Season 1 Episode 10: Overworked and underrated: Hospice CNA’s!

Thanks for joining Hospice Nurse Penny and Halley (Hospice Social Worker) on the journey to #NormalizeDeath! Our guest is Celeste Wooten. Celeste has been a Hospice CNA for over 25 years. She also obtained her Associates Degree as a Medical Assistant as well being a CHPNA (Certified Hospice Palliative Nursing Assistant. She also holds certifications as a dementia practitioner, grief coach and an end of life doula. She serves on several community boards helping families navigate hospice, dementia and caregiving. Celeste is the CNA Lead for Bristol Hospice in Virginia Beach. When not involved in community outreach, Celeste spends time with husband, Eric, three adult children and two grandsons. LinkedIn: Celeste M. Wooten TikTok: HospiceCNA2u! Instagram: livelikeyouweredyingdoula Thanks for joining Hospice Nurse Penny and Halley (Hospice Social Worker) on the journey to #NormalizeDeath! You can reach us at [e-mail],  on all places you find podcasts are found. A video option can be found on YouTube at https://www.youtube.com/@DeathHappensInsiders Hospice Nurse Penny on the socials: @HospiceNursePenny Halley on Instagram, TikTok, and Facebook: @HospiceHalley Our intro music was composed by Jamie Hill (misfitstars.com)

Episode Transcript

(00:00):
- Once their loved one's gone,
sometimes they feel forgotten.
Mm-Hmm. . Mm-Hmm.. 'cause they're
like, oh, everything's over now.
And so, you know, I I I liketo liken it to the point of,
it's almost like a caregiver loses a job
because their job is over.
Mm-Hmm. And so, notonly are they, they are

(00:21):
mourning the loss of their loved one,
but now they have to figureout who they're again
and learn their new normal.
- Welcome to the Death Happens podcast.
An insider's guide toDying. We're your insiders.
I'm Hospice Nurse Penny.

(00:42):
- And I'm Halle Hospice Social Worker.
- Today we have a CNAwith us, a hospice aide,
as we call them in the biz.
Her name is Celeste Wooten,
and she has been ahospice aide for decades.
We'll let her introduceherself when she comes on,
but first I believe, Halle,you have a hot topic for us.

(01:03):
- I do. Today's hot topicis going to have to do
with ducklings .
So recently you did a video about a
bear enclosure.
It was at a kid's birthday.
It was on TikTok and a mother duck,
and some very cute furry ducklings
who are swimming in the bear enclosure.
And as we all know, naturedoes what nature does

(01:25):
that bear jumped in andstarted having a little snack.
and, uh, , of course,
the children started screaming.
And I think valid to your point,
and some other people's points.
I mean, they could have stopped filming,
but more valid than that.
I think they could have used that
as a teaching moment about death.
I also, on my way home theother day, had a mother duck

(01:48):
and two ducklings crossingI five on rush hour.
And somehow they survivedand nobody got an accident.
So I thought today's perfect,uh, topic would be ducklings.
But my other thought, ifyou are okay with it, penny,
I think kind of goingforward, since the landscape
of news has changed vastlyin the past couple of years,

(02:09):
and especially in the,in really the last year
or two, that if we're nottalking about a hot topic
that day, then it's already old news.
- I agree.- And so I think going forward,
what would benefit us is
to more focus on the educationpieces rather than trying
to keep up on hot topics.
- Yes, absolutely.

(02:30):
Uh, although we can educate
with the duckling story, because yes.
As I did make a video aboutit, explaining that, uh,
it's a perfect opportunityto use that as an example
of death to Mm-Hmm.
children, you know,
the ducklings won't beswimming in a pond anymore.
They're not gonna be with their mom.
They're gonna be notliving, not breathing.

(02:52):
They're, they're dead.Mm-Hmm. .
And as I said in my video,
when they then experienced the death
of a person in their family,that you can also use that
as a, a teaching point
to say at least grandpadidn't get eaten by a bear.
.
- I think a lot of parents, rightfully so,
will use pets early on in life when they

(03:13):
have a pet that dies.
Beloved pet. Yes, of course.It's hard. We all hate that.
But we also know goinginto it, having a pet,
unless it's a parrot,
you are likely going to outlive this pet.
Yes. Mm-Hmm. .So I think it's just a great
teaching moment withanimals and nature is rough.
- Yeah. And you don'teven have to have a pet.
You can use anything dead. Youcould use roadkill. Mm-Hmm.

(03:37):
, you could use dead insects.
You could use dead flowers. Yeah.
And the the flowers aren'tgoing to grow anymore.
They're, they're dead.
- Yeah. Seasons are a great way
to show death in the lifecycle.
- Yes. And it's importantfor us to be real
with children about death
because they are going toencounter it in their lifetime.

(03:58):
And if we teach them from the beginning
that it's a taboo topic,we don't wanna talk about,
then when it does happen, it can,
it can really frighten them
or they can develop deathanxiety like I had .
So it is important tobe real with children
and to, to explain kids know more
and understand more thanwe give them credit for.

(04:19):
I think I heard the other day
that at age four is when they start
to develop object permanence
where they Mm-Hmm. three
- Or four.
- Um, yeah. So, so they understand
when things are, are not here anymore.
And it's important for us to explain
to them in a very real way
why those things are not here anymore.
It's really important to usethe terminology, death, dying,

(04:40):
dead and death, death, death,dying, died, and dead .
Um, and to tell themwhat that really means.
- Absolutely. Well, I'm excitedto talk to our aide today.
- Yeah, me too. We love our hospice aids.
- That's right. Let's get to it.
- All right, let's do it.Hello, Celeste. Welcome.
Welcome, welcome. We'reso happy to have you here

(05:02):
representing hospice aids.
Woo woo. Why don't give us a little, uh,
give us a little rundownon your, on your bio.
- Okay. Well, again, my name is Celeste.
I've been in hospice, thisis year 27 for me. Um, wow.
Yes, . I keepsaying I'm gonna let it
go, but it hasn't happened yet.
Um, . But I enjoy what I do.

(05:25):
Um, I enjoy being amentor at the other CNAs,
and I just tell people allthe time that, you know,
it's a cliche to tell everybody.
It's your passion, it's your calling.
I tell everybody it's my gift.It's what I was given to do.
And, um, I don't see myself stopping.
I'm also certified at Chip,which is a certified hospice

(05:47):
and palliative nursing assistant, as well
as a end of life doula.
And I'm a certified grief coach as well.
So I add little pieces
and things to my toolkit to be able
to help my families as much as I can.
I'm a big, big advocate of CNAs,learning from their nurses.
And, you know, while we may not be able
to do everything the nurses do,

(06:07):
it's still a good training process
because it teaches us how to look
for changes in our patients.
So I'm, I'm a big advocateof that team approach.
- Love it. Well,- We, we love hospice aids.
I mean, we recognize thathospice aids are the backbone
of hospice care and do somuch to support families

(06:29):
and hospice patients, and work so hard
and are underpaid and often undervalued.
So, yeah. We appreciate what you do
and we appreciate you being here.
And I wanna know, whatdoes your shirt say?
I see hospice aid.
- It says, if you think my hands are
full, you should see my heart.
- Aww.- Aw. I love that. I love that.

(06:50):
I also love that you said,um, you know, that it's cliche
to say it's a calling and all that.
I feel the same way. And, andI always think it is a gift.
And, and not that I'm gifted,
but that it's like a gift to me.
Mm-Hmm. tobe able to do the work.
- Mm-Hmm. .- Yeah.
I think most people I know inhospice are definitely feel
the same way, that it really is a calling.

(07:14):
- Absolutely. Absolutely.
- All right. So tell uswhat led you to hospice?
- Funny story, .
So, um, my mom, it wasa dare to be honest,
to be completely honest with you.
Um, my mom, um, is a doctor in Atlanta.
And so we had some family members

(07:34):
that we need to take care of.
And she was like, listen,if you go to school
to become a CNA, I'll payfor you to go be to school.
And I was like, that'snot what I wanna do.
I mean, I was teaching little kids then,
and I was like, I don't wannadeal with nobody, you know, on
that realm after thestories I've heard her

(07:55):
tell over all these years.
And so I went and did it.
And, you know, I went and took care
of my family no matter what.
But my first couple that Itook care of, it was a husband
and wife and I, I walkedinto them actually
as a home health, and theywound up being hospice.
And, and the family was like, well,
we would love for you to stay.

(08:15):
I think, I dunno anythingabout nobody dying, ,
I know, I know what's going happen.
If they die, I might walkout and say, I'll be back.
See you later. You know,
and it, it was just, it was scary to me.
I mean, to be completelyhonest, it was scary to me.
And, but I got to realize that, um,

(08:37):
this is what I was made for.
I mean, the husband passed away first,
and I was there with him every single day.
And we tried to keep thingsas routine as possible,
but we just did it in away that was end of life.
You know, he had his dignity.
We were still just tryingto do things around him
and include him as much as we could.

(08:57):
And then I took care of hiswife as well until she passed.
And I was living in Georgia then.
And so I called here to Virginia.
I was moving back to here, Virginia.
And I thought, okay, that's it.
You know, I'll do home health.
Maybe hospice did thesame for me, ,
because I was just like, I know.
And so I called and there wasa hospice here in Virginia,

(09:19):
and the nurse that answered the phone,
her name was Kathy Lyes.
And I'll always be grateful to her.
She said, well, we'rehiring for hospice days.
What do you think abouthospice? I like, is it that
where I like, aren't they dying?
Yes. Yes. And I said, you know, I just,
I dunno if I'm the right person.
And she said, trust me. Shewas like, we just talked.

(09:41):
And she said, I just feel like
you're gonna do great in this.
And so I moved here andit was under her guidance
and another, um, administrator,administrators to Joe.
And they saw something in me
and they saw how I was with patients.
And, um, they saw howfamilies were like, you know,
just responding with mebecause I didn't walk in

(10:02):
and treat them like a, a job.
And that was the one thingthat everybody kept saying.
They were like, she doesn't come in here
and treat us like we're a job,
or we're a set of tasks that she has
to get done for her day.
And I said, no, they're personal.
And so it was then thatI just started saying,
okay, maybe I got a knack for this.

(10:22):
Maybe I can handle it. Mm-Hmm.
until my firstperson that passed away.
And then, you know, andthat kind of bothered me
because I was like, this is a person,
or a family's loved one,what do I do to give them
a, a aing memory other than,you know, give them a bath.

(10:43):
So, you know, I, I did thatand I just watched the family
and I, I made sure that, you know,
their loved one looked good
and that, you know, everything was good,
the surroundings and the environment.
But it was then I startedlearning to add more things to it
and hone that because afamily sees them in the home,
and that's their last memory.

(11:04):
Yes. They see 'em at the funeral home.
But that last memory in thehome is very important to me.
Mm-Hmm. . And
so I just learned to hone that skill. So,
- So Celeste, I havebeen a hospice nurse for,
as you know, for a really long time.
I've taken care of a lot of dead people,
especially when I worked in the
inpatient hospice care center.
I've never figured out,

(11:25):
nor have any of my colleagues, the trick
to keeping the eyes closed
and keeping the mouth closed without doing
something very unnatural.
Like putting a worm wet,washcloth on the eyes,
or rolling up a towel under the chin
and raising their head at the bed.
So they're hunched over. Imean, I finally got to the point
where I was like, that's what a
naturally dead person looks like.

(11:45):
I'm okay with it. Peopleseem to be okay with it.
Do you do anything inthat area that you can,
like, share with people?
Or do you find the same issue?
The eyes are just gonnabe open or partially open
and the mouth is gonna be open.
- The I thing, I kind of just do the warm
and kind of hold my hands overtheir eyes until they kind

(12:07):
of seal up a little bit ,
or I've used, uh, Visine to kind
of moisten the eye and that kind
of holds it a littlebit better versus water
because, you know, theeyes are already dry.
Uhhuh, .So if you, I use Visine
and sometimes that willhold 'em down better.
That's interesting. But themouth, I don't always get it.

(12:27):
And I just tell the family, like you said,
that's just a natural thing
because it, it's notgonna look very pleasant
with the towel under here.
Yeah. Like, that's not a very nice visual.
And I said, but it's just natural.
It's just, you know, themouth is, is relaxed.
And once I explain it, sometimesthey're alright with that.
- And I think too, if they've been
with the person while they were dying,
they get used to how they look.

(12:48):
Mm-Hmm. , they already
know that they look that way.
Yes. So, have you, um, everworked in inpatient hospice
or strictly home hospice?
- Strictly home hospice.- Okay.
So, and I'll just say the difference
between inpatient hospice
and home hospice is inpatient is gonna be
where people are actually in a facility.
Usually it's gonna bea higher level of care.
They're more acutely sick.

(13:09):
Symptom management needs home hospice
is where most people are.
And that's when we, the hospiceclinicians go to the home
to take care of the family. So, uh, and
- That most people, mosthospices don't have access
to an inpatient hospice.
- True. That is very true. That's true.
If they have a higher levelof care need than they usually

(13:29):
go to like a hospital.
So why don't you walk usthrough your typical day.
How many patients do you see your driving?
What is your normal day like going to see
patients, hospice patients?
- Um, normally like if myday, if I have a, a community
or facility, long-term care
or member care, like I may have three

(13:51):
or four in there, I'll spendmy morning there getting them
ready because I try tokeep them on their routine.
If my home patients, I might have two
or three that I do, um, driving,
it can range anywhere from an hour
to maybe two hours throughout the
day because of where I live.
I live in Virginia Beach,so, you know, we have tunnels
and bridges and mountains,all that kind of stuff.

(14:12):
So it's a little long,
but I try to make sure thatnone of my patients feel like
I gotta hurry up, get inand do my task and get up.
Mm-Hmm. ,because I'm like, when I,
when I start doing that,that's not giving them
a good hospice experience.
And I said, you know, withhospice, there is no redo.
Mm-Hmm. . Sowhatever you do that visit,

(14:33):
that's, it's what it is.
And normally, you know, sometimesI, I have to remind people
that while they do ask for a hospice aid,
sometimes they're reallyjust wanting that hospice aid
to kind of be their confidantor their companionship.
Because a lot of peoplethink, you know, I,
I had this conversation the other day.
They were like, you know,mom needs a bath every day.

(14:56):
No you don't. .
You know, because she comes from the era
where they didn't have baths every day.
Mm-Hmm. .And I said it too, I said,
is slowly declining and transitioning.
Her skin becomes more tender,you know, as you know, or,
and everything hurt.
And I said, so whenwe're constantly bathing
and we can break down herskin, I said, we can hurt.

(15:19):
You know, she just hurt. It'snot a pleasant experience
to do that every single day.
And I said, so sometimes, you know,
our visits may be justsitting there laughing.
And it, it took a little whilefor her to get used to that.
And I said, we're used to it
because we get up every day,we hop in the shower, you know,
we do our thing becausewe're walking around.
I said, with her, it's comfort.

(15:40):
And I said, so she's notout running a marathon.
She's not going shopping,she's not going to the job.
So we can do a little big bath one day.
And the other times, youknow, just kind of come in
and do a little something.
And I said, and then shewants us to spend time.
So I think that's a bighurdle for some people
because they still want the same routine

(16:01):
that their loved one hadbefore they started to decline.
And, and that's hard forthem to not see that routine.
But once I, you know, I kindof explained it that way.
They're like, I didn't thinkabout that. And I'm like, yeah.
I was like, you know, ifI'm in that situation,
I don't want somebodymessing with me all the time.
I said, maybe just a nicehand rub or foot rub,
or sometimes it's, it's justbeing there in that moment

(16:24):
and that present becauseI'm a different person.
They don't see me all the time.
- Yeah. You know, I love thatyou, that you talked about
that because, uh, hand rubs and foot rubs
and having conversation, Ihad an aide that would go
and play games with my patient.
I always would. If I hada patient who lived alone,
I would have my aide go every day
because I wanted to have

(16:45):
as many eyes on my patient as possible.
Mm-Hmm. . But somany people call hospice aids,
bath aids, and it drives me crazy ,
because y'all do somuch more than bathing.
Yeah. Uh, one of my, Ihad the most fantastic a
for quite a while when I wasa home hospice case manager.
And one of my favorite things was

(17:06):
to get her in when I hadsomebody who was gonna,
was resistant to having an, an aide,
because I, I would always say, look,
at some point you're not gonna be able
to bathe yourself anymore.
You're gonna need somebody to help you.
You're gonna need somebodyto teach your family how
to do this if they're care caregiving.
Mm-Hmm. . Um,wouldn't you rather have
that be somebody that you've met

(17:26):
instead of somebody that's a stranger?
Right. So I had my aide go seeone of my patients one time
who was like, I don't need an aide.
And I knew that she was gonna need one.
Eventually, she would haveher wash her living room
windows whenever she came.
She'd come once a week and she'd have
her cleaner windows .
That was what the aidedid until she was finally
to the point where she needed

(17:47):
that assistance. So what, what
- I that just wanna milkshakes every time.
- Oh, you said you made milkshakes.
- Yes. So we made milkshakes, or I stopped
and got milkshakes andwe sat on the front porch
and that was our aid visit.
And you know, so I get thereare some patients that are
resistant to having an aid,
and you have to come up with creative ways

(18:09):
because like you said,you're gonna need one.
Yeah. So why not find a,a, a different opening
to get in to, to make that relationship
before you have to be veryintimate with that person. Yes,
- Exactly.
- You know? Yeah. Build
- That rapport while they're reluctant
and then have it established.

(18:30):
So why don't you give uskind of a rundown of some
of the tasks that aids do at your agency.
And they may, it may bedifferent at other agencies.
I know mine, they cando light housekeeping,
they can clean windows, they
can take garbage out to the curb.
Mm-Hmm. They can make a sandwichsometimes it might vary.
Mm-Hmm. .But, but what do you do
as a hospice aide besidesjust giving people a bed bath?

(18:53):
- So we could do showers,we could do baths,
we can help dress, wecan do fingernail care.
You know, we can paint nails.
We have one lady, I love her dearly.
She likes to have spa day.
That's how we got into it with her,
because she was the lady who went
to the hairdresser all the time.
So the way we got in with herwas we would wash her hair,

(19:15):
we would roll it, blow dryit, we would put makeup on her
and just make her pretty.
And that was her hospice aid visit.
So we could do stuff like that.
There are some times where ahospice aid visit may just be a
hand rub or foot rub.
And I know with, uh, mycompany, we are able to do, um,

(19:35):
something with essential oils.
And so we use that with ourlotions. We have the diffusers.
So we're able to have thatgoing when we're bathing them.
We play music so we can do,like you said, the housekeeping.
We can, you know, takethe trash out, you know,
whatever we need to be done.
There's a way to care plan. Wegotta find a way to care plan

(19:58):
- .
- We completely do.
But you know, thatthing about the bathroom
thing, going back to that.
Yeah. That irks me too.
I'm like, you know, Ido a lot more than that,
but if that's what you think.
Okay. But, you know, Ijust tell people that
I'm there to do what I canto make their hospice journey

(20:21):
as good as it can be for what's happening.
- Totally. And make milkshakes. I love that.
- It's so funny because it was like,
when I would visit, Ihad to bring strawberry.
When the nurse visited, shehad to bring chocolate .
I kept up with the daysof who was coming when.
- Mm. Oh, wow. That's awesome.

(20:42):
- That straw. She knew I was coming,
if she was getting chocolate,she knew the nurse was coming.
Wow. So that's my way for herto keep up with it as well.
Huh.
- Okay. So you said you're also a, you're,
you're a death doula, is that right?
- Yes.- Okay.
So tell us a little bitabout being a death doula.
- I find being a deathdoula, sacred, intimate,

(21:07):
I've, I've had a couple of clients,
and I can talk about one of them.
There was a family that I had,
and this lady loved the oceanagain, out in Virginia Beach.
And she was a ocean baby.That's what we called her.
And where she lived, thatwas right on the water.
And so on the day that she was,she went from transitioning

(21:30):
to acid like very quickly during my visit.
And it was, the family was there
and she was just like, she was struggling.
She just, she wanted to, youcould tell her body was ready,
but it's like she was struggling
and the kids were goingin and talking to her.
And so I stepped outside,

(21:51):
and this is a storyI'll never ever forget.
The waves that day werebad, like bad ways.
Like they had the red flagsgoing that, you know, don't go
so far in the water.
Like, okay. So they werein there talking to her,
and I, I walked back in
and I said, you know,open all the windows.

(22:12):
Open all the doors, you know.
And I said, it's not that you
know, the release and soul thing.
I said, I want her to hear the water.
And I was like, let theocean breeze come in here.
And they're looking at me like,
Celeste has lost her mind, but go ahead.
Let's do it . And Isaid, if she can't hear it,
because it's, you know,I said, let's turn it on.

(22:33):
I turned it on my phone, thewave, and I put it beside her.
And I told her that, you know,
when she was ready, go out with the wave.
I was like, you know, you arealways gonna be a ocean babe.
I was like, just go out with the waves.
And everybody was holding her hand.
And I'll never forget it,

(22:56):
the minute she stopped breathing, the,
the water got still, it kindof creeped me out for a minute.
I was like, but the water got still.
And I was like, okay, she's good.
And so the nurse home, I called the nurse

(23:16):
and I was like, Hey,you know, as she's gone,
they came me in and maybeabout 45 minutes into it,
the most beautiful sunsetcame like right over the water
and you could see it from her house.
And I just, I, I lied tothe kids and her brother.
I said, that's her sayinggoodbye. She's good.

(23:38):
And so I just, I thinkmoments like that, being
with families, being able to assure them
that they have done everything
and giving them that, that okay moment,
that's very important to me.
Because some families think, you know,
they should have done more.
They should have fought more.They shoulda did this more.

(23:59):
And sometimes, you know, notall, all deaths are beautiful,
but I just wanna remember that one.
Because like I said, thewater that day was just crazy.
And when she passed, it gotreally still and really quiet.
And she was, she was young.
She was a young lady and she had a LS

(24:20):
and I just will never forgether as long as I lived
because she was, youknow, she was gorgeous
and just, it was about that water,
everything in her househad to do with the ocean.
Wow. So I just felt likethat day she chose that wave
and went out.
- Wow. - That's amazing.That is a beautiful story.
Celeste, I'm, that's, no wonder you keep

(24:40):
that story with you.
I definitely, the social workbrain in me is making sure
that we tell our listeners
that sounded like it was also in service
of your aid position.
And so that was, you were being a doula.
- I was being a doula. BecauseI know you can't do the
both at the same Well,
- That's what I wanted,that's what I wanted

(25:00):
to clarify for people.
So, so it's my understandingthat doula is more
of a paid position ratherthan what the aids would be
as part of hospice service.
So I just wanna make sure that's clear.
- Yes, absolutely. You saidwhen you're going in as a doula,
you are not, it's a nonmedicalrole that is there to offer

(25:20):
education, uh, whether it's,you know, spiritual or physical
or mental support.
And you are not working with your hospice.
So, no, I was not working at that time.
This was somebody totallydifferent. So, yes.
Thank you for clarifying that,
because a lot of people belike, so you were doing both.
No, I promise I was not doing both
- .

(25:41):
- But, you know, becauseat that time, you know,
and that was a hard, nowthat was a lesson too,
because I had to backaway from being an aide,
even though I was beinga doula, I had to learn
to back away from being an aide.
So that, that was, thatwas a learning curve for me
because I wanted to step in and be like,
and I was like, no, I can't. So
- Yeah.

(26:01):
'cause doulas can't do caregiving. Right.
Am I understanding thatright? Yeah. You're
- Understanding that, right?
- Yeah. Yeah. I'm, it's a good thing
to partner if they can,if they can do that.
- That's right.- I'm getting a better understanding of
doula work now since I just read the book.
Uh, briefly, perfectlyhuman by, uh, ELOA Arthur.

(26:21):
Do you know who she is?Celeste. Mm-Hmm. .
- Yes. I've heard that book.- Yeah.
So really, she really has a way
of talking about the doula work
that made me understand more why people
want to have a death doula.
And it's a lot like whatyou were just saying there.
It gets deeper than, youknow, just the physical.
I mean, we get intophysical care and emotional
and spiritual care in hospice too.

(26:43):
Mm-Hmm. . Butthere's something even more that
we don't, we don't have the time,
we're not allowed the time Right.
To do as hospice clinicians. Right.
And that's what's really unfortunate.
And, uh, Barbara Carns, andy'all know Barbara Carns, right?
Yes. . Um, shetalks about hospice nursing
when she did it, which was back

(27:04):
before the Medicare benefit even Mm-Hmm.
. So in theseventies and eighties
it sounded a lot more likewhat death doulas do today.
Mm-Hmm. Like, she wouldcamp out on the floor
and stay there all nightwith people while they
were dying, you know?
And it was like, oh yeah, wedon't get to do that anymore.
Yeah. You don't get to do that anymore.
So tell us about grief counselor work.

(27:25):
'cause that's another hatthat you wear, right? Grief.
Grief. Yeah. I'm grief coach. Grief coach.
I'm a grief coach. Yeah.Tell us about Grief Coach.
- Um, sometimes I get to talkto families during bereavement
with my hospice, with mehaving the grief coach.
And sometimes it's just amatter of, they just, you know,
need that little extra, we dohave bereavement that talks

(27:45):
with them, but sometimesjust having a face
and somebody thatthey've seen all the time
and they've got a rapportwith, I just kind of go in,
you know, let them saywhat they need to say
and just kind of do a lotof handholding afterwards.
Because, you know, oncetheir loved one's gone,
sometimes they feel forgotten.
Mm-Hmm. . Mm-Hmm.. 'cause they're

(28:07):
like, oh, everything's over now.
And so, you know, I I I liketo liken it to the point of,
it's almost like a caregiverloses a job because Yes.
Their job is over. Yeah.Mm-Hmm. .
And so not only are they,they are mourning the loss
of their loved one, butnow they have to figure out
who they are again andlearn their new normal

(28:29):
- And also lost the supportof their hospice team for
- That part.
That's right. You know, we're done.
- Yes.- You know, while the bereavement calls,
they don't really have that big connection
with them all the timebecause they don't know them.
You know, they just know thatnow they've lost somebody.
So sometimes I get togo in with our families
and just talk to them andjust be a listening ear.

(28:51):
I, I know I tell 'em I can't fix it.
I can't take it away, butI can sit here and listen
and you do what you need to doand say what you need to say.
Mm-Hmm. . Andthen just give them resources,
you know, for what they may need.
Um, our social workerthat works where I work,
we do a lot of tag teaming.
And so she and I will getto go out and talk to them.
And so, and then sometimes I get, um, some

(29:12):
of my doula clients that will do, uh,
after grief care with themas well and caregivers.
And so I get to, I get totalk with them on that basis
because like I said, itbecomes a, like I said, a loss
of a job, a loss of identity.
And so they have to learn how to find
that identity back again. Mm-Hmm.
- That's a great way to putit. It's a loss of a job.
And it's also the loss of their coworkers

(29:34):
who are the hospice team.
Mm-Hmm. And I hear a lotthrough my social media
and through my actualwork where I review a lot
of the CAPS comments.
So CAPS is the consumerassessment of hospice
and palliative care surveythat goes out months
after the person has died.
It's something that most hospices
participate in with Medicare.

(29:55):
And I see the comments where they say
it was like we were forgotten.
Mm-Hmm. andeverybody left. We were alone.
And I hate that. I hatethat. Mm-Hmm. .
And I think that smalleragencies are able to,
like some smaller agencies,the social worker,
that's the team socialworker can also be the
bereavement person after.

(30:15):
Mm-Hmm. . But I think most
agencies, it's separate.
It's a separate department,it's separate people, you know,
to your point, it'speople they don't know.
Mm-Hmm. . And, but,
but it's the nature of thework and it's kind of necessary
because at the end of theday, it really is a job.
It's our job to go in thereand care for these people.

(30:36):
Right. And once the persondies, it's a job well done.
You know, if we prepared the family
and the person died comfortably
and without any symptomsthat needed to be managed,
or they were managed well.
Right. You know, we'vedone a job, a good job.
It was a job well done, butit does leave a gaping hole
for the, the bereaved.
And it's kind of unfortunate that, that
that is the way that it is.

(30:58):
- Right.- Right.
And I think, to your point, penny,
we can do all the educationwe want to end of life,
but they may not be in a place
or there might not be time
to help educate whatthat looks like after.
- That's right. Yeah.- Yeah.
I mean, we do get those shortstay patients that come in.
They're gone in just a coupleof days and we don't even

(31:19):
- Have a, and, andbecause we're in the home,
it's a much more intimate setting.
So even though we are amedical process Mm-Hmm.
. And wearen't paid for by Medicare,
you wouldn't expect yourprimary care doctor to come
to your house after death.
But we have already been there .
- Right? Mm-Hmm. . Yeah.
Because I literally had alady who took care of her mom,
her dad, and unfortunately her husband.

(31:41):
Wow. And once they all freepassed, she was like, so
what am I supposed to do now?
Yeah. So for,
because she was like, all I've ever done
was take care of my family.
Mm-Hmm. . AndI was like, at that point,
I was just like, I I, you,you're gonna have to go talk
to somebody , because I'm
like, I dunno what to tell her.

(32:02):
But I felt so bad inthat those words stung
because she was like, what do I do now?
Mm-Hmm. . I don'teven know who I am anymore.
- Wow. Yeah. Yeah. It's true.It happens to so many people.
Mm-Hmm. does, uh, I'm just curious,
does a nurse have topronounce death in your state?
- We can do RN and LPN

(32:22):
and I think that a
social work can do ituntil an RN can get there
and do like, official.
Official. Okay. But that's it. Yeah.
- Yeah. I guess it'sodd that in some states
it has to be pronounced.
And so people know theirperson is dead long
before the nurse gets there.
And something that I foundwas interesting is that, uh,

(32:46):
somebody told me
that actually she made a videoabout it, somebody on TikTok.
She, her, I was followingher journey with her mom
who had cancer, and her mom died on a day
that was actually like aspecial day to the family,
but the nurse didn't comeuntil after midnight.
And, and so the time, the date

(33:07):
of death on the deathcertificate was actually the day
after she really died.
Wow. And so it was, it really,it bothered her, you know,
she was like, you know, that'snot the day that she died.
And I thought that, youknow, in our state, we,
the family tells us what time
and day the person died, they'll tell us.

(33:27):
And that's what goes onthe death certificate.
We aren't, we aren't requiredto pronounce death. Mm-Hmm.
. So whatever they
tell us is what goes on there.
And it never occurred to meuntil I, I watched that video
and thought, wow, you know what?
I can see where thatcould be really something
that bothers people.
Mm-Hmm. that, you know,
if the nurse can't get outthere right away, that,

(33:49):
that it does, it changes thewhole, their whole experience
with the death of their person.
'cause for her it was an important day.
Just like if your persondies on Christmas Eve.
Yeah. You know, but, but,
but they don't get it till outthere, till after midnight.
It's Christmas day andnow your person just like
for legal purposes, hasdied on Christmas day.

(34:11):
Mm-Hmm. .So I just thought it
was kind of interesting.I seen that happen.
- I've seen that happen. And so now
it's like our nurses are, are,
or are quick to tell them, you know, Hey,
just wanna forewarn you that, you know,
while you may see your levelof pass at say, six 30,
if I don't get here
or someone doesn't get heretill six 50, that's the time

(34:35):
that's gonna go off the death certificate,
because that'll be the official time.
But I have actuallyseen what you just said.
I have seen somebody die.
They stopped breathing at 1150
something according to the family.
And it was a holiday, I think,
I wanna say it was Thanksgiving,if I remember right.
They did not get pronounced till 1202

(34:57):
on Thanksgiving Day.Mm-Hmm. .
- Wow.- And so that was like a big debacle
because they were like, you know,
our loved one did notdie on Thanksgiving Day.
I was like, I know, butyou know. Yeah. Sorry.
You know, but, and, and thatbecomes kind of a sore spot.
And unfortunately it popped up on a survey
- Yeah.

(35:18):
- When they came back and they were like,
my loved one did not die on this day,
and your nurse put, you know, so
I feel bad for stuff like that.
I was just, like I said, Ithink they could be, you know,
in the, in the talk that,Hey, when your loved one dies,
just letting you know it maynot be the time you saw it.
- Yeah.- Or when the family's ready,
maybe they can advocate fortheir state legislator to change

(35:41):
- That, that that's what Isaid in my response video too.
. So Halle, that'sexactly what I said in my video.
I said, if you live in astate where a nurse has
to pronounce, um, youknow, you can advocate
with your legislature,leg legislation, whatever.
Yes. Um, to try to change that,
because there are many,many states like mine, um,
and Halley's that don't requirepronouncement by the nurse.

(36:04):
And it's funny becausepeople that live in states
where they, the nurse has topronounce, they'll say, well,
how do you know when they're dead?
You know, when they'redead. You know. Exactly.
You know, when they're dead, there's
no, there's no question. You know, or
- I know when we get asked, are they dead?
Yeah. And I to say, well,unfortunately, due to legal,

(36:32):
don't
- Care.
I say that they're dead.
- Wink, wink, wink. Yeah. You know,
- Any, when they come in, I'm like,
please do not say someone's dead.
And they're looking at melike I said, you can't,
you just say, you can't say, you know, so
- I would say, well,they're not breathing,

(36:52):
they're not moving.
Yeah. Every other person I've ever seen
that has been dead looksjust like that. So Yeah,
- They're looking a little different.
- Yeah. Put the pieces together. Yes.
But yeah, I mean, it's ananticipated death on hospice.
So we even used to have tocall, when I worked in Seattle,
we had to call the coroner to get a,

(37:14):
it was called an NJA number.
No jurisdiction applies,
which means the coroner doesnot have to be involved.
That now changed. So we don'teven have to do that anymore.
It's an anticipated death.
But there are some placeswhere the coroner still has
to go out there.
- There are some counties,
there's still some countiesin Washington that do that.
- Are there? No.- Yeah, San Juan Island is one of them.

(37:35):
- Oh my gosh. Oh my goodness. Wow.
My agency doesn't serveSan Juan Island, so. Wow.
That's interesting. Theyhave to go to the house.
What a waste of taxpayer dollars. Yeah.
- I dunno if- They have to go to the house,
but there's definitely the NJI number.
- Well, there's some states. Well, yeah.
So if they need the nu like,we have a couple counties,
my my agency serves too,where we call, we have

(37:57):
to call them and get the release.
But, um, there are somestates where the coroner,
the medical examiner has to go
to the home. I don't remember where
- And how traumatic that is, you know? I
- Know.
Yeah. Unnecessary.
I mean, I've had that happenwhere, um, a couple times where
two times that I remember.
So, as we know, um,

(38:17):
but in case our listeners don't know,
usually when people die onhospice, we can see it coming.
It's, it's, um, progressionof symptoms until the end.
Like you were saying, Celeste,sometimes they go through
that transition period, kindof the period where, you know,
we're more living andthen we're less dying,
and then we become more dying
and less living that's transition, um,

(38:39):
to actively dying when that'sthe point of no return.
And we know they're gonna die soon.
Sometimes it goes fast,sometimes it goes slow.
But usually they go throughthat Mm-Hmm. .
But every now and then we have somebody
that just drops dead.
And I've had two patientsthat, that happen
to one drop dead on her kitchen floor,
and the other one diedsitting up on the couch,
and his wife came down and found him both,

(38:59):
both times Police were calledbecause they freaked out.
Mm-Hmm. . Um, and,
and fortunately the policeknew as soon as I got there,
they were like, okay, we'regonna turn this over to you.
No problem, no worries.
You know, as soon as Isaid they're on hospice.
But, um, how traumatic tohave to have police involved.
- Well, that's why you're,they kinda warn people when

(39:21):
they're, they're a reportable death.
Right. If they've had thatrecent severe fall that led
to a decline, et cetera.
Mm-Hmm. . Orif there's an, an open a PS
investigation, then youwanna also give the family
that warning of, Hey, mostof the time they won't,
but every once in a while they'll,
- They might take them.
Yep. Yep. Usually you can still send them

(39:43):
to the funeral home and thecoroner will pick up the body
from the funeral home when that happens.
Yeah.
- Well, let's move on to something fun.
Celeste, tell us like a funnystory, an awkward story, some,
some good memory besidesyour lovely wave story
as an aide. Let's say that
- As hospice. So
- As a hospice aide, I gotto help a family, a daughter

(40:06):
who was taking care of her dad.
And her dad was a retired serviceman.
And he just noticed that hewas having difficulty adjusting
to her home, you know,
having somebody kindof taking care of him.
And so I, I asked her questions.
I was like, so what did he used to do?
Did he go to the officer's club?

(40:28):
You know, she's looking at me like,
how do you know about an officer's
- Club? ?
- There's one on the base.
I was like, you know, did he, you know, go
to the bars or anything?
Like, I just thinking.And so that's what he did.
And I said, okay. So I knew
that he had an empty room in her house.
And so I said, um, don't think I'm crazy,

(40:50):
but let's make a pub for your dad.
And she said, what ?
She said, let's make a pub for your dad.
So we got to working on this,
and she put a TV in there.
We had a recliner in there.
And then we had a low tabletop there,
and, uh, something he couldsit in if you wanted to.

(41:13):
We had the pretzel thingsin a little basket,
and we did like the nearbeers or whatever, .
And so we had, you know, wejust, we kind of did it up.
We had like, you know, littlepool table pictures on the
wall and different things like that.
And so I called to visit him one day
and I said, said, comeon, we gotta get dressed.

(41:34):
And got all dressed up. Hesaid, well, where are we going?
I said, man, you gonna, thebar don't tell nobody .
And he goes, what? We'regonna the bar, I'm clock out.
We're the bar I my clock out.
I was like, I'm clocking outta work,
we're gonna the bar come on.

(41:55):
So he said, okay.
So we're walking down thehallway and we opened up the door
and he looked and he goes, he
said, SI your pub.
And we had a, um, I printedit out off my computer
and we had the name of his name,
and it was, it said, his name's Pub.
And he looked and hegoes, I got my own pub.

(42:17):
I said, yes, , let's do, so
we sat down and he turned the TV on
and we were drinking our little near beers
and having, you know, our little stuff.
And he was like, thisstuff is pretty good.
And I had to start laughing
because he was like,just throwing them back.
And I was like,

(42:49):
Care.
But that day, I mean, wejust kind of hung out.
Um, I made him my last visit of the day
and I just kind of hung outwith him and he took a nap.
And, uh, the daughter calledme that later that evening,
and she said that was thebest experience he had had
because he did used to hangout at the officer's club

(43:10):
or go to the bar with his,you know, Navy buddies
and, you know, hecouldn't do that anymore.
And I said, well, now ifthere's any of his Navy buddies,
you know, that can still come visit,
they can go hang out in his plant.
That's, and so, you know, that weekend one
of the gentlemen came over that,um, they had went to church
with, and he gotta hangout with them in his,

(43:31):
and, you know, so she had,
she would take pictures everytime somebody would come sit
in his, so for his funeral,
they had those pictures on the screen
and they were showing people coming in
and sitting with his pub anddrinking their near beers.
And, you know, and thatwas a good memory for her.
And once he passed, he said,I'm not taking that room down.

(43:52):
I'm going in there to sit,because I can go in there and sit
and remember and think about, you know,
the good time he had.
And she goes, I, I can nevertell you thank you enough
for even thinking of this.
Because he was like,this just made his day
because he knew he couldget up, get dressed,
and he was gonna, the pub thatyou were coming to clock out
and go to the pub withhim, . So yeah,

(44:15):
- I love that.
- Thinking outside the box
and having it so personalized too. Yeah.
- Yeah, yeah. Yeah. That's great.
So love that story. What else? Uh,
- I see, I want another story.
Another story would probablybe, um, we had a lady,
um, she wanted to remarry her husband.

(44:37):
- Mm - Mm-Hmm. .So I was like, okay.
So we, we got it all together.
Our chaplain and her daughtergot some things together,
and I brought over to othernurse aides with me, CNAs,
and we were her bridesmaid.
And so we made, we worematching color scrubs.
I was like, we can't wear glasses

(44:58):
- ,- Because we gotta work still.
I said, but we all wore matching scrubs,
the same color scrubs.
And her husband's buddies came over
and we gave her, like,
she unfortunately had lost theability to get in the shower,
so we gave her a good bedbath, washed her hair,
curled it up and curled.
And her original weddinggown, her daughter went

(45:21):
and had it altered to
where we could flather hands in like this.
And so she got, she didn'tdo the original wedding,
she did the original,but they had it shortened
to be in the bed, so it kind
of draped over the bed a little bit.
So you didn't really see thebottom of the hospital bed.
And we kind of sat herup and we had flowers.

(45:42):
So I think that waslike the biggest memory
to be a part of somebody's wedding.
And unfortunately she did passaway about three weeks later,
but that day she rallied andshe rallied hard ,
and she got, she got through the wedding,
she ate wedding cake.
And I knew kind of what was gonna happen
after all this was said and done.

(46:03):
But it was a good dayand a good memory for her
and a good day and a goodmemory for her husband.
And so to be a part of that,
that's something I'llalways be grateful for,
because that's very personal.
And so, you know, it was, itwas not a dry eye, you know,
everybody was doing alllike this and stuff,
but it was, it was good for her
because she, you know, shegotta say, you held up your end

(46:25):
of the bargain in sickness and in health.
Hmm. So that was, that was a good thing.
- I had a similar, uh,
experience we had at thehospice care centers,
we would frequently have weddings.
Mm-Hmm. . Um,but we had someone that wanted
to renew their vows and shedidn't have anything to wear.
And I lived really close tothe care center, so I said,
I've got a, I've got a dress at

(46:46):
home, I've got a white dress.
It's really beautiful. And so I ran home
and grabbed the dress and brought it back
and she wore, wore my white dress
and Chaplin came to the roomand they renewed their vows.
It was our 25th anniversary. Oh.
And they renewed their vows, so Oh my God.
- Yeah. - Yeah. So thatwas really, really cool to,

(47:07):
to be able to bring her the dress Mm-Hmm.
and have her have her wear
my dress while she did that.
But we had a couple ofweddings where people, in fact,
I remember one time the, um,it was that it was the dad
that was dying and hisdaughter was getting married
and they had the wedding plannedfor like three weeks out.
And it was apparent that hewas probably not gonna live

(47:27):
that long, and he was not,definitely not gonna be
going anywhere to the wedding.
And so they changed the plans
and they decided to havethe wedding right in
his room at the care center.So that was really awesome.
- Aw,- We, uh, . Yeah.
We helped with a wedding one time
and we had our therapy miniature horse
as the best man .
And he was dressed upwith flowers in his tail.

(47:49):
And, and then that same person had a dog,
and the dog was the ring bearer.
And the patient would joke for the rest
of the time on servicethat, uh, they had a dog
and pony show Wedding . Aw,
- That's good.
That's a good one.
- That was really cute. .
- That's a good one.
- Well, while we're,while we're wrapping up,

(48:11):
I wanna make sure we'remindful of your time
and we're getting close to that hour.
I know we could talk to you,
you've got lots more stories in 27 years.
My goodness. Yes. That's a long time.
So we'll definitely haveto have you back on.
But I wonder what you mighttell someone if they're
considering getting intobeing a hospice aide,
being maybe a littlescared, a little reluctant,
what would you tell them tosway them? To come to our side?

(48:33):
- Come to our side. .
I would just say, if youhave a passion for people,
if you have a heart, aservice, um, I tell you know,
everyone that while empathyis, is great to have
to be in this, you also haveto know how to do boundaries.
You also have to know howto make sure that,

(48:54):
you know, you canseparate yourself from it.
But we're more than just,you know, bath aids.
We're more than just,uh, someone that goes in
and cleans someone up.
We're there to walk home someone
in their most intimate time.
And it's, it's quality oflife versus quantity of days.

(49:16):
And if you have the, weknow we had the skillset,
but if you have the heart todo that, the heart to, to stand
beside the patient, to help the family,
then I would say be a, becausesometimes people, you know,
and it, it's a fear of death.
Everybody has a fear of death.
I, I will, I'll be thefirst one to tell you.
I had a great fear of death.

(49:38):
And as someone who,
and this could be a whole notherpodcast one day, as someone
who almost died myself in2015, I got a respect for it.
And I made a promise, you know,
that if whoever was up there looking out
for me would just let me stay.
That I would do my bestto make sure that anybody
that came in contact withme while I work in hospice,

(50:02):
that their hospice journey was going to be
as best as I could make it.
And so I tell AIDS allthe time that, you know,
your work is your autograph.
So sign it with excellence and pride,
and you can do that in hospice.
- Hmm. Well, you clearlyjust signed your own ticket
for the next episode because Yeah.
Throw that little taglinein there. Yeah. Yeah. Yes.

(50:26):
. Well, as a final word,
is there anything we forgot to ask you?
Anything that you wanna tell us about? Or
- Where can people find you?
- Us- Go ahead. Where we can find you,
where people can find you
- Can find me, um, on LinkedIn.
Uh, es you find me on,I gotta be better about,
because I'm so busywatching everybody else.
I have to be better. But, um, hospice, CA

(50:50):
and then the number two,and then the letter U.
And then I'm also on Instagram
and it's under my doula name, which is Joy
n the Morning,
which is M-O-U-N-I-N-G.
Perfect. And if I could leaveanything, I just would say

(51:11):
that I'm just so glad
- We lost Penny .
We've had, I mean,
last week's technology problemswere much worse than this.
So I'm grateful we've gotten through
as much as we have, frankly.
- Okay. Okay. But, um, yeah,

(51:31):
, I can sayanything about hospice.
I'm just grateful that hospice chose me.
I might not have chosehospice. Hospice chose me.
- I love it. I love it so much. Celeste.
Well, you're welcome to, um, hang out
and see if Penny comes back on,
but I'm gonna stop the recordingso we can make sure we save
what we have with you, .
- Okay.- We have the technology

(51:56):
curse right now, I swear.
Ah, man, I was freaking out.
I'm like, like, that wassuch a great interview.
And then if, if itdoesn't record, oh my God.
- Well, as with all of ourguests, they had amazing stories
and we could have kept talkingto them all night. .
- Yes. Yes. That was areally great interview.

(52:17):
I love Celeste. She's been a hospice aide
for so long.
- She's been 27 years. Shehas so much wisdom to give.
- She does. She does. She'sgot great wisdom to give.
- Well, I'm glad she was on with us.
I loved all her stories. They were great.
I loved that shementioned boundaries. Yes,
- Yes.

(52:37):
Boundaries. That was great.
That's such a hard part ofour, our job is boundaries
because we are going into people's homes
and sometimes we have to givea little bit of ourselves
to get a little bit of them.
And, and it's, it's an art. It's a dance.
And boundaries for sure areso important as our, uh,
you know, and not only justregular professional boundaries,
but emotional boundariesso that we can continue

(52:57):
to do the work and not loseour shit when our patients die.
- , maybe we'll do a whole episode
on boundaries next season. .
- Yes, we should do that, for sure.
- Well, until next time, remember to live.
- 'cause someday we will all be dead.