Where Presence Meets The End Of Life (w/guest Jay McDonald)

The room changes when a hospice nurse walks in—not because the end is near, but because presence arrives. Jay McDonald has built houses and built care plans, and today he opens up about what decades of life and years at the bedside have taught him about dignity, acceptance, and the choices that actually matter.

We get clear on the difference between home health and hospice: one aims to restore strength after a hospital stay, the other centers comfort, symptom relief, and connection when cure is no longer the goal. Jay shares what families most need to hear—why appetite fades at the end of life, how comfort meds like morphine reduce suffering without “starting the end,” and why so many patients speak peacefully with loved ones who have already passed. He talks about the relief that comes with life review, when people tell the truth about regrets and milestones so their families can heal with them, not after them.

We also explore how to show up better for the living. Jay’s approach is deceptively simple: be present, listen actively, hold confidences, and let judgment pass through without steering your actions. He leans on faith and mindfulness, using short breathing practices and guided meditations to return to the moment where things are “okay enough” to keep going. We highlight community resources—from volunteer vigils like No One Dies Alone to meal and respite support—that help caregivers endure the marathon of care with their humanity intact.

If you’re navigating serious illness, weighing treatment side effects against quality of life, or caring for someone you love, this conversation offers clarity and calm. Tap play, share with a friend who needs it, and if this helped, subscribe and leave a review so more people can find their footing when it matters most.

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Transcript

SPEAKER_00 0:09

Okay, here we are. Hello. Good morning. Good morning. Okay, welcome to Deep Dead with Dr. D. Uh love that you join us. Uh this has uh been a good start to the year. I've had guests every week, I think since the start of the year. Last weekend was Chair. This weekend is Jay. Next weekend, I think it's Brad Case. Um yeah, so here we are. Welcome, glad you're here. I have with me Jay McDonnell, who's just staring at me intently. Uh so let's get started. So this isn't a question that's on the list. I like to kind of do this a little impromptu. Um, and that is for you to introduce yourself to the world. This, you know, I've got some followers, some people listen to this, people that don't know you, like I know you pretty well. Um, introduce yourself.

SPEAKER_02 1:06

Hey.

SPEAKER_00 1:09

That's trademarked.

SPEAKER_02 1:11

That is that is gold. Uh my name's Jay McDonald. Um yeah.

SPEAKER_00 1:19

Okay.

SPEAKER_03 1:21

Hey.

SPEAKER_00 1:21

Uh Married. Married. Yeah.

SPEAKER_03 1:25

Got the ring.

SPEAKER_00 1:26

Okay.

SPEAKER_03 1:26

Yeah, tricked her. Yeah. That's funny. Yeah. We had a we had a COVID wedding. Oh, you did? Yeah, it was great. It was kind of ideal because you don't have to worry about inviting anybody and everybody.

SPEAKER_00 1:42

Yeah, right. You know? Yeah. Well, it wasn't that a time period. Yeah, it was. Yeah. The end of the world. And so that was you guys got married in 2020, 2021. 2020. It was 2020. Followed by the birth of Cody in 2021. Oh, yeah. Oh my gosh. Cody's. Is she five yet? No, four. She's four. Four. Oh, she's a character.

SPEAKER_03 2:06

Got her first haircut shortly before her fourth birthday.

SPEAKER_00 2:10

Yeah. That was a big deal.

SPEAKER_03 2:12

It was a big deal. Yeah. Who cut her hair? There is a place in Yakima that's just devoted for kids. Oh. I mean, it's a whole thing. Yeah. Yeah. Sure.

SPEAKER_00 2:23

Yeah.

SPEAKER_03 2:23

Yeah. My wife took her there after a family member had brought her.

SPEAKER_00 2:27

And then oh, sorry. Yeah. Yeah. Uh Giselle is 10th. 11th? 10th. 10th grade. 10th. Yeah. Just started driving. Driving. Like she's driving on her own now. Yeah. That's crazy.

SPEAKER_03 2:40

It is. To think. I remember the first day when she just took off and I was following her, and it was, you know, it was kind of a weird experience. Yeah. To see her drive away.

SPEAKER_00 2:49

Kind of surreal. Yeah. I have pictures uh from well, let's see, how old is she?

SPEAKER_03 2:57

She is 16.

SPEAKER_00 2:58

I actually think it was a birthday party for Chiba, but of you in my backyard um when I lived on Dennis Street, when we had a party back there, and you had Giselle and she was like four years old or something. Yeah.

SPEAKER_02 3:16

She was little.

SPEAKER_03 3:17

Yeah. Little, little.

SPEAKER_00 3:18

You were a single dad for a long time.

SPEAKER_03 3:20

Yeah.

SPEAKER_00 3:21

How long?

SPEAKER_03 3:23

Oh, I don't know.

SPEAKER_00 3:24

Decade? Eight years?

SPEAKER_03 3:27

No, I mean there were some relationships there, and you know.

SPEAKER_00 3:29

Oh, yeah, yeah, yeah. Yeah. Weaved in and out a little bit. But I've always admired you for that. Yeah. Now Sam's been a strong positive influence in her life. Yeah, she has. Yeah.

SPEAKER_03 3:44

So that's that's been a really good experience as far as that goes.

SPEAKER_00 3:47

Yeah, for sure. Yeah. Okay. And then uh what do you do to uh pay the bills? I am a nurse. You are? Yeah. How long have you been a nurse now?

SPEAKER_03 3:58

Well, I got uh I got my LPN license in 2016, and followed by when I finished up the nursing program, I got my RN degree or RN license. It was actually an associate's degree, but yeah, yeah.

SPEAKER_00 4:12

Yeah. But that gets you your RN. Yes. I just learned that talking to you. I I don't know why I always assumed that was a bachelor's degree to get an RN, but it's not. Nope. That's cool. That's good. So someone can start working pretty quickly.

SPEAKER_03 4:27

Yeah, it's about two years of prerequisites.

SPEAKER_00 4:30

Okay. And then for the RN.

SPEAKER_03 4:32

Uh to get into a nursing program. To get into okay. And then typically a two-year program to complete the associate's degree or you know, whatever.

SPEAKER_00 4:43

So, like you're doing enough that would be equivalent to a bachelor's degree.

SPEAKER_03 4:47

Yeah. And I had already done a bachelor's degree in biology up here.

SPEAKER_00 4:51

Yes. Okay. Okay, that's all right. So then you did another two years down there. Yeah. But you don't end up with what you should, a master's degree. You just can get an RN, the license. Yes. And you're now working on your master's degree, though.

SPEAKER_03 5:06

Yeah. I did my bachelor's degree in nursing last year and working on my master's degree currently. Wow. If I wasn't here right now, that is what I'm saying. You'd be doing homework. Well, thank you for giving up your time.

From Construction To Nursing

SPEAKER_00 5:19

Yeah. You're welcome. Uh okay, so um married, two kids, um uh work in the healthcare industry, you have done that. You were in construction. Yeah. You were for a while. Yeah. I remember that. Yeah.

SPEAKER_03 5:40

You were a framer. Yeah, I was building houses around here up in Sunkadia. Who did you work with? Uh well, one of the first guys that I worked with for a few years was Lance Knight. Okay. He was fun. He was a it was a good cry of fond memories of that time. Good. Uh the guy after John, I don't remember his last name. Okay. But yeah, very good guy. And then I have a family member who ended up getting me into the carpenter's union over over on the west side. Oh. So I ended up moving over there. When did you move over there? Oh gosh, it was like 2006, I would say. Okay. So before we met.

SPEAKER_00 6:24

No, we had met we so that's a good one. Yeah, we had each other a long time. We have. I was the because that was the next I was I was thinking in my brain how long we've known each other. A long time. Yeah. You used to have a backpack you'd carry around. I remember you were young. Because you're 40. 43 now. You're 43. Long time. So pro I'd say we met what? Well, what year do you think we met? 2003, 1933?

SPEAKER_03 6:53

Early, early 2000s, yeah, probably 2003.

SPEAKER_00 6:57

So then you moved to the west side. How long were you was that with uh um what's her name? Jen. Jen. Yeah. Yeah. Because you guys were together off and on for a while.

SPEAKER_03 7:07

Uh we were together for a few years.

SPEAKER_00 7:11

Yeah.

SPEAKER_03 7:12

Yeah.

SPEAKER_00 7:13

So you moved over there, you got in the carpers union over there. Where were you living?

SPEAKER_03 7:18

In it was right on the border between Woodenville and uh gosh, what's the other name of the other town right there? Um Kirkland. Technically in Kirkland, but it was right on the it was actually uh uh King's Place? Oh yeah. Right I lived right next door to the hockey arena where the Thunderbirds practiced. Oh, fun. Okay. How long were you over there? Uh two or three years. Did you like it? I mean, yes and no. You know, it you kind of adapt to any environment. Yeah. I ended up buying some kayaks while we were there and would go down to Lake Washington and Oh, you love that. Yeah, that was cool. You really've done a lot of kayaking. Yeah. Yeah. I mean, you kind of adapt to the environment. Yeah, where you're at. You know, I took those kayaks out in the out in the sound and did all sorts of stuff.

SPEAKER_00 8:15

Now I'm trying to remember your dad live lived because he passed. Did your dad pass? Yeah, he passed away. Okay, that's what I up north? Darrington. Darrington, which is by not Anna Cortis on more this side.

SPEAKER_03 8:30

Yeah, so if you go about an hour north of Seattle, you're gonna go through Everett, Marysville, and then Arlington. Arlington, yes. I mostly grew up in Arlington, but that's right, okay. Yeah, I spent a few years in Darrington, then Oso.

SPEAKER_00 8:45

You and Steven are close to the same age. Yeah. Did you guys know each other? No. Because he's from that area. Yeah, no, I didn't know him until we met up over here. Interesting. Okay. Now, yeah, so that was the question Nia. Uh we've known each other a long time. Over 20 years. And I always I can, you know, I can laugh about it now. We broke up for a little while. We broke up for a little while because I was an ass. Um, I remember it. And it was, I don't know, would we take a two-year-ish?

SPEAKER_03 9:20

Something like that.

SPEAKER_00 9:21

Yeah. And it was just oddly enough, it was about that same time, not too long after that. Um God. Ryan. Ryan and I had a fight and broke up.

SPEAKER_02 9:39

I was like, what the fuck?

SPEAKER_00 9:41

Uh yeah. But life. Yeah, life's interesting. It sure is. Okay, so there we go. So there's your introduction to Jay. Um, I consider you interest. You're in my book. In the book. Yeah. With the support of many friends, and you I consider someone, um, I always like to say this because I think it's funny to say it how I say it, are squarely in my circle of influence. Yes. That sounds about right. Um, you're someone that, you know, we communicate pretty regularly. Um, but if I'm struggling, you're someone I'm gonna reach out to. And you've always had a way about you that um I feel like I can just share whatever with you, and it's gonna be okay. And we've laughed a lot, we've had a lot of fun. Yes, we had. Were you I think you were with when we would make those trips over to Seattle with Ryan. Oh, yeah. In the crazy days, yeah. Yeah, he was hilarious. Yeah, yeah, I miss Ryan. Yeah, yeah. Same.

SPEAKER_03 11:00

Crazy.

SPEAKER_00 11:01

All right, now your mom lives here. Okay, so where would you say you are from?

SPEAKER_03 11:08

Well, I mean, generally the west side, right? The the west side, yeah, we got it over here. I know. But yeah, I uh I mean I spent a few years in Arlington uh and then uh we lived in Oso tiny, tiny. Oh, yeah. People know Oso. Okay. Well, and within Oso, there is this tiny little trailer, and that's it right next to the uh like Grange or the the uh big white building right when you get right when you're coming in, heading up towards Darrington, right past that. There's a little tiny white trailer on the right, and that's it's still there, yeah. Oh, yeah, it's still there. Wow, yeah.

SPEAKER_00 11:48

And you lived there with your mom? Yep, your dad? Nope, they had split up, they split up when I was two. So your mom, you and your brother? No, he wasn't.

SPEAKER_03 11:58

Uh my mom remarried. We moved in when I was five. Oh that's when we moved to Arlington.

SPEAKER_00 12:05

Okay. So you would say you're from the west side, but you've been here long time now. Long time. Yeah, since late 90s. Oh, wow. Yeah. Wow. Long, yeah, you can almost say you're from Ellensburg. I remember when I moved here in 2001 and I was with Fred Meyer, you know, and people, it was, you know, like, oh, you're a Westsider, blah, blah, blah. People either really were excited about Fred Meyer or they just thought it was the devil, right?

unknown 12:36

Yeah.

Home Health vs Hospice Explained

SPEAKER_00 12:36

So anyway, I was getting to know people, and Dave Bastion, who now he lives on the West Side, he's from here. I remember asking him, so Dave, how long do I have to live here before I can say I'm from Ellensburg? You know, he's like 30 years. It's always just stuck in my head. So you're you're almost there. Well, and then I cheated. I went back to the West side a couple years. The clock starts again. Yeah. Yeah. That's funny. I always think it's funny when we do that, you know. You need to go back to where you came from, or don't come over here and it's like we're all from the same place. Yeah. Yeah. So okay. Want to do a question? Sure. Here we go. So you work in home health and hospice care, walking alongside people and families during some of the most vulnerable moments of their lives. How has that work shaped the way you see life, presence, and what really matters?

SPEAKER_03 13:31

Well, I think kind of in line with that, when my dad passed away, like there was a very real understanding that, you know, everybody's got an expiration date.

SPEAKER_00 13:42

Yeah.

SPEAKER_03 13:43

Right. And uh, and that kind of changes your perspective. You know, I uh home health and hospice, right? Two completely different things. They are.

SPEAKER_00 13:54

A lot of people don't understand.

SPEAKER_03 13:55

And it's, you know, you you you go, you can go from one extreme to the next, right? Like, you know, home health, we're we're focused on getting people better or getting them to their max potential. You know, oftentimes we're getting people after they just got out of the hospital for some reason, um, you know, had some you know cardiac event or you know, fell and broke something, and you know, medication changes and just keeping them healthy, kind of getting them healthy, keep yeah, okay. Connecting with their their doctor's office, you know, kind of being that go-between. Often you know, people have a hard time getting back and forth to the doctor's office. You know, and then hospice is all about keeping people comfortable. You know, it's uh it's a little different mind frame. Uh but both of those experiences have uh given me some unique opportunities to have some you know very intimate moments with people who I probably would have no other, you know, interaction with. And it's you know, time and family, it's it's all precious. You know, uh you if if you ask people, you know, in their you know, end days what's what's important to them, the majority of people will say, you know, family. And yeah, I I get that. Yeah, you know. Um oftentimes you you see these really beautiful moments with families coming together, and you know, for the for the most part, people are ready when the time comes. But you know, I remember when I was a kid just randomly thinking about death and you know having this fear about it. And for the most part, what you see is when the time comes, you know, there's an acceptance, people embrace it. You know, I I've heard people talk about you know, I'm looking forward to this next journey, this final journey, you know, like what's this going to be like this experience? But you know, it's typically people who are a little younger or have some things unfinished that have a little bit more difficulty with it, you know. And you can have a say on you know how long you live. I mean, you can definitely put up a fight, um, but it it'll get you, life will get you, you know.

SPEAKER_00 16:25

Do you find that um um do you find that there's more acceptance from the person who's dying than from the family members accepting it?

SPEAKER_03 16:38

There's a there's a fair amount of that. Um often, well, sometimes people are they're they're really trying to push through for their family. You know, they they are, and and part of our job is just to have conversations with people and find out what's important to them, and somewhere along that process, you know, allowing giving them permission to let go, like and validating the things that they're experiencing and just the you know, you're you're tired, your body's shutting down, you're just you're tired, and it's okay to rest. It's okay to do the things that you need to do to just be comfortable, you know. It's very common to lose your appetite at end of life, and you know, as family, you know, we're we're constantly you need to eat, you need to eat, yeah, and um you know, people lose their appetite, they and that's a just a normal part as as things are are shutting down, so just validating that what they're feeling, what they're thinking, that's that's totally appropriate at this point in your life, and just giving them the time and the space to verbalize what's going on in their head in the presence of their family so that they can hear it from them.

Acceptance, Family, And Final Days

SPEAKER_00 17:57

Yeah, as we're having this conversation, it's you know, it's bringing back um when I walked through my mom with hospice and Chad, who um was phenomenal in his role as a hospice care nurse. Um, I remember the conversation he and I had. We went outside and we were in my mom's yard. And I'm a realist, you know. I I was just I very kindly I'm like, you know, I'm asking you, what do you think? You know, how long? And we had this conversation about end-of-life, and he was compassionate and caring, and and I remember him after I asked him, I wanted to hear, how long do you think my mom's got? And he says, Well, you know, I can't say for sure, but this is what I've seen, right? I'm sure you've had that conversation. And there was part of me that was like, okay, and then there was another part of me that as a family member seeing my mom who's very lucid and very, you know, nah. He was almost exactly correct with what, you know, because he's seen this again and again, and just listening to you now and watching mom as she lost her appetite. And my sister and I and Katrina were like, mom, you need to eat. And and I know, you know, if my sister's it was hard, but you know, we're we're struggling with seeing our family member who we there's part of me that knew, oh, there were the markers that our hospice nurse uh the call, yeah. I'm gonna jump around a little bit. Um, mom was struggling one night and we called, and I don't know if it was Chad or the on-call nurse. I think it was the on-call. Very professional asked the question because I remember when Chad brought over the morphine. You know, you bring over the two meds. The there's one that's uh the barbituate. What is it?

SPEAKER_03 19:48

Lorrazepin. Lirazepin.

SPEAKER_00 19:49

We had been given yeah, benzo, and then there's the morphine, you know. And I remember him that individual saying, Have you started giving her the morphine yet? I'm like, oh no. And he was very kind and you might consider that. And that's when I was I'm getting a little emotional. Because that's when I went, oh, this is really real. And it's hard. And and and here I am just a family, not just a family member, but you guys see this on a on a daily basis. Like that's that's a lot.

SPEAKER_03 20:22

It can be a lot. Yeah. Yeah. There is some satisfaction providing you know that level of help and you know like quality of life at a time that can be very challenging. It is a very rewarding job. Yeah. Emotionally taxing. Yeah. Yeah.

SPEAKER_00 20:46

Yeah. Uh so let's see. Walk yeah, what's vulnerable? How is that work shape? So I has it changed because you've lived a pretty full life yourself, you know, in a lot of different ways. Working in hospice, because you've done this for how long now? Six years, five years?

SPEAKER_03 21:02

With hospice? Uh just a little over four years. Has it changed how you view life? I mean, absolutely, right? One of the the very interesting things that I I found early on is that is it is extremely common for people in the last days of life to start talking to and interacting with things that I don't see. Right? You oftentimes find people talking to people who have previously passed, right? As if they're in the room. Yeah, but yeah. Yeah, it's it's it happens all the time. Interesting. Very, you know. Interesting. So yeah, how do you interpret that, right? Like, is this because their brain is shutting down and there's all these chemicals that are changing and right, toxins building up? But why over and over and over again are they talking with past loved ones who are comforting them? And yeah, it's yeah, it's an amazing thing to see. Interesting. Yeah, yeah. So yeah, life. Weird. Life is just weird for sure.

SPEAKER_00 22:31

Okay. Yeah, this is good. Question number two. As a father, husband, and friend, how have your life experiences influenced the way you show up for the people closest to you? Because you do show up in a way that is, like I said, I'm I I'm I'm not just calling anyone if I'm really struggling. Like I don't want to call anyone, but if I'm thinking of calling someone, you're gonna be at the top of the list. Andy's gonna be at the top of the list, Corey's gonna be, you know, like if I just need someone to just be a certain, you know, no one how do you uh how has your life created the you that you are today and the way you are? Because you do show up in a pretty unique way for people.

SPEAKER_03 23:22

Well, I mean, based on on history and just you know some of the experiences. And I, you know, I'd love to say that I'm I'm not distracted. There are, you know, sometimes you gotta, as my wife would say, you know, put the phone down, you know. Um sure. But I do try and be present, and I I have to I don't know if other people experience this, but you know, get to talk, and then all of a sudden I'll just like you know, ram trail off somewhere else, and then all of a sudden, like, oh, we're having a conversation. What's funny?

SPEAKER_00 23:59

Can you catch me up on that?

SPEAKER_03 24:00

Yeah, but I you know, as I'm having conversations with people, I'm trying to relate what's going on and you know, just try and pull up some of my experiences and just do my best to actively listen. You know, I try and try and focus and and give people the time to talk and express what's going on, and uh and also not sharing those things with other people. I I think that's that is important just to allow somebody the safety to be able to verbalize what's going on in their head, you know, because if you let stuff just rattle around in there, it can cause some problems.

SPEAKER_00 24:43

So no, there has to be, yeah, you know, yeah, you have to have safe people and and and areas who has been who have who so I would say this is a learn skill for you based on your life. So who has been there for you along the way in this way?

SPEAKER_03 25:01

Well, um, I mean, there's been a variety of people over the years. I mean, you being one of them, right? Like I've been able to talk with you about stuff before in the past. Um a variety I remember having kind of so my my parents split up when I was relatively young. And uh I remember having some questions about just who my dad was years later, and I remember just like uh prompting him one day, like, hey, you know, like how do you where do you stand on this? You know, and um and he was you know just very straightforward and um but yeah, it's it's good to have those kind of more in-depth conversations with people and kind of find out who they are. You know, um Ryan was a person you know I could talk to. I've I've had plenty of uh good conversations with Andy and uh uh Glenn, who has also since passed, and I've had tons of great conversations with him. Okay. Uh he uh he's definitely there to to listen and you know, had lots of interesting life experiences himself.

SPEAKER_00 26:14

Do you think it's the people that have lived what we might call full lives, you know, with a lot of different roads they've been down and experiences that those are the people that are better suited to be in a position to be empathetic like you are and be good listeners and have more open minds, like Andy's someone like I've never had a bad talk with that guy, like you know, and he's and you're the same. Like we had our little you know breakup, that was because I was an ass. But I've always felt comfortable talking to you. Do you think it's because of life and experiences, or do you think it's from parenting, or what do you think that comes from?

How To Show Up For People

SPEAKER_03 26:58

I don't know, yeah. I I don't, you know, it's hard to say like what defines a full life, right? Like I I don't know necessarily, right? Because we're all different, we all have different life experiences, and and it is good to talk with you when you're opening up to somebody, you don't just dump everything on the table initially, no, right? Like you just kind of throw some stuff out. Broach it out, yeah, yeah. See how things play out. I'm gonna see what he does with this. Yeah, as you get more history with that person, and there is that establishment of of safety, and you know, uh you you are able to have more in-depth conversations, and you probably are gonna get to know that person on a much more intimate level than you otherwise would have. You know, I don't I I don't I can't really think of anyone who I've had really in-depth conversations with that I I haven't really gotten a lot from them. You know, there's so many different people and different experiences. I I don't know, it's you you have something to learn from from everyone. Yeah, I like that.

SPEAKER_00 28:19

All right, let's do another question. You've spent years in healthcare and caregiving roles. What's something you wish, and this kind of goes off of the the question we just walked through, maybe this'll this'll tease some more stuff out of Jay's brain in this way. What's something you wish more people understood about compassion, dignity, and meeting people where they are?

SPEAKER_03 28:48

Well, yeah, so in this job, we are going into people's homes and and you get a wide spectrum of experiences, right? Um, but it you really do have to factor in, right? Like this is a person, this is you know, I need to take judgment of, you know, because I'm human, right? Like you go into situations and we all judge, you know, what's what's going on in here.

SPEAKER_00 29:17

I always say to students when I'm talking about ethics and things like that, and and it's just the reality that we all judge, it's what you do with that judgment. Right. So go on.

SPEAKER_03 29:28

Yeah, so I just show up, right? Like, what are your needs? What are your desires? You know, um, typically, especially with hospice, you know, there's some a big portion of what hospice is is allowing somebody to do life review, give them a time to, you know, process things, talk about anything in the past that they've had difficulty with, and you know, you really get to know somebody through that process, and uh, you know, it it can kind of you know bring to light some things that you know you might not have when you first walk in, yeah, you know, like first appearances, like that whole thing.

SPEAKER_00 30:07

You end up hearing some heavy stuff, yeah. Yeah, how do you how do you think you show up that allows that to happen for that person? What is it about you?

SPEAKER_03 30:18

Being present, right? Giving time and doing active listening when you're engaged, like we show up, we have a you know, we gotta get X, Y, and Z done, right? Like, especially when we're first meeting someone and we're getting them started. Yeah, there is so many questions we gotta go. Remember, yeah, right? Like it is it is a lot. Um, and there's you're just throwing so much information at people too. Like it's you know, but you in the middle of all that, right? Like, you need to take the time to connect and just ask questions about what's important to people and listen, you know, and uh and validate what they're experiencing and just provide presence. You know, time is limited at the end, and and giving somebody your time is is valuable.

Compassion Without Judgment

SPEAKER_00 31:15

I'm hearing there's some common themes that I'm hearing from you, and and one is being present. And what does it mean to be present? I'm hearing you say, you know, taking the judgment away, allowing people to be where they are, active listening, which is a skill, right? Um, and but you've said it a few times, just being present, and I think that's that's an important one. I remember when Chad came, we were all, you know, we were waiting for him, me and my sister, because mom went into hospice, and I remember he had a whole bunch of processes that he had to go through. But one thing that he was really good at, and which I think you are the same, is also being human, right? He wasn't just a nurse, just you know, some person from the hospital doing a job. He was a human and and he shared that. And we we actually we actually had, I think he's in our we had we had the whole family and mom's tiny little place. You might remember seeing the picture, and we took a picture, we had like 30 people in there. I think he's in that picture, yeah. Because he we we brought him into our family, and and I think you probably have had that same thing happen with you in different ways because you bring that, and I think it's a skill, it's a it's something that you've developed over time, not just you know, all of a sudden in hospice care, but just you as a human that you you allow people to be where they are when they when they're at that place. Does that make sense?

SPEAKER_02 32:54

Yeah, yeah.

SPEAKER_03 32:55

Allowing people to be people, yeah, be vulnerable, yeah, express whatever they need to express, yeah, just being there, giving them time and presence.

SPEAKER_00 33:07

Um so uh last year my niece passed, and she it was fairly sudden, and we spent time up at St. Joe's in Tacoma in the ICU. And there I'm gonna get to a question for you. You can just answer it very generically, you don't have to say any specific time, but I was like, oh wow, we had a lot of family there in the ICU coming and going, and and um they were very accommodating, very kind. And I remember one of the doctors, I was having a conversation with him, and he says, um he didn't like say thank you in a way like oh thank you. He was just like, it's really really nice to see all the family here. And I'm like, Well, yeah, it's our and he's like, Well, it was the nurse. She's like, a lot of people die alone, and I'm like, oh my gosh, do you see that?

SPEAKER_03 34:11

That that does happen. I wouldn't say in our program that happens a lot, yeah uh, because one of the requirements for being on hospice is you have to have somebody there because we're not we're not going to so what happens if someone doesn't? So you you stay in the hospital, uh or you can go to like a to a home, yeah.

SPEAKER_00 34:36

Okay, so there are people there that you're not dying alone, right? Yeah, interesting.

SPEAKER_03 34:42

We have had times where they're you know, for whatever reason, the primary, you know, caregiver didn't work out, or whatever the reason is. And we have had to do uh called continuous care, where it's just our team there all the time. And you will you will find that people are coming and and going right, right? But there can be those incidences where you know, for whatever reason, you know, like they're the last one left, and right, like or become estranged from family. You know, oftentimes this process kind of brings people back together and yeah, allows them a time and a place to to kind of put things to bed. But yeah, that that can happen.

SPEAKER_00 35:28

And even more powerful or good that you people like you and Chad and the other hospice nurses that are around so that someone doesn't die alone. I say this about um weddings and funerals. You see, I know you see this, it's when it brings all the family stuff out, yeah. And I would be willing to bet that end of life that's when families may be a little more willing to put things aside than weddings, because weddings, families, some families act really weird. But yeah, so I was curious about that. So that so in our community, someone's not gonna be the structure, and I remember this with mom. We were like, Yeah, we have people that can can someone be there with her. So that's part of before someone goes to hospice is their family to care for that person.

SPEAKER_03 36:18

Yeah, that's good. And there is a service that's provided here in the community. Uh it's called NOTA, no one dies alone. Right? There are hospice volunteers band together.

Presence Over Protocol

SPEAKER_00 36:31

Yes. And I remember that. Yeah. Yeah. Uh not that, but the meals on wheels. You know, we mom had that put in place. And um we we are fortunate, and I know there's many communities like this, but we're fortunate in our community that we have a strong level of support in all areas, but I think also in this area with volunteers. We do have a great community.

SPEAKER_03 36:56

Yeah, when you look at all the support that the community has, it is yeah, it is amazing.

SPEAKER_00 37:01

I always say that for being a rural, you know, we've got a lot. We're fortunate. Okay. Last question for you, and then we're gonna wrap this up. So, as we've been talking, um uh this kind of work can be emotionally demanding, right? Duh. What helps you to stay grounded and continue showing up with care and intention?

SPEAKER_03 37:27

Well, uh developing a relationship with God is uh is definitely something that I've done and I've I've leaned more on over the years. Um also uh mindfulness practices, you know, being present, like pulling your your brain is an organ, right? Like your nervous system, and uh, you know, my mind can wander and take me into weird places if I'm not actively, you know, utilizing it on something and uh having the ability to pull myself back into the moment, right? Because everything in this moment is okay, yeah, right? It's when I'm worried about the future or stressed past, right? Yeah, but in this moment, rarely is I actually I can't think of a time in my life where in the moment things weren't okay on some level, right? So just having that ability to detach from whatever, you know, fear or what is going on and just pull myself back into the moment and and you know, through meditation, and uh, you know, one of the great things that my employer provides is uh a meditation app called Headspace. Apparently it's like$75 a month if you're paying for it yourself, but it's uh my employer does pay for it, and I I appreciate it very much. Everything from there's all sorts of like guided series you know on anxiety or depression or you know, whatever in between. And there's also just like short little like one-minute breathing sessions. There's like a flower that like expands as it's taking a breath. And I watch that stuff with my with my kids, you know. That's oftentimes when we're waiting for the bus, you know, Cody will ask, can we take some breaths? Right, like it's the cutest little thing. Awesome, and it's powerful, yeah. Yeah, and there's also uh there's like little sleep stories that you know just kind of help settle your mind and help you to relax. There's yeah, meditation's actually been a pretty amazing thing for me over the years, just being able to relax the body, and yeah, so those are a lot of things that uh that I utilize. Uh I I would always say that I have plenty of room uh to improve upon my active relationship with with God, right? Like I could I could always be spending more time trying.

Faith, Mindfulness, And Headspace

SPEAKER_00 40:09

to you know improve that relationship there's been plenty of times in the past where I have been having a moment we're just really struggling in the moment and just you know a quick little prayer right is just so so relieving right just to just connect uh and that is that has helped me greatly just I'm not the best at always thinking about like hey you know maybe I could uh I could connect in this moment you know but when I do there is great relief in it I hear that you know um so if I'm hearing you correctly your your relationship with God is helpful I'm also hearing um using meditation skills a variety of different meditation skills and um that it's a works in practice right I when you're talking about meditation mindfulness is huge for me and uh having gone through a lot of counseling I went through uh dbt and one of the best skills that I still use in my life to this day is called radical acceptance you've heard of that right this is what we got this is where I'm at in this moment with whatever's and it's not that we have to go oh this is great it is what it is and it's temporary right though something that I use for myself that I can almost guarantee you is feelings are temporary. You know how I'm feeling now while I'm not being it dismissive of it it's temporary. Another feeling's gonna come and and yeah so I I appreciate what you said about that I I uh definitely the meditation and the mindfulness and staying in the moment um I you know what's out there I'm not sure you know when you were talking about um people in their closing days talking to people who haven't been here in a long time you know I look at those things and I go I I I go twofold well the brain's doing different things or okay cool like our little dog Daisy just died and there's her ashes up there and I talk about oh she's up in the sky you know achieving now and blah blah blah yeah I I I appreciate your perspective I always have um so thank you for sharing that I think and I think it'll be helpful for people and that goes into our our closing question for you um this is a good segue into that what's a message of hope you would offer to someone listening who's navigating serious illness issues caregiving or just in a difficult period of their own life what what's that message of hope you would offer to them well uh I guess the message of hope is that there's help out there you know uh if you need help reach out for it I think sometimes people have a hard time reaching out for help there's a lot of caregiver assistance here in the community but it can be very difficult taking care of somebody like you you're devoting a lot of time and energy and it is you do need time for yourself to take care of yourself.

SPEAKER_03 43:23

I know that one of the big things that can like be a challenge after somebody's passed is all of a sudden you have all this time and you know what do you what do you do with that time you've been devoting all this you know all this time and energy and you know um you know as far as somebody dealing with a a challenging health condition and and concerns about what to do and how to do it it you know if we're talking about end of life it really depends on what what you want. I mean sometimes there is a treatment for whatever you're going through um but there's often some pretty significant side effects and you you see people weigh that out yeah like yes I can get more time but I'm going to feel terrible you know and what's more important have you accomplished the things in your life that you wanted to you know and uh we're here to support you no matter which way you want to go with that. You know if your goal is to strive towards getting better and do that that route uh there's some things that all health can offer and you know same to be said with hospice you know and if you're if you're ready to just and it's not necessarily let go but to just focus on on quality of life and and symptom management you know hospice isn't a isn't a death sentence people do graduate from hospice. We've had people who looked like they were appropriate for hospice and then after a period of time they got better. And you can graduate and then come back at a later time when things have changed but that that does happen. You know it's uh it's and as far as I know we talked a little bit about about morphine early on and that like that realization that you had and like we're there now right like oftentimes people do feel like morphine and you know starting to take those meds is like a death sentence right like oh you know yeah that's your what I want people to know is I have seen the impact of somebody not taking those comfort meds. Yeah and yes sometimes you do live longer but that's because your body is in such discomfort but that that it can't relax to be able to let go. You're on your way out regardless. Yeah you know and how do you want to go how do you want to go right it uh it kind of depends on on what you want to do.

SPEAKER_00 46:07

Yeah um as far as a a message of hope um I mean based on my experiences with uh with people seeing past loved ones right I'd I'd say you're on your way uh to a new journey you know I don't I don't know what that looks like yeah I don't know but it is such a common experience it is it happens so often and it it is interesting to just sit there and be present in those moments and just observe what's going on yeah I don't know yeah no that's I I like you know I like that you started with and this is a little bit of a plug and I think it's a good plug that there are resources out there to help people with health conditions right um especially for end of life um you were I think you were alluding to for family members because I'm pretty sure Chad talked about this that even us as family we could have a relief person come that way mom would never be alone we were fortunate we never had to have that happen but you know just those little things so asking for help I think is is is hard yes because I think in my own self sometimes you know nope I'm gonna do it all myself and there's resources out there um and I think you talking about being realistic um you can have hope and be realistic at the same time you know for whatever's coming next right um so those are all all good things but the key one I think that you you talk about you know if we're talking about hospices there's resources out there for help.

SPEAKER_03 47:56

Absolutely yeah it's good okay we're gonna wrap it up what's a qu now I'm a little nervous with you of all people I don't know why what's a question you've always wanted to ask me I you know honestly I couldn't think of anything because if I've ever had a question I've just asked right like um I guess my question in this moment is tell me a little bit more about what you're doing right now with with all of all of this that's going on right now. No that's good.

Hope, Choices, And Comfort Meds

SPEAKER_00 48:25

What are you what are you hoping to do? What's what's you why yeah why am I doing this yeah uh so this particular the podcast um I started it because of Tyler. So Tyler my son um he's told me you know different things along the way and I never like to listen to him because he's my kid what does he know blah that's kind of a joke right but he said you know Dad you should start a podcast I'm like all right so I started it it's been just over a year ago it was just me doing it and it was cool and then I think it was him who said you should have guests on. I'm pretty sure it was I'm like okay all of this so oh so having guests has been really cool like I've had people like having you on I've known you for 20 something years I learned new things about you and my overall mantra in life is I want people to see that they have it within them to do amazing things. That's it everything I do my teaching on campus my work in the community this you know being a father or grandfather when I'm talking to the grandsons you know whether I'm challenging them or encouraging them it's I want them to see that like look at you look what you've done with your life you haven't you know been handed the best deck of cards to live your life with but yet here you are right so that's my thing that sign that's on the wall they can't see it on the camera my sister gave me that he believed he could so he did right and you do that so that's that's the why um I love what I get to do as a community member you know I believe I believe that the best way we can have a positive effect on society as a whole which I think we could all agree that right now it's a bit of a shit show right but the best thing we can do to have a positive change is do the things we can do in our community and that'll bleed out. So there you go. That's why yeah and this is fun. This has been really fun like last week was Kathy Day do you know Kathy Day by chance? The name sounds familiar but super cool human you know just the different people that I've had and I want to have and if you're listening I want to have all age groups too I want to hear all different perspectives because if this like if someone listens to this and they're about to walk through hospice with their loved one and it can help them my job's done. There it is we did it yay thanks for coming on absolutely that was good