Season 2, Episode 12: Hard Choices for Loving People with Hank Dunn

Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Then she stopped me. She says, I know.
I know when his heart stops, there is
nothing that's gonna be able to save his
life. And then she said,
but it's just so hard letting go.
Welcome to the death happens podcast, an insider's

(00:22):
guide to dying. We're your insiders. I'm hospice
nurse Penny.
And I'm Hallie, hospice social worker. Today, we
have a fantastic author for you. We're gonna
have Hank Dunn. He is a hospice chaplain.
And before we get him on the pod,
we're gonna talk a little bit more. We
already interviewed a hospice spiritual counselor chaplain,

(00:44):
on season one,
but,
I think we really need to round out
a little bit more about how important spiritual
counselor is, and it's never a bad reminder.
Yeah. Definitely. We have, unfortunately,
quite a lot of our patients. I don't
know about yours, Hallie, but many of ours
will reject the spiritual care counselor. They're called
chaplains where I work.

(01:06):
Mhmm. And sometimes they will reject them from
the go. Like in the admit visit, you'll
see a nurse from the admit or you'll
see a note from the admit nurse saying
chaplain declined.
And we have really tried to encourage
our hospice nurses to
not present the chaplain role,
but rather to say something along the lines

(01:28):
of the rest of the team will be
calling you. Or there is a hospice team,
there's a lot of support, everybody will call
you to make their appointments,
because the chaplains don't want someone else to
represent their role. Many people
are confused,
especially because we call them chaplains.
Mhmm. And, this is something I'm pretty,
passionate about educating on.

(01:51):
Not that I try to educate completely on
the chaplain role because I'm not a chaplain.
So I don't, you know, I don't wanna
be the one misrepresenting them. But the importance
of spiritual care and what it's not is
what I like to educate about.
Because when I was, in my late thirties,
early forties, can't remember exactly when I had

(02:11):
a hysterectomy
in a military hospital.
And
just before the anesthesiologist
came in to put me out for the
surgery,
the hospital chaplain came in, and he was
wearing a military uniform with the white collars.
He was a priest.
And he asked me if there was anything
I needed to talk about, and it really
freaked me out. I thought, does this guy

(02:33):
have an inside scoop on something? Yeah. Does
he think I'm gonna die? I am not
religious. It says that right in my medical
record. Why is he here talking to me?
Mhmm. I had no idea that the chaplain
role is not to proselytize,
that they don't actually have any inside scoop.
Yeah. Yeah. They aren't they aren't able to
know exactly when you're gonna die,

(02:55):
but that they're there for spiritual support.
And one of my favorite things that I've
read, it's actually in the Medicare quality reporting
program when talking about how
to do, there's a quality metric that we
all have to do. We don't have to
do it, but we get paid more if
we do it. And that's the hospice item
set. It talks about spiritual
preferences,

(03:16):
and it says, in there
I think it says in there or somebody
said one time. I remember somebody saying it's
about
how are your spirits today? Like, that's a
question you could ask somebody. How is your
how are your spirits today?
So that people aren't confusing that with religion
or some kind of woo woo thing, you
know, and that even an atheist

(03:36):
can have spiritual
needs, you know, because we all have good
we're in good spirits. We're in bad spirits.
Right?
So I just always think it's really important
that people understand that the chaplain is
there for religious support. If you want it,
they're not gonna bring it to you. If
you don't want it, they're not gonna even
try. They're not even gonna Yeah. You know,

(03:57):
they're gonna ask you what you believe, and
they're not gonna be like, well, let me
tell you.
You know? Because our chaplains are, come from
a lot of faiths and some even from
no faith.
Mhmm. So that's my little
spiel on
spiritual support.
So Yeah. Absolutely. I think, I mean, as

(04:17):
we get into this conversation with Hank, we
you're you're gonna really hear as a listener
why
spiritual counselors can be and chaplains can be
so supportive
because they have this way of talking that
is not medicalized.
It's not in that medical model. It really
is relating to the person where they are
and getting down to the emotional support of

(04:38):
it all.
So I'm really excited to to talk to
him and and learn more about what brought
him to this and all that he's learned.
Yeah. Me too. Me too. It's whole person
care and part of our whole person is
our spiritual
care. How are our spirits doing? So, yeah,
I'm excited to talk to him today and

(04:58):
especially to have him tell us a little
bit about these amazing books. He sold millions
of books worldwide. Mhmm. They're amazing books. I've
they've been around for quite a while. I've
seen them in many of the hospice agencies
that I worked at. So
let's do it. Alright. Let's do this.
Hank, welcome to our interdisciplinary
meeting. Yeah. I'm glad. I'm glad they're here.

(05:20):
Can you please tell us a little bit
about yourself?
Okay. I,
got into health care. It was in 1983.
I grew up,
Southern Baptist, actually. I went to Baptist Seminary,
the Southern Baptist
Seminary in Louisville, Kentucky.
I've served,

(05:41):
church in Georgia Macon, Georgia for five years
right after
seminary. I was a youth minister and done
a lot of things with kids and stuff.
And then
we moved.
To tell you the truth, we got out
of the Deep South. I'm back in it
now, but we left,
Macon, Georgia to go to Washington DC and

(06:04):
be part of a real creative
nontraditional church in Washington.
And I did inner city work for, like,
five years, and
I was
basically, I was out of work and
got this opportunity
for a half time
chaplain's position at a

(06:24):
nursing home. It was
a, 200 bed
for profit family owned nursing home, but the
family was very committed to the spiritual care
of their residents. And so
that's
why they had a chaplain.
It's not required by law like,
hospice is required to have a chaplain
available.

(06:46):
But, anyway,
so I started that was in August of
eighty three. And about that exact same time,
the Virginia legislator
legislature passed a natural death act.
So it gave Virginians
in code a right to refuse treatment, a
living will,
durable power of attorney, all that kind of

(07:07):
stuff that was in now in the law.
And so our nursing home was really progressive,
and we formed an ethics committee to talk
about this new law. And so there was
doctor, lawyer, social worker,
chaplain, nurse,
all kinds of folks on the ethics committee.
And we
asked the question, what are we gonna do

(07:28):
about this new law and our residence?
And we decided, well, we'll tell everybody about
it. And I that just changed from being
a half time chaplain to full time chaplain.
I think they were thinking,
what we're gonna fill up his time with?
So
I said, okay. We'll talk to every patient
or

(07:48):
a competent patient or their family
about,
these end of life decisions. And, Hank, we
want you to do that. So
I was so unprepared.
I I I really had no clinical background,
but,
the nurses, I'm telling, bless their heart, they
just helped me so much

(08:10):
in learning about these end of life decisions.
So I started talking to everybody and reading
a medical lecture on it, things like that.
And so that's where I really got interested
in what became,
Hard Choices book is,
me talking to all these people.
And how that came about,

(08:31):
what most people might know me from my
hard choices for loving people book, and it's
I first published it in 1990. What happened
in about 1986
or somewhere around there, I suggested to the
ethics committee after I've been talking to all
these patients and families. Let's put a little
book. Let's put this in writing, a little
booklet we can hand everybody.

(08:53):
And the ethics committee first says, no.
We don't want you to put it in
writing. We like what you're doing. You're doing
a great job, but don't put it in
writing. Mhmm. So
I, of course, didn't put it in writing.
And
two years later in 1988,
the study came out of CPR done in,
the VA hospital in Houston,

(09:16):
And the survival rate
was, like, eight percent of those who got
CPR survived to be discharged from the hospital.
But of the, like, fifty or something patients
who are over age 70,
none of them survived.
And I said to myself,
we have got to tell people this information.
So I wrote a draft of

(09:38):
a what became hard choices for loving people.
And I sent it around to the ethics
committee, and they said, this is great. Let's
do this.
So so we did.
I did hang on and wait. There was
a medical ethics case
in the late
eighties, and it was finally decided in 1990,

(09:59):
the Nancy Krizan case.
And just a short summary of that, this
is what young woman was in an auto
accident,
ended up in a ditch face down. And
when the rescue squad got there, her heart
was probably had been stopped for for twenty
minutes, and they were able to resuscitate her.
But she ended up in a vegetative state

(10:20):
with a feeding tube.
And her family
asked that
the tube be removed and let her die
peacefully.
And the nursing home she was in,
said no. We can't do that. Missouri law
is where she was, said you have to
have clear and convincing evidence as this is
what she would have wanted.

(10:40):
So I went all the way to US
Supreme Court,
and the Supreme Court in,
June of nineteen ninety
made the decision that
Missouri's law was
constitutional.
They could require it. But they went on
to say, had she been in another state,
you could remove it.
Or if she had had clear and convincing

(11:01):
evidence, you could remove it.
And so, basically, it said it's okay to
stop feeding tubes of these federal
state patients.
So when that came, I waited that was,
my last piece that went into that first
edition of Hard Choices.
So that it came out in December of
nineteen ninety,
and it's still selling now. I've sold over

(11:22):
4,000,000 copies, and,
it's in its sixth edition.
It's expanded greatly. The the first I actually
brought a a the the first edition. Oh,
wow. It was just a little I got
the first edition. Yes. Yeah. So they live
in the
Keep working on the visual media.
Yeah. Yeah. So, anyway,

(11:45):
and that was first edition was just,
what was it, 29
20 something pages.
Oh, wow. Excuse me. 34.
And so it it grew from there. And
in the subtitle
of the first edition, it said, CPR, artificial
feeding tubes,
and the nursing home resident. Because this is

(12:06):
my world. I knew nursing home residents,
and I was gonna hand this to nursing
home residents, patients, and their families.
Well,
long story short, we started
we
we printed, like, a thousand copies, and I
sent a hundred
out to other nursing homes in the state
of Virginia, see if anybody else might be

(12:26):
interested in this. Well, out of that hundred
I sent out, we sold about 4,000 copies.
And we said, I think we got something
here. So so we started sending it all
over the country to every nursing home in
the country.
So we were it was starting to be
sell by boatloads. And,
one of the big surprises

(12:48):
early on was
hospices
were buying them by the boatloads,
and it said nursing home resident
in the
subtitle.
And now this was my ignorance of hospice,
and you two will, I'm sure, have this
experience.
I was under the understanding. Once people go
into hospice,
they've made all their end of life decisions.

(13:09):
They don't want CPR.
They don't want feeding tubes. They don't wanna
go to the hospital and get on. And
so I was just blown away. Why would
hospices be well, then, of course, I became
a hospice chaplain
years later, and I was still dealing with
helping people
with these end of life decisions. So, anyhow,
that's that, I changed

(13:30):
that subtitle.
Eventually, it said the
with the
senior senior citizens or something like that. And
then then I then I changed it to
those with a terminal disease, and the subtitle
now is, of course, with those with a
serious illness.
So it could be hospitals, nursing home, hospices,

(13:51):
whatever.
I I love this book, and
I have been a hospice nurse since 02/2005.
And I remember, I was telling Hallie, I
swear I know I saw this book a
long time ago. And in this new version,
it doesn't have, like, the light in the
shadows.
You have, like, a list of all the
different dates that it was first published, and

(14:11):
this one doesn't say that. It says copyright
2016, and I'm like, I know it's been
around a lot longer than that because I
remember
seeing this book. And one thing that I
love about this book, Hallie and I were
just talking about this,
is how
the how it's laid out. Like, it's super
easy
to read because of the bullets,

(14:33):
the bold you know, the lines,
and also not a lot of medical jargon.
Yeah. Breaking up words and not a lot
of medical jargon. Like, anybody can
read this. You don't you know? Yeah. And
it The layperson can read this and find
your parts down. That you wanna read. I
mean Yes. Like, somebody might have decided about
CPR, but they're so you don't need to

(14:54):
read that chapter. Just go ahead to about
feeding tubes or whatever.
Yeah. Yeah. I tell people to skip around.
One interesting thing that happened with the first
edition and continued through all,
six editions of the book.
So I sent out
drafts of the original,
book to friends and doctors and people I

(15:18):
knew, people I had
a lot more experience in this than I
I had.
And I had one of them,
sent to a physician friend, was at,
I was at Church of the Savior in
Washington, and he he was doing some inner
city work there. And, anyway,
I sent one copy to him,
and he wrote back. He says, Hank,

(15:40):
you are being so manipulative
in this book. Oh. You're you you
want people to make the decision you want
them to make, and it's so clear to
me that, you know, you're just trying to
you're you wrote it in a way that
well, another person I sent it to was
a psychotherapist. I was in therapy group
for her with a year,

(16:00):
years with her. And, one of my issues
in therapy,
and and
follows me along is telling people what I
really believe and what I think
and,
being honest about what's going on inside of
me. As as you can imagine, that can
cause problems in relationships, which it did. So

(16:22):
so, anyway, so I sent it to the
psychotherapist, and she wrote back. She says,
Hank, I can't tell where you are on
this. What do you think about these things?
So it was so interesting. I got the
exact from two people I respected, and they
knew me. I respect I got the exact
opposite.
And so
because of those two comments,

(16:45):
I cleaned up the language where I was
talking about CPR or whatever and really tried
to give them the facts, but don't say
you have to do it this way or
feeding tubes or whatever.
But I put a new section in the
back,
a chaplain's thoughts about these things. Mhmm. And
I was really honest with what I thought
about CPR and nursing home residents

(17:07):
or feeding tubes and dementia patients.
And I and I
and I was
now since I had the section
with the chaplain thing,
I didn't have to be manipulative,
which is what happened,
obviously. And,
anyway, it I think it made it a
better book. And I I get that comment

(17:28):
quite often when people say, you know, he
doesn't tell you what to do.
You he just gives you the facts about
it. And
literally, I do tell him what to do,
but it's in the back. Oh, no. No.
No. No. No. No. No. No. No. No.
No. No. No. No. No. No. It it
it so I I think it's,
again, that's one of the compliments I get
about the book is that it's it's just
lays it out and

(17:49):
doesn't
make you feel guilty if you do choose
CPR or feeding tube because
there are reasons people wouldn't do that.
I also think too though that sometimes people
don't even want they just don't want
they don't wanna know the hard truth. And
if you give them the hard truth, then
they feel like you're trying to convince them
that that's what they should do even when

(18:09):
that's really not what you're trying to do.
You're just trying to give them the facts,
and the facts are hard. You know? It's
it and
I land the same way you do, you
know, the same place you do on it.
Like, I think
that we keep people alive way
past when they should be kept alive through
artificial means,

(18:30):
and they have no quality of life,
you know, but
it is their choice to make,
But they need to have all the facts
so that they're making an informed choice. Right.
Yeah.
Right. You know? I that's what I really
one of the first things that struck me
reading this book was
I mean, I've been doing hospice for almost
ten years. I've been alive since the seventies,

(18:52):
but I don't think you really realize unless
you live through it how recent
these things are, how recent CPR is, how
recent just like you were saying, the law
saying you can withdraw
a feeding tube, which is insane to me.
And
and it's no wonder that we have hard
choices to make, and it's so hard to

(19:13):
accept these things when before the fifties, sixties,
there wasn't even a conversation. You didn't have
a choice.
Yeah.
Yeah. And there was that reminds me of
the story of of when I was nursing
home chaplain. We had a retired physician
who was one of our nursing home patients,
and he had gone to med school, like,
in the thirties or something like that.

(19:33):
And I asked him, I said,
were there feeding tubes around in the the
thirties when you're in med school? I said,
oh, yeah. We've had feeding tubes
a long, long time.
He said, but the big difference
is antibiotics,
which really
came along in the forties and fifties
because there's so many infections
that go along with feeding tubes. Right. So

(19:55):
people might you might be able to get
food into them, but they're gonna get infection,
and we're not gonna be able to cure
it, and they're gonna die from aspiration pneumonia
or something like that. But, of course, now,
generally, we can cure these pneumonias and stuff
that that go along with feeding tubes.
Mhmm. So, yeah, it is it it's relevant
to the CPR. I remember I'm old enough

(20:16):
now when I was, like, in Boy Scouts
in
the fifties and sixties, and
they taught that there was no such thing
as CPR.
It was artificial
respiration.
And what they taught us to do, you
get, let's say, a drowning victim. You lay
them on their their,
stomach
in, on the ground, and you put their

(20:36):
head in their hand,
like that. You you put their
elbows up, and you lean over them. You
kneel above their head. You push on their
back. You go, out goes the bad air.
You pull up on their arms, then goes
the good air. What? Out goes the bad
air, then goes the good air.
Now,

(20:57):
you know, we know CPR, and you do
it on their back, and you you
you pump on their chest really, really hard
Yeah. Really hard. Their mouth or just now
it's optional for the mouth breathing. But anyway,
so that's it was it was in the
fifties and sixties that they first started doing

(21:17):
CPR.
And
it is the one treatment
that you can get done to you that
that they they're not required to get your
permission.
Mhmm. You know, you you Mhmm.
In a hospital,
if you do not have a do not
resuscitate order or no CPR order, you you
could end up getting CPR and even if

(21:38):
the docs might think it's not gonna do
any good.
Yeah. Well, they're always gonna on the side
of life because nobody wants to be sued.
Yeah. Yeah. They don't have a chance to
ask those questions. So
I was just having this conversation with a
family member asking me
why do they keep asking us every time
we have a new shift? The nurse asks,
are you going to the person's not, you

(22:00):
know, dead yet. Obviously, they're but they're becoming
unresponsive and have pneumonia.
And they're asking
every shift, do you what do you want
for licensed training treatment kind of things? And
I said, that's because they're not telling you
the hard part.
Yeah. They're not having the other part of
the conversation, which they need to be. Because
they're like, his advanced directives are in the

(22:22):
thing. Why do they keep asking us? That's
not what they're asking you.
Yeah. It's to me.
Because they will air on the side of
life exactly what you're talking about. Yeah. Yeah.
So one of the things
as a as the book grew over the
years,
on feeding tubes with dementia patients in in

(22:44):
the late nineteen nineties,
a number of, studies came out
showing that feeding tubes just do not help
advanced dementia patients like Alzheimer's patients.
At the time,
there were about about 30
of advanced dementia patients in the nursing homes
had a feeding tube.

(23:05):
Thirty percent
had feeding tubes. That's incredible. And the research
now showing,
that it just doesn't do any good. You
don't even actually, you don't even live any
longer. You live about the same amount of
time with careful hand feeding
as with the feeding tube.
And I don't know if it's my book,
but, there's a lot of it because of

(23:26):
the research.
The doctor now reading, it doesn't do any
good. So there it's less and less you're
seeing,
fitting tubes in advanced dementia patient.
But, you know,
bless our hearts, sometimes those nurses' aids who
were saying, you know, I can't feed your
mom anymore. She's coughing all the time. She
needs a feeding tube.
Yeah.

(23:46):
And, you know, it's hard.
Hand feeding is hard.
Careful hand feeding is hard with advanced dementia
patients, but you can do it. They they
can do it. Well and also now some
people are opting out of that too in
advanced directives saying that they don't wanna be
fed.
Interestingly,
I I just my wife and I, we

(24:07):
changed our living wills last year, and we
added an addendum
for dementia
and
withdrawing hand feeding.
I am so curious how that's gonna play
out with state regulations and facilities.
Very, very good question.
Yeah. And what you're referring to, Hallie, of

(24:28):
course, is, you know, if you have a
weight loss
significant weight loss in patient,
state regs, they're gonna what are you doing
to address this? Mhmm. And
I think what you need to do, you
know, now I've seen
this work a lot of places, is
have become a hospice patient.

(24:48):
And if they're a hospice patient, we know
they're toward the end of their life, and
you don't have to put a feeding tube
in,
to keep on careful hand feeding, keep monitoring,
but
you you don't have to to do it.
So I think the nursing homes will be
covered
for that, but but it is it is
a concern,
and understandable that

(25:09):
nursing homes don't wanna be written up and,
you know, for
starving patients to death. So Mhmm. So,
but anyway, I think I think we get
oh, so so the,
the advanced directive now
well, I actually just took one. I think
it was
the, New York,
State of New York.

(25:30):
Compassionate,
compassionate choice. I can't remember what Compassionate tradition.
Goes by one thing.
But there was there's several of these
dementia
advanced directives you can copy off the Internet
and,
just fill them out and have two non
family members as witnesses.
And,

(25:51):
so
that is in my
living will now, and it's like if and
that
it states specifically
what states
six or seven on the,
Greensburg scale.
There there's,
I can I I I I'll give you
the the links for the show notes that
you can put this up? But

(26:13):
so
if I get it to that advanced dementia,
I don't recognize my family.
Even if I'm open my mouth and taking
in food,
I want you to stop the hand feeding
and let me die.
Okay.
So I I don't want
that's a quality of life that I've
do not want to have. And I don't

(26:35):
wanna drag my family through it and the
expense and,
you know,
literally be dying for years. And,
so
so even with the hand feeding, and I've
and I've seen this actually clinically.
Even when I was back in the nursing
home, occasionally, we'd have families come to us
and say,

(26:55):
you know, mom's not herself.
She
if she could see her what she's doing
now,
you know,
poo and peeing all over herself and all
this,
she would just be horrible. We want you
to stop the hand feeding.
And we were able to do that,
even without this more advanced stuff that we
know nowadays.

(27:16):
But we were convinced that they
they convinced us this is what the patient
would have wanted, and so we honor that.
And and
the patient died, you know, not long after.
Stop the hand feeding.
Yeah. And a problem with dementia patients is
that if you put food in front of
them, they often will open their mouth and
accept it. So that that's then it's like

(27:37):
people think they're hungry. We gotta feed them,
but it's just a like a reflex that
they're opening their mouth to accept the food.
So I love what you just said about
if you don't recognize your family anymore, even
if you open your mouth, you don't wanna
be fed that way. You know, going back
to
being able to put patients who are in
nursing homes,

(27:58):
onto hospice. Unfortunately,
one of the issues with that is
the qualifying factors for dementia patients because weight
loss alone is not enough to qualify a
person for hospice. And, you know, I really
wish that we could expand that hospice benefit
even if it was just specifically
to include dementia patients to where maybe they

(28:19):
have a longer life expectancy so that we
could bring them on a little earlier because,
you know, they almost have to be in
a fetal position and completely not talking to
qualify for hospice. But we know that, you
know, if they're in a nursing home, especially
to your point,
they're gonna keep trying to keep them alive
because they're gonna have to have some kind
of an action plan

(28:39):
around
weight loss in a patient who's 80 years
old with Right. Alzheimer's dementia, you know, if
that's Uh-huh.
So that's kind of an issue with that.
Yeah.
Although,
not my personal
preference for my advanced directives, I do love
in your book, at least a couple of
times you mentioned a few,

(29:00):
issues where folks do want
all life saving treatments.
And really love the focus also in the
book of it's about the patient choice. It's
it's not that golden rule. It's not what
we want. It's what they want,
and that's why these conversations are so important.
If you don't know, you're leaving it to
your loved one to figure out,

(29:20):
and they may default to what they want,
not what you want.
Yeah. Yeah. And you can't make decisions about
those things if you don't know what you
don't know. Yes. You have to you have
to be informed to make those
decisions. And that's that's where I think we're
really having,
you know, trouble. And that's why I love
your book, and everybody should read this book

(29:41):
because Just for people may not have seen
it,
expanded.
I I have several smaller sections of other
decisions. Of course, the the big one, CPR,
the feeding tube,
and in that
conversation with the feeding tubes is IVs for
hydration of dying patients.
Mhmm. Which Mhmm. I saw that. Do any

(30:01):
benefit to them.
Only makes,
the dying worse
with, IV for hydration. You might have a
IV open to get some meds in, but
it for hydration.
And then I added a chapter
on shifting the hospice
or palliative care
and explain explain what that is. And then

(30:23):
I have several smaller sections on just hospitalization
of, like, a nursing home resident or people
in their own home.
Some of the issues of,
do or do not
hospitalized
advanced
disease patient.
Ventilators, I'll talk about that.
I added,

(30:44):
a section on dialysis,
I think, in the 02/2001
edition maybe.
And then
the most recent edition, the 2016, when I
added a section on pacemakers
and defibrillators.
Love that.
Yeah. Me too. Turning them off, especially the
defibrillators
as people are dying.

(31:04):
And, of course, section on, pain control and
just about, you know, you
you you can't kill a patient with morphine
if you titrate it. So very much. Do
you appreciate that?
Oh, yeah. Good. So we're not.
We gave her the morphine and she died.
And we killed I kill mom, you know,
and it's horrible.
Mhmm. So and I'm sure,

(31:25):
Penny, especially you as a nurse, are having
to explain this to families all the time
that we're not gonna kill them. Make sure
she gets that morphine every six hours, eight
hours, whatever it's diagnosed. I mean, whatever it's
prescribed. So
Yeah. There's a couple of specific quotes I
wrote down to make sure I reference them.
Page 30 that were my favorite.

(31:47):
Page 33.
The death
hooked up to machines is an accident. The
peaceful death in your own bed takes planning.
I was like, oh my god. Yes. Yeah.
This is exactly what I was telling Penny.
It's like, it doesn't matter how long you've
been in hospice.
It is so important to keep your ears
open to other clinicians and people that have

(32:08):
worked in the field because
there are new ways, even though it's information
you agree with or you know, there's new
ways to say it. And that's what I
really love about your book because there's different
language that I'm gonna start incorporating as as
I go through this. Oh, thank you. Yeah.
Yeah. That that's what I've heard and still
hear from
professionals, nurses,

(32:29):
social workers, whatever.
Hank, you give you you give me words
to use. Mhmm.
So yeah. And on, page 45, this is
speaking
again to turning things off and not killing
people.
Turning off the device
does not kill the patient. It's removing a
barrier to natural death.

(32:51):
Oh, I like that one too. Yeah. Yeah.
I just recently in a in a blog,
on my website,
I was talking about dialysis because it's still
in the news about dialysis and how,
you know,
it doesn't help a lot of patients
and is a great burden.

(33:11):
The most recent research was about,
these patients who go on they
they looked at patients who went on dialysis
and other similarly
afflicted kidney failure patients who did not go
on dialysis.
And they did find the ones who went
on dialysis lived on average, like, twenty five
months,
but the and the ones who,

(33:33):
did not do dialysis
lived on average twenty three months.
So you got two months longer of life
Wow. With a huge burden.
Huge burden. Dialysis, you know, three times a
week.
The entire
wearing your ass off out. And so,
so, anyway,
this this is,

(33:54):
I I wrote this blog, and I told
this story about when I was a nursing
home chaplain.
We had a man in the nursing home.
It's actually had it was a very
well known
opera singer.
I I didn't know opera. I didn't know
who he was, but
I I started reading up on his oh
my gosh. This guy's famous.
Anyway
and he was on Dallas's, and three days

(34:15):
a week, he'd be sitting there by the
nurses' station with a bag lunch bag
and his wheelchair, and the transportation people would
get come and take him to over to
the Dallas Center, and he would go through
his Dallas and come back. Well, it was
just wasn't doing much good anymore,
and he was thinking about
stopping the dialysis.

(34:35):
The guy was a very devout Catholic,
and he was worried as a suicide, which,
of course,
this Catholic phase, he had suicide. It was
was, you know,
would damn you to hell if you committed
suicide.
So
he asked me to come see him, and
he asked me that question.
He says, if I stop the dialysis, will

(34:56):
I be committing suicide?
I said, absolutely
not.
You'll be dying from kidney failure, which is
what's going on here. It's a natural death.
You will not be committing suicide, and he
took it to heart
and stopped the dialysis and died very peacefully.
I don't feel those days or how long

(35:16):
it was later after he stopped dialysis.
But back to your point, Hallie,
with all this stuff,
not doing a feeding tube, are are you
dying
because we start? No. How come you can't
swallow
anymore?
Mhmm. You know, Nancy Krzan, who who had
been kept alive for

(35:37):
several years on a feeding tube.
When they withdraw
the feeding tube,
yes, she technically, she might have been dehydrated
that actually ended her life, but it was
she died from
results of a
traffic accident.
Mhmm. They left her in the ditch for
twenty minutes. Yeah. It was the accident was

(35:59):
the cause of death even though it was
years later. Yeah.
Well, I always say it's easier to make
a decision to not put the intervention in
place
than it is to make the decision to
remove it because then you're so far away
from the actual event
that it feels like you've just caused their
death. Whereas if somebody has a stroke and

(36:19):
you say, no, we're not gonna put a
feeding tube in, they die from their stroke.
Yeah. No. But it says you starve them
to death. Exactly. Exactly. But if you put
it in and then, you know, six weeks,
a month, a year later, you say, let's
pull it out, then it's really more like
you just starve them to death rather than
die from their stroke.
So Yeah. Which

(36:40):
they I end up my
book, Hard Choices,
on the emotional and spiritual issues, and which
I think,
and and, of course, this is kind of
my bent as a chaplain, but that this
is the real
struggle that people have
as
what I call the emotional spiritual issues. And,

(37:01):
there was a
patient came to our nursing home, and he
gave us a really bad shape when he
came there. And but he was a full
code. Everything
must be done to try to keep him
alive. And,
he got he went bad almost,
within a day or two. And so we
called the rescue squad, sent him out to
the emergency room because he was a full

(37:21):
code. And,
I rode with him in the ambulance
and waited at the,
emergency room for his daughter to show up.
It was his only caregiver
family caregiver.
And, the doc had asked me before,
she got there. He says, what what's his
coat status? I was like, he's full coat.
And,

(37:42):
it he had been there so shortly. I
didn't have a chance to talk to this
daughter about it. The man was in no
condition to be able to make a decision.
So one of us, the daughter comes and
she, you know, wanted she wanna see her
dad. We we went in and saw him
and,
off and said, would you like to have
a prayer? And I said she said, yeah.
And so we had a prayer together. And
I says, can I talk to you out
in the hall for a sec? And so

(38:04):
I I went through my spiel about CPR
not doing any good for patients like her
dad.
And and it just, you know, you can
have this do not resuscitate order. We call
it, in our place, call it the no
CPR order.
And, you know, it it would keep him
comfortable. He'll get pain medication,
but, we just won't be on his chest

(38:24):
trying to get it going. She's she's listening,
and so
seemed to agree with me. And so
I left, and then God came back to
our nursing home a couple days later, and
he's still a full code.
I'm thinking,
what did she know I'm a national expert
on this thing, and I
know what I'm talking
about. So, of course, I called her up,

(38:46):
and I started my spiel again with her,
saying the same thing. She's and she stopped
me. She says, I know.
I know when his heart stops, there is
nothing that's gonna be able to save his
life. And then she said, but it's just
so hard letting go.
And it was the symbol
that no CPR order symbolically

(39:07):
saying,
I'm gonna lose dad. Mhmm. He's gonna die.
And it's hard to
make that statement. And and bless her heart,
she did call the doc
and got the no CPR order, and he
died very peacefully couple days later.
So
this this is what I I think
all these decisions

(39:29):
really comes down
to the emotional spiritual side of it because
because a lot of times,
the medical side of it is really clear.
And people understand the medical side. That's what
this woman was telling me. I know he's
not gonna survive CPR,
but it's hard letting go.
And so so to put it in a
way
Okay. That

(39:50):
that they know it's it's about letting go
at the end of life.
And,
what I go on and say, call them,
just let things be. Just let them die
naturally.
Yeah. Allow natural death. I remember the first
time I saw a d n r slash
a n d at I worked in a
hospice
care center, and all of us were like,

(40:10):
what
is that? And the doctor was like, a
low natural death. Oh,
that really makes sense.
You know, I've had patients that
just did not want to,
let go of their full code status. They
didn't wanna talk about it. And then the
family would be like, we're just not gonna
call 911.
You know? And they and they wouldn't. The

(40:31):
person would die, and they would just be
like,
can we just let them die? We're not
gonna call 911.
Back at the nursing home days, we had
this lady,
advanced dementia,
you know, and she's still eating and doing
doing fine with it. But she has a
full coat.
And she had two sons. One lived near
the nursing home in Virginia, and the other

(40:52):
one lived out in Arizona.
Well, this one son from Arizona,
very faithfully,
every year, he called his mother on her
birthday
to wish her happy birthday.
And he wanted the full coat, everything to
keep his mom alive.
And the son, locally, he he's,
I know, but my brother is just like
this.

(41:12):
So,
the doc,
she's a wonderful
geriatrician,
and,
I talked to her one time. I says,
would you like us to call an ethics
committee? And we'll say the ethics committee recommends
that she get the no CPR order
to and tell to the son in Arizona.
She says, don't you dare.
She said,

(41:34):
he's not gonna go along with it no
matter what. But listen, I've made it clear
to the nurses
not to do CPR
on this man, even though she did not
have,
a do not resuscitate heart, no CPR on
her. And and
as you could imagine,
the patient started going bad. It was slowly

(41:54):
declining.
Obviously, she's dying.
And they would check-in on her every once
in a while, but not too often.
And one time they went in and she
had died.
And, of course, they
the the sun in Arizona was fine with
it, that she died in her sleep peacefully.
Yeah. And she did.
So

(42:15):
it's,
you know, and,
Penny, I'm sure you
in hospitals, a lot of times, that's the
slow walk down the the hall or Yes.
Not checking on any when these full code
people you know are not. Because you're you
know, if you if you do,
if so if you did not witness the
cardiac arrest when their actual heart started, you're

(42:37):
not obligated to start CPR.
And,
you know, just say they died in their
sleep. They died peacefully.
And most families,
can accept that.
People like that terminology,
died in their sleep. I get questions all
the time on my social media about do
people ever die in their sleep, and I
say pretty much that's how they die. Like

(42:59):
most people who die a natural death, slip
into unresponsiveness
and then they slip away and you could
say that's like dying in their sleep. And
I think if you
maybe even pose that to somebody who's saying,
I want everything I want, would you rather
have that? Or would you like to die
in your sleep?
My, social worker who I worked with was

(43:21):
really good at saying to people,
if your heart stops and you no longer
are breathing,
do you want us to beat on your
chest to try to attempt you,
attempt to bring you back to life,
or would you rather just
let that be it and just let it
go and die a natural death? And once

(43:42):
you put it that way, people were more
like, oh, because I think people don't understand
that when you are doing CPR in somebody,
they're dead
for all intents and purposes. They are not
breathing. They have no heartbeat. They are literally
dead, and you're trying to bring them back
to life. And I think I think a
lot of people don't really understand that about
CPR.

(44:02):
Mhmm.
Yeah. I think I've been using that as
a good explanation for
why I don't. I mean, I realize if
I'm in a car accident, they're gonna default
and give me CPR, but I have already
asked and gotten a DNR for myself.
And that is because my doctor knows I
work in hospice.
I don't want to die, but if I

(44:23):
do,
don't bring me back so I can die
again in a worse way.
I've already gone through it. Please let me
be. Let it be.
Yeah. Yeah. Yeah. I have my five wishes,
which are a little more,
like,
detailed as far as if you're not expected
to recover. Do you want this? If you
know what I mean? Like, like you, Hallie,

(44:43):
I would expect
that if I'm in a car accident or
electrocuted or something like that, then, you know,
go ahead and try to bring me back.
That's when you have your better chance of
it. But if I
get some kind of illness, COVID or whatever,
and it takes me out,
you
know, don't try to ring me back. Let
me go. Yeah.

(45:04):
One of the things I was thinking about
recently in the book also kind of got
me thinking about this is something we really
don't talk about, and why would we? Right?
We're we're patient focused.
But we don't think about the trauma
that that causes the responders
for people that they know are not going
to survive.
That I've I've had friends that were first

(45:24):
responders and had to
were forced to
do CPR
on, you know, 90 year olds
that
are gone. Crack their ribs. And it is
horrific. It is so traumatic, and it's traumatic
for the families to witness too.
And I don't think that part of CPR,
at least that's really why I like Andrew's
video that we talked to him about last

(45:46):
season
that was and and like your book, Hank,
that is more
not graphic, but direct about what CPR looks
like and what happens and what are the
consequences of it
so that people can make hard decisions.
Speaking of first responders, when I was in
nursing school, I went to do a clinical
in this place called Ashley House, and they

(46:07):
have children in there. It's children with serious
illness or terminal illness.
And there was a boy who was I
think he was about 17 because they were
talking about how when he turned 18, they
would have to find a new place for
him because he would no longer be a
child. When he was 10 years old, he
drowned.
Mhmm. And he was resuscitated,
but he was in a persistent vegetative state,

(46:28):
tube feeding, the whole nine yards,
trach, everything.
And,
the people that that worked at the at
Ashley House told me that the first responder
came in
after he had been transferred there,
and saw him and told the nurses that
if he would have known what that boy
was going to end up, what his life

(46:49):
was going to be like, he never would
have done CPR in the first place.
Yeah. What made you include
children and because you do include some
children's
stories and stuff. Something I I added over
the because, again, I started out nursing on
top of them
with all these old people. We
we never had we had

(47:10):
only, I guess, because we had a
a a boy who was, like,
17
at a vegetative state. So but most of
the time, I wasn't dealing with children. So
then, of course, I get to hospice and
running into children occasionally,
and so I I added this section on
children. The,
the medicine side of these decisions is no

(47:32):
different
for a 10 year old, a 17 year
old, a 75 year old.
It's
the the physical
medical condition of the patient that makes them
not a candidate for CPR is not the
age.
But what makes decisions so difficult for the
parents
is, say,

(47:52):
not only are they losing
the life of a loved one,
whether it's 75
years old or 17 year
old, but you're losing
all
of the promises of that 17 year old.
Mhmm. Seeing them graduate from high school, from
college, getting married, having grandchildren
from this child.

(48:12):
You know, all the stuff that is wrapped
up with being a parent,
and you are having you're you know, you're
saying goodbye
to all those things.
And it's it's really hard. And so that's
why I said, like, an I did that
specific specifically in the feeding tube chapter.
Mhmm.

(48:33):
And that,
you know, to a child that might have
kept alive
for
some time on a feeding tube,
you're having all that letting go of of
what it might be
the years that they might have given some
pleasure.
It's grief.
Right? We we don't know how to name
that, but it's grief.

(48:54):
You know, it is it's it is grief.
It is
and all of us grief is as far
as these decisions
because you're
deciding
that what
I was hoping for is not gonna happen.
And now I've changed what I can hope
for.
Yes.
Well, Hank, while we're coming towards the end

(49:16):
of our interview today, I wanna make sure
I mentioned the light in the shadows for
the visual people can see what that looks
like. Tell us a little bit about this
book.
Yeah. So
I'm sitting in hospice team so often, and
I I can remember saying this to our
team.
You know,
patients dying, and the family is just

(49:37):
bouncing off the wall and trying all these
different things and just making it so hard.
And I would say to my team, I
says, you know, dying is hard enough.
These people are making it so much harder
than that needs to be.
And
so what I did, I basically sat down
and just
wrote list of of the different issues that

(49:59):
patients and families
deal with, that make dying so much harder.
Things like forgiveness.
Mhmm. I I have a section on forgiveness
there. And,
you know,
I I like Ira Biag's question. I actually,
I think, quoted him.
He would say to a family,

(50:22):
or a patient, if you were to die
today, god forbid, but if you were to
die today, it's anything that would be left
undone.
And often, it's like reconciling with,
family members or something like that. They're for
you know, seeking forgiveness
or granting forgiveness,
which are two of again, our box question.
I forgive you.

(50:42):
Will you forgive me? So
that is some of the things, you know,
that people
that are the emotional and spiritual issues that
they have to deal with. So Well, I'm
definitely excited to read this one. Unfortunately, I
didn't get to it. I did read all
of this first book. Yeah.
Yeah. So it and, actually,
I

(51:02):
had,
almost
tried to work grief into the title of
the subtitle of the book. Mhmm. Because,
a lot of people say they read this
after so and so died.
And so I gathered all these different things.
I did the first edition in '99 and
then,

(51:22):
updated in 02/2005.
So it's just they're short little things. You
know, people
who are sick and dying and their families
are they don't read long stuff. So they're
short little
meditations with with,
a little bit of of thoughts,
along the way.
And you might have it in here, but
I wondered from reading the hard choices book,

(51:45):
you've kind of skirted around this, but not
this question directly. So as the chaplain, what
would you suggest we tell folks that say,
I don't know why God hasn't taken me?
I'm sure you've heard that a million times.
Oh, I've heard that.
Yeah.
You know, I mean,
put it conversely,
sometimes that's especially at the nursing home, they're

(52:06):
disabled person, they're in a wheelchair, they're in
a nursing home, depending on those for their
care, And then and they would say something
like, I know God has something for me
to do.
Let him do. You know? And so we
talk about that. You know? Spread love to
your family.
You know, pray for your family. Things that
you can do.

(52:26):
But yeah.
Action steps. I like it. Of course, it
it
depends on what their code status is too.
Why hadn't God taken me?
And it might
bring up a conversation about code as well.
I have a suggestion. If you really want,
to take it when it's time,
is to get that do not resuscitate order.

(52:48):
Yeah.
People it's,
you know,
most people are
religious in some way,
spiritual or whatever words. And,
of course, around death and dying,
god's name gets used a lot.
You know, like, well,

(53:09):
people would say, you know, somebody's on a
vent, let's say, and and the doc's talking
to them about withdrawing the vent and let
let them die peacefully.
And then the family was, oh, we can't
make that decision. Only God can choose
when they're supposed to die. And I feel
like saying, I got an idea.
Let's turn that machine off and see what
God does.

(53:30):
Mhmm. Yeah. Right. I don't say that to
people because
what is it that is
making you hold on so much? Is there
anything
left undone?
Mhmm. Saying goodbye,
you know, somebody from out of town to
come in to visit, you know, the the
last things. And then and I we had

(53:52):
we had
a,
got it was a a advanced dementia patient,
and he got pneumonia.
And they started
antibiotics
on him. And
so and I talked to the family, you
know, it might this might be an opportunity
just to let him go. And they they
listen, and,

(54:12):
a day or two later, this other child
came in from California
and visited with his dad. And the and
the the wife came out and says, okay.
We can stop the antibiotics now. So
Yeah. It was that piece that was left
undone was the son to get there from
California.
And,
you know, especially in

(54:33):
ICUs in the hospital,
that happens often. They do keep it going
just for somebody else to get in to
say goodbye.
You know, is that the best use of
our resources? I'm not sure.
But we acknowledge
that's a piece
is
that family coming in there and saying goodbye.

(54:54):
So that's you know? Yeah.
We actually did that at the hospice care
center. I remember there was a patient that
had somebody coming in from somewhere else in
the world, and
they actually did some a little bit of
IV hydration for them just to try to
they were a younger person, and,
you know, they just try to kinda hang
out keep keep them hanging on just for

(55:15):
a little bit longer until their person got
there. Yeah. Mhmm.
Well, is there anything we haven't discussed with
your books or your work that,
we haven't talked about or things upcoming for
you?
You know,
I'm I'm working on actually adding some paragraphs
if if we do a seventh edition. I've

(55:37):
been talk talking about it, the publisher about
this. We don't have one plan. Don't worry.
Keep buying the six. But if we ever
did,
about voluntary stopping eating and drinking
Yes.
These six
include Yeah. Accolade and dying. Yeah. Yeah. So,
in short,

(55:58):
you you thought to, of course, live in
a place that has medical aid in dying.
Mhmm.
A lot most of your I've never lived
in a jurisdiction that has medical aid in
dying, so I have no experience with that.
But,
even even in Oregon, Washington, California, and other
places that have medical aid in dying, there

(56:20):
are certain patients that don't qualify for it.
Yes. You know, dementia patients,
some MS patients that are not in the
final, you know, six months or ALS, things
like that. Mhmm. So,
people can choose,
and there's a wealth of information
on the Internet now about
voluntary stopping eating and drinking.

(56:42):
You really need,
well, let me
say exactly what it is. So a person
decides,
based on them, I'm gonna fast until I
die, not eat or drink anything.
And,
since beginning of time,
people have done that. This is not new.
Yeah. And,
but now with things that are able to

(57:03):
keep you going, whether it's just
your heart medications and things like that, but
and people are just tired of living.
Mhmm. And so there's some great
videos of patients themselves,
their family taking a video of mom saying,
I've decided I'm gonna stop drinking and eating
and
die peacefully. So there's some really

(57:25):
touching videos of patients and families going through
this. So
it is an option.
I,
my hesitation in putting it in too much,
I just I I don't want
there might be some facilities that don't want
to suggest this to people. And I can
understand that, not
actually suggesting it. But if somebody comes to

(57:47):
you and says,
I don't know why God keeps me around,
you know. I wish I just wish I
would die sooner.
Then I think when people are asking that
question,
would be able to say, well, one option
I'm not saying that you should do this,
but some people would choose to stop eating
and drinking.
And it is so important to have clinical
help with that. Mhmm.

(58:09):
Hospice
because as soon as you stop eating and
drinking, you basically are terminal, and you can
qualify for hospice. And so get hospice or
palliative care involved.
There's medications you can take. There's things you
can do to ease the,
sense of thirst. And
so that would that might be one thing
I would I would I'm not gonna add

(58:31):
a whole chapter, even a a big section,
but I think I might add it in
the section on, feeding tube the feeding tube
chapter. Mhmm. It's just it's an option that
that people could
could do to hasten their their death.
Well, in season two, we have a final
question that we're asking folks, and I'm gonna
make yours a two part since you do

(58:51):
talk about advanced directives.
Do you have your advanced directives complete? I
know you said you have your living will,
but do you have everything else done?
And what do you want done with your
body when you die?
Oh, okay.
Season two questions.
Yeah. I have my advanced directives, and I've
had them for years since I started doing

(59:13):
doing this stuff. And, like, so we we
just updated
to add that,
thing about he said for,
if I get his dementia
Okay.
To
to
withhold.
Yeah.
Yeah. You know,
my body.
Right now, it's to be cremated, but I
know that uses a heck of a lot

(59:35):
of carbon fuel to to, cremate
my body. So
I haven't looked around.
I know in Northern Virginia where I used
to live, there's a Trappist monastery out,
in the country there that has
a natural green burial
ground. Mhmm. And they will accept

(59:56):
people in caskets. They gotta be wood. They
can't be anything that's not gonna
decompose.
Or you can just bury somebody in a
shroud
and,
just like, that's how they bury the monks.
There's no casket with the monks. They just
put them in the ground and put dirt
over them.
Them. And, so that would be a a

(01:00:17):
thing I would I would really,
like to do if
I know,
I think in Oregon, they're working on composting,
aren't they? Well, they are in Washington. We've
we've got composting here in Washington.
Yeah. Oh. So yeah. It's it's starting to
spread. It's in other places. I think Colorado
now too is doing it. I don't remember
all the places. But, yeah, I like composting.

(01:00:40):
And then I like
there's also another thing they're starting to do
where they
it it does involve cremation, and maybe they
can do aquamation instead, but they mix your
ashes with some kind of concrete,
and they make a ball out of it,
and they lower it into the ocean. It's
called the eternal
reef. What's it called? The eternal reef. Yeah.

(01:01:00):
It makes a reef out of the Oh.
Your remains. Yeah. Which is kinda cool because
we're losing reefs in some areas. So it
it actually makes a reef, and I think
that's kind of a fun idea.
Yeah. Yeah. It's,
you know, it's tough.
I I mean, I'm I'm spread out. I'm
here in Mississippi. I have a daughter. Two
daughters actually live up in Northern Virginia and

(01:01:22):
a son in Asheville, North Carolina. And,
you know,
I think it's important to see the dead
body, but, you know, if they're not around,
would I die? And
so
that that I would miss if if,
people can't be around when I'm actually dying
or I'm dead.
So, that that's what I one of the

(01:01:44):
wonderful things with hospice, of course, is
having
deaths at home, and the family can gather
around
and actually see this dead person that that's
it can help the Greek process.
Absolutely. You know, direct cremation is
might be the option, but it's it's not
the best.
Right. Well, Hank, thank you so much for

(01:02:06):
joining us today. It's just been a privilege
to talk to you.
Well, thank you. And tell us where people
can find you, Hank. Yeah. Well,
just hang on on Facebook and
on Instagram. It's,
hospice chaplain Hank. I pin it out. I
took your lead on,
hospice nurse, Danny. So hospice chaplain Hank. Oh,

(01:02:28):
that's a no brainer.
I do have a YouTube channel too.
It's
well, you know, they stick these numbers behind
your name, but I I I checked to
see what it was. Hank Dunn six three
zero four, but you can just, I think,
just search Hank Dunn. And I I do
these short little videos, and they're not all
about
death and dying. It's, I do a lot
of stuff in the in the out of

(01:02:49):
doors where
paddling or hiking or camping or something like
that. So Yeah. I've seen some of those.
I like those.
So
where can people get you I'll send you
those books for the show notes. And the
book yeah. Just hankton.com.
Okay. You can buy the book,
online there.
And, you know, the more you buy, the

(01:03:10):
cheaper they get.
So, you you can get them on Amazon.
If you're just buying one or even five,
they're gonna be the same price as you
get,
from my publisher. But if you get 10
or more, there's there's,
bulk discount. So it's better to go. And,
I mean, the average order is, like, a
hundred. So we sell them to hospices, nursing

(01:03:30):
homes, hospitals,
churches.
Yeah. Well, they should be everywhere. Things. They
should be in every
in every place where there are people who
are gonna die, and that's every one of
us. Yeah. I'm just gonna start giving them
out as gifts.
So Yeah.
Happy birthday. Hard choices.

(01:03:51):
Yeah. Yeah. That's
thirty four years coming up. So That's amazing.
Wow. Well, thank you so much again. So
much for being on here. Welcome. Thank you
for having me. Thank you for doing what
y'all are doing. It's great work, so I
wish you the best. Thank you. You.
Well, that was Hank Dunn, amazing author and

(01:04:12):
hospice chaplain.
Amazing.
Amazing author, amazing chaplain, amazing human.
Yes. So much experience.
So, I mean, he's been
he's been in it for a long, long
time.
A long time. I am for sure gonna
be making sure our hospice has this book
in our library because it's great. I'm gonna

(01:04:34):
be passing it around to my colleagues as
well.
Yeah. I mean, let's pitch these again. Hard
choices for loving people.
Mhmm.
CPR, feeding tubes, palliative care, comfort measures, and
the patient with a serious illness.
Mhmm.
By yeah. And Life in the shadows.
Light in the Shadows, Meditations While Living with

(01:04:54):
a Life Threatening Illness. These are
both just fantastic books by a fantastic
man, a fantastic author. Mhmm. Definitely wanna get
these books. They're so good. I mean, I
like I said,
hard choices for loving people.
I this has been around since I started
hospice nursing twenty years ago. I remember

(01:05:15):
seeing this book and learning from it. Yeah.
You know? I'm just glad he
kept pushing to write stuff down because
it's great. It's a really helpful guide for
clinicians and for families.
Yeah.
Alright.
Hello? One in the can, man.
Yeah. Hank is our last interview. We have
one more episode with just us, and we'll

(01:05:37):
do our season wrap
up. Yeah. Sounds like a plan.
Until then, remember to live because someday
You'll all be dead. We'll I almost said
you'll
you'll all be dead, and so will I
because we all will be dead.
Well, as Hank says, none of us get
out of this alive. We're all a hundred
percent accurately certainly going to die.

(01:06:00):
Yep.

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Season 2, Episode 12: Hard Choices for Loving People with Hank Dunn

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