Lady of Death
Are you curious about death, dying, and the funeral industry in Australia?
Join us as we chat and learn from experts from funeral directors, to embalmers, from those who create floral arrangements to photo presentations and so many more. We will gain insights and have open and important conversations about this topic that is so often shrouded in mystery.
Hopefully you will come away enlightened and have a deeper understanding of this essential part of life!
Lady of Death
When Time Matters Most: A Conversation about Dying with Dignity
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What does it truly mean to die with dignity?
Behind the clinical terminology and medical frameworks lies a deeply human experience that most healthcare systems aren't equipped to honour.
In this powerful conversation, Callie Watt takes us through her 31-year nursing odyssey from remote indigenous communities to emergency departments, and finally to founding Wattletree Health Group – a private nursing service determined to transform end-of-life care.
The reality Callie reveals is both sobering and hopeful. While 85% of people express wishes to die at home, our healthcare system remains structured around institutional endings.
What makes this conversation truly exceptional is Callie's philosophy on authentic connection. Rather than the clinical detachment we often associate with healthcare providers, she advocates for genuine presence. This approach represents a profound shift from traditional models focused on efficiency rather than experience.
Whether you're facing end-of-life decisions, supporting someone who is, or simply interested in how we might better approach our final chapter, this episode offers vital insights into reclaiming death as a dignified, human-centered experience. Join us as we explore what it means to raise the standard of care when it matters most.
Callie Watt is the founder of Wattletree Health Group
Phone: 03 9140 0944
Email: contact@wattletreehealthgroup.com.au
Website: https://wattletreehealthgroup.com.au/
Have questions about death, dying or the funeral industry? Email ask@ladyofdeath.com.au to have them answered in a future episode.
Introduction to Death Industry Podcast
Speaker 2Funeral Directors, embalmers and Grief Counselors too, share stories of death to mooring and true.
Speaker 1With some quirky insights, they will slowly unveil the shroud of their industry, while they tell us their tale.
Speaker 3Hi there, my name's Robyn O'Connell and I'm the Lady of Death. In this series of podcasts, we're going to be talking to people that work in and around the area of death, from celebrants to those who work in a mortuary, to all sorts of other peoples involved in death and dying. It's really weird, isn't it, that we don't talk about death. We don't talk about all those things. So hopefully, over this period of time, you might learn something, but you might also have questions that you'd like to ask. So at the end, I'm going to give you an email address to send your questions to and then, after we've done our first series of 10, we'll look at the questions and answers that come from that and then work out where we go from there.
Kelly Watts' Background and Family Life
Speaker 3I want to know from you what you want to know about the industry that seems to be all cloak and daggers. It's not really. There's some good people in it. Broken daggers it's not really there's some good people in it. Yes, there's some shonky too, but, as you'll discover, the people that I talk to absolutely love it. Today, my guest is Kelly Watts, founder of the Waddle Tree Health Group, who provide private in-home nursing services. I should note here that Waddle Creek caters for all nursing needs. However, given this podcast is about death, dying and the funeral industry, in this session we'll be talking about their palliative care nursing support. Welcome, kelly. Thank you Robyn. Thank you so much.
Speaker 2Tell us about yourself, who. You live with family pets. So we are living in Greensboro, so we're local to Melbourne. We have an office in Diamond Creek. We've got a couple of dogs. In fact we're off to meet siblings of the dog that turns one today. So he's a Border Collie Cross Australian Shepherd, so we're off to meet his siblings in the park a little bit later today, which has got to be a bit exciting. And I've got I live with my fiancé of nine years and I've got we're a bit of a Brady bunch. So we've got. I've got two kids. He's got three, but there's two that live with us. I call them newborn adults. They're 18 and 20 years old, so a newborn adult and a two-year-old adult. We say so they live with us. And then there's, you know, girlfriends, boyfriends and all that sort of stuff. So yeah, it's all good.
Speaker 3Great. So before I get you to share with us about your nursing journey and starting Waddle Tree Health Group, I always ask people what is their why? Why do you do what you?
Speaker 2do. Oh gosh, why do I?
Speaker 3do the nursing service? Or is it just? Why did I do nursing? No, why? Why did you start? What's your why?
Speaker 2now oh my, why now? Is to raise the standard, and that means what that means. What that means that in my 31 years of nursing so far there, and especially on this side of covid, we we are in a time and a situation where I feel like the the health system is broken more than ever and there's a skill set and a level of detail and comprehensive collaboration that is missing, and just the level of nursing home, nursing services and standard and the care that people deserve to receive is just not there. So I think that I have sort of the culmination of all the years of my experience has led me to. Something has to be done, and that's where I started, quite simply, with that mission to raise the standard.
Speaker 3It's interesting, isn't it? Because I'm very much the same with funeral celebrancy. I started training because I, and it still saddens me now to see poor quality services and think the families deserve so much more than that. Yep, it's not about me being good or anything else. It's about the family's needs and not being met.
Speaker 2Yeah, and generally the reason for that is that it's a financially driven business model. It's punch in, punch out, so people don't get the time. You know people aren't met where they're at, which can take time. And I think that you know a lot of health services. You know people aren't met where they're at, which can take time, and I think that you know a lot of health services you know obviously want to be profitable. They can be very punch in, punch out and we don't allow for the unexpected just presence and time, just to listen. And it doesn't matter what service you're in, robyn, it's all about relationships, isn't it? Yes, it's time and relationships and just listening and meeting people where they're at, and I think that's missing and I think that's how we need to raise the standard, by just kneecap this expectation that you know it's a punch-in, punch, punch out service and that we have to re-educate everyone that no, these kinds of services and relationship building it takes time, often takes time, and that's what people want. They want your time.
Speaker 3Oh, they do, and I think, not just in our work, but in every business. I think one of the greatest skills that's lacking in the business world is being able to actually listen to people. Couldn't agree more, they, they, you know people just listen to answer rather than listen to what people actually say. And listening to what people actually say will give you so much more. Yeah, and you know, and so they. If they just took the time to actually listen to what the person that they want to sell something to, or whatever, actually needs, rather than selling them what they think they want, you know, the whole, the whole world would change if we just all actively listen to one another.
Speaker 2Interesting. You say that there was actually and I'm really bad at remembering people's names and details of research, studies and things like that I sort of am immersed in it but I struggle to retain it, but I do remember listening and reading something about that. It's the four second gap, so you can most people will only give you seven seconds to respond. Should you give someone 11 seconds to respond and actually just hold that space and allow them to respond, you actually get more. It's amazing, isn't it? It was four seconds of just allowing someone just holding that space and being comfortable in that silence and that gap, just to let them to respond, rather than people basically hit that sort of seven-second mark and feel uncomfortable in a silence and feel like they have to fill the gap, and that just made a profound impact on me it's.
The Why Behind Waddle Tree Health Group
Speaker 3It's interesting how little lessons like that stay with you always. I remember at at one point in time and I can't remember where I actually kind of came across it or how I came across it but I changed my my way of asking a question about Christmas, and so you know, I come from a grief counselling background. So rather than saying what are you doing for Christmas, I would say what does Christmas look like to you? Yeah, I. And suddenly you get a whole different response and and I told this to my chiropractor because she said to me I've got this client coming in. You know, it's coming up to Christmas, I don't quite know what to say to her. And I said to her to say this, and she said that it made such a profound effect on what this woman said to her was that she actually encouraged all her staff to now do it as well, and so the whole clinic does it now. And and she said, it's just amazing, it just takes all that pressure off about you know how?
Speaker 3How to ask that question of you know, is it going to be difficult for you? You, because it might not be, but you don't know If somebody has just died, you don't know whether it's going to be difficult for them or not. It might be a relief for them. You can't be in their shoes, you know, but it's interesting our term of phrase and how we ask things.
Speaker 2How we frame the question, absolutely.
Speaker 3And when I first spoke to you I said we may go off on tangents. We just went off on one.
Speaker 2So let's go back to where we are and share with us the story about how you came to be a nurse, oh goodness. So look, I remember, you know, final year of school, in year 12. And I remember, you know, putting all my preferences down for teaching predominantly teaching and, you know, went to open days and things like that, and it was my mum who very casually, just sat, you know, at the kitchen, sort of breakfast bar, and I here I am thinking, oh my God, everyone else in Year 12 knows what they're doing and I've got no idea. Nothing just had clicked. And she just very sort of flippantly said have you thought about nursing? I think you'd make a great nurse.
Speaker 2And it was just like the, you know the angels singing, the light shining on us. You know the, you know time stood still and I've just gone. Oh, my gosh, had not even crossed my mind. It's like thanks for not helping without careers counsellors. So I think there's a lack of any kind of careers guidance at school. I just think, wow, no, I hadn't even contemplated it. So thanks to my mum um, who, you know, I I thank at every opportunity. So it was just she planted the seed and then the rest is history.
Speaker 3So going on, that, was there nurses in your family or anything was there.
Speaker 2No, I didn't have no one sort of in the healthcare sector. Really, in my family I had a cousin who I'd sort of developed sort of more of a relationship or you know sort of reconnected with a cousin up in Queensland who was an emergency nurse, and other than that no other nurses. Oh, my grandfather on my dad's side was a volunteer with St John's Ambulance back in the day and I think, you know, had he been alive, you know, when I was stepping through you know nursing studies, we probably would have found some common ground. But other than that I sort of had no one in the family who was medical or healthcare nursing.
Speaker 3So tell us about your journey from there. So what sort of nursing have you done? Where did you? Oh my gosh, it's quite fascinating, it's quite fascinating what you've done, I'll rip through 31 years.
Speaker 2So so I did my uh. So I finished my nursing degree, which you know just gives you all the theory and the and the license to you know, to get to gain, you know, experience and consolidate all that. And I did that year, or my graduate year at heidelberg repat, which, over in heidelberg, so it had just gone from, it was just shifting from Commonwealth funded hospital to state funded and then amalgamated with the Austin. So that was sort of quite a pivotal year and I think they just celebrated the 50 years of the hospital's beginning. So they're sort of hospital celebration of 50 years, which was obviously, you know, veteran hospital. They even wrote a book. You know Life on the Duck Boards, you know, with the old sort of blue outhouses, you know, at the heart of a group hat Anyway. So it was a fantastic foundational year. I reflect on it a lot and I was just very fortunate. It was just a time and space beginning that I thoroughly embraced. I went. Obviously that was back then when only 20 nurses were offered a graduate year at that hospital. I was lucky to be one of those. At the end of that year only two nurses got offered full-time positions and I was not one of those and that was okay. So I then hit the papers, as you did back then, to look for jobs and in the newspaper I saw that there was a job going in Port Hedland up in the Pilbara in the Northwest, and there was also some jobs in Townsville and I thought, oh, I've got a cousin up there in the Pilbara, I'm just going to apply. So I got the job and very quickly I was employed there remotely, flew over to Perth, perth up to Port Hedland, and I was there for two years. So I went straight from Melbourne to the Pilbara and completely immersed myself in the indigenous culture and was at the Port Hedland Regional Hospital for two years and loved every second of it. So I went from there.
Speaker 2I then came back to Melbourne. I did a year at Cabrini in cardiothoracics. I rang the nurse unit manager and I said oh, listen, I'm interested. She rang me back and said hey, just come in for a cuppa and a chat, we'll walk around the unit. And I thought, wow, you never get that opportunity. Normally you just have to blindly trust that. You hand your CV and you go in for an interview and then you don't ever really get to go and have a look-see around on a unit. But Annette O'Leary was the nurse unit manager at the time and she was a Western Australian girl. So when she had heard that I'd gone from Melbourne to Port Hedland and stayed there for two years which was very unusual it was quite a transient sort of town and nurses only never really sort of stayed longer than three or six months. So I think she straight off sort of saw the value and probably the skill set that I came back with as a critical thinker and she said look, anyone that can handle being up in that kind of environment for two years is welcome on my unit. So that look-see around the unit turned into an interview which turned into a congratulations, you've got the job. When can you start? I was there for 12 months.
Nursing Journey from Hospital to Outback
Speaker 2I got itchy feet and after that I packed up my little Hyundai and drove up north to Townsville and I was up there and stayed on the floor of a friend's place for I don't know five weeks, seven weeks. I bought my first flat as a young, oh, I think, 20,. What was I? 23, 24-year-old renovated a flat, moved into the flat there, just sort of on Ayr Street, the Strand near the original Townsville General Hospital. It's now sort of out near the university and I got a job. I walked up to the. I didn't have a job to go to, but I knew that. That was back in the day where you just walked in and just hey, I'm in Townsville, I'm a nurse, I'm up from Melbourne, where do you need staff? She said, well, I need staff in the paediatric unit. So there I went. So I was there at Townsville General on the paediatric unit, ended up consolidating that experience as a clinical nurse, specialist in paediatrics. I was there for three years.
Speaker 2I then came back to Melbourne After three years. Mum had cancer. She ended up sort of quite quickly having a kidney out and then just made a full recovery and is, you know, is 82 this year. So. But she developed cancer and so I thought, oh, that sort of expedited my thoughts around, maybe my time here sort of at Townsville sort of ending I'm sort of getting itchy feet to sort of move on somewhere. So that sort of process got spread up a bit.
Speaker 2But I came back to Melbourne, sort of was wearing multiple hats, you know, as the daughter, as the nurse, as the carer and all that sort of stuff, you know, when you're looking for looking after a parent who you know needed that kind of care. Dad wasn't coping particularly well with that and that diagnosis at the time, so I was kind of it, so moved back home for a bit, moved out, did some agency work, realised wow, melbourne's really changed in just a few years. You know there's a northern hospital out near Epping that had been built and I was doing some agency and I was getting called. I was getting lots of shifts out that way. I was living in the family home that mum and dad still live in in Lower Templestowe and it wasn't that far to travel. So I headed out to, I was doing lots of agency work but I was getting more and more shifts out in the emergency department, in the paediatric section of the emergency department, because lots of nurses, you know, didn't particularly wanted to do the paediatric section in the emergency department.
Speaker 2So, long story short, I got offered a full-time job. So as an agency nurse I sort of got asked into the office and I thought, oh my gosh, what have I done? And in fact it was to be offered a contract, which was great. And then I was in the emergency department for 10, 11 years I did postgraduate emergency nursing studies Can.
Speaker 3I just stop you there, because one of my friends that I made many, many, many years ago I worked for the sudden infant death research foundation and I used to do lectures to staff dealing with families uh, who, uh, whose baby had died? And, um, one of the nurses there, the head of the, the nursery nurse, she, she, at the children's hospital said to me she's never having children. After seeing all the things, did that affect your decision to have children, realising how many things can go wrong?
Speaker 2Oh, absolutely. Actually, when I was pregnant, I know, when I was pregnant with my first, I remember heading out on a lunch break and I was in the back tea room and in fact one of our emergency department consultants at the time, absolutely gorgeous woman. She actually had a background, her skill set was obstetrics, and she just very casually said, you know, how are you going, how are you feeling? Said, you know, how are you going, how are you feeling. And I've just gone.
Speaker 2You know, I actually just hit this wall with anxiety of all the things that can go wrong, because you know, you just you know a little bit more than you know the rest of the population and you just get focused on all the stuff that can go wrong. So, and she just gave me a piece of advice and helped me, sort of just reassure me that you know all would be fine and anyway. So it was actually very real in that first pregnancy. You know it was a very quick delivery and things like that. And then the second one, you know, was not so quick, but I have an inherent I don't catastrophize, I'm very sort of quite pragmatic, I guess.
Speaker 2So I was not one. For, you know, matching curtains and bottles of wine and you can have your partner stay and have sort of you know, private rooms. I was sort of, I guess, because of my background, I opted for public hospitals and I was very grateful because I needed, you know all of that in my second pregnancy, when I sort of had a postpartum, a massive postpartum hemorrhage and nearly sort of not quite you know all of that, in my second pregnancy, when I sort of had a massive postpartum hemorrhage and nearly sort of not quite, you know, never sort of quite made it. So I relied on the 24-hour theatre surgeons and the special care nursery for the second one. So I was very grateful. So you had two healthy children.
Speaker 2Two healthy children, two healthy children which I, you know very, very grateful. So you had two healthy children, Two healthy children, two healthy children which I, you know, very, very grateful for. So, yeah, but the little bit of knowledge. It is hard in that position where you know, especially with the paediatric background and emergency nursing background and all the things that can go wrong, that you do see go wrong, and all the tragedy, and it is hard, it is hard.
Speaker 3Some people who listen to this will know, and others may not, that I run the Rebecca Jane Foundation and we pay for the funerals of babies when parents can't afford to do so, and so, unfortunately, I only hear about the babies that die right. So when anyone I know is pregnant, I'm ultra paranoid because I don't hear about the thousands of babies that are born healthy every day. Yeah, I only hear about the ones that died, you know, and and it does kind of like it just warps your view on on whether you know, because you know that the myriad of things that can go wrong and do go wrong, but in the context of You've had lived experience.
Speaker 2You've had lived experience of when it doesn't go well. That's right, yeah.
Speaker 3So again, for those that don't know, my daughter, rebecca Jane, died when she was nearly 10 months old of what we then called cot death. It's now called sudden infant death syndrome, but it's that sort of like you know. So then I worry about them once they're home, you know. Until they're walking. I'm kind of like the you know, the person that you don't want to know. Anyway, we have progressed again, so let's go back to what you did after paediatrics.
Speaker 2So paediatrics. So I ended up in the emergency department for about 11 years. I was a single parent at the time and I left a toxic relationship and married and I was on my own. And then, when I knew that my son was about to start school and the 10 months leading up to that, I'm like, oh gosh, how am I going to get before school care? Gosh, how am I going to get before school care? It's all great when they're at daycare and you can drop them off at 6.30 and gun it to the emergency department and fly through the door at 7 o'clock. But when before school care and I only started at 7, I thought, wow, maybe I need to be looking outside of. This system is not going to adapt to my needs so fast forward. I ended up in the community. So, despite my efforts to get management to come to the party. You know the world of shift work. You know for nursing. You know there was going to be no exception. You know for Kelly.
Speaker 2So I didn't fit into that system. So I reached out to the community. So I went on and did my nurse immuniser certification when I was when my second child was born in 2006. And I thought I'll just do this through La Trobe Uni. It might open up some doors, you know, and of course it did. So I did some nurse immuniser work and a whole bunch of other things. I did some trauma research. I did some nurse immuniser work you do all the things that you do to keep a roof over your head and feed your kids and things like that.
Speaker 2And I started doing some community nursing and got into some case managing and then also just some normal hands-on client-facing home nursing work. So I have done prison work, which is considered sort of primary health, so anything outside of a hospital is called primary health care. So GPs, home nursing, community health, prison schools, things like that. But I did help roll out a vaccination program in a lot of the prisons in Victoria. And then I just sort of was doing some palliative care, community palliative care, and I was seeing that even sort of some of the palliative care services were not affording people the time that they deserved it was. You know, you're sitting in front of a laptop, you're punching in all these KPIs and all this data and the essence of what I felt the essence of nursing and communication and listening and meeting people where they're at was even getting lost in that sort of scenario. So I'd floated the idea, probably seven years prior to turning a private nursing business, which was just myself, into a company in 2020, I floated the idea of starting my own nursing service, sort of probably in 2013.
Speaker 2And then I didn't quite have that confidence. I sort of lacked, probably the confidence you know, reflecting on the. You know, do I know enough, am I good enough? The whole imposter syndrome, yeah, the whole imposter syndrome, 100%. So I just thought, you know, am I going to be believable? Do I have enough integrity, do I have the skill set? And then anyway. So I had a bit of a false start with that. So I thought, no, I'll just keep accumulating some experience and some diverse skills and knowledge.
Speaker 2I did lots of extra sort of studies on the side and then I dropped the hammer in January 2020 when I decided, no, if I don't do it now, I'm never going to do it. So I just backed myself in January 2020 and turned sort of that sole trader private little business into a company. And yeah, we're five and a half years in now and the rest is history. So I've spent probably 15 years in the community now 15 years at a hospital based and the people that I've got on the team now.
Speaker 2So what started as just a Kelly is the only nurse I've now got 24 nurses and we just have this collective team of amazing skills from continence, respiratory, palliative, age care, dementia, wound care Amazing, just amazing. So, and I think our service is different in that's nurse-led, it's nurse-driven. I jump on the road, as I did this week when we either don't have a nurse in that area or just to help out the team as well. As much as I'm sort of driving clinical operations and driving the business, I'm on the road as well. So I think there's a team that appreciates that. You get, you know, you understand all the challenges as well.
Speaker 3Yeah, In essence, you're getting your hands dirty, right. Yeah, you're in amongst it. You're not just sitting back and you know going. This is what should happen. It's keeping and I think you know it's a sad fact that a lot of managers, once they go up the line, fail to ever kind of keep their hand in on what happens on the day-to-day basis type stuff.
Speaker 2Which is the business, like your nurses at that primary interface, they are the face of your business. Yeah, so you know I, they are the face of your business. Yeah. So, you know, I'm still that face of the business too, but less so because I have this amazing team that I trust you know to act on. You know act with the same values.
Navigating Motherhood as an Emergency Nurse
Speaker 3Yeah. So tell me what people's reactions are to you when you talk about being involved in palliative care. Like, how do people respond to that? Because I mean, as soon as I say I work in the funeral industry, you kind of get one of three responses. You get the I don't want to talk about this type thing or the questions or the sharing of experience that they've just recently lost someone and they know that you are willing to listen to them. So how do people react to you in that sort of in a nursing capacity of working with palliative care patients?
Speaker 2So, look, there is always that, you know, varied response. So people that have had some kind of exposure. They'll often say, oh wow, you know, when dad died, you know we couldn't think you know more highly of the nurses that sort of came and helped us. We couldn't have done it without them and they've had that lived experience. Others will automatically say, oh wow, take my hat off to you, I don't know if I could ever do that and that's, you know, for me that's just horses for courses, like you know people.
Speaker 2There's people that could never be a funeral celebrant or yeah, so and it's I mean, but someone has to do those jobs right, whether it's, you know, the mortician or the celebrant or the, you know the nurse that goes in to do a verification of death at home.
Speaker 2You know we might want to talk about, you know there's misunderstanding around that and people call triple O and then police get involved and it just is disastrous, but anyway. But I think health services and Ambulance Victoria are getting better at managing palliative and end-of-life care for end-of-life patients or patients that have died in the community, that there has been significant improvements in communications there, largely with ambulance or AV. Members that were nurses, have a nursing background that have then transferred that knowledge and skill into their role at Ambulance Victoria, skill into their role at Ambulance Victoria. So other responses I think, oh, look, you know, there's a generation that just don't want to go and talk about death. They can just either just be too confronting or a bit too real with their own sort of mortality. So, and yeah, people just there's, but on the whole there's a lot of people that just aren't comfortable talking about it.
Speaker 2So, look, I've got friends and family that just think that's all they do is palliative nursing. I'm like, no, that's just, that's not. They just think, oh, it's just palliative nursing. No, that was a big part of, you know, the first year and a half of the business. We, of course, we were all navigating COVID and that's you know. I was getting those calls to beg, you know me to bring families out of hospital and home to die, which was incredible.
Speaker 3But yeah, I think there is generally still a discomfort in the community talking about palliative, absolutely in the community talking about palliative Absolutely so and people always think of palliative care in a hospital or hospice as a place that you only go to at the end. Can you explain about that and what else happens, rather than it just being the place to go to die?
Speaker 2Oh look, I think we have a fantastic palliative care services in Victoria and in our country as a whole, where I mean we have centralised bodies that help sort of govern guidelines. But I'll talk probably locally, like even with the Olivia Newton-John palliative unit. They're on Ward 8 attached to the Austin Look their palliative care unit. There is not just the place that you go to die, it's not just the place where you know you're getting transported unconscious or you know very nearing the end, it is also a place to have some respite. If family aren't sort of, if they're a little bit burnt out at home, they can actually choose to have an elective sort of respite admission where they can just go and give the family like a bit of a break. But also if they've got any symptoms that they're experiencing and they're not quite getting on top of the and they're not feeling sort of stable or comfortable with the management at home, they can go in there for symptom management yeah, I think.
Building a Private Nursing Company
Speaker 3I think that's one of the the fallacies that that is out there, that you only go into palliative care at the very end and, and you know, they don't realize that. You know, I've had a few people go through, uh, the onj center and just gone in for pain management or whatever. Many people express the wish to die at home. What do you think is the reality of that for most? Is it doable for most people, or is it, you know, just something that can't always happen.
Speaker 2I think that there is still. It's a financial divider. So there's still the although that's about to change for people over the age of 65 who are under the my Aged Care, a home care package if they qualify. But for people stoically, if they cannot afford a nursing service to help or they haven't got the financial means for extra support at home, then going into aged care or palliative care is the only option.
Speaker 2So, going back a step though Robin, people's definition of palliative is for the most part can mean that someone's dying, when in fact you know that is not the definition of palliative. Palliative is just, you know, something is a medical or a disease process that is not curable and is life limiting. So a lot of people just think if you're palliative you're actively dying, and that is not correct. So there is seeing far more language differentiation, sort of on social media and in the literature. That separates very clearly, you know, palliative and end-of-life care. So just, you know, I come across that a lot Just because someone's palliative doesn't mean they're actively dying. So sorry, what were we talking about?
Speaker 3So for me personally, I want to go into palliative care. Yeah, I have seen because I've done it, you know, with my own mother at home and you know the burden of looking after someone 24-7,. People just underestimate how much time and energy that's going to take from you. And if you don't get a break, you know I had a sister who came once a week on a Saturday for a few hours and gave me a break. You know I was. I had a sister who came once a week on a Saturday for a few hours and gave me a break.
Speaker 3But if you don't, if you don't have that break, and what people don't realize is that if you're in hospice care or in hospice or wherever you are, you know you've got three shifts of people looking after you, not just one person. Yeah, I think that's a really big thing. The other thing for me is that you know usually it requires a hospital bed and normally that goes in the first room that comes in because they're large and your bedroom's not made up for that and all that sort of stuff. And for me personally, I don't want my husband to come into the house and for that to be the first thing that he sees after I'm gone, that that is the place that I died. Now that's a purely personal thing for me, but my mother-in-law went to a place in Queensland and I think from memory it's called Hopewell Hospice. This magnificent oldice, yeah, this magnificent old house. Yeah.
Speaker 3A big old mansion. Yeah, I know. Nobody wore uniforms, yeah, and things like you know meals and stuff like that. Instead of having this you know piece of paper that you had to fill out or whatever you know, the person in the kitchen would come in and say hey, Pat, what do you feel like today?
Speaker 3Would, you like me to make you some scrambled eggs or would you like me to make you? You know you name something, I'll see whether I can make it for you. And her stay at that place and she was a long resident at two weeks, because primarily that one is just for driving, yeah and so she became kind of quite well known in the place and her last two weeks were absolutely beautiful, Beautiful. I just said to my husband shove me off to Queensland.
Speaker 2Look me in. That's where I'm going. I know that's where I'm going I know that's where.
Speaker 3So has this changed your perception of what you would like at your end of life, all of this work?
Understanding Palliative Care Misconceptions
Speaker 2I don't know yet. I actually haven't, I haven't decided. All I know is that I want to leave a legacy of just how it's getting done and it needs to get. It needs to be done better. So I know that, look, there is some organizations out there, one in particular, it's actually called end of life essentials and that is an organization that is dedicated to educating hospitals, the hospital environment on how to manage, how to recognise when someone's dying, the language, and so there's organisations that are like End of Life Essentials are doing amazing work out there to help do better with connecting with families and people that are dying and the language and the communication and the conversations, and like hats off to them. I think that you know there needs to be clearer conversations around what the community support looks like. We have all over Melbourne. We have patches that you know geographically sort of patches and areas of Melbourne that services will look after. So you've got South East Palliall Care, eastern Palliative Care, banksia Palliative Care and Melbourne City Mission, can you?
Speaker 3just stop there. Can you explain what their role is and what they do?
Speaker 2So they are government funded, so they are not-for-profit services that everyone is entitled to in the community to actually have. You can self-refer or ask someone to refer you to, even if you're coming out of hospital, your GP, or you can just get on the website and ring them yourself and you can ask to be on their service. And what their service provides is a consultative service. They'll have nurses, they'll have social work, psychosocial supports and most of them will have palliative physicians. And it is a free service but it is consultative, so they don't do the hands-on nursing care. It is predominantly symptom management.
Speaker 2So it's, you know, this is your diagnosis. Where are you at with that? How are you managing? And there is like a palliative care outcome sort of scales and scores that we use. This is like the seven or nine sort of top main common symptoms that we then sort of assess. And, oh, this is what these services use. And so the missing gap here for people who really want to be looked after at home or stay at home it's their wish. Doesn't always work out that way, but their wish is to stay at home. Often they can have a palliative care service come in. They get referred to a palliative care service. Um, but the miss, the, the, the mismatch here is the expectation that they're going to come in and help look after this person and, as you say, it's a 24-7 gig. It's the, you know symptoms.
Speaker 3I thought someone would help me bathe her and things like that, you know, and I just I had no idea that that would still all fall on me and that we would get our, and at that time it was a 20-minute allocation, that's all that had to end with me and I so desperately needed to talk to someone after being on the phone for 23 hours with her.
Speaker 2And it's exhausting. And this is before, you know, they've started before someone's actually taken that sort of terminal phase, entered that terminal phase where they are truly 24-7, where you are attending to their pressure area care because they are now unconscious and they're in that real sort of active, sort of dying terminal phase which you think, oh gosh, you know, where am I going to get energy for that? And then, and then, and then someone dies and then all the energy that's, you know, needed for the next stage and then the, the service stage, it's, it's exhausting, it's absolutely exhausting. So having these, these conversations, you know, are missing and we need to do better at helping to support people with what's coming next and what to expect. But coming back to the funding part, I guess in the latest election the government has recognised this, thanks to, you know, people like you know Ged Kearney, who's got the house for Cooper, who was, you know, part of the. She was a president of the ANMF and she, you know, with her nursing background, is really sort of trying to bring to light some of these gaps in the community that are needed, and palliative care is one of them. So they're, you know, they have promised that people will get like a bolus of like $25,000 to help support someone who might be at that sort of end stage, don't want to go into a palliative care unit or aged care facility, but need $25,000 to provide maybe 24-7, round-the-clock care so that families can just be, families show up as family members and not as the carers and the support and the nurses and the bed washers and the carers and the support and the nurses and the bed washers and the bed makers and the getting your, because it's multiple hats, as you know, and it's exhausting, absolutely exhausting. So there's also carers carer gateway. So there is a carer gateway that people can also register with. And this is in Victoria, victoria, so it's going to be different for different states, but in Victoria there's the carer gateway which they can go and request some respite so they can get some funding for some respite, and it might be that, you know, it might be the overnight respite, respite that they need so they can get a bloody good sleep, so then they can show up and be the carer during the day. So that's very much.
Speaker 2What we see is that carer burnout. So at the moment, if you don't have a home care package under the MyAgeCare system, if you're over 65 in this situation and look, we've looked after many people with a palliative diagnosis and end-of-life care at home who have been as young as 26. I've even helped palliate someone at home, a 10-year-old. So you know there is very much a need for that. People look, pre-covid, the numbers were sitting at 70%. Pre-covid, the numbers were sitting at 70%. According to Palliative Care Australia, the statistics on people's wishes to stay at home and to die at home were sitting at 70%. Now I had conversations, probably a few weeks ago with a bit of a network meeting, and those numbers are sitting on about 85% at the moment of the people that choose to stay at home to die. So look, there's still that. You know the financial cost starts and the potential to be looking after and doing more for people at home is huge.
Speaker 3How do you stay emotionally resilient and maintain a healthy work-life balance in this?
End-of-Life Care at Home: Reality and Challenges
Speaker 2field. Oh, wow, great question. So we often get asked you know how do nurses sort of express their emotions or how do they disconnect you know? Well, you don't ever. You actually, you know we're all humans, you know we're people, we're mums, we're sisters, we're daughters, we're sisters, we're daughters, we're. You know all of that as well, as you know a working hat and our role, you know, as a job. So I think we harden, don't they? Yeah, that's right, and I think the older you get, robyn, I think you give yourself permission as well and you're more comfortable within yourself and it's okay to share emotion. I've sat with many a client, probably in the last five years, and just sat there in a space of tears and showed them that you're a human, yeah, and it's okay to say I don't know the answer to's okay to say I don't know the answer to that yeah.
Speaker 2I don't know the answer to that and I think it's more about just holding the space and being human with them. Um, and it's it's not about what you do for someone, but it's about you know, as you know, it's about how you leave them feeling. I just felt that safe in that space for them to just shed tears. And I'm going to say it's a lot of the time it's the men who sort of sit there and try and stifle down the tears or the emotion, and sometimes you literally just have to reach across the coffee table or sit next to them on the couch and just hold their hand and just say that's okay, I've got you, that's okay, I've got you, and just hold the space. And that's where you know you're not saving lives in the trauma resource, you know, in the emergency department, which you know most of us have had that sort of that hash. You know, on the team, they've sort of you know, been in that sort of role. You are showing up for them in their hour of need and holding the space.
Speaker 2So, and I think the resilience, I think I'm not sure if it's about resilience I think there's, I think there needs to be a healthy balance and I think it comes down to how you view death yourself and how comfortable you are with it. Yeah, so I think if you're not comfortable with it, then it's probably going to translate as it not really being your skill set. You know, yeah, and that's the thing. I think I've found that that is very much my skill set. I know that most of our team it's very much their skill set because, you know, the nurses that we have on our team sort of have, you know, at least 10, 15 years' worth of nursing and they've had some life experience and it's all about relationships with people and it's being okay just to sit there and hold the space. Again, it's, you know, it's meeting people where they're at and being emotional is okay. Yeah, for sure it's. Being emotional is okay. I can, for sure being emotional is okay.
Emotional Resilience in End-of-Life Care
Speaker 3I can't believe how quickly this time has gone and through my in case, people caught a little bit of a cough here and there. I do have the dreaded loogie at the moment and I think we could go on and talk for another two hours. Kelly, Such a fascinating area. Okay, to wrap up our sessions, as a big fan of the Actors Studio, I'm going to take a leaf from their book and ask a series of questions to each of our guests. So what is your favourite word and why?
Speaker 2Oh, my favourite word, authentic. And why. I think authenticity is the comfort of being the acceptance of who you are and what you can give and how you give it, of who you are and what you can give and how you give it. And I think it's that natural state of us being ourselves, our true selves, and when you're with someone who's authentic, people pick up on that and it gives them permission to be real.
Speaker 2What is the thing you're most grateful for in your life? Oh gosh, so many things. It's a daily gratitude. Oh my gosh, that's really hard to narrow it down to one. I'm going to say where I'm at in this very moment my health and everything that has led me to here, the now.
Speaker 3If you could work in any other role other than what you do now, what would it be?
Speaker 2do now? What would it be? Uh, I can't think. Um, I I just feel so fortunate to have found an avenue where I could express everything that I have to give. I just feel like every day is a day that I get to be of service and I feel like I am absolutely living my life on purpose. I struggle to think outside of that, other than the massive potential and the legacy that I have to leave, which is raising the standard and educating the next generation of nurses. So whether that I step away in the next I don't know five, six, seven years as a silent director and become more of a mentor, I think that's where I'll be guided as sort of a mentor in the field. But for the moment, I'm living my life as I on purpose. I feel like I'm absolutely where I need to be.
Speaker 3What is the sound that you love the most? Water, the ocean.
Quick-Fire Questions and Closing Thoughts
Speaker 2If you could have dinner with one person, living or dead, who would it be? Oh gosh, I've thought about this because someone else has asked me this before. I am going to say my grandfather that I never got to meet my Scottish grandfather. He died before I was born.
Speaker 3Okay, what do you think is the most important lesson you've learnt in your life so far?
Speaker 2My most important lesson I'm stronger than I realise.
Speaker 3And directly from the Actors Studio. If there is a heaven, what would you want God to say to you when you're met at the pearly gates?
Speaker 2Thank you Excellent.
Speaker 3Thank you so much for your time. Kelly Watts, what can I call you? The dying person's Florence Nightingale? As we wrap up this podcast, if you have a question you'd like to ask or any other related occupation you'd like to learn about, please drop an email to ask at ladyofdeathcomau and we will look at possibly doing a podcast of the questions that you've always wanted to know but never knew or were game enough to ask. This is robin o'connell, the lady of death, whose philosophy is organizing your final farewell is not about wanting to die. It's about wanting to reflect who you really are in your goodbye.