're even willing to listen to this kind of conversation means a lot.