Episode 18 - Lisa Pahl // The Death Deck // Candid Conversations About Death

The Death Deck, death, dying, hospice, grief, acceptance, end-of-life, conversations, regrets, humor, planning

In this conversation, Lisa Pahl, CEO of Death Deck LLC, shares her insights on death, dying, and the importance of having open conversations about these topics. Drawing from her personal experiences and professional background in hospice care, she discusses the significance of showing up for loved ones, common questions faced at the end of life, and the role of humor in coping with death. Lisa also introduces the Death Deck, a tool designed to facilitate discussions about end-of-life wishes and planning, and emphasizes the need to normalize conversations around death to ease the grief process for families.

You can find Lisa online at www.thedeathdeck.com

You can find me online at www.dearpsychopomp.com

or contact@dearpsychopomp.com

I hope your weekend is gentle and full of opportunities ♡

Transcript

Dear Psychopomp (00:02.439)
Joining us today is Lisa Paul, the CEO and owner of the Death Deck LLC, which creates tools that inspire meaningful conversations on what matters most in our lives and our deaths. She is a licensed clinical social worker with over 18 years of experience in hospice and seven years in emergency medicine. Lisa, welcome. Thank you so much for being here today.

I love meeting others in the death care industry, if I may call it that. There's not many people I get to nerd out with about death and dying.

Lisa Pahl (00:42.158)
Well, I'm happy to be here because I love to nerd out as well on this super important topic.

Dear Psychopomp (00:49.755)
Yeah, thank you. So my first question, what is your relationship with death? When did it start?

Lisa Pahl (01:02.86)
It started, well, in two different ways. One, I was raised on a farm, and so a family farm, my dad, mom, and brother and I, and so my brother and I had a lot of tasks and chores regarding the farm and were firsthand witnessing death.

within the farm setting. so, you know, in that kind of, and we lived in a farming community, and so there's a matter of factness about death and dying within farming communities. And so I think in some ways that kind of set the stage for me to be a little bit more comfortable with death and dying from the get go.

And then my dad was diagnosed with leukemia when I was about 19.

He basically turned his entire life around once he heard that he had this serious illness. He's still alive today at 72. He has lived with it for 30 years. This form of leukemia and he basically became this incredible human being. Not that he wasn't a great person beforehand, but

He had quite a temper and he focused on work. That was what our family did together. He was a truck driver and a farmer. So work and productivity came number one above relationships. And I got to witness this beautiful transformation over a few years after his diagnosis and saw firsthand how when we

Lisa Pahl (03:03.97)
take inventory of our life and recognize that our time on earth is finite, we can change, we can prioritize different things. And now he's this incredibly loving, compassionate man who journals every day and is a wonderful grandfather to three grandkids. But you know what's interesting about this? I just did a series with my dad on the death deck.

Dear Psychopomp (03:26.823)
Lisa Pahl (03:33.9)
We covered a lot of different topics and I think really what happened was I'm embarrassed by how I responded when he was first diagnosed. I avoided him in the hospital as long as I could and I was afraid and I, looking back, I wish so badly I would have handled it differently.

And so I think there's a piece of me going into this space that's kind of like a redo. Like I'm gonna treat other people, though he wasn't terminal and most of my work is with people who have a terminal diagnosis, but I wanna be there to support them along the way and show up for them in meaningful ways.

Dear Psychopomp (04:07.047)
Hmm.

Lisa Pahl (04:29.42)
Obviously I was like 19 at the time, so I didn't have the wisdom and skills that I do now, but I do feel like I'm trying to right that wrong. So yeah, that's my very long-winded answer.

Dear Psychopomp (04:38.311)
Mm-hmm.

Dear Psychopomp (04:45.911)
It wasn't wrong. There's no right or wrong way to respond when you need time to sit in your feelings and process everything going on, especially at 19. You're doing the best with what you have and be gentle.

Lisa Pahl (05:10.626)
Hahaha.

Dear Psychopomp (05:11.377)
Be gentle, you did good. It's not that you're writing a wrong, it's that you've learned and you're passing on your knowledge. You know? Yeah.

Lisa Pahl (05:20.78)
Yeah, yeah, I think, you know, the compassionate side of me says that most of the time. Occasionally, I just remember how...

how much guilt I felt about that. And I think that's what I have been trying to release for the last 30 years, to be honest, is releasing the guilt from that, which I just, like I mentioned, I did this series with my dad for the death deck and it was incredibly healing because he of course shared with me that that's not what he remembered. He remembered me coming to the hospital and bringing a little

Dear Psychopomp (05:41.55)
Mm-hmm.

Dear Psychopomp (05:48.903)
Mm-hmm.

Lisa Pahl (06:09.71)
portable basketball net and we shot hoops in his hospital room and he loved it and that was his memory. it's interesting the perspective, right? We know what we're on in our mind and in our feelings, but it does demonstrate to me that showing up is what people remember even if it took you a minute or you

didn't do it exactly the way that you wanted to, it's the showing up that matters.

Dear Psychopomp (06:46.275)
Absolutely. It's holding that space. It's being there and saying, you know, I don't know what to do. I don't know what to say, but I'm here.

Dear Psychopomp (06:59.879)
Yeah, that's hard. I remember I was hospitalized a few years ago for, had to have a surgery for a GI issue and I was in the hospital for, I'll say 12 or 13 days and my husband came every single day. It was an hour drive one way because we live out in the country and he brought

a mini Monopoly board. Like tiny. You couldn't even read it. And we were playing cards and Monopoly and that was some of the best time we had because all we had to do was sit down and talk.

You know, there were no chores waiting. There... It was just those moments and that's still some of my favorite moments. Even if I had to count how many holes were in the ceiling tiles.

Lisa Pahl (07:59.32)
Yeah.

Lisa Pahl (08:05.538)
Yeah. Yeah, in the quiet of...

Dear Psychopomp (08:05.863)
through my boredom.

Lisa Pahl (08:13.258)
illness or grief or something that you're going through, you know, when people show up, moments, like you mentioned, because it's concentrated and the outside stuff doesn't matter in that moment, I think we can get, we can have these really meaningful interactions and connections. When my mother-in-law was dying, my husband and I flew back and forth from

Dear Psychopomp (08:37.927)
you

Lisa Pahl (08:43.362)
California to Michigan to take care of her. We took turns and.

Those are some of my most precious memories with her because she was diagnosed with pancreatic cancer in May and she died in August. And so it was a very concentrated period of time and we knew it was going to be very short. And so we just, we ate all the things, we said all the things. It was a really, those are some of my best memories with her.

even though there was uncertainty and fear and pain management and all these other things and caregiving, the special moments I just, I treasure every day.

Dear Psychopomp (09:34.119)
Absolutely. Do you find when you're helping someone who does have a terminal diagnosis, loved one or not, do you find there's a common theme with questions that they ask you or things that they say they wish they had done?

Lisa Pahl (10:01.838)
Common questions are, nobody's being straight with me. Can you tell me how much time I have left?

Dear Psychopomp (10:09.711)
Nyeh.

Lisa Pahl (10:11.82)
I would say that's one of the questions I get the most. And I'm a hospice social worker, but I have been at the bedside of, you know, hundreds, potentially thousands in my 18 years. And so I can give a general estimate and with a lot of caveats, you know, I'm a social worker. say all the things.

But people find it so helpful to try to at least have a general timeline. I also use Barbara Kern's book Gone From My Sight, which really gives a timeline with symptoms. And so that can be a really effective tool because they can kind of see it themselves instead of me saying it. So that's usually how I answer that question as we go through that booklet together.

Dear Psychopomp (10:52.71)
Mm-hmm.

Lisa Pahl (11:09.666)
The other question that people ask is,

What do you think happens after we die? Like people ask me that all the time.

Lisa Pahl (11:26.146)
And then in terms of their regrets or what they're thinking about, I would say what people talk about the most are their relationships, being really proud of their kids or grandkids. And then they talk about their travels. Travel is like really high on the list. I think people feel a sense of like,

I've done all the things I've seen the world when they've done some traveling, whatever that looks like to them. And so it gives kind of this sense of accomplishment. Like I've been to 12 countries, you know? And so people, relationships and travel or specific memories, you know, we just had a 90th birthday party and I got to see everybody, you know, in my family and.

Dear Psychopomp (11:58.855)
Hmm.

Lisa Pahl (12:23.84)
So those memories with people and those important moments are what people talk about. With regrets, they're kind of the standard ones that are like, I work too much, I missed a lot of my kids' lives.

Dear Psychopomp (12:42.919)
Mm-hmm.

Dear Psychopomp (12:48.423)
the coulda, shoulda, woulda.

Lisa Pahl (12:48.546)
I let myself, yeah, and not taking risks. I think that.

There's a lot of questions about what could have been had I done this thing that come up. But I would say most of the time.

In my experience, people are focusing on the good and not the regret.

If they're focusing on regrets, then they tend to have deep regrets, you know? And that's kind of its own beast in end of life. But in general, most people kind of, in my experience, get to a point of...

Unless, well, let me, here's a caveat. Unless they're dying very young, then there's a lot of, I wish I could live longer. I don't feel ready to die. There's a lot more in general angst and things that come with dying at an earlier age. But I would say people over 70 tend to focus on the positives or what they're appreciative for as they're dying.

Dear Psychopomp (13:55.431)
Hmm.

Dear Psychopomp (14:07.687)
Yeah, for sure. I had a client that died in December and he made it to 27.

and to be a part of his...

journey of acceptance. He was stage four by the time we met. I unfortunately only knew him for a few months. And still don't know what he looked like. But he's really bad at battleship. I will claim that. But it's... With him dying so young, it was...

It was so profound that he was able to accept it.

And of course that's what we hope for when helping someone at the end of life is acceptance and...

Dear Psychopomp (15:14.439)
for him to say like, you help me accept this and I'm ready now. was just...

Whoa. And it's... I think the biggest part for him was the injustice of it.

He wasn't done yet and he was living very loudly, very happily, like absolute genius. The world is lesser for not having him in it. And I think that sense of injustice is something that a lot of people can relate to with things like chronic illness and cancer and

especially in the younger part of the population.

Lisa Pahl (16:12.782)
What a beautiful gift you gave him. I mean, that's, yeah, that's very profound.

Dear Psychopomp (16:15.951)
thank you.

Lisa Pahl (16:23.414)
I think that...

Lisa Pahl (16:28.844)
My experience talking with people whose children have died of cancer, I haven't worked with pediatrics myself, but I have talked to a lot of people who've lost a child or whose child died of cancer. typically the kids get to a point of acceptance.

And I think in some ways there's a, I'll use the term blessing, but in the fact that their brains aren't, like if they're younger, their brains aren't fully developed to really think about.

the massive loss or the big picture of the life they're not gonna live. I think in a lot of situations, kids and younger people who have lived with cancer a long time also just kind of get to a point of being tired. There's an acceptance that can kind of sneak in as it relates to

Dear Psychopomp (17:18.874)
Mm-hmm.

Dear Psychopomp (17:34.737)
Mm-hmm.

Lisa Pahl (17:43.51)
I just can't go through this anymore, you know? And I hear this with caregivers a lot. You know, it's like, I don't want him to die, but I can't watch him like this anymore. I don't want him to die, but he's suffering, you know? And I don't want him to suffer anymore. And so there's a lot of ways that I think lead up to...

some acceptance. I think it's pretty rare that people are fully accepting, know, without having any, I just wish I had more time or there's like any caveat to that. But I think a lot of people get to a point of tolerating the fact that they're, that they're gonna die, you know, and

And for me, what I find can be helpful is the people who approach death and dying, who have this ability to be curious, I think can be such a gift because people will share with me, you know, that question of what do you think happens after we die? And then

they'll give me their thoughts on it. Like, can I give you one example that makes me laugh? Okay, so I had this patient, he was in his 90s, and he was an engineer and a very logical thinker, and his wife had died years ago, and he was getting very close to the end.

Dear Psychopomp (19:17.516)
yes please.

Lisa Pahl (19:39.554)
This was within the last week of his life. I came over to see him and we had been having these really deep conversations for I'll Be Frank, a man in his 90s to be so open with me. And he said, Lisa, Lisa, I got a question for you. And I said, okay, what is it? And he's like, well.

Bye.

had a dream last night that Mary came to see me and

At first I was like, how lovely, Mary came to see you. But then I was like, but wait, wasn't your wife's name Elizabeth? And he said, yeah, but Mary came to see me. so I started laughing. I said, well, who's Mary? And he said, she's the one that got away. And so we then had this, he then asked me, know,

Do you think that after we die, and he identified as a Christian, do you think after we die and we go to heaven that we're like stuck with our wives? Because it says till death do us part. So like, could I date in heaven? Like, could I be with Mary?

Dear Psychopomp (20:52.551)
You

Lisa Pahl (21:03.214)
Obviously, I have no answers on this topic, right? But we had a really interesting thought provoking conversation about like, what would that look like? he was curious and he was hopeful, you know, that he would get some time with Mary. And so I think of him.

Dear Psychopomp (21:06.779)
Yeah.

Lisa Pahl (21:32.15)
I think of him often, just like this is an example of some of the thoughts that go through people's head, you know? It's like, what's it gonna be like? you know, am I gonna be this wrinkly version of myself or can I be the hot version or like?

Dear Psychopomp (21:50.032)
Yeah.

Lisa Pahl (21:54.382)
So I, I'm more of an agnostic, I believe that there's something that I don't quite believe in heaven as he was describing or anything. But, but I get into all sorts of conversations with people about their spiritual beliefs and, and what they think happens.

Dear Psychopomp (22:04.615)
Mm-hmm.

Dear Psychopomp (22:15.995)
I the religious conversations with open-minded people who, I'm atheist. I just, don't believe in God. That's my own story. I believe in the law of conservation of energy.

I believe in science, I believe in magic, and I believe our energy continues on. I just don't know where or how. But the different perspectives that people have and the comfort that they get from their beliefs is just so beautiful.

And I love, like, I don't impose my beliefs on any clients or anything. I meet them where they are. So I have this, I call it my, ironically, I call it my Bible. And it has a bunch of prayers and rituals and things you can do for just about any religion you can think of just to be able to honor them that way. And...

It's really...

profound when people let you in on on that because they're opening their whole heart like this is what I truly truly believe it's like that's beautiful usually

Lisa Pahl (23:58.936)
Yeah, yeah, yeah, yeah. No, those are really special conversations. You know, when you brought up being atheist, I've had hospice team members make comments like,

Lisa Pahl (24:20.812)
you know, it's so sad that person's an atheist because they're feeling like they don't have hope as they're dying. And I was like, have you talked to our atheist patients because they have a lot of hope, you know, and, and I think, you know, some of the common things I hear from people who are atheists as they're dying is

Dear Psychopomp (24:36.133)
Yeah.

Lisa Pahl (24:47.308)
You know, I know I'm going to live on in my in the people that love me. They're going to like hear my voice in their head and they're going to make decisions with my guidance.

Dear Psychopomp (24:53.479)
Mm-hmm.

Lisa Pahl (25:02.93)
I also get great comfort in knowing that when I die, it's all over and I don't have to think about a single thing again. I take comfort in being released from this pain that I've been in and the worries of this world. There's just so many ways that people take comfort in whatever their belief system is. And so I am always speaking up for people.

Dear Psychopomp (25:24.913)
Mm-hmm.

Lisa Pahl (25:32.852)
who have varying beliefs, including atheist, including identifying as atheist because there is hope and peace to be found in any belief system. And that's why they're belief systems, right?

Dear Psychopomp (25:46.695)
Mm-hmm. Yeah, exactly.

It's, I know I'll still exist, I just don't know in what capacity and I mean the biggest thing, you know, I've been doing a lot of soul searching lately, especially with like Carl Jung theories and things like that and it's...

You know what? If I can picture myself on my deathbed...

Dear Psychopomp (26:22.94)
What can I do that's gonna make me go like, that was awesome?

Dear Psychopomp (26:30.469)
And so I kind of based my decisions around that and I want to leave a legacy. And so here we are, you know, suddenly podcasting my, my client who actually became like a very, very dear friend. called me his dear psycho pop.

Lisa Pahl (26:52.28)
Hmm.

Dear Psychopomp (26:53.477)
And so that's where I got the name from. And it was just the highest of compliments. It's like, my goodness. And just to be able to have a connection with someone that you've never seen their face.

You know, we talked on the phone probably two hours a day, you know, on and off for months. And it was just, you get in this different head space when you've...

had to face your own mortality.

Dear Psychopomp (27:29.615)
and it kind of just takes away all the fluff and not that the fluff isn't important. It's very important, but it's having those conversations. And I mean, I'm the little ray of pitch black like on people's birthdays and like, hey, did you update your will? Do you have a will? What do you want when you die? And like, well, it's my birthday. So I'm like, yeah.

Lisa Pahl (27:55.886)
Good time to talk about it.

Dear Psychopomp (27:57.777)
Good time, like there's never a bad, well not never, but you know, it's good to know and you know, so what do you want when you pass away? How do you want to be sent off?

Lisa Pahl (28:05.198)
Yeah.

Lisa Pahl (28:16.334)
Do you mean disposition or what type of service?

Dear Psychopomp (28:22.929)
all of it.

Lisa Pahl (28:24.564)
Okay.

Currently, because things change, currently I, well, I'm gonna, my dad is really top of mind because I just did this series with him. So we just had this conversation. He had always said that he wanted his ashes dumped into a manure spreader and, you know, add some manure in there and spread it across the crops.

I had to share with him that that was not good for crops. And so we moved on to our conversation about human composting. And so he has agreed to that now. And that's what I'm interested in as well. My dad wants to return to his parents farmland that's still in the family. And I want to return to my family farm, at least a portion of my soil remains.

That's what I'm interested in. I've thought about whole body donation as well in the sense of being of service to others. And I have huge respect for the training that medical professionals need in order to, you know, become our doctors and nurse practitioners and stuff. so,

Dear Psychopomp (29:50.823)
Mm-hmm.

Lisa Pahl (29:53.618)
I do go back and forth between those two options right now. I'm leaning towards human composting. I think because I'm. 2025 is feeling very unsettled and, returning to farmland and farm country feels, like calming for me. And so, that's where I'm at today, but I,

Dear Psychopomp (30:16.677)
Mm-hmm.

Lisa Pahl (30:23.692)
I talk with my husband about these topics all the time. so I'm like, and updating my advanced directive and all the things. So he's like, okay, well, let me know if that changes again. Cause you know, but we've had advancements, you know, there's aqua nation, which I think is a, is also a nice environmental invite a more environmentally sound option than.

Dear Psychopomp (30:33.435)
Mm-hmm.

Dear Psychopomp (30:38.833)
Yeah

Dear Psychopomp (30:42.855)
Mm-hmm.

Lisa Pahl (30:54.424)
fire cremation. So and of course green burial, which I haven't been like green burial. I love the option for some people but

Lisa Pahl (31:10.316)
I don't know. I think because we buried so many of our pets and animals in our backyard, like in our, on our farm, it just doesn't feel ceremonious enough or something. Like I have a connotation that's not quite what I'm envisioning, but I've also thought about whole burial at sea where you just get plopped into the ocean. kind of like a mobster, know, like,

Dear Psychopomp (31:24.433)
Yeah.

Dear Psychopomp (31:34.375)
Mmm.

Dear Psychopomp (31:37.927)
That'd be cool, yeah.

Lisa Pahl (31:40.142)
I'm a huge kayaker and love the ocean. So, but I brought that up to my family and they were like, no, we're not comfortable with that. We don't want to drop you off a boat and be eaten by sea creatures. So I believe in my personally, I believe my family has some say because they're going to be grieving and I don't.

Dear Psychopomp (31:45.159)
Hmm.

Lisa Pahl (32:08.226)
want to choose a disposition option that is, might impact their grading. So, the human composting is where I'm at. How about you?

Dear Psychopomp (32:13.937)
Mm-hmm.

Dear Psychopomp (32:18.215)
Okay. I would like to be aquamated. I love the water. I don't want to be buried. I don't like bugs and like the dark and stuff like that. I want to be turned into like a diamond or a rock or something and then shot it into space.

Lisa Pahl (32:46.862)
Mmm.

Dear Psychopomp (32:48.647)
I don't know the logistics of that, but that's what I'm hoping for. Or, cause I have a, I have a, another business where I do resin memorial keepsakes and jewelry. And so I always joke with my husband like, me into something cool. Like, I'll teach you how to, how to do the science and turn me into something cool. Like bury me in a plant. I don't know, but.

Lisa Pahl (33:06.979)
Yeah.

Lisa Pahl (33:17.08)
Yeah.

Dear Psychopomp (33:17.435)
top of the list is being shot into space and going to live with the stars.

Lisa Pahl (33:22.498)
There is a service that

But I assume they would, the service that I know about sends cremated remains, but I'm sure they would send aquamation remains as well since they're so similar. But I can send you that information. I don't have it off the top of my head, but there is a service that does that. I mean, that's what's been so fascinating, you know, like,

Dear Psychopomp (33:39.911)
Mm-hmm.

Dear Psychopomp (33:46.937)
Yes please. That just made me so happy.

Lisa Pahl (33:56.59)
We developed the death deck in 2018. I was working as a hospice social worker long before that, but like, I really became into the death and dying space outside of clocking in and out of my job, you know, in 2018. And it hasn't even been 10 years and there's just been so many changes and so much, so many more conversations and podcasts and.

in the mainstream media, even so many more conversations on death, dying, grief, caregiving, all of these topics that it just makes me so happy because I feel like we're making progress. We're moving the needle little bit by little bit, you know? And I spend so much time with like death folks like you that sometimes I have to go home to middle America.

Dear Psychopomp (34:41.319)
Mm-hmm.

Lisa Pahl (34:51.602)
or the Midwest and have a conversation with someone else and then they're like, what are you talking about? I'm like, okay, it's not everywhere and everybody that's having these conversations still. We have quite a bit of work to do, but we're certainly making progress.

Dear Psychopomp (35:07.399)
Mm-hmm.

Dear Psychopomp (35:12.431)
Absolutely, which is so important, I find, especially with, so I do like online and in-person grief work. And as you know, grief is all encompassing. It's not only with death, but every other type of loss and things that could have been and whatnot. And I find that...

most

I'm going to go ahead and say everyone that I've met is grieving something. Everyone. Everyone has a story that can break your heart and to also have to do the whole life thing while you're grieving. And you you don't just get to grieve one thing at a time. Sometimes it's complex and there's more to it and life doesn't stop happening just because you're grieving. And I think if...

we could normalize talking about death and dying and grief and loss, that it would make it

not easier but gentler.

Lisa Pahl (36:27.5)
Yeah, I think it's, you know, when we give.

Dear Psychopomp (36:28.497)
You know?

Lisa Pahl (36:33.633)
voice to the things that scare us, hurt us.

We.

Lisa Pahl (36:48.238)
I believe we lessen some of the power of it. And I think normalizing these conversations and modeling for other people that you can talk openly about this topic, that your connections with other people can become incredibly rich and full by having these type of conversations, you know, like,

Dear Psychopomp (36:52.071)
Mm-hmm.

Lisa Pahl (37:17.036)
I feel super connected to you right now and we're just sitting in front of our computers, right? But we're talking about deeply meaningful things, life and death, right? And so I think there's just so much that we gain by opening ourselves up to these conversations. And for those of us that are comfortable having them to keep sharing them out so that other people feel like they can too.

Dear Psychopomp (37:22.491)
Mm-hmm.

Dear Psychopomp (37:46.119)
Absolutely. And once you embrace it, there is a whole new world of jokes out there for you too.

Lisa Pahl (37:56.27)
I love using humor in my end of life work and yeah.

Dear Psychopomp (38:03.141)
Yes, me too.

Dear Psychopomp (38:07.623)
What's the one you get the most?

Lisa Pahl (38:11.756)
What do you mean?

Dear Psychopomp (38:13.147)
Well, when I meet a new client or someone finds out I'm a death doula or something like that, they're like, people are just dying to see you. Like, yeah, I've never heard that before.

Lisa Pahl (38:23.906)
yeah, yeah, yeah.

well, I have a favorite one that this, one of my new hospice patients, I called and oftentimes I'll speak with the family member to make the first visit, but in this situation, it was the patient herself. And so, you know, I was mentioning that when a person comes on to hospice, the whole team is trying to come out and meet them.

Basically, Medicare requires that each of the disciplines do an assessment within five days. And so it can feel really busy. And so I was telling her about this, you know, and, and the reason for my visit and why we were all trying to schedule at once. And I said, but, you know, once we get these initial visits in things will settle down a bit. And she said, are you saying they're going to die down? And I started laughing.

And I was like, oh damn, I'm going to love working with this woman. And I did. She was delightful and hilarious. And we just laughed our way through her dying process, to be honest. Sadly, she didn't live a very long time. And I was really sad when she died because we had that, she just exuded humor in everything that she said and did.

Dear Psychopomp (39:29.602)
Ugh.

Dear Psychopomp (39:39.143)
Mm-hmm.

Lisa Pahl (39:56.578)
And you know, sometimes humor can be really deflective in a way to not get into the real stuff, but.

But I find that's pretty rare. I find that most of the time people use humor in some ways to cope, but they still get to, sometimes the humor is the way into the harder feeling. And I also find that that connection feeling again, when you laugh together, like walls come down and people find you more relatable and you can.

you can dive deeper once you've had some laughs together is my experience. And also people are dying for a release. They really are looking for an opportunity to release a little bit of all of the different energy and feelings and tears and laughter are very...

Dear Psychopomp (40:41.786)
Mm-hmm.

Dear Psychopomp (40:47.313)
Yeah.

Lisa Pahl (41:04.462)
closely related and so people will often start out crying and end up laughing and vice versa. So both release serotonin and dopamine and make you feel better. yeah.

Dear Psychopomp (41:12.369)
Mm-hmm.

Dear Psychopomp (41:18.129)
Yeah, love those brain chemicals. That reminded me, had this one lady, she was terminal. She had...

I think maybe two weeks at the point that I met her. And so I went over and we did pre-knead package, things like that.

We hadn't established the joking rapport yet.

Dear Psychopomp (41:58.705)
So I was getting ready to leave her house and she's like, okay, thanks, know, thanks for everything. And she's being just very solemn and beautiful. And I was like, yeah, yeah, yeah, I'll see you soon, but not too soon.

She just lit up, my goodness. And then after her passing, her brother came and found me. She's like, are you the one that said, not too soon? Yes. It's like that made her life. I just think that's awesome.

Lisa Pahl (42:34.466)
Well, you know, the other thing about humor is you have to be comfortable talking about death and dying to use humor within it. There's just...

You know, when I supervise social workers, I share with them that two of my most effective tools are silence and humor. And both of those took a while to develop. You know, the use of silence, of not filling silences and sitting for five, 10 seconds after someone says something to wait for them to go deeper. It's virtually impossible when you're first starting out.

Dear Psychopomp (43:18.631)
Mm-hmm.

Lisa Pahl (43:19.83)
because you have so many ideas and you don't know if you're doing it right and those silences feel like you said something wrong and all of these different things. But with time and experience, you can really use silence. And I think the same is true for humor. I don't suggest that people who first start out in the end of life space are leading with humor. I don't really.

Leading with humor is a little bit strong for end of life space, but finding opportunities to connect with humor is definitely a skill that takes some finesse, but people are so grateful when you can bring it as part of who you are showing up in that space.

Dear Psychopomp (44:05.935)
Absolutely. silence is 99 % of holding space. It's just, I'm here. I'm waiting. You want to talk? You want to not talk? That's cool. I'm still here. I find it's... It can often be more powerful than words at times. And when you can sneak in the humor and the lightheartedness...

you're reminding them that they're still human.

Like yeah, you're dying, but that doesn't mean you can't laugh. That doesn't mean you can't have fun while you're still here. You know, it's okay to still be human until you're not, like there's not... You know, you must be super serious now and no funny business.

But I had all these questions for you about the death deck and we have just been, like I could talk to you for days, days and days and days. So tell the listeners a little bit about the death deck, if you would please.

Lisa Pahl (45:16.704)
I agree.

Lisa Pahl (45:28.622)
Sure, yes. So the Death Deck, so the Death Deck LLC, I'll say, so that's the main business, has two products and we have a third on the way, which I'll tell you about here in a second. So our signature product and the first product that we created is the Death Deck and that's 112 questions, most are in multiple.

choice and there is a lot of humor infused in the questions to try to make the topic more approachable and lighthearted. And the idea being that this is the tool you use to just kind of get general conversations about death and dying started, talking about advanced care planning and really just encouraging healthy communication about death and dying, giving people some practice.

and talking about it, as well as being able to express their thoughts and wishes on things like disposition, medical decision-making. We have some fun like party game questions, like can mediums communicate with the dead? questions that are more lighthearted, and then we have more specific.

Dear Psychopomp (46:28.017)
Mm-hmm.

Lisa Pahl (46:56.558)
end-of-life wishes. And then the next deck we created in 2023 was the EOL deck, and that's the end-of-life deck. And so that's the deck that I use with my hospice patients. And it digs deep into specifically end-of-life preferences. So this was really designed for people living with serious illness or people of advanced age where we know that death is probably coming sooner.

Dear Psychopomp (47:14.631)
Mm-hmm.

Lisa Pahl (47:25.494)
And so there's a little bit of humor, but it's more of a gentler tone than the Def Deck and obviously has a gentler name and logo as well. And so, and then in September, 2025, we're releasing the Dementia Deck. So the Dementia Deck is a planning tool. It's a collaboration with Compassion and Choices. So I took inspiration from Dementia

Compassion and Choices, Dementia Values and Priorities tool, and used inspiration from those questions and added some more of my own to help people talk through what they would want for their care if they were living with dementia. So that one I'm super excited about. It'll launch the beginning of September. And so,

Dear Psychopomp (48:13.799)
That's phenomenal.

Lisa Pahl (48:23.574)
If people wanna get on the list to hear about that first, they can reach out to us at the death deck. Our website is the deathdeck.com and also we're on all social media as the death deck. you can get on the list for the dementia deck, but it's not available yet. The other two products are available today.

Dear Psychopomp (48:51.079)
Sign me up. Yes, there's, I have, I've had multiple clients with dementia.

Lisa Pahl (48:53.334)
Yay, I will. I'll add you to the list.

Dear Psychopomp (49:03.384)
and it

It was kind of shocking to me how other people were treating them.

Dear Psychopomp (49:18.119)
And, you know, it's different with dementia. You kind of have to meet them where they are.

and

you know, talk normally kind of thing. And I think having that resource is amazing, absolutely amazing. That's, yeah.

Lisa Pahl (49:44.312)
Thanks, yeah. My grandma lived with dementia for nine or 10 years and so the family took care of her, which only happened because there were seven children and 20 grandchildren, 30, 40, I don't even know how many there are of us.

Dear Psychopomp (50:06.342)
Mm-hmm.

Lisa Pahl (50:13.848)
There were so many points in time where it was like, man, we wish we would have known what grandma would want, you know? Because some of the important factors are like, you know, how do you feel about a feeding tube? Some people have released, as it relates to dementia, right? And how do you feel about your code status or like whether you would want to be resuscitated?

Dear Psychopomp (50:19.751)
Mm-hmm.

Dear Psychopomp (50:43.207)
you

Lisa Pahl (50:43.432)
if you no longer could recognize family, right? And so it's really trying to reduce some of the fear that people have surrounding living with dementia by helping them articulate as best they can, you know, what preferences they would want. And then the hope is for people to then fill out their dementia values and priorities tool, because this you can add on to your advanced directive and it can give your family members

Dear Psychopomp (51:11.367)
Mm-hmm.

Lisa Pahl (51:13.548)
very specific guidelines on what you would like if you were living with dementia. And it doesn't mean that these things are gonna happen. We know that about advanced directives. We know that about a dementia type directive as well. But at least you can let your wishes be known and you can give your family members some guidance on what you think about these topics.

Dear Psychopomp (51:42.535)
Mm-hmm.

Lisa Pahl (51:44.012)
Because I do recognize that sometimes the execution of what people want, there may be limitations and there may be people's own feelings about that. And so I always encourage people, the most important thing is who you designate to be your healthcare decision maker, because you can spell all this out and if they disagree with it or they don't know your wishes, it's not gonna happen.

Dear Psychopomp (51:52.613)
Yes.

Dear Psychopomp (52:13.127)
Mm-hmm.

Lisa Pahl (52:13.312)
So you need to make sure that the person you choose understands and respects and is willing to hold true your wishes. And it might not be your kid or your spouse that can do that. Recognizing.

Dear Psychopomp (52:23.591)
Yeah.

Yeah, recognizing their capacity for it, for sure. it's, I find it interesting how we'll get flooding insurance and earthquake insurance and we have our car insurance and everything just in case.

And that's fine, that's non-negotiable.

But final wishes? no, no, we don't talk about that. Like that's the one thing we're guaranteed is gonna happen. Like we know for sure, so, you know, one thing I like to say is like talking about it isn't inviting it. Like, it's gonna happen either way, but.

Lisa Pahl (53:22.892)
Yeah, well, and it's so hard. I mean, that's really the main reason we developed the death deck was because it's so distressful and chaotic for family members to try to make decisions on your behalf when they don't know what you want. you know, it makes situations so much more difficult when people haven't had these conversations.

Dear Psychopomp (53:40.999)
Mm-hmm.

Lisa Pahl (53:52.726)
And it really impacts the grief experience because if you first of all haven't had conversations, they are second guessing and wondering if they did right by you or took care of you in the way they wanted. But also if you haven't done your paperwork and passwords and these important facts, the people grieving are going to have a harder time. They're going to be inundated by tasks.

Dear Psychopomp (54:13.253)
Yes.

Dear Psychopomp (54:20.103)
Mm.

Lisa Pahl (54:22.426)
and being unable to access accounts. And let me tell you, people get mad at their dead relatives often in grief because of the lack of preparation and the mess that's left behind. I recently had a woman whose husband died pretty young and she was so upset and just said, I don't feel loved by him because he...

Dear Psychopomp (54:30.355)
yeah.

Lisa Pahl (54:51.552)
you know, said he was taking care of things that he didn't and he left me in a horrible financial situation. And I mean, that is so hard and hurtful to be faced with those feelings and grief. And so I, I encourage people who are like, who cares? I'll be dead to say.

Dear Psychopomp (55:05.255)
Mm-hmm.

Lisa Pahl (55:18.238)
Yeah, your family and those left behind care an awful lot because they're going to have to clean up your mess.

Dear Psychopomp (55:21.479)
Yeah. Those people that you love so much, they care. Yeah, guarantee. Ask them.

Lisa Pahl (55:26.196)
Yeah, they care. Yeah.

Dear Psychopomp (55:33.723)
Yeah, and it's, you know, I used to be a cemetery director and...

Dear Psychopomp (55:43.853)
Death either brings out the best or the worst. Rarely ever anything in between. And you know, I've assisted with interments that have been just absolutely beautiful. The whole family comes together. Everyone's hugging and laughing and telling stories. And then I've had other ones where, you know, we're in the columbarium and, you know, putting, putting dad with mom and people are arguing.

over like furniture and like is this this is really what you want to fight about right now?

and it's...

I think there should be like a year after someone dies, or you have to wait until the estate is settled to like, dole things out and things like that, so that people can kind of maybe remember themselves and, you know, material goods are great, but we don't get to take any of that with us. Anyway, so.

It's just, I've seen families torn apart over a car.

Lisa Pahl (57:02.626)
Yeah, or money. House, yeah. Yeah, I mean, there can be so many practical reasons why people have to kind of decide things earlier.

Dear Psychopomp (57:04.219)
Yeah, money, yeah, definitely.

Lisa Pahl (57:18.606)
although I think your ideas is great, I've worked with a lot of people who just financially have to then sell the house and so then they have to then figure out what to do with the stuff and those things are hard. And again, that's why these conversations can be so incredibly helpful and putting things in writing. If you know that your kid,

Dear Psychopomp (57:31.665)
Yeah.

Dear Psychopomp (57:44.231)
Yes.

Lisa Pahl (57:47.05)
one of your children really loves the dining room table, you perhaps at your next family dinner say, know, Mary really wants that table. We're going to give her the table. And that's the, know, and, and it's just out in the open because this whole idea of, you know, there's just so many feelings and grief. It's like,

Dear Psychopomp (58:15.847)
Mm-hmm.

Lisa Pahl (58:16.342)
Well, you didn't do anything for mom and dad while they were living. So you shouldn't get the table, you know, like there's all these things that come up. But if you hear it from mom and dad themselves, Mary's getting the table like.

Dear Psychopomp (58:28.103)
Mm-hmm.

Mary's getting the table.

Lisa Pahl (58:30.964)
At least, yeah, mean, at least, you know, you've got, you've got receipts.

Dear Psychopomp (58:38.747)
Yeah.

I mean, it makes me think back. Like, I've always been kind of nerdy about death. And since I was...

I say like 11 or 12, I had been asking my dad, just deadpan, hey, would you die? Can I have this painting? And the first time I asked him, was like,

Yeah, sure. And then he passed away in 2018 and there was no... I was like, Anne-Marie gets his painting.

And I mean, I did make sure to ask him like yearly on his birthday if I could still have it, but.

Lisa Pahl (59:30.702)
You're like, how about that painting dad? Still good? You want to sign here on this little contract I drew up?

Dear Psychopomp (59:35.867)
Yeah, still good, just renewing it, yeah.

Dear Psychopomp (59:42.631)
Yeah. Well, it has been absolutely amazing talking with you. Thank you so much for coming on the show. Yeah. And one more question. What is your favorite planet and why?

Lisa Pahl (59:55.434)
you too.

Lisa Pahl (01:00:06.008)
Wow, my favorite planet.

Dear Psychopomp (01:00:07.623)
Or dinosaur.

Mm-hmm. The important questions.

Lisa Pahl (01:00:20.174)
I think, okay, this is not technically a dinosaur, but I have a son who is almost 17 and he was a very precarious.

Dear Psychopomp (01:00:37.137)
Precautious?

Lisa Pahl (01:00:38.51)
Thank you, he was a very precocious kid. I'm like precarious, that's not the word, precocious kid. And loved to talk and was super animated and I have all these videos of him. He had a dinosaur book and so he was like always acting out dinosaurs and stuff. But he became obsessed with megalodons and so he, I can like.

Dear Psychopomp (01:00:42.663)
You

Lisa Pahl (01:01:07.182)
Close my eyes and picture this video of him where he's talking about, it's a megalodon, of course, and he's dramatic and he's like sharing all these facts and he's excited and yeah, I.

Dear Psychopomp (01:01:14.257)
Aww.

Lisa Pahl (01:01:26.412)
There are very little things, there are very few things to me as tender and sentimental as thinking about looking at dinosaur books with my son. Yeah, little kids at that age, they love to learn facts and memorize them. yeah, that just really took me back to a really sweet time. So thank you for that question.

Dear Psychopomp (01:01:36.849)
That's amazing.

Dear Psychopomp (01:01:48.903)
Hmm

Yeah. Does, does he have any Megalodon teeth?

Lisa Pahl (01:01:57.752)
Does he? does my son have any Megalodon teeth? You know? No. Do you have one?

Dear Psychopomp (01:01:58.46)
Yeah.

Yeah.

Dear Psychopomp (01:02:05.287)
I have three.

Lisa Pahl (01:02:08.308)
my gosh, do you really?

Dear Psychopomp (01:02:09.479)
I can hook you up.

Lisa Pahl (01:02:13.23)
Oh my God, that's so crazy. Oh wow, that's so cool.

Dear Psychopomp (01:02:19.207)
Yeah, I have a 100 % one too, but it's black and it depends on like the colour of the teeth, depend on the sediment with where it landed. So I have a white one, I have this grey one, I have a black one. I can nerd out about it forever. I will email you.

Lisa Pahl (01:02:36.576)
my god that's so funny. I just love the serendipity of all of that.

Dear Psychopomp (01:02:43.213)
I love it so much.

Lisa Pahl (01:02:45.966)
This has been a great conversation, Anne-Marie. Like we mentioned, I think we could talk for days here. And I would love to come back any time and continue our conversation.

Dear Psychopomp (01:02:46.976)
alright. This has been...

Dear Psychopomp (01:03:02.051)
Absolutely. Absolutely. All right, well thank you so much for listening to this week's episode. You can find Lisa online at thedeathdeck.com and in September you'll be able to get the dementia deck. So you can go and get your name on the list. And if this episode resonated with you, please hit the like button, share, follow, subscribe.

If your platform allows, leave a comment and let me know what you think. Your support fills my soul and keeps this podcast going. You can find me online at deersycopomp.com or by email at contact at deersycopomp.com. Death isn't a secret. Let's talk about it.