Latest / Voyage Clinics Podcast / Building Resilience Through Life's Hardest Moments | Advice from Michael Webb Part 2

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Building Resilience Through Life's Hardest Moments | Advice from Michael Webb Part 2 · Voyage Clinics Podcast

• 0:09
  Speaker 1: Hello, Welcome to the Boys Clinics Podcast.
• 0:11
  Speaker 2: I'm your host, doctor John Sanders, family physician, and our
• 0:14
  Speaker 2: podcasts our objective is just to help our community learn
• 0:16
  Speaker 2: and grow and health and wellness space. Today my guest
• 0:20
  Speaker 2: is Michael Webb. He's a good friend and we walk
• 0:23
  Speaker 2: our dogs a lot and we talk a lot, and
• 0:25
  Speaker 2: so today is one of my favorite topics. I worked
• 0:28
  Speaker 2: in hospice and end of life care for four years
• 0:31
  Speaker 2: while I was in Moab working as a country doc
• 0:33
  Speaker 2: as well. So I was doing delivering babies and working
• 0:37
  Speaker 2: in the er, working in the hospital, and then after
• 0:39
  Speaker 2: hours I was often out doing some hospice care. And
• 0:42
  Speaker 2: so today we get to talk about death and life
• 0:48
  Speaker 2: and perspective and it'll be beautiful.
• 0:53
  Speaker 1: So Michael Webb, thank you, my pleasure. Let's get into it.
• 0:57
  Speaker 2: You shared the story the journey of your mother, and
• 1:00
  Speaker 2: that is beautiful. At the end, I want to hear
• 1:02
  Speaker 2: a little bit about the party. He says he's getting
• 1:06
  Speaker 2: in transfusions every week.
• 1:07
  Speaker 3: She's yeah, she's about every seven to ten days. She's
• 1:09
  Speaker 3: getting transfusions. And she decides, I've got one more in me.
• 1:14
  Speaker 3: And so I have a nephew who when I was
• 1:17
  Speaker 3: young lived with me for a while, but he and
• 1:18
  Speaker 3: my mother were very close. He was living in New
• 1:21
  Speaker 3: York and he was able to get home, and my
• 1:24
  Speaker 3: sisters and their significant others were there, and aunts and
• 1:30
  Speaker 3: uncles and cousins, the people that were closest to my mom.
• 1:34
  Speaker 3: Probably a two day pizza party with people coming and going,
• 1:38
  Speaker 3: and it was just an opportunity to express love to
• 1:43
  Speaker 3: a person who spent her life taking care of people,
• 1:47
  Speaker 3: and showing her the love and gratitude that she had
• 1:50
  Speaker 3: shared with all of us, and it was nothing but wonderful.
• 1:56
  Speaker 3: My mother and I don't have the same religious beliefs,
• 1:58
  Speaker 3: but we have unbelievably and spiritual beliefs, and we both
• 2:01
  Speaker 3: believe that there was something greater beyond this world. She
• 2:05
  Speaker 3: had a near death experience after a childbirth, and she
• 2:09
  Speaker 3: just has just shared it openly my entire life, and
• 2:13
  Speaker 3: so she didn't have fear of death. And I think
• 2:16
  Speaker 3: that when she was between transfusions, as it got close
• 2:19
  Speaker 3: to him, she was in a lot of pain and
• 2:20
  Speaker 3: discomfort and not herself a little crazy at times or
• 2:26
  Speaker 3: completely out of it, and I think she was just
• 2:29
  Speaker 3: she was ready. She had fought or fight, and she
• 2:31
  Speaker 3: was at peace with moving on. I think that helped
• 2:34
  Speaker 3: a lot. And I think it helped that she and
• 2:37
  Speaker 3: I were absolutely always on the exact same page as
• 2:41
  Speaker 3: far as end of life, what was wanted. We didn't
• 2:44
  Speaker 3: have to talk a whole lot about it because we'd
• 2:46
  Speaker 3: been talking about our whole lives. I always knew, you know,
• 2:49
  Speaker 3: And I think because I'm the responsible party, she always
• 2:53
  Speaker 3: wanted me to know sure I would ensure that. So
• 2:56
  Speaker 3: she got into assisted care. She had the last transfusion
• 3:01
  Speaker 3: and we called hospice.
• 3:04
  Speaker 1: John.
• 3:05
  Speaker 3: They were amazing. Our lead hospice nurse, I kid you not,
• 3:10
  Speaker 3: her name on her birth certificate is Sunshine. God created
• 3:14
  Speaker 3: this am seriously. And the amazing thing to me was
• 3:19
  Speaker 3: is I don't think that hospice was there for my mother.
• 3:23
  Speaker 3: I think they were there for me. They invested in
• 3:28
  Speaker 3: me so that I was prepared for everything that was
• 3:34
  Speaker 3: going to happen, and not just prepared, really well prepared.
• 3:41
  Speaker 3: They taught me because she was an assisted living they
• 3:44
  Speaker 3: couldn't give liquid morphine. They taught me how to mash
• 3:47
  Speaker 3: up morphine pills and mix them with diet coke and
• 3:49
  Speaker 3: put them in a syringe and dribble it into her mouth,
• 3:52
  Speaker 3: and they taught me everything. And I really like because
• 3:55
  Speaker 3: I had to take over there. And by the way,
• 3:57
  Speaker 3: I didn't know this hospice isn't there twenty four to seven.
• 4:00
  Speaker 3: I thought when hospice came in, they were just there.
• 4:04
  Speaker 3: Now they come to visit when you need them. They
• 4:07
  Speaker 3: come to you know, help with a bed, bath or whatever.
• 4:10
  Speaker 3: They would help with those things. But I don't think
• 4:14
  Speaker 3: they were in her room more than four or five
• 4:16
  Speaker 3: times in the ten or eleven days.
• 4:21
  Speaker 1: There's so much high level stuff here.
• 4:22
  Speaker 3: I kind of want to there's so many times ask
• 4:25
  Speaker 3: the questions and all unpacked.
• 4:27
  Speaker 2: The first one that was really significant that I'm listening
• 4:30
  Speaker 2: to this story and it's how prepared she was.
• 4:33
  Speaker 1: She had been acquainted with death at a young age.
• 4:36
  Speaker 2: Yeah, and that prepared her to look death in the
• 4:39
  Speaker 2: face without much fear. And yeah, everybody has that gift
• 4:44
  Speaker 2: for sure. And so I think as we make the
• 4:48
  Speaker 2: journey toward these end of life days, whether we're personally
• 4:52
  Speaker 2: there or we're helping someone else navigate those waters, understanding
• 4:56
  Speaker 2: that if you're not acquainted with death in some way,
• 4:59
  Speaker 2: shape or form, can be very scary and.
• 5:02
  Speaker 1: And yeah, so that's really cool.
• 5:06
  Speaker 3: I think that's part of the role hospice.
• 5:08
  Speaker 1: Hospice one hundred percent, one.
• 5:10
  Speaker 3: Hundred percent prepared. Even though we and they were surprised
• 5:13
  Speaker 3: that we were so comfortable talking about it, we were
• 5:15
  Speaker 3: just unbelievably comfortable. Tell me everything, there everything to expect.
• 5:19
  Speaker 2: The other part that's super clutch is that you and
• 5:22
  Speaker 2: her were always on the same page. And that is
• 5:25
  Speaker 2: so clutch. So often I see someone coming to the
• 5:28
  Speaker 2: hospital they're dying, and.
• 5:33
  Speaker 1: Everybody's it's a firestorm, everybody's afraid.
• 5:36
  Speaker 3: Are arguing about what needs to happen.
• 5:37
  Speaker 2: Nobody's talked to mom about what she wants, and they're
• 5:40
  Speaker 2: all doing what they want.
• 5:42
  Speaker 3: And I didn't have to battle my sisters that we
• 5:46
  Speaker 3: were all on the same page. The mom and I
• 5:48
  Speaker 3: were on the same page, and then we were able
• 5:50
  Speaker 3: to communicate that with the rest of the family so
• 5:52
  Speaker 3: that everybody could accept it. Yeah, there was. There was
• 5:55
  Speaker 3: never an argument about anything, never, not a one. I believe,
• 6:00
  Speaker 3: be grateful we worked about other stuff. You know, goes
• 6:02
  Speaker 3: on the pizza at that party.
• 6:03
  Speaker 2: The piece that brought to your mom or the end
• 6:06
  Speaker 2: of her life is invaluable. To not have anybody squabbling
• 6:09
  Speaker 2: over what she wants, and because because everybody's on the
• 6:12
  Speaker 2: same page when I do hospice, and as someone is
• 6:16
  Speaker 2: approaching those final chapters.
• 6:18
  Speaker 1: We have what I call a group meeting.
• 6:20
  Speaker 2: A family meeting, and and we're going to bring everybody together, grandkids, kids,
• 6:26
  Speaker 2: in this medical office room that's all squished up, like,
• 6:29
  Speaker 2: bring them in because we all need to talk this through.
• 6:31
  Speaker 2: And it's I just listen, and some people are angry,
• 6:34
  Speaker 2: some people are sad, some people are frustrated, and we're
• 6:38
  Speaker 2: listening and we're kicking the ball around and everybody's expressing things.
• 6:42
  Speaker 2: And then I just pause because it's really cool for
• 6:46
  Speaker 2: me to hear what everyone else is thinking and wanting
• 6:49
  Speaker 2: and feeling.
• 6:50
  Speaker 1: And that's beautiful. But the one person.
• 6:52
  Speaker 2: In here who's dying is the most important person to
• 6:55
  Speaker 2: understand what they want.
• 6:58
  Speaker 1: So let's just pause for a minute and let's listen
• 7:00
  Speaker 1: to mom.
• 7:01
  Speaker 2: And sometimes she says, I just want what little Johnny
• 7:03
  Speaker 2: wants or what my grandkid wants, or I just want this. Nope,
• 7:07
  Speaker 2: this is not their journey. This is your journey, and
• 7:09
  Speaker 2: you get to want something, and let's hear it. Let
• 7:12
  Speaker 2: me let me ask a few questions to Guida.
• 7:15
  Speaker 1: If this happens. Do you want this?
• 7:17
  Speaker 2: And this if you if your heart stops and you
• 7:19
  Speaker 2: stop breathing, do you want me to push on your chest,
• 7:23
  Speaker 2: give your medicines bring you back?
• 7:25
  Speaker 1: Do you want that? That's why we're here.
• 7:28
  Speaker 2: Yeah, let's think about it, because that's that is not
• 7:31
  Speaker 2: always the kindest thing to do to someone.
• 7:33
  Speaker 3: Yeah, it's and John, I think because and not a
• 7:37
  Speaker 3: lot of dogs do hospice, right, so you've got unique exposure.
• 7:40
  Speaker 3: I know, it's a different kind of thing, and you're
• 7:43
  Speaker 3: in a small town and that's probably why that mantle
• 7:46
  Speaker 3: fell on you. And but you bring up a great
• 7:49
  Speaker 3: point of I don't know, to express it. Just the
• 7:54
  Speaker 3: expressing what the patient wants and letting all of the
• 7:59
  Speaker 3: family hear it helps everybody deal with it in hopefully
• 8:04
  Speaker 3: a better way. And I'm grateful that my mom was
• 8:07
  Speaker 3: really comfortable talking about it, and that I was really
• 8:11
  Speaker 3: comfortable talking about it and addressing it with people, whether
• 8:14
  Speaker 3: Mom was in the room or not, and just in
• 8:17
  Speaker 3: creating a coalition before the final days so that there
• 8:22
  Speaker 3: wasn't an argument. The one thing I knew my mom
• 8:25
  Speaker 3: wanted long before we were talking hospice was when the
• 8:29
  Speaker 3: doctors were saying she's got two or three years. Maybe
• 8:33
  Speaker 3: they're wrong, that's okay. You know, you know what they
• 8:35
  Speaker 3: call the person that graduates last in medical school, right,
• 8:38
  Speaker 3: they call him doctor. Sorry, that's just for you, John.
• 8:42
  Speaker 3: So they and I'm not saying that they were wrong.
• 8:44
  Speaker 3: I think they were just trying to be kind and
• 8:46
  Speaker 3: polite and give hope. But the struggle with not having
• 8:50
  Speaker 3: everybody on the same page was something we just have
• 8:52
  Speaker 3: to deal with. And every medical drama has it. I've
• 8:55
  Speaker 3: watched it unfold on your favorite medical show where siblings
• 8:58
  Speaker 3: are arguing over what's going to happen. We didn't have that,
• 9:00
  Speaker 3: And part of it was I knew the importance of
• 9:03
  Speaker 3: having a coalition and getting people to buy in early.
• 9:07
  Speaker 3: And it started with the even when you had two
• 9:10
  Speaker 3: more years to live, sitting down with mom and her
• 9:12
  Speaker 3: doctor saying she wants a DNR. She wants to do
• 9:15
  Speaker 3: not resuscitate. She's made it very clear to me. Can
• 9:19
  Speaker 3: you please ask her because I don't want to come
• 9:21
  Speaker 3: in from me and used to come from her.
• 9:24
  Speaker 2: They've changed the name of that now allow natural Death, okay,
• 9:28
  Speaker 2: which is beautiful.
• 9:29
  Speaker 1: It's kind of nice.
• 9:29
  Speaker 3: Is it still on the pink sheet? That goes on
• 9:31
  Speaker 3: the refrigerators a pink or yellow.
• 9:35
  Speaker 1: Yeah, that's so beautiful.
• 9:37
  Speaker 2: At one point in her journey she said, I have one.
• 9:41
  Speaker 1: Tell me about that for you.
• 9:42
  Speaker 2: For her, that is the precipice that when when someone's
• 9:51
  Speaker 2: close to death, they can feel it in their bones,
• 9:54
  Speaker 2: they know it's happening, and they kind of stop fighting
• 10:00
  Speaker 2: doing the extra because.
• 10:01
  Speaker 1: It's not always kind because we can.
• 10:03
  Speaker 2: Should we in medicine, is I think always should be
• 10:07
  Speaker 2: asked yeah, by the patient, by the doctor.
• 10:10
  Speaker 1: By the team.
• 10:11
  Speaker 2: We should look at that, we should talk about that
• 10:14
  Speaker 2: because we could keep transfusing you until the end of time.
• 10:18
  Speaker 1: That's a really crappy life.
• 10:21
  Speaker 2: And tell me about that moment when she decided it's
• 10:24
  Speaker 2: okay to die.
• 10:25
  Speaker 3: So first of all, making the decision to have one
• 10:29
  Speaker 3: more transfusion, knowing I've got a week to ten days,
• 10:33
  Speaker 3: because that's literally what she said. By saying I've got
• 10:37
  Speaker 3: one more transfusion when we had one scheduled for forty
• 10:39
  Speaker 3: eight hours later or something like that, it's like she's
• 10:42
  Speaker 3: literally she literally assigning her death sentence. Right she's and
• 10:47
  Speaker 3: at the same time, she's still a person, She's still
• 10:50
  Speaker 3: a normal human and the only argument that we ever had,
• 10:56
  Speaker 3: because we had just moved her into this assisted living.
• 10:59
  Speaker 3: She's in this large studio apartment with a big, beautiful bathroom.
• 11:03
  Speaker 3: It's brand new, nobody's ever lived in it. It's gorgeous,
• 11:06
  Speaker 3: it's got a view of the mountains. It's awesome. And
• 11:10
  Speaker 3: she says, I really want you to bring in that
• 11:14
  Speaker 3: Crups coffee maker.
• 11:15
  Speaker 1: That I have.
• 11:16
  Speaker 3: And I said why, She says, in case I want
• 11:18
  Speaker 3: to make coffee. I said, Mom, you can't get out
• 11:21
  Speaker 3: of bed. They bring you coffee every time you ask
• 11:25
  Speaker 3: for it. It's hot and perfect and wonderful. And why
• 11:30
  Speaker 3: are we having this conversation. I would just feel better
• 11:33
  Speaker 3: if it's here. I said, Okay, I will go bring
• 11:35
  Speaker 3: it here. I'm going to tell you right now two things. One,
• 11:37
  Speaker 3: I'm not plugging it in not making me a coffee,
• 11:40
  Speaker 3: because I can go downstairs and bore you a cup
• 11:42
  Speaker 3: and bring it here. And but it was to me,
• 11:45
  Speaker 3: it was just indicative of she's still she's still a personally.
• 11:49
  Speaker 4: It was her autonomy. It was it was it was
• 11:52
  Speaker 4: I want this to be my home. And I acknowledge
• 11:56
  Speaker 4: that I've got a week to ten days, but this
• 11:59
  Speaker 4: is my home, and I want to make it my home.
• 12:01
  Speaker 3: Great, what else do you want? I'll bring it whatever
• 12:03
  Speaker 3: it is. Yeah, not that dog, it's horrible.
• 12:07
  Speaker 1: Yeah.
• 12:09
  Speaker 2: The autonomy part of end of life is hard because
• 12:12
  Speaker 2: as they move into aging, they lose layers of autonomy.
• 12:16
  Speaker 2: I can't drive anymore. Ye, there goes my mobility. I
• 12:20
  Speaker 2: can't walk very well anymore. I can't walk without the
• 12:22
  Speaker 2: stupid walker anymore. So there's all these little pieces of
• 12:24
  Speaker 2: autonomy that slowly fade as we age. I'm having to
• 12:28
  Speaker 2: wear readers now, and it's annoying. I'm losing some degree.
• 12:33
  Speaker 1: Down, but you.
• 12:35
  Speaker 2: Can imagine the higher levels of autonomy losses we age
• 12:39
  Speaker 2: is tough.
• 12:39
  Speaker 1: And so giving her that, Yes, I will go gain
• 12:42
  Speaker 1: coffee maker. That's beautiful. That's beautiful. Yes, I'll do that.
• 12:45
  Speaker 3: I could have done a little more lovingly, but yes,
• 12:48
  Speaker 3: I'm not plugging it in. I'm not plugging it. I'm
• 12:50
  Speaker 3: good getting a fresh You can look at it all
• 12:52
  Speaker 3: you want.
• 12:53
  Speaker 1: It doesn't even make good coffee. What are you talking about? So?
• 12:58
  Speaker 3: Yeah, it was again, I want to read it. The
• 13:00
  Speaker 3: thing that really blew me away when getting back to hospice,
• 13:05
  Speaker 3: I was flabbergasted at how well they prepared me and
• 13:09
  Speaker 3: in going through I didn't know that there are stages
• 13:12
  Speaker 3: of death that it's literally like you when sometimes they're
• 13:16
  Speaker 3: really short. This this stage could be really short, it
• 13:18
  Speaker 3: could be really long, and it didn't matter what anybody said.
• 13:23
  Speaker 3: The best compliment that I received about my mother and
• 13:28
  Speaker 3: I and what we were going through. So this was
• 13:30
  Speaker 3: a large assisted living in Redding, California. Beautiful place.
• 13:34
  Speaker 1: It was wonderful.
• 13:35
  Speaker 3: They took great care of my mother in the short
• 13:37
  Speaker 3: time she was there. She wasn't there two weeks, barely,
• 13:40
  Speaker 3: barely two weeks, maybe three, but not longer than that
• 13:44
  Speaker 3: as she was winding down and she was pretty much
• 13:47
  Speaker 3: out of it the last two and a half days.
• 13:51
  Speaker 3: In the middle of the night, you know, a medical
• 13:53
  Speaker 3: technician kind of they were checking on every hour. Sent
• 13:55
  Speaker 3: around hospice. They have to come by once an hour
• 13:57
  Speaker 3: to make sure everything's okay. I'm asleep in a chair
• 14:00
  Speaker 3: with you know, horrible afghan pulled over me. Why the
• 14:02
  Speaker 3: horrible afghan because that's what made mom feel at home?
• 14:05
  Speaker 3: And the door knocked and I opened an eye when
• 14:07
  Speaker 3: I got this, and I went yeah, And they said
• 14:10
  Speaker 3: ask you a question, and I said, yeah, sure, won
• 14:13
  Speaker 3: it and she's whispering, and I said, you don't need
• 14:15
  Speaker 3: to whisper. She's out. She's out. And she says, I
• 14:22
  Speaker 3: got to know two things. If it's okay, I said,
• 14:24
  Speaker 3: you can ask me anything. And she said, are you
• 14:29
  Speaker 3: a minister? And I said, not really, but not really.
• 14:33
  Speaker 3: I'm very involved in my church, but I'm like and
• 14:36
  Speaker 3: she said, we've all been talking about you. I said,
• 14:39
  Speaker 3: who's we all?
• 14:40
  Speaker 1: Like?
• 14:40
  Speaker 3: All the medical texts. This place is swarming with them, right,
• 14:43
  Speaker 3: it's a large place. She says, this is the happiest
• 14:48
  Speaker 3: room on hospice we've ever seen. Just there's laughter coming
• 14:51
  Speaker 3: out of this room all day and all night. And
• 14:54
  Speaker 3: I said, we're happy people, you know. We believe that
• 14:57
  Speaker 3: there's something greater beyond this world. And she says that's awesome.
• 15:02
  Speaker 3: I said, what's the other question? And she said and
• 15:04
  Speaker 3: she started to cry. I said, are you okay? And
• 15:07
  Speaker 3: she said, two nights ago, I was medicating your mother.
• 15:11
  Speaker 3: You remember, And I said, yeah, I remember. She says
• 15:15
  Speaker 3: I was making a mistake and giving her medication. You
• 15:20
  Speaker 3: caught it, you told me, and I was convinced I
• 15:24
  Speaker 3: was right. And an hour later, when I came back,
• 15:27
  Speaker 3: you showed me how I had done everything wrong and
• 15:29
  Speaker 3: I said, you made a mistake.
• 15:30
  Speaker 1: It's okay.
• 15:33
  Speaker 3: She says, the mistake I made is the kind of mistake.
• 15:35
  Speaker 1: That gets people.
• 15:36
  Speaker 3: And I said, you made a mistake, it's okay.
• 15:39
  Speaker 1: I said, it's.
• 15:40
  Speaker 3: Not like you're going to kill her. You know that's
• 15:43
  Speaker 3: inevitable at this point. You made a mistake, and it's okay.
• 15:48
  Speaker 3: And she just was like, I can't thank you enough.
• 15:50
  Speaker 3: I said, it's fine. Did you learn anything?
• 15:52
  Speaker 1: Yeah?
• 15:52
  Speaker 3: I said, great, you'll take that the rest of your life,
• 15:55
  Speaker 3: and you'll be forgiving of somebody else who's made a mistake,
• 15:58
  Speaker 3: because we're all human make mistakes.
• 16:00
  Speaker 1: It's okay.
• 16:02
  Speaker 3: Anyway, that was just just because that was cool. These
• 16:04
  Speaker 3: things were kind of winding down. Those were the conversations
• 16:07
  Speaker 3: that were being had.
• 16:08
  Speaker 2: I want to make a point about caretaking as you're
• 16:12
  Speaker 2: in that room with her. It's one of the most
• 16:14
  Speaker 2: common things I see as someone loses their autonomy, they're
• 16:17
  Speaker 2: heading toward the final chapter of their life. There's caretakers
• 16:20
  Speaker 2: that need to step in and it's beautiful and it's awesome,
• 16:24
  Speaker 2: and then sometimes it's not, and sometimes it's really hard,
• 16:28
  Speaker 2: and then sometimes there's caretaker fatigue. And the most I
• 16:32
  Speaker 2: think people feel guilty about it. Yeah, like I should
• 16:35
  Speaker 2: be taking care of my mom twenty four to seven
• 16:36
  Speaker 2: and I can't and I can't do this, and they
• 16:38
  Speaker 2: feel bad. And it's a struggle for everybody because mom
• 16:42
  Speaker 2: or Dad's not getting the care that they need because
• 16:44
  Speaker 2: you're exhausted.
• 16:45
  Speaker 1: And you know you need help.
• 16:47
  Speaker 2: And so I want to I want our listeners to
• 16:48
  Speaker 2: know about resources for this timeframe, and one of them
• 16:52
  Speaker 2: is home health. They can come in and bathe mom
• 16:55
  Speaker 2: three times a week, four times a week. Whatever, they
• 16:57
  Speaker 2: can come in and do housework, they get and it's
• 17:00
  Speaker 2: all working through your primary care doc. We can order
• 17:03
  Speaker 2: all of the things. We often order a nurse assessment.
• 17:05
  Speaker 2: We'll send a nurse out to the home. They'll look
• 17:07
  Speaker 2: at all the needs of the home, including bathroom in
• 17:10
  Speaker 2: stalls and all the seats and the housing, trip hazards
• 17:13
  Speaker 2: and all the things, and they can help Mom be
• 17:15
  Speaker 2: comfortable at home. And that works for a season, but
• 17:19
  Speaker 2: then eventually Mom might not be able to stay there,
• 17:22
  Speaker 2: and that's really hard, that transition to have to go
• 17:24
  Speaker 2: to a skilled nursing facility, assisted living facility, and then
• 17:29
  Speaker 2: eventually to the highest level of care.
• 17:31
  Speaker 1: Which would be like the nursing home.
• 17:32
  Speaker 2: Those are difficult steps for everybody involved, and I want
• 17:37
  Speaker 2: folks to know that there are resources available to give
• 17:41
  Speaker 2: them respite from their caretaking out mom. But then there's
• 17:44
  Speaker 2: also the facilities that are appropriate at some point and
• 17:47
  Speaker 2: never feel guilty about that. The most common form of
• 17:50
  Speaker 2: abuse in the elderly neglect and you have no intention
• 17:55
  Speaker 2: of doing that.
• 17:56
  Speaker 1: You're just so fatigued it's happening. And that is where
• 17:59
  Speaker 1: I want.
• 18:00
  Speaker 2: It's a tender it's a tender space because there's a
• 18:02
  Speaker 2: whole bunch of feelings there and so I often have
• 18:05
  Speaker 2: that long discussion with my you know, person who's dying
• 18:10
  Speaker 2: and person who's caring for a person who's dying, or people,
• 18:13
  Speaker 2: and we just get rid of the shame and the
• 18:15
  Speaker 2: guilt and we do the right thing for Mom, even
• 18:19
  Speaker 2: if it's hard, and we give mom autonomy. Yes you
• 18:22
  Speaker 2: get your coffee maker, Yes you get your terrible blanket
• 18:25
  Speaker 2: that you've had forever. It's okay, and it is hard.
• 18:28
  Speaker 3: I know you want that chair, but it's nasty. I'm
• 18:30
  Speaker 3: buying you a new chair.
• 18:31
  Speaker 1: Yeah.
• 18:32
  Speaker 2: And the hurdle of going to the care center of
• 18:35
  Speaker 2: whatever care center that needs to. That's also a hurdle,
• 18:38
  Speaker 2: an emotional mental hurdle that that has to be overcome
• 18:40
  Speaker 2: as well.
• 18:41
  Speaker 1: But it's all in the.
• 18:42
  Speaker 2: Best interest of the whole team. It is about the
• 18:46
  Speaker 2: person who is passing towards the end of their life,
• 18:49
  Speaker 2: but it's also about the people who are caring for
• 18:51
  Speaker 2: that person as well.
• 18:52
  Speaker 1: And like you said, hospice is you're like, hospice was
• 18:55
  Speaker 1: for me, not for it's way for me. That is
• 18:58
  Speaker 1: super true. It is for the whole of it.
• 19:00
  Speaker 2: I delivered babies for a long time while I was
• 19:03
  Speaker 2: in MOEP as well, and I found hospice and delivering
• 19:07
  Speaker 2: babies to be very similar in a lot of ways.
• 19:09
  Speaker 2: There's something sacred to those passing through the veil in
• 19:12
  Speaker 2: both directions. It's raw and it's real and it's hard,
• 19:18
  Speaker 2: but it's beautiful. Yeah, it's poignant, and it's just so
• 19:21
  Speaker 2: sobering and emotional and beautiful, and it can be a
• 19:26
  Speaker 2: really beautiful process.
• 19:29
  Speaker 3: I witnessed it, and I'm happy to tell you about it,
• 19:31
  Speaker 3: but I just want to reiterate what kind of what
• 19:34
  Speaker 3: you were just talking about in that unbeknownst to me
• 19:39
  Speaker 3: for about a year and a half before I flew
• 19:42
  Speaker 3: in to take over. I had no clue that my
• 19:47
  Speaker 3: aunt had been acting as a primary caregiver for my mother.
• 19:51
  Speaker 3: I knew they were together a lot, they're clothes I had.
• 19:55
  Speaker 3: They were both keeping it from me that my mother
• 19:59
  Speaker 3: had heard left her unless she was going to a
• 20:01
  Speaker 3: doctor at hardly left home. I had no clue, you know,
• 20:06
  Speaker 3: that she was what she was. And when things got
• 20:09
  Speaker 3: rough and I got parachuted in, I quickly became aware
• 20:12
  Speaker 3: that things were way worse than I thought, and I
• 20:16
  Speaker 3: remembered and I had to be tough love at times
• 20:20
  Speaker 3: when my mom was in the rehab facility after she
• 20:22
  Speaker 3: fell on her face, had a horrible concussion, and while
• 20:25
  Speaker 3: she was in the hospital, they had to move her
• 20:27
  Speaker 3: to a rehab facility. And after about a week and
• 20:30
  Speaker 3: a half in the rehab facility, you know, my mom
• 20:32
  Speaker 3: says when I get back home, and I said, Mom,
• 20:35
  Speaker 3: I got tough news for you. We've passed. We've passed
• 20:39
  Speaker 3: the ability for home to have anything to offer you,
• 20:44
  Speaker 3: with the exception of if we brought in a couple
• 20:46
  Speaker 3: of people full time to help, because that's where you're at,
• 20:49
  Speaker 3: not just a person to help. It's way more.
• 20:51
  Speaker 1: Than me and I did see take that.
• 20:54
  Speaker 3: It was a rough twenty four hours. I don't think so,
• 20:58
  Speaker 3: I don't ye. It was definitely hard and I'm probably
• 21:02
  Speaker 3: the only person on earth that could have told her
• 21:04
  Speaker 3: that and for her to listen. And I'm grateful that
• 21:09
  Speaker 3: we had the relationship that I because she just had
• 21:11
  Speaker 3: somebody had to make the decision and she wasn't going
• 21:13
  Speaker 3: to make it. I'm sorry that your days and again
• 21:17
  Speaker 3: we were the playbook we were given was two to
• 21:19
  Speaker 3: three years, so this wasn't it was terminal, but it
• 21:23
  Speaker 3: wasn't immediate. It wasn't until we got her into assisted
• 21:27
  Speaker 3: living that it became immediate. And she thought, you know,
• 21:31
  Speaker 3: I'm being taken out of my house. I'm never going
• 21:33
  Speaker 3: to drive again. And she's I want to go back
• 21:36
  Speaker 3: one last time, and I said, I'll FaceTime. We can
• 21:38
  Speaker 3: walk through the house if that's what you want. How
• 21:40
  Speaker 3: am I going to get you in the house. There's
• 21:42
  Speaker 3: four steps to get in. You're morbidly obese, you can't walk,
• 21:49
  Speaker 3: you know.
• 21:49
  Speaker 1: Yeah.
• 21:50
  Speaker 3: It was just the tough love that could only come
• 21:54
  Speaker 3: from at this point of incredibly loving son. Loved her immensely.
• 21:59
  Speaker 1: She gave you that, I love your whole life too
• 22:02
  Speaker 1: all the time, and it's totally fine. I think I
• 22:06
  Speaker 1: loved your courage.
• 22:07
  Speaker 2: I love that there was no guilt or shame around
• 22:10
  Speaker 2: your toughness and and I think that those are hurdles
• 22:14
  Speaker 2: that most people have to overcome. And yeah, sometimes it
• 22:17
  Speaker 2: takes a lot of talking and some therapy and some counsel.
• 22:20
  Speaker 3: Yeah. There were three separate occasions where I had to say,
• 22:23
  Speaker 3: we have to have the serious talk right now, and
• 22:26
  Speaker 3: I'm sorry that we have to have it, you know,
• 22:28
  Speaker 3: And one was, you know, when's the last transfusion you
• 22:31
  Speaker 3: get to choose? One was I'm sorry, but you're not
• 22:35
  Speaker 3: going back home. And there were a couple of other
• 22:37
  Speaker 3: associated with them were just difficult decisions that had to
• 22:40
  Speaker 3: be made that she could not make. Yeah, And eventually,
• 22:44
  Speaker 3: in this she turned all decision making over to me.
• 22:50
  Speaker 3: She was comfortable with whatever decision that I had because
• 22:54
  Speaker 3: because she understood that we were on the same page.
• 22:57
  Speaker 3: And I just I think the fact that she could
• 22:59
  Speaker 3: hear it from me. She heard me on the phone
• 23:01
  Speaker 3: with the family members, she heard me talking to nurses
• 23:04
  Speaker 3: and doctors. She knew that we were on the same page,
• 23:06
  Speaker 3: and I think that made it so much comfortable for her,
• 23:09
  Speaker 3: for me just to take over everything, and it was
• 23:14
  Speaker 3: I'm grateful I had an employer that was unbelievably understanding
• 23:18
  Speaker 3: because I was gone all summer. You know, there was
• 23:20
  Speaker 3: a period of time where I was back as soon
• 23:21
  Speaker 3: as I got home. There were two or three separate
• 23:24
  Speaker 3: occasions that the day after I got home after being
• 23:28
  Speaker 3: out there for a couple of weeks, something happened and
• 23:31
  Speaker 3: I was literally like on the phone with my mother
• 23:34
  Speaker 3: or my aunt or a doctor and telling my wife,
• 23:37
  Speaker 3: get me on the next flight. In fact, knowing that
• 23:43
  Speaker 3: I left a vehicle in the Sacramento airport because it
• 23:47
  Speaker 3: was just easier than renting cars. I drove out there
• 23:49
  Speaker 3: and just left a car at the airport and figured
• 23:51
  Speaker 3: it's cheaper to just leave a car at the airport
• 23:53
  Speaker 3: because I'm coming back.
• 23:54
  Speaker 1: I just don't know, that's funny. How did you deal
• 23:58
  Speaker 1: with your caretaker fatigue? She was in a care center
• 24:01
  Speaker 1: ish type thing.
• 24:02
  Speaker 3: I think the fatigue comes from the you always hear
• 24:05
  Speaker 3: it's a marathon, not a sprint. I got to show
• 24:07
  Speaker 3: up for the sprint. Yeah, you know, I was there
• 24:11
  Speaker 3: two and a half months.
• 24:12
  Speaker 1: That's a pretty long sprint, man.
• 24:14
  Speaker 3: Yeah, but none of that, but all of that time
• 24:18
  Speaker 3: she was under care, so I was clearing out the
• 24:22
  Speaker 3: house and selling it. I did not sit still. I
• 24:24
  Speaker 3: was busy the whole time. But it wasn't all caring
• 24:27
  Speaker 3: for an aging sick mother. We had people to do that.
• 24:31
  Speaker 3: I was with her three meals a day. I would
• 24:32
  Speaker 3: always come over for meal time. But I was busy
• 24:36
  Speaker 3: cleaning up her life. You know, the finances and the banking,
• 24:39
  Speaker 3: all the stuff that she told me she was taking
• 24:41
  Speaker 3: care of. None of it had been taken care of.
• 24:42
  Speaker 3: I'm still digging out taxes and stuff.
• 24:45
  Speaker 2: And we've been talk enough about that space. I think
• 24:48
  Speaker 2: my father passed a couple of years and it was astronomical.
• 24:52
  Speaker 2: It's been brutal, astronomical. All the medical bills, all the
• 24:56
  Speaker 2: follow ups, all the things I had.
• 24:58
  Speaker 3: I had come today for pathology.
• 25:02
  Speaker 1: She died in August.
• 25:04
  Speaker 3: It's June, ten months almost of the day.
• 25:08
  Speaker 1: Brutal, just tough.
• 25:09
  Speaker 3: Yeah, anyway, changing gears. Can I share the end, Yes,
• 25:16
  Speaker 3: because it was about the most beautiful thing I've ever
• 25:17
  Speaker 3: witnessed in my entire life. Gives me hope for my future. Everybody,
• 25:24
  Speaker 3: the party was over, she'd had her three good days
• 25:29
  Speaker 3: and things started dropping off, and then she was out
• 25:34
  Speaker 3: her last words. I came into her room at one
• 25:37
  Speaker 3: point and she was having a full on conversation with somebody,
• 25:41
  Speaker 3: and she'd been pretty out of it, and I walked in.
• 25:44
  Speaker 3: She was talking to somebody who wasn't there, and I said, Hey,
• 25:48
  Speaker 3: you talking to somebody. She goes, oh yeah, And I said,
• 25:52
  Speaker 3: cause you have a full on conversation with somebody. You
• 25:54
  Speaker 3: got visitors here. She goes, oh yeah, And I said,
• 25:58
  Speaker 3: who are you talking to? And crap, what was the
• 26:02
  Speaker 3: name she gave? She gave some silly name for somebody
• 26:04
  Speaker 3: and none of us know who it was. It's like
• 26:07
  Speaker 3: her husband was Jimmy, and so it wasn't Jimmy, but
• 26:09
  Speaker 3: it was something like Jimmy when it issue. But she
• 26:12
  Speaker 3: was having a full on conversation with somebody. And that
• 26:13
  Speaker 3: was our last conversation. I had not shaved in quite
• 26:17
  Speaker 3: a while and i'd just shaved that morning, and she's, oh,
• 26:20
  Speaker 3: you got your hair and you shaved. And that was
• 26:22
  Speaker 3: the last conversation we had. And then she was out
• 26:24
  Speaker 3: of it, and I was medicating her on a clock,
• 26:26
  Speaker 3: and hospice had really prepared me well for everything that
• 26:29
  Speaker 3: needed to happen. And as things were really coming to
• 26:31
  Speaker 3: the end, my little sister showed up with her husband
• 26:35
  Speaker 3: and they came in late at night and I said, okay,
• 26:38
  Speaker 3: I'll spend the night tonight, call me in the morning,
• 26:41
  Speaker 3: come over around breakfast time. I just need to go.
• 26:44
  Speaker 3: I had a cot set up, I'd cleared out my
• 26:45
  Speaker 3: mom's whole house. All I had was a cotton a
• 26:47
  Speaker 3: sleeping bag in the whole house, a refrigerator that was
• 26:49
  Speaker 3: a I said, I need, I just have to sleep.
• 26:52
  Speaker 3: I have to sleep in a quasi bed. And so
• 26:56
  Speaker 3: my sister called and she showed up and I said.
• 27:00
  Speaker 3: I met her outside the room and I said, I
• 27:02
  Speaker 3: have to prepare you. Hospice has prepared me. But since
• 27:05
  Speaker 3: you left here last night, Mom's breathing has gotten really scary.
• 27:10
  Speaker 3: I said. They have a name for it. It's the worst
• 27:12
  Speaker 3: name you could possibly imagine. They call it the death rattle.
• 27:16
  Speaker 3: I said, please, no, she's not in any discomfort. It
• 27:19
  Speaker 3: sounds horrible, you know what it sounds like. Sounds like
• 27:22
  Speaker 3: she's dying. And I said, I'll be surprised if she
• 27:27
  Speaker 3: makes it through the day. So it's go time, okay,
• 27:30
  Speaker 3: but let me so we came in. She said, okay,
• 27:33
  Speaker 3: you know my dad died two years ago. I've heard
• 27:35
  Speaker 3: this before two starting. I said, okay, great, I said, okay,
• 27:38
  Speaker 3: I'm going to go home. I'm going to sleep for
• 27:40
  Speaker 3: two or three hours for the most. I reached for
• 27:43
  Speaker 3: the door, and John before I got to the door,
• 27:45
  Speaker 3: I stopped and I turned my sister. I said, you
• 27:49
  Speaker 3: feel that says what I said. Mom's dying right now,
• 27:54
  Speaker 3: said how do you know? As I can feel it.
• 27:57
  Speaker 3: And we sat on either side of her bed, holding
• 27:59
  Speaker 3: her hand and telling her that we loved her, and
• 28:02
  Speaker 3: telling her it was okay to go, and maybe ninety
• 28:06
  Speaker 3: seconds woll and when it was over, my sister was
• 28:13
  Speaker 3: just big tears around. She had the most beautiful blue
• 28:16
  Speaker 3: eyes and she just looked at me and she says,
• 28:19
  Speaker 3: I had no clue it could be that peaceful. Oh,
• 28:22
  Speaker 3: I said, I've only experienced this once before. This clothes
• 28:26
  Speaker 3: It's about as peaceful as it gets. And that's the
• 28:30
  Speaker 3: memory I want. And I'll be honest with you. We
• 28:34
  Speaker 3: had so much time together that she was winding things down,
• 28:38
  Speaker 3: and we laughed and we cried and we held each other,
• 28:42
  Speaker 3: cleared up any of the crap that families have. I don't.
• 28:47
  Speaker 3: I just don't think I've experienced grief, and I don't
• 28:49
  Speaker 3: think it's not coming. I just think that I'm just
• 28:53
  Speaker 3: okay with it that she's gone on to somewhere better.
• 28:57
  Speaker 3: I believe that she did, and I'm cool with that.
• 29:02
  Speaker 3: And I love that my little sister could be there
• 29:08
  Speaker 3: and experience that after having gone through a traumatic death
• 29:11
  Speaker 3: of her father because it wasn't pleasant to do everything
• 29:14
  Speaker 3: they could to keep them alive.
• 29:15
  Speaker 2: And Michael, thanks for sharing that. I think it can
• 29:18
  Speaker 2: be so beautiful and peaceful like that. Hospice has such
• 29:22
  Speaker 2: a unique skill set, but then also to give certain
• 29:26
  Speaker 2: medicines at certain times and to train you how to
• 29:28
  Speaker 2: do that and make sure that those are in place.
• 29:32
  Speaker 2: The morphine toward the end, it helps with air hungry,
• 29:36
  Speaker 2: so there's a sense when that hits that you know
• 29:39
  Speaker 2: and morphine just takes that away so you're not suffering
• 29:42
  Speaker 2: as much.
• 29:43
  Speaker 1: And so it's really neat the understanding.
• 29:47
  Speaker 5: They prepared me that even when she was out, I
• 29:53
  Speaker 5: knew what to look for that when she was in pain, like, oh,
• 29:56
  Speaker 5: we need to push through bedstyle.
• 29:57
  Speaker 3: Yeah, we're on the clock. We've been following everything, but
• 30:00
  Speaker 3: we've got this extra that we can apply at this point.
• 30:02
  Speaker 3: And knowing that and recognizing it, I just felt so.
• 30:07
  Speaker 1: Unbelievably prepared.
• 30:10
  Speaker 2: I think the closure towards the end of someone's life
• 30:13
  Speaker 2: is it matters, and it matters the grief. I'm ducking
• 30:18
  Speaker 2: like my matters the greef. It really changes the grief.
• 30:22
  Speaker 2: Because you had such a beautiful closure and such a thorough, beautiful,
• 30:26
  Speaker 2: consistent closure on that chapter that.
• 30:31
  Speaker 1: I don't know that there will be a ton of.
• 30:33
  Speaker 2: Grief for you because it was just such a beautiful closure.
• 30:37
  Speaker 2: I think it's a model for us to look at
• 30:40
  Speaker 2: and to say, this end of life thing can be beautiful,
• 30:43
  Speaker 2: can be peaceful. It's always hard, there are always hurdles,
• 30:47
  Speaker 2: but I think your story is so profound because of
• 30:50
  Speaker 2: the courage, the direct conversations, the love and the support.
• 30:55
  Speaker 2: I hope our listeners get as much out of it.
• 30:58
  Speaker 3: I don't want to make it no judgment or grief,
• 31:00
  Speaker 3: because I've had it at other times. No judgment.
• 31:03
  Speaker 2: Yeah, and it'll come, there's waves, it it hits in
• 31:06
  Speaker 2: different ways. But I think it was the closure that
• 31:08
  Speaker 2: you had that was so beautiful. And I've seen death
• 31:11
  Speaker 2: in a whole bunch of different ways and a whole
• 31:14
  Speaker 2: bunch of different people, and and it's always hard. It's
• 31:17
  Speaker 2: always hard, but it's it's sometimes beautiful, it's sometimes not beautiful,
• 31:22
  Speaker 2: but at the end it's there's relief there for everybody involved.
• 31:26
  Speaker 2: And I used to think we're kinder to our animals
• 31:29
  Speaker 2: than to our people, because I grew up rural, and
• 31:32
  Speaker 2: you know, we take care of an old dog or
• 31:34
  Speaker 2: an old goat or an old horse that was suffering,
• 31:38
  Speaker 2: and that's what it was.
• 31:40
  Speaker 1: It was pragmatism. There was love there still, but it
• 31:43
  Speaker 1: was strong.
• 31:44
  Speaker 2: And I used to get really flustered at hospice a
• 31:47
  Speaker 2: little bit because I'm like, I saw some horrific suffering,
• 31:51
  Speaker 2: horrible suffering, just horrible. But as I spent more time there,
• 31:58
  Speaker 2: several more years, I realized something new, and that was
• 32:03
  Speaker 2: that person that was suffering in my eyes, really had
• 32:06
  Speaker 2: already left. There was a body with automatic systems in
• 32:10
  Speaker 2: play to keep breathing and to keep the heart going,
• 32:13
  Speaker 2: but they were pretty much gone. And that end of
• 32:16
  Speaker 2: life chapter, the growth that happened there was not for
• 32:20
  Speaker 2: that person. It was for all the other people taking
• 32:24
  Speaker 2: care of that person. And I saw it as a
• 32:27
  Speaker 2: growth experience for the community, their family, and not just
• 32:33
  Speaker 2: suffering of that one person. I changed my view on it,
• 32:37
  Speaker 2: and so yeah, end of life is beautiful. It's hard,
• 32:40
  Speaker 2: and it's for everybody. Thanks for sharing your story today,
• 32:44
  Speaker 2: Michael Webb, You're awesome.
• 32:46
  Speaker 3: It's Roberta's story. Happily share roberta story.
• 32:50
  Speaker 2: Roberta. Sorry to our listeners. I hope you learned some
• 32:53
  Speaker 2: cool stuff. There's so much to end of life. If
• 32:56
  Speaker 2: you or loved one are in that chapter of life,
• 32:59
  Speaker 2: talk to your prime doc. They can get stuff ordered.
• 33:03
  Speaker 2: Home health, hospice, palliative care. It's we didn't talk much
• 33:07
  Speaker 2: about that, but that's the step just before hospice, and
• 33:10
  Speaker 2: they're often married to each other. You can switch from
• 33:12
  Speaker 2: palliative to hospice and actually back.
• 33:15
  Speaker 1: And back and forth. You can do that. There's all
• 33:17
  Speaker 1: kinds of little.
• 33:18
  Speaker 2: Minutia in that journey, but family physicians are trained in it.
• 33:22
  Speaker 1: We're trained to help navigate it.
• 33:25
  Speaker 2: We're not as much trained to do hospice unless you're
• 33:28
  Speaker 2: rural like me. But but it's beautiful and there are
• 33:32
  Speaker 2: resources for folks, and talk to your docs, talk to
• 33:35
  Speaker 2: the nurses, and start learning about it.
• 33:37
  Speaker 1: Thank you.