Hospice Uncovered
All about hospice
Hospice Uncovered
Disease Progression & The Hard Conversations: When It's Time for Hospice
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Rachel and Shanna dive deep into recognizing the subtle signs that a loved one may be ready for hospice care. They discuss concrete indicators of disease progression—altered mental status, increased hospitalizations, mobility decline, urinary tract infections, and loss of independence in activities of daily living—that families often miss or ignore. The hosts emphasize that these conversations must happen early and honestly, before a medical crisis forces rushed decisions. Through real patient stories, including a terminal patient struggling at home after leaving a care facility, Rachel and Shanna explore the guilt, avoidance, and difficult dynamics families face when safety must take precedence over a loved one's desire for independence. They stress that families shouldn't wait to seek help, introduce upcoming expert guests who can guide listeners through Medicaid, Medicare, financial planning, and medical power of attorney, and paint a vision of generational healing through open end-of-life discussions.
00:00 Opening Grounding & Welcome
02:34 Disease Progression: Understanding the Indicators
04:18 Altered Mental Status as a Key Warning Sign
05:12 Hospitalizations, Falls & Mobility Decline
06:22 UTIs, ADLs & Activities of Daily Living
07:48 Recognizing Subtle Progression Over Time
08:45 Having Honest Conversations Early
10:12 Good Days vs. Bad Days: Avoiding Rose-Colored Glasses
12:05 Guilt, Avoidance & Family Dynamics
14:22 Real Patient Story: The Dangers of Going Home Too Soon
17:30 Safety Must Take Precedence Over Independence
19:15 Capacity, Medical Power of Attorney & Difficult Decisions
20:45 Don't Wait—Avoid Turning Problems Into Crises
22:30 Upcoming Expert Resources: Medicaid, Medicare & Financial Planning
24:50 You Don't Have to Do This Alone
26:15 Generational Healing Through End-of-Life Conversations
27:45 Closing Thoughts on Peace & Legacy
We just know that, like, it's gonna be a hard conversation. Hey, we don't think you should be driving anymore. Hey, probably shouldn't be cooking in the kitchen with fire on your own anymore. Like, I've noticed you're forgetting to turn off the stove. Um, you're putting things in the microwave for 35 minutes.
SPEAKER_05Wait, wait, I keep it in 35 seconds. And so now conversations have to change where now that loved one has to be more of a parent figure.
SPEAKER_02Um be able to tell them actually more than one thing because we're not talking about the money, we're talking about living.
SPEAKER_00That's what it is. It's living with intention.
SPEAKER_05Hi, Rachel.
SPEAKER_02Hi, shall I? Ready for another podcast? Ready, ready for another compassionate conversation. Absolutely. So ready. Ready to ground? Let's ground. Okay. Everybody join us feet flat on the floor. Sit up straight. Bring dignity and honor to your spine. Pull your shoulders up. As you take a deep breath in, and then drop your shoulders down into your back pockets essentially. Open up your heart center. We are sharing our open heart with the world. We're meeting today heart to heart. Take some smooth inhales and some cleansing exhales.
SPEAKER_06Deep breath in.
SPEAKER_02Breathe in trust. Breathe in power. Exhale fear. Exhale self-doubt. And as you take your next deep breath in, think about your purpose, why you're here on this earth, and how much you matter. How much your voice matters, how much your thoughts and your creativity and your uniqueness you matter. Exhale, exhale all the stress, all the anxiety, all the worry, all the doubt. Exhale it all out. Make room for fresh, new inhalation. Final deep breath in. Breathe in, breathe in, breathe in. Take one more sip of air at the top. Hold it, hold it, hold it. And exhale slowly and smoothly. Push your air out down the bottom of your feet through your shoes into the ground. Connect with the earth. Breathe all your air out. Now breathe normally. Open your eyes and meet us right here. We're ready. Ready to connect. We're ready. Yeah. So, Shauna, we get to talk more about life and living and the end of life, which each one of us will face in our time here. Yeah.
SPEAKER_05Let's talk about decisions that will change everything. Okay. Understanding disease progression and when it's time for hospice. Okay. What do you think about that? Disease progression and disease progression. Do you mean like indicators? Yeah. Indicators. Okay. Um, how what would be a good indicator to know that your family member is ready for hospice? I think in the United States we keep everything so medical and we're waiting for a doctor to tell us. So true. Yeah. But there's opportunities for family members and to really identify some of that progression. Yeah.
SPEAKER_02So my wisdom tells me if my loved one starts to have altered mental status, like I know they're not functioning, thinking the way that they, the way that I know that they have been thinking, decision making, articulating, communicating, like when I see that their disease is bringing them to a different place, an altered mental status.
SPEAKER_05Yeah. Another one is more hospitalizations. And then doctors not being able to do anything for them. Yeah. Um, maybe they have more falls at home or more broken bones. Those are some good indicators. Not good indicators. But those are some indicators. Right.
SPEAKER_02Um, I would say urinary tract infections, especially people who are elderly, uh, urinary tract infections start to increase because they decrease their mobility. They really don't want to have to get up to go pee. And so subconsciously, they just stop drinking as much water, and that bacteria can cause UTIs. Yeah.
SPEAKER_05So that's You mentioned mobility. That's another one. They're not as mobile as they once were. Maybe they're more reliant on a family member or caregiver to be able to get them out of bed. Maybe they need more assistance, you know, using the restroom or taking a shower, that sort of thing.
unknownYeah.
SPEAKER_05Even simple things like combing their hair or brushing their teeth.
SPEAKER_02Um we call those ADLs, activities of daily living. So when activities of daily living, when they're not able to perform those independently, one or two or three or more of those, and you notice that, that's uh that's an indicator. Yeah, that they could use some home health care or some hospice.
SPEAKER_05So I think a good point is that the progression sometimes is not all of a sudden, like it's a it could be subtle, and just making sure that you realize those subtleties.
SPEAKER_06Yeah.
SPEAKER_02Best way to broach that with the person that we're concerned about. My ideas are honesty, honesty and connection, and don't wait. As soon as we start to notice, be honest. I know in my family, uh, you know, we have tended to like talk about each other behind each other's backs, not in a gossipy, malicious way, but just out of concern. Like, hey, mom's head is shaking. Do you see that? Like, what do you think is wrong with her? And so much better to really connect one-on-one and say, like, hey, are you feeling okay? Yeah. And um, because that's really gonna help us understand better what's what's happening.
SPEAKER_05I think too that when family's involved or anybody's involved, like bad good days can be misleading. Yeah. And so it's really being honest about bad days um or bad moments, you know, things that they see in that progression. That's a great point. Yeah.
SPEAKER_00Yeah.
SPEAKER_05And just because, you know, they, yeah, we're all hopeful. Like we want, we want our family members to have good days every day constantly. And so um they tend to capsize on a really good day in a moment of like seven bad days. Yeah. What is that? Is that the avoiding pain? Oh, absolutely. Yeah, I mean, I'll speak for myself, is would be avoiding pain, avoiding guilt, you know, maybe feeling guilty. Oh, yeah. Yeah. Not avoiding guilt.
SPEAKER_02Well, I don't know. Yeah. Because at that point, we don't live with it. Guilty nine times out of ten, we're not living with our loved one, our parent, our family member. And yeah, I can see how guilt is a is a part of that.
unknownYeah.
SPEAKER_02Probably subconsciously, these are things that we don't aren't even really thinking through. We just know that like it's gonna be a hard conversation. Hey, we don't think you should be driving anymore. Hey, probably shouldn't be cooking in the kitchen with fire on your own anymore. Like I've noticed you're forgetting to turn off the stove. Um, you're putting things in the microwave for 35 minutes instead of 35 seconds.
SPEAKER_05Yeah, I'll give you a good um, I can tell you a little story. So we have a patient that um is terminal, went to a care home, got phenomenal care, got back up and going, started ambulating more, not completely on his own, yeah, but ambulating more. Um, definite medication management. He was being cared for, yeah. Truly cared for. And he didn't want to be in that care home any longer. And so he decided to go home. Well, he's been home now for a week, and you talk about the conversation. I had to have a conversation um with his loved one, letting him know like he can't do this on his own anymore. He's falling, he has scrapes and bruises. He's only been there for a week. Scrapes, bruises all over his arms and his body on his head. Um, even though, yes, we've bathed him. He you just you you see the decline, you know. Um I expressed that I was worried, like he says he's eating, but do we really know? Like, we know he's eating when we get there because we're able to prepare something for him. Um, but what happens the rest of the day? Right. You know, and so um hard conversation to have with a loved one. But the loved one realized, yeah, but he can't make that decision on his own any longer. And so we're gonna meet hopefully today or tomorrow, yeah, and come up with another game plan. Right. Um, and unfortunately, where where this patient lives, services are extremely limited. So finding somebody to be in home care for him, it's it's difficult. And we we we move mountains and we can we we find people, but yeah, we haven't been able to.
SPEAKER_02It's the rootless area where he lives. Yeah, and I know where you're talking about. Yeah, and which patient you're talking about. Yeah. So his loved one is there like kind of like that rose colored glasses, like, oh, okay, he's doing better, he's out there, like just kind of hoping for the best.
SPEAKER_05And so I I think on that side, I think that he understands um that he needs a higher level of care. Um, I think part of the frustration from the loved one is that the patient really believes and has that hope that he's gonna be a hundred percent better. And um the loved one's trying to support him in his journey right now. Makes sense. And so the patient was just really adamant about moving. I want to move, I don't want to be here anymore. And so the loved one was in support of that. And so now conversations have to change where now that loved one has to be more of a parent figure and be able to tell him, hey, like this is not okay.
SPEAKER_02You know, yeah, I actually can't support what you're wanting because you being safe is actually a higher priority. For me, yeah.
SPEAKER_05Yeah. So difficult, difficult, hard, hard conversations.
SPEAKER_02Yeah, that's what happened to my granny too. And there is value in people remaining as independent as possible for as long as possible. And when they begin to fall and their heads going into like the ceramic bathtub and they're getting hurt or robbed. My granny was robbed because she just wasn't able to lock her apartment door and keep herself, have that safety awareness. Yeah, I mean, safety must take precedence over that, you know, what they say they want. And altered mental status is often meaning like they're not they don't have really the understanding of what's possible for their body and their mind. Right. At some point, which is why medical power of attorney is a tool that we use. Yeah.
SPEAKER_05So I think what I'd like to like pinpoint to is that families shouldn't wait, they shouldn't avoid. Um, because the longer they avoid, then the problem or potential problem now becomes a crisis. And then, like, wow, we're trying to figure out how we we put out that fire. And the mode of it and the feeling of it, the anxiety and the frustration and all of these negative emotions like build up. And yeah, it it's beyond impactful in a not so good way, a very negative way.
SPEAKER_02Yeah.
SPEAKER_05Yeah.
SPEAKER_02And the family that's trying to make the decisions for the person who's struggling, who's got the disease, like they still have to work and take care of their family, yet all of this is like weighing on them. Oh, and that's what we want to. It's heavy.
SPEAKER_05Yeah, that's what we want to avoid. Yeah. I'm so looking forward to like some future podcasts that we have where we bring in, he is like, his name is Miguel, and he is phenomenal regarding like benefits, Medicaid, and Medicare. Yeah. And he can help talk through that. Uh, we can bring on Antonio, the our social worker, and talk about, you know, financial planning and financial power of attorney and medical power of attorney, right? And funeral planning and all of that, and um just letting people know that they don't have to do this alone. Like you don't have to do this alone. Yeah. What tools and resources are gonna support? Yeah. We want to help you. And the reality is, is if they probably don't know the questions to even ask. Exactly. Yeah.
SPEAKER_02Don't wait. Yeah. Even, you know, my my friends who are they're so wealthy and so successful. They have so many resources at their fingertips. I was on the phone with her the other day, taking a walk outside. We were just having a talk and catch up. And she was like, Hey, you're doing hospice. My mother-in-law is really struggling, you know. And she's like, I just don't even know where to begin. She's in a rehab facility right now. And I described, you know, the social worker's role. And I was like, try to connect with the social worker and ask these questions. She's like, I have.
SPEAKER_05And so it's like, you know, um, you know what, Rachel, I'm more than happy to go in into that rehab facility. They're in, um, I want to say they're in Florida. Yeah, I think they're in Florida. Or, or even we can Zoom or we can FaceTime, whatever the case might be. Like, it's about awareness. Exactly. Um, and giving people the knowledge to be able to make those decisions and to know what questions to ask and what's going to work for their family. Yeah, absolutely. And the more awareness that we can have around hospice and future planning for end-of-life journey, like, oh my gosh, can you imagine the the level of peace that our world could potentially have? And can you imagine the generational healing because people are actually having some conversations that they've been pushing down for so many years?
SPEAKER_00Yeah.
SPEAKER_05Yeah.
SPEAKER_02So, and what a joy or what a gift to our children too in their youth. You know, like my kids are six, eight, and 14. And to start having that talk, like, you know, what what would be your wish when you pass away? What do you, what do you see for your funeral? For who do you think, what what will your family look like, you think, when you die at like 80, 90, 100 years old? And just really start to like let them think out there that this life is to be honored. Every day is a gift. Yeah, every day is absolutely a gift. Any of us could be gone at any moment. And and then especially for my kids to hear what are my wishes, so that when I do leave this world, hopefully before them, they'll know, like, we talked about that. This is what mom would want. Let's honor what mom wanted. You know, and my mom lived her biggest life possible. Like, of course, I want them to feel that kind of like life, you know, appreciation energy too. Like, dang, my mom did this. She exercised, she went on hikes, like she hung out with her friends, she went on girls' weekends, she took care of herself. She always fed us healthy food, she always sat by us when we did our homework. So, like, that's just like the whole, you know, um, all of this coming together and culminating into like a life without regrets.
SPEAKER_05Yeah, life without regrets. And it's like even thinking about your eulogy before it's time and what you want that life to really truly look like and the legacy that you want to leave for not only your children, but your great, great, great, great grandchildren, you know. So now we're not talking about dying, we're talking about living.
SPEAKER_00Yeah, and that's that's what it is. That is what it is. It's living with intention, yeah.
SPEAKER_05Yeah.
unknownYeah.
SPEAKER_05Pretty empowered. I think it would be beyond empowering to write your own eulogy.
SPEAKER_02Okay. So that's our homework. Yeah.
SPEAKER_05So that's our homework for this week and our audience. And you know, like I I'm even sitting here thinking, too, like, there's things I haven't told my children, you know, that I'm avoiding. You know, and I'm pretty sure they see things in me that there's progression, you know. Of course, it's not a terminal progression, but progression in in what I have going on health-wise. And so it's having those conversations early.
SPEAKER_00Yeah.
SPEAKER_05Even though we don't want to, but we need to, you know, I've been doing some research on how other countries um talk about the dying process and the end of life journey. Yeah. What are you learning? Well, I'm learning that we're a little, we're off here in the United States. Like we're avoiding that conversation. We avoid it. And I've been trying to process like, why do we avoid it? Um, but they're so ahead of us. They don't avoid the conversation. Some countries have it completely integrated within their health system, like they have hospice integrated within their health system. So they're talking about it. Um when whenever the the diagnosis, the chronic illness is already diagnosed. Um, they start talking about it. They start planning, you know. Um, it's not a, you know, my my mom has passed away now, what do I do? You know, they they have they have the tools that are in place to make sure that the family is set up when the when when their loved one does die.
SPEAKER_02Um what is the average age like of somebody initiating hospice care in other countries versus the United States?
SPEAKER_05I don't know. I'm gonna look that up too. I'm just curious. Well, we're we're so grounded by the guidelines through Medicare here in the United States. You know, you have to be 65 and have a terminal diagnosis and pass away within six months. Um, that sort of thing. And so it sounds like they they approach it completely different because they're approaching it from a living standpoint.
SPEAKER_00Yeah.
SPEAKER_05Yeah.
SPEAKER_02Um isn't that interesting, Shauna? Here's where my mind goes because we're literally killing ourselves in this country with our with our food, with our poisonous, toxic, ultra-processed food. Oh, sure. And the sugary sodas that our kids are even having, the fruit juices our kids are have, like our kids are unhealthy, less active, more sedentary, their bones aren't even developing well. Like the military is having trouble recruiting enough soldiers because this generation has grown up like couch potato video games, poor nutrition, like malnourished, overfed, malnourished. Like, so we're killing ourselves and our society with our habits big time. Yeah. And let's layer on top of that. We don't want to talk about death and dying and anything that's unpleasant.
SPEAKER_04Yeah.
SPEAKER_02It's this like avoiding pain, comfort society, snowball effect. It's hard.
SPEAKER_05That's a hard combination. So our goal is to change a trajectory and have those conversations early and spread the word that it's. It's not a scary thing. It doesn't need to be avoided. We need to have those conversations now. Like I am creating that checklist. And yeah. I'm gonna have that conversation by the end of this weekend with my children. What will you create? Uh create openness. I believe it's radical compassion so that they're not wondering or thinking you know that they have to come up with solutions. Um I think it will create open communication, connection, an opportunity to have really clearing conversations, positive conversations with them. Um it's not like it's gonna happen tomorrow. But those conversations need to we need to start planning now. What will that open up for your son? Uh I I think initially it probably will be fearful, not wondering or wondering why I'm having a conversation. Um, but my goal, I want to change that. Like if I were to change this, the trajectory of hospice and the word hospice in the world, like I got to change that in my own life. Yeah. And I want to do that. And I I want to start with my kids. And I want to start that planning. And the planning is not gonna happen like overnight, but at least we could start having those conversations, making sure where they know where investments are or all my passwords, you know, or all the accounts. Like this is yeah, like just things that we don't typically think about that our loved one definitely has to know, you know?
SPEAKER_02That's really exciting. I commit to having that conversation with my kids and my husband and my parents as well.
SPEAKER_05Yeah.
SPEAKER_02We all share a home. So I commit to having that conversation in my life as well. Yeah. And then we can talk about it next week.
SPEAKER_05And, you know, it's it's even planning for them, you know, where they can start even, it's not too late, you know, like it's the perfect time for them to start their financial planning, you know. Um, the other thing I want Miguel to talk about is like long-term life insurance policies and things like that, and yeah, how it can impact you and me right now. You know, we're we're at the age where I believe we need to start investing in that in the event that for that rainy day, you know, where we do need 24-hour care.
SPEAKER_00Yeah.
SPEAKER_05Um, so yeah, we're we're gonna be bringing some really good things to this podcast.
SPEAKER_00Yeah.
SPEAKER_05A lot of good information.
SPEAKER_02Um What do your kids think about what you do working in hospice? Do they have any comments or feelings, or what did they say when you first shared within that you want to have a business where you provide hospice care?
SPEAKER_05I'm not real sure what my son thinks. Um I know that he, you know, he's been active, like he's actively volunteered and helped. Um, my children have always been involved in anything that I do, um, professionally or within the community. And so they've always been around um circumstances where like compassion was never an option. And so um I believe that my kids are proud of what I do.
SPEAKER_00Yeah.
SPEAKER_05Yeah. I believe that they know that I do operate off of radical compassion, that I love people and you know, um that I operate fully from my heart. And that's my driver. Yeah, I I believe that they're they would be, they would say that they're proud of me.
unknownYeah.
SPEAKER_02Can I tell you a funny story? Yeah. I was driving my kids to school, elementary school, so it's early in the morning. Um, and my eight-year-old gives my six-year-old a hard time, like all the time. He's always like, Oh, Fisher, you're gonna be late. Uh, you're gonna miss clubs this morning. Uh, you're not gonna get to go. Sorry, buddy. Oh, you're gonna miss library time.
SPEAKER_01Oh, Fisher, it's not good. He's just messing with them constantly the other morning. I go, Declan, have you ever noticed how you're like Mr. Bad News? And he's like, oh really, uh Tony Ferguson. And uh let me just um show you my tonem collection. Um, while you're on hospice before you die, let me show you my tonec collection. Five of them have cooties and two of them have a fungus, and the other one is really special. And I'm gonna read them. What is this guy from? Oh my goodness. So he's, I mean, he just busts out of nowhere. So I don't talk a whole lot about what I do with him, but like this is apparently the toes. He talks about the toes. And he picked up on and was like, oh yeah, well, I'm Tony Ferguson and before you die, can I show you my toenail collection? I was like, okay, little toot. So yeah. I I would love to just hear a little bit more about where their, you know, where their mind is at.
SPEAKER_05I think it's eye-opening. You know, we uh Micah helped us move a patient one day from one bed to the other. And I think it was humbling for him. Yeah. To see it, to experience it. And this patient is a hundred percent bedbound. So no mobility at all. Yeah. And he is solid. I mean, you talk about solid. Yeah. Um, and uh, you know, very tall man. And um yeah, some of the comments that he made was I I can't believe you all do this every day.
SPEAKER_02Micah said that, yeah, yeah.
SPEAKER_05Um and he I believe that he said it in a very endearing way. Um just out of disbelief that that we care for people that way.
SPEAKER_00Yeah, yeah. So sweet.
SPEAKER_02I w I want my kids to honor their life. And I feel like with video games and TV and just constant like stimulation and boom, boom, boom, boom distractions in our society that somebody could easily go through a whole lifetime, at least a whole upbringing where it's not even really spoken about in an open, honest, compassionate way. Like what are your fe what are your fears? You know, what do you dream of in your life? What are the things that you can't wait to do in high school and when you get to college? Like, what do you think you'll be, who do you think you'll be hanging around? Like, you know, what do you want your friend circle to be like? Like just intentional, intentional living.
SPEAKER_05Yeah.
SPEAKER_02Because our life is what we make of it, and it's never too late. So even somebody who's 90, 95 to have that conversation, like, what do you still want to do? And just talking about like having those conversations with our loved ones. Um, I don't know if there was a patient that you and I were talking to, and uh, he was like, we were like, hey, what is your desire for your care? Because we want there, we want to know where they're coming from. Um, and he was like, I want to live to be a hundred. And his family members were like, Well, you should have taken better care of yourself. Like, you're kind of like, you know, like a guilt trip, like it's a little too late now. And my point is, like, sometimes what they want is unreasonable. Right. And we just lovingly be like, okay, here's what's possible. Get you a hundred. A hundred more, a hundred more days. Yeah. Like, and and that all is determined by disease progression and what the doctor's professional opinion is, and knowing, like, we are not God. God gives and takes away life. He's the only one. So, and we want to be reasonable. Yeah. But, you know, if somebody's got dementia, there's also a way to have a conversation with somebody with dementia so that we're not upsetting them. And, you know, and our staff is trained on that too, to be able to guide our patients and families on like, okay, here's how to speak honestly and openly and feel like you're communicating the best plan for their end of life and what uh how everybody's gonna have their needs met and be happy with the plan.
SPEAKER_04Yeah.
SPEAKER_02Um, and not freak out the pa, not have unnecessarily, you know, upsetting conversations. Conversations. Yeah. So there's there's some skill and some finesse to that, but it's always gonna be the intention to be open and honest and everybody be understood.
SPEAKER_05Yeah. So we'll make sure that we have disease progression tips, kind of a list for families um on our website, you know, some tools that they can look at in order to to start asking those questions with their loved ones. Right. And it doesn't mean to be it doesn't have to we don't have to wait. You know, don't wait. Start having those conversations now. Yeah, you know, we could just call those connecting conversations. Yeah, maybe we call it our connection corner online. We'll see.
SPEAKER_02Yeah. More to come. Yeah. A loving list.
unknownYeah.
SPEAKER_02It's exciting. It's exciting to be able to have some guidance as we all want to live our best life.
SPEAKER_05So, some myth busting things that we can talk about is that hospice death isn't immediate. You don't have to avoid the pain. Let's start having those conversations now. Um hospice is how you live in the season now. Right? Right. Can help you live in your current season.
SPEAKER_03Yeah. Intentional.
SPEAKER_05And just because they're on hospice doesn't mean that um it's gonna expedite the death process.
SPEAKER_00Right.
SPEAKER_05Yeah. I mean create comfort and care and take care of their their needs and their necessities.
SPEAKER_02Yeah. We do want to make sure that there is a good diagnosis, though, that there is been a great checkup. Because you know, a lot of people avoid going to the doctor. So we could get somebody who hadn't even seen a medical professional in a long time. And we want to make sure. Um, and we do, I mean, we don't bring anybody onto hospice without them being medically appropriate.
SPEAKER_05And, you know, if somebody doesn't feel comfortable having those conversations with their loved ones and they see our podcast, reach out. Like we will come and meet with you. We will talk to you about disease progression, we will talk to you about medical necessity and diagnosis and caregiving and all of those things, Medicare, Medicaid. We will talk to you. We will help guide you. Um, all you have to do is just reach out, even if you just have questions.
SPEAKER_02Yeah, please like what are the out. What are the main diagnoses for our hospice patients that are on service?
SPEAKER_05Oh, you had to ask me that. So definitely dementia. Yep. Dementia Alzheimer's, COPD, yep, um, end stage renal end stage renal disease, chronic kidney disease, chronic kidney disease, liver failure, liver failure, cancer, cancers, yeah, congestive heart failure. Yeah, congestive heart failure. I think those are those are the main ones. Yeah. Yeah. So that's six. And usually a lot of people have multiple. They have several of those on that list. Some only have one, but some have many of those on that list.
SPEAKER_02What's the average age of our person in our agency that we're treating right now? I would say the average age Well, that's a good question.
SPEAKER_05I'd rather look that up than than guess. But if I were to make a guess, I'd probably say about 75, 80, between 75 and 85, about a 10-year gap. That's probably our average age.
SPEAKER_01Okay.
SPEAKER_05Yeah. But we we have seen quite a few that are about to turn 100.
SPEAKER_02Yeah, I've seen I have quite a few that I've seen that are 90. Yeah. They're 90s.
SPEAKER_05Yeah.
unknownYeah.
SPEAKER_05But we've also taken care of that are 67. Yeah. Yeah. That that are younger than 65. Right.
SPEAKER_06Mm-hmm.
SPEAKER_05Yeah. And it seems um what I've noticed with the disease progression with dementia and Alzheimer's is it's creeping up on younger, uh, a younger senior age.
SPEAKER_02So have you heard that they're calling Alzheimer's um diabetes type three? So there's type one diabetes, which is typically um, you know, at birth or you're born with it, or and then there's type two, which is usually because of diet and lifestyle, type two diabetes, and they're calling Alzheimer's type three because of the change in the brain with excess sugar through diet. Wow. I was wondering why all these memory care facilities were popping up around our big city.
SPEAKER_05Well, I think I think we've always had dementia and Alzheimer's. We just I growing up, I remember my my family saying that my granny just it was old age, like they attributed it to old age. It was senile, you know, she's just senile, it's old age. Um, but I think now with technology and science and yeah, they just they know a little bit more about it. And so they can identify it, you know, memory loss as dementia or Alzheimer's. Like there's there's more to back it up. And yeah, man, it would be phenomenal if they could come up with medication or something that would either halt it or stop it altogether.
SPEAKER_00Yeah.
SPEAKER_05At a very early onset. I know that there's some medications out there that um are sane.
SPEAKER_02It's hugely diet related, though, is what I'm saying. There's a there's a lot of lifestyle changes. Changes that people can make to really help their brain.
SPEAKER_05So I'm curious to know if like better. Our seniors now that are facing a higher level of dementia and Alzheimer's, right?
SPEAKER_06Mm-hmm.
SPEAKER_05The level of sugar. Like, what did their diet look like as they were growing up? You know?
SPEAKER_02And people were more active then throughout. Yeah. And though, like compared to next, like I've seen when people retire, you know, their alcohol intake increases, the recreational eating, dining out, you know, socializing, some of that socializing is great. And it does matter what we put in our body. So it's kind of like, you know, if from 65 retirement till like 85 for 20 years, there's a lot of like sweets and treats and alcoholic beverages and stuff. Well, all of that, the body has to deal with that. And the brain takes a huge hit on that stuff. So I think a lot of physicians are really guiding their geriatric populations.
SPEAKER_05Like, I even thought, like, could be paying attention to that. Could it be like our cell phones are up to our ears? Is it creating some kind of frequency in our brain? Like, I mean, could is it part of the environment? Like, there's so many different it sounds like a conspiracy.
SPEAKER_02Well, medicincy theorists right now. Metabolic health is a huge thing, like having insulin resistance because of eating so much ultra-processed food. Like that goes for bread too.
SPEAKER_05Yeah.
SPEAKER_02Bread, crackers, like all the stuff. And it's the standard American diet, is is what it is. So it's highly acceptable, socially acceptable. So you really have to like fight against the grain of what's normal to really protect your brain and keep your brain healthy. And so I think we're just seeing the fallout of all of the like all the corn syrup that's been like going into our foods because government subsidized corn farmers to grow all that and then just spruced our food all up with it. So there's in other countries, they don't allow these same ingredients that go into our food and our food industry in America. And so it kind of all makes sense to me that yes, they honor death and dying, and they're not afraid to talk about it because they live rich, healthier lives that are more active, they're more socially connected to the people in their life. Like they prioritize togetherness, human connection, human socialization, walking from here to there. They don't sit on their booty nearly as much. They don't work their fingers to the bone nearly as much as we do in our society. So it's multifactorial of all of it. That'd be an interesting study to do. Mm-hmm. Or to, yeah, to look at the research, because I think the studies have been done.
SPEAKER_05Yeah, to link the research, that's what I meant.
SPEAKER_02Yeah. And so what we talk about here is death, dying, like not being afraid to open those conversations up. But it's really all goes back to like honoring that every day is precious. And who do we want to be for ourselves, for our family, to honor like our purpose in life? Yeah. And to have a rich life. Having a rich life doesn't mean having money and having a bunch of things and having a bunch of food to put in our mouth and drinks to drink on, like, and comfort, comfort, comfort. That's actually not what creates fulfillment in a human being and joy and peace. Yeah. It's like really getting messy in life and like doing life with other people and trusting, right? Like trusting other people. And trust is a choice. Trust is a choice. Um, and trust is necessary for relationships and for having these conversations.
SPEAKER_05Yeah. These are some big So trust and no fear. Yeah. And connection.
SPEAKER_02Trust, right? And compassion. Connection, compassion, yeah. Honesty, authenticity. Like just being real. Be yourself. Be real. Yeah. Be messy. Yeah. Because none of us have it all. That's why it's all messy. None of us has it all figured out. Nope. That's why we get a team. Yeah. We have teams. Like the people doing this podcast. I mean, there's a team. Nobody, it's there's no one, one man show just doing awesome in life all on their own. That's a myth, too. I think that we struggle with in this society. We think reaching out and even asking for help. Like you're like, hey, if you need help having that conversation, reach out to us. Right. And we know when we make the offer that most people are going to be like, nope. Yeah. Because that's so common in our in our America of like, I don't need that. I could do that on my own. And I'll do it later. Yeah. I've got all the time in the world. I'll get healthy later.
SPEAKER_05And and reach out for help. They might not even be hospice appropriate. They might not be, but let us help. Like, truly, that is my heart. Is just let us help. Let us help you have those conversations now. You know?
SPEAKER_02And that's that's what starts any new client, any new patient that comes on service with us in our agency is it starts with a conversation.
SPEAKER_05Yeah.
SPEAKER_02We always we're meeting at their home, typically, right? Because we provide our services in the home right now.
SPEAKER_04Yeah.
SPEAKER_02Um, so yeah. So we get the referral from the doctor, from family member, whatever. We get the even a self-referral. We get the referral from the person, yeah, or we get the phone call. Hey, I'm I want to talk about your services. And we go and we sit face to face, eyeball to eyeball, and you are so great at it. I'm still I love listening to you because I'm still learning and it still makes me nervous to kind of be like, okay, let's sign this paperwork. And it's saying that you don't go seek doctors' appointments anymore. Like you let the care come to you. And all of that is just so different that it is scary. And but what's on the other side of that fear is like comfort, comfort, peace, and really choice, like the power of choice. Like just because you've always gone to the doctor and you've always tried to get better doesn't mean that that's how it has to go going forward.
SPEAKER_05Like I'm thinking about that right now. And um we have a patient and her toenails need to be trimmed, but she's diabetic. So we we can't do that. So we'll we partner with a podiatrist and he'll go out and do it. Um, but this particular podiatrist, it's really hard to get podiatry, mobile podiatry here. So call out for mobile podiatrist. Like we need to partner if anybody's willing to, or go to school to get your podiatry um degree.
SPEAKER_02Uh we'll keep you busy.
SPEAKER_05Yeah, we will totally keep you busy. Um but because of the wait, they were ready to take her out, like to go get an appointment outside the home. And they realized we can't anymore. Like it's way too difficult to get her in the car. Yeah. It's taxing on on her granddaughter, on, on her daughter, on the family, yeah, her son. Like it's taxing on the husband. And they physically can't put her in the car anymore. Yeah. And so And what's the experience like for her? Yeah, I'm sure it's it's miserable for her. Yeah, painful. She's in tons of pain. Yeah. So um, yeah, that's the nice part about hospices. Well, we will find a solution where there's a need, we'll find a solution. You know, so they'll come out to her. Yeah, yeah.
SPEAKER_02What is the concern with clipping nails, trimming nails on people with diabetes?
SPEAKER_05Um, well, I'm not clinical. Um, but I would say you you clip it incorrectly and you cut off part, you know, cut their toenail wrong and they start bleeding. Um, their healing process is takes a lot longer if they're diabetic. So it can lead to infections and things as such. So yeah. Um yeah. So we just let the professionals do it.
SPEAKER_00Makes sense.
SPEAKER_05Yeah, it's just too risky.
unknownYep.
SPEAKER_05And their nails get thicker. Of course, of the age they get thicker, but you know, they're thicker. And so they have to there's different techniques and yeah, that they have to do medically, yeah, to make sure that they're they're done correctly.
SPEAKER_02I am clinical, but I'm cardiopulmonary, yeah. So I'm like a previous clinical, but you know what though?
SPEAKER_05But you bring that knowledge to the table. You know, you bring that experience to the table too, which is I've got it in there. It's in there. Yeah. All right. So a scripture. Grab it. Yep.
SPEAKER_04What scripture are we sharing with our so we talked about trust and fear?
SPEAKER_05Yes. I think the perfect scripture would be Proverbs 3, 5 through 6. And it's trust in the Lord with all your heart and lean not on your own understanding. And so how it can tie in today with what we've talked about is and why it works is that the family can give away the control and trust God that everything will be taken care of for the betterment of their loved one. Yeah. Um, I think that it speaks to releasing fear and fully trusting the process and trusting the journey. Yeah. Yeah. And being at peace with it. Um like I can relate because sometimes the unknowing is the hardest thing to get through. Like the not knowing. I don't know what's gonna happen. Or you know, not having that control is probably one of the hardest things. But just trusting that your loved one is being taken care of can really set you free. Yes, and set them free too.
SPEAKER_02What control do we really have?
SPEAKER_05None.
SPEAKER_02Don't we don't. And we have God, and God takes care of us, and God speaks to us, and we can pray to him, and he is the almighty, and he has a plan, and his ways are always good. And even if it's bad, if it seems bad, he's still using it for good.
SPEAKER_05Yeah.
SPEAKER_02For those who love him and are called according to his purpose. So it's all an illusion, anyway, that we have control. Yeah. So as we practice, letting go of fear and letting go of that illusion of control, it almost make it brings me back to grounding, like being able to really like capture our thoughts. Like, okay, that's a thought from fear. That's not from faith, that's not from trust. Like, I love this person, I am concerned about them. Let me honor that and let's go talk about it and gain some understanding and just take it step by step. We don't have to solve everything in one day.
SPEAKER_04Yeah.
SPEAKER_02And if we put it off and we choose not to have those conversations when we know that we get to and the signs are all there, disease progression is like in our face, it's getting worse. We know it, we put it off. Then it is the worst case scenario of oh gosh, now what? Like they're gone. We didn't take care of the things, all the details. Like now what? Yeah. And that is the gut-wrenching, heartbreaking scenario that you and I don't want. Yeah. Don't wait for the crisis. Yeah.
SPEAKER_05Yeah. Don't wait for the crisis.
SPEAKER_02Here is our healthy, tasty delight for the day. If you're joining us and you're a caregiver, it's so important for you to take care of yourself, your body, your mind. Nutrition is such an important habit of health. And we want you to stay strong in your physique and um not have to be hangry. Who wants to go through life hangry? So um, today I made deviled eggs. These are tangy, spicy, smoky deviled eggs. And the ingredients are I did it with three eggs. And this is three eggs, is actually a great serving of protein for one meal because it's about 18 grams of protein. Um, very, very nutritious. Combine it with about a cup and a half of vegetables, and you got a good old hearty, lean and green meal, I call it. Um, and but today we're just kind of going to do a snack. So Shauna and I'll taste these, but the ingredients, um, hard-boiled three eggs and split them in half. And I put the yolks into a bowl, and I did a tablespoon of dill pickled relish, yummy, um, a fourth a cup of this 2% Faye Greek yogurt, plain. Um, and that's kind of like instead of the mayo that typically goes in deviled eggs, it's healthier and it's got a lot of protein in there. So for a fourth a cup of our yogurt, we've got about um 10 more grams of protein. Yay. And then a half a teaspoon of jalapeno juice, give it some kick, and then a half a teaspoon of gray coupon of Dijon mustard. So these are spicy, tangy, smoky, and um stirred all of that together in a bowl. And then I used a um like a little ball, like a little melon baller to like scoop it and pop it right back in. And then smoked paprika is the beautiful sprinkle on top. So it gives it that smoky, smoky flavor. So, Shauna, you want to come grab you one? Let me taste one or two. You pick which one. If you chill them before you serve them, even better. Is it smoky, spicy, tangy?
SPEAKER_04I like the smoky. Really good.
SPEAKER_03That's just the paprika on top. So there you go. Could not be easier, inexpensive, simple ingredients. Good, healthy could make these ahead of time, take them along the protein for a snack if you're like visiting a friend or you've got a loved one at the hospital, you're on the go. Do not sacrifice your health. Now I have egg all over my face.
SPEAKER_04Egg on your face. Those are really good. Thank you guys for hanging out with us. Great, great talk today. Yeah, great talk.
SPEAKER_05Um, I'll end with a business tip.
SPEAKER_04Right?
SPEAKER_05So we talked about not waiting for the perfect time, talk about hospice and disease progression and all of that. Um, don't wait for the crisis. And so uh that's what I wanted to kind of pull back in is don't wait for the perfect idea. Like you have an idea, jump. It's gonna be messy. Business is gonna be messy. So good. Um, and solve something that's real, like solve something that's tangible, solve a problem that you see in the world that um you can truly make some change. Um, it might feel small. Like I said, it might feel messy, but what's the worst that could happen is you tried it and it failed. And all you do is reposition yourself and try it again. You express a piece of you that you've always wanted to express. But what the the good part about it is, is or the positive part is that it could be extremely successful. And if you don't try it, then you'll never know. So anyway.
SPEAKER_04Dream, declare, deliver. Absolutely. You have everything you need, but go trust it.
SPEAKER_03Yeah, trust. Yeah, get messy, lean on support. Move forward. Thank you. Yeah, move forward. All right, we'll see you on the talk today. Yeah, bye.