November 5, 2024 • 35 mins
In this episode of Purpose Project, host Leslie Pagel welcomes Brandi Combs, a social worker with extensive experience in hospice care. They explore the concept of purpose at the end of life through Brandi's compassionate lens. Brandi shares her personal journey, and the significance of connections and resources in end-of-life care. She also discusses the role of a life review in helping patients and families reflect on their legacy. The episode underscores the value of learning from seniors.
00:00 Introduction to Purpose Project
00:39 Meet Brandi Combs: A Journey in Hospice Care
02:17 Exploring Life's Purpose
04:17 Dying Well: Insights from Hospice Care
05:56 The Role of Resources and Connections
09:20 Living with Intention and Purpose
17:21 Understanding Hospice Care
23:02 Life Review and Legacy
26:12 Advice for Dying Well
31:15 Volunteering and Learning from Seniors
34:34 Conclusion and Reflections
Purpose Project is a research study on the topic of life's purpose. You can follow along in the making of Purpose Project:
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Episode Transcript
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Leslie (00:05):
Welcome to Purpose Project.
My name is Leslie Pagel and I amso glad that you found us today.
I knew when I started PurposeProject that I wanted someone on
the show who has experienceworking with individuals at the
end of their lives.
And I found the perfect person.
Her name is Brandi Combs, andshe has spent a portion of her
(00:27):
career as a social worker inhospice care.
On the show today, she talksabout how purpose comes up at
the end of life.
Let's take a listen.
Brandi.
Thank you so much for being herewith me today.
I am looking forward toexploring this topic of purpose
(00:48):
with you and learning from you.
Brandi (00:52):
Thank you.
Leslie (00:53):
I think a good place to start is to start with you.
Who is Brandi Combs?
Brandi (01:00):
Thank you so much.
Well, first and foremost, I am amother of two children.
I have a four and a seven yearold.
I live just outside of Austin,Texas, and I have been a Texas
girl my entire life.
so I grew up in Texas.
I have a love for the outdoors.
(01:20):
Anything from fly fishing tocamping, which most of the time
is camping these days, don't getout as much with the kiddos.
and I have had a career, a veryinteresting career, actually.
I am a licensed social worker.
and I worked for the last 15years in hospice care, and had
the privilege,at bedside withprobably, I was thinking about
(01:45):
it before this podcast, a couplehundred patients.
And so, getting to hear theirstories and learn a lot about
life.
Um, so that's, I think what'sbrought me here today and I'm
excited to talk about it.
Leslie (02:01):
You were the first person that came to mind when I
thought I need to speak withsomeone who has been in hostess
care, who's been around peopleat the end of their life to
understand what comes up in theconversation.
But before we get there, Brandi,we'd love to explore your
(02:23):
purpose in life.
Would you say you have?
A purpose in in your life?
Brandi (02:30):
I think that's a really good question.
you know, I, I do feel thatthere are individuals who have
purpose.
and I do feel that in life, youknow, each phase of life brings
a really unique purpose, to, foreach of us.
And so, I, I do feel that Ifound my purpose in my career,
(02:52):
maybe in a different phase inlife, when I was, in hospice
care.
currently I would say my, thisphase of life, my purpose is to
provide the best life for myfamily.
However, that be by being agreat example, and, and
connecting with others andteaching them how to connect
with others in their life.
but I do, I do think thatthrough my journey in hospice
(03:16):
care, that I really did find thepurpose.
For me is ultimately thoserelationships, that we build
throughout life and how I wantto leave this world is actually
something that I've thoughtabout.
and I want to be able to havethose relationships and I do
feel a calling, towardssupporting, supporting people at
(03:38):
that time of life.
Um, but I think my purpose isalways evolving.
Leslie (03:44):
Yeah, it sounds that way.
It sounds like as you.
Gone through your life thatthere are times where you've
connected to what you're doingfor, for a sense of purpose.
and right now, where you're atyour stage of life, that
connection is to your family andto your role as a mother and
(04:08):
being there for your kids andproviding the best support that
you can for them.
Brandi (04:13):
Absolutely.
Leslie (04:15):
Absolutely.
Yeah.
You're the first to say, I'vethought a lot about the end of
life.
Um, and I think that would benatural, you know, given your
experience in hospice, but whenyou've thought about that, what
are some of the things thatyou've asked yourself and how
(04:36):
have you thought about that?
Brandi (04:39):
Yeah, I think it's very interesting in that stage of
life to when I've gotten to walkthat journey with patients and
families.
Um, you know, we use the termdying well in hospice care, and
that is my goal when I wouldwalk into a situation with a
(05:00):
family is to help them figureout how to die well.
And, it looks very different forevery patient and every family.
Um, what that means to them,different goals, things they
want to accomplish during thattime.
You know, there's a lot ofthings that a lot of that
families may not be aware ofthat is going to have to happen
(05:22):
in order to take care of theirloved one.
And so we want to be able toprovide as much dignity.
As is possible for, for thatpatient who is passing away.
,but I do see common themes,that we can definitely dig into
that I saw across all thefamilies and all the patients,
and that was, Really, again,those connections, resources, I
(05:46):
was talking with a good friendof mine, a colleague before
this, to get her, her insight onwhat, how she felt patients and
what their purpose was.
and she and I were talking aboutresources and I think everyone
comes to, we all are going todie.
We're all going to get to that.
Um, that's something we don'tget away from.
(06:08):
And what kind of resources do wehave around us?
And that's not just financial,there's, of course, financial
resources are very helpful.
but I would say that, I've seenfamilies without resources that
do it so well.
Because they've talked about it.
They've figured out how they'vehad those connections.
They've made this lastingimpression and and have a
(06:31):
legacy, with people around themin a community.
And so I think it's really thatthat is something, that I think
is so important, in life andgetting and that those are the
things that I've thought about,is how when I get to that stage
of life, will I have thoseconnections?
Will I have prepared my familyenough for what to expect?
(06:52):
Um, and I think, you know, it'sinteresting that I've thought
about those things so much, Iguess, at my age.
but I think it's such animportant we come into this
world and we plan so much forthe birth of our children and
how is that going to look, butwe don't do a lot of discussing
or talking about how do we wantto leave this world.
(07:13):
So, given that quite a bit ofthought and just, you can only
hope that things turn out well.
Leslie (07:19):
Yeah.
Well, and, thinking about it interms of Kind of those resources
at the end of life, that youhave, is a new way of thinking
about it.
For me, I hadn't thought of itthat way.
I, part of the reason whyPurpose Project started is
because I was thinking about.
(07:43):
When my life is all said anddone, did I do everything that I
could to contribute the way thatI want to contribute or to have
the impact that I feel like I'msupposed to have?
And the answer to that was no.
And, and I didn't know what towork on.
(08:03):
I didn't know what I wassupposed to do.
And so it was.
I want, I'm going to study this.
I'm going to study purpose andreally understand how do people
find their purpose in life andthen how do they realize it.
And, this idea of at the end oflife, having those resources
(08:24):
around you, whether it'sfinancial is important, but
really those connections is.
is something that people at theend of their life find valuable
and meaningful for them.
Brandi (08:41):
And I think, when you're saying making an impact, and how
do you make an impact, I thinkhow that translates at the end
of life is in those people whoare there.
for you and who are availablefor your family.
and so I think too, that wedon't always know the impact
that we're making.
(09:02):
it's hard to, it's hard todefine that.
but it is, it is, it is allabout how you make others feel.
Leslie (09:11):
Which you had talked about, as a core part of your
purpose now is buildingrelationships and the
relationships with your kids.
What are some of the things thatyou're doing that you do to live
out that part of your purposewith where you are?
Today.
Brandi (09:31):
I, I, you know, I think I'm a work in progress for sure.
There's intentions that I have.
But I think what's mostimportant in the lessons that
I'm teaching is how to treatother people.
How to treat other people withrespect.
And so.
I'm still in the early stages,even though it feels like the
kids are growing so fast, ofwhat I want to accomplish as far
(09:52):
as what I want to teach them.
I do.
Interestingly enough, I, youknow, we've had a couple of
family members pass away and Iwant them to be able to see
that.
Experience.
I think a lot of times childrenare sheltered from that, but I
think it's important that weshow, what it looks like to die,
because I think that's somethingwe're missing as a, as,
(10:13):
culturally is mm-Hmm, how do,how do you do this and how do
you take care of, others?
And so, there's been people inour life, that I want them to be
able to see that.
And I, you know, I.
Definitely am in no way, um,saying that I do that.
I do that.
Well, I think it's somethingthat I want to do well and live
(10:35):
out.
so
Leslie (10:37):
how does that pursuits?
with your family and and yourkids.
How does that make you feel?
Brandi (10:48):
How does that make me feel?
I think that I think that's agood question.
I'm just such a person who whonever feels like I have done
enough.
And so it does make me a littleanxious that I haven't done
enough.
To really do really accomplishthose things, which I think is
what we're talking about todayis, how do you discover your
(11:10):
life purpose?
And I was even just saying thata little earlier is that we
don't really truly know theimpact we're making.
So, I think it's a very, it's agreat ambition and I think it's
always an ambition to strive foris to make this impact and to do
things with intention.
But I also, uh, I always feellike I could be doing a little
(11:32):
bit more if
Leslie (11:33):
that makes sense.
Well, I appreciate you sharingthat because I do think that.
When I talked with people aboutthe topic of purpose, that it
can seem like, oh, it just makesme feel so good and I'm
motivated and, but there'sanother side of purpose and you,
(11:57):
you talked about.
Anxious, it makes me feelanxious.
I feel like I'm not doing enoughor, I could be doing more.
And, there are some, negativeside effects of purpose.
I, that's not the right languageto use, but some uncomfortable
feelings that arise as well.
Brandi (12:17):
Yeah, I think we're just, we're all always striving.
And if you're not keeping youreyes open for opportunities to
live with intention, then you'remissing.
And if you're so closed mindedto think that there's just one
thing that you're supposed to bedoing, then you may miss out on
other opportunities in life.
Leslie (12:37):
And
Brandi (12:38):
that's a personal opinion, I guess.
Leslie (12:41):
Yeah.
Yeah.
You talked about the feeling ofanxiousness, but what is the
most challenging as you set outto be the best mom that you can
for your kids and as, thepurpose that you're living right
now?
Brandi (12:58):
The most challenging.
It always feels like time, youknow, just having that time to
be able to do those things.
And I'm sure, everyone is busy.
Everyone has time.
And I do think, going back towhat we were talking about
earlier, those humanconnections, finding the time
(13:19):
and the space, and to be able toreally make heartfelt.
Connections sometimes feelsalmost impossible and that's
outside of family.
Cause I feel like my world is myworld is work and my world is my
kids.
And, so then making sure thatyou're making those connections
and being of support to otherswhen they need that support is
(13:42):
challenging.
Leslie (13:43):
Yeah, yeah, absolutely.
Yeah.
As you, you talked about howyour purpose.
Has evolved through stages ofyour life, and you've also
talked about thinking about yourend of life when you look
forward, let's say, 10, 15, 20years, have you considered what
(14:08):
your purpose might be?
Then that is it a version ofwhat it is now?
Does it change evolve?
What do you see as you look outin the horizon?
Brandi (14:20):
Yeah, I like to keep my mind open to what that might be.
I think family is always goingto be very important as far as
my purpose.
But then, I know things willchange.
Like you said, in 15 years, I'vestarted to dabble in, how can I
support other women?
And in health and wellnessactually is actually a passion
(14:43):
of mine.
So that is something that I, Iwould love to see my life take
that, take that route.
And how can I support others, ontheir health journey?
So that's, a vague thought, butagain, I'm just trying to keep
my mind open to what we'retalking about, and opening my
(15:05):
mind to opportunities to connectand talk with people and, see
where life takes me.
So,
Leslie (15:11):
yeah, I love that.
Like being open and accepting ofwhat comes your way.
And then you also talked aboutyou use the word passion to
describe, connecting with womenand helping them and their
health and wellness.
And I've often wondered.
If passion and purpose are oneof the same, I don't know if you
(15:37):
have thoughts on that or not.
Brandi (15:40):
I, I, I do think so.
I mean, I think that what wespend time thinking about
learning about is a passion andthat does translate into
purpose, but I do think we alsohave some purpose that, we don't
necessarily.
That we don't, we can't exactlyvocalize.
(16:03):
I do think that there is more tothis life than what we think
we're passionate about and whatwe think we're doing well.
Um, I do think that life has apurpose that we may not be able
to see right in front of us.
And the opportunities that wehave to, keep our mind open to
and just do the best we can.
So I, that's my belief.
Leslie (16:24):
Yeah, yeah, and when you say, the purpose right in front
of us, or is that because whatyou talk, you talked earlier
about how we might not alwaysknow the impact that we're
having.
Is that is that what you'rereferring to when we might not
see it in front of us becausewe're having this impact.
(16:47):
That's unknown.
Absolutely.
Brandi (16:49):
Absolutely.
Yeah, you just don't know.
You don't know the people whoyou've touched and I think
that's 1 thing that you see andend of life is, is, is the, is
the people that actually do comeout and support.
Um, and you just don't know whoyou've touched.
But we're all trying to just dothe best we can.
(17:10):
And that stage of life is verytelling and how much of an
impact or how much we've livedour life with intention and
purpose.
Leslie (17:20):
Yeah.
Yeah.
Let's talk about that.
This is shifting into yourprofessional experience, in
hospice, but first, could youjust, so you're a social worker
working in hospice care, what,what does a social worker and
hospice care do?
Brandi (17:39):
So the social worker is there for.
psychosocial well being.
So the whole premise aroundhospice care is it is an all
encompassing care of somebody atthat stage of life.
So in order to if you want me togo into what hospice care is
because I think there's somemisconceptions.
(18:00):
I can definitely go there.
Go there.
Okay.
So hospice care is meant forpeople at the last stage of
life.
And medically, what that meansis the last six months of life.
It's hard to determine if youhave six months to live.
But is, is this going to be, isyour disease going to end up Is
(18:23):
your life going to end becauseof this specific diagnosis?
And is it expected that it willbe potentially in the next six
months?
We always, the doctors wouldsay, would you be surprised if
they were still with us in thenext six months?
So it's kind of a vague.
guideline, but it is medicallynecessary.
(18:43):
And so the idea around hospicecare is that we are supporting
the whole person.
So that's not just physical, butwhat is pain, at the end of
life?
Is it social pain?
Is it spiritual pain?
Is it physical pain?
And so we have professions, thatsurround the individual and
(19:03):
their family to help address,maybe what might be causing pain
or some, or need symptommanagement.
And so the role of the socialworker is to, a lot of times
what I was doing was reallysupporting the families.
And so I talked about how whenyou come in to meet with a
(19:24):
family, is asking the question,how could we help you do this
stage of life?
Well, and what does that mean toyou?
What are your, is it caregiving?
Do we, is it, is it talkingthrough maybe, their life's
purpose and, and like what we'retalking about talking review and
(19:45):
helping them talk through that.
Is it getting, advanceddirectives in place?
It's addressing the psychosocialneeds.
And then we lean on, we work asa team to be able to address the
patient's needs and the family'sneeds so that they can die.
well
Leslie (20:03):
are you, you mentioned that a lot of this is focused on
the family versus the patient.
Is there a difference betweenthe family and the patient or
Brandi (20:18):
I think a lot of that more has to do with care.
And so how do you help themunderstand the resources that
are available to them?
How do you help them understandhow to take care of the end of
it, of the patient who is dying?
And also help them support thememotionally with the path
(20:40):
they're walking.
Because as I had mentionedearlier, there's so much that
goes into taking care of apatient.
That a lot of times there's amisunderstanding from the
beginning of what all that'sgoing to entail.
And it's, they need thatsupport.
Leslie (21:01):
And you mentioned these categories of care, um, is there
a category that is more commonthan others?
Brandi (21:13):
So, um, there is, I know, I think we all go, we all
experience at that time of life,All aspects of ourselves.
So we experienced dying from aphysical perspective.
We've we experience it from anemotional and psychosocial and
spiritual perspective.
(21:35):
And so that's the reason for ateam, um, is to be able to
surround that the patient andfamily and help them to walk
through those different aspectsso that the patient dies symptom
free.
With all, what, considering allof those aspects.
Leslie (21:51):
Yeah.
Brandi (21:53):
And what is psychosocial?
So that would be more, in linewith the social worker's role.
So that is how they are coping,with the situation, how they
are, coping what it entails asfar as caregiving and resources.
So psychosocial more has to dealwith how an individual is
coping.
Leslie (22:13):
Okay, and so you are working with families and
patients at the end of life tounderstand how can they die well
and what care across thedifferent aspects do they need
so that the team canappropriately serve the patient
(22:35):
and the family.
Right.
And I imagine there's.
a lot under there.
I'm curious about the role ofpurpose.
I don't imagine that that wordpurpose comes up.
I don't know.
It might.
But how might the topic ofpurpose come up at the end of
(22:56):
life, whether from the family orthe patient or both?
Brandi (23:02):
So one aspect of my role was, life review with the
patients and family.
And that is therapeutic in andof itself, to be able to share
your story, to share the impactyou've made on others in your
life.
And it helps.
It helps not only, take care ofthe patient, but also the family
(23:26):
to be able to share and, and tofeel, feel heard and to feel, be
able to express what you wantothers to remember about you.
So I think that that correlateswith purpose.
You, ideally for every singlepatient that I had, we had the
opportunity to do life review,but I think A lot of times,
(23:50):
there's so much going on at thatstage of life that it's hard to
get to that, that piece.
And so it goes back to all ofeverything we've talked about is
being able to be prepared forthat time of life.
So that you can reflect on thesememories and be able to give
your family, that gift oftalking through everything
(24:13):
that's happened in your life andhow you want to be remembered.
Symptom management is the pointbehind hospice care.
And, When there are othersymptoms like lack of resources,
lack of caregiving needs,physical pain, we don't get the
opportunity to do this in veryimportant step.
Leslie (24:35):
Okay.
Okay.
So let me make sure Iunderstand.
So there's a part of the processwhere, there's a life review
that you do with the family.
And, depending on the situation,that piece.
Might not always happen or is itthat it is happening, but the
(25:00):
families have a hard time doingthat.
Brandi (25:04):
I think,
Leslie (25:06):
yeah,
Brandi (25:08):
I think both, I think we want our families and we want
everybody to understand maybewhat we feel our legacy and our
purpose has been.
But I do also think, you know,as we talked about, and this is
my perspective, as we talkedabout, that purpose changes,
(25:29):
throughout our life, I thinkwhen you are facing end of life
and what you want to beremembered for may change from
what you thought your whole lifepurpose was.
Um, and it really becomes aboutthose people that are around
you.
Um, yeah, yeah.
(25:50):
And, um, you know, it's such animportant time that we can spend
with family and that we canspend, and we can do dying well.
And I hope that for all thepeople that I meet and, we have
to, I think we have to talkabout it before we get to that
stage.
Right.
Leslie (26:11):
Yeah.
What advice do you have forthose who are listening on what
they can do To die well and, andto equip their family with this
life review conversation.
Brandi (26:30):
Yeah.
Advanced directives are soimportant.
So important.
What is that?
What's advanced directives?
is actually putting in writingwhat you, your wishes are.
And that's not just financial,it's medical.
And I think there's amisconception out there that to
do these advanced directives,you have to have a lawyer
(26:53):
present, but you really don't tobe able to express what your
wishes are.
Um, there's, um, directives thatare in place that you can
actually even just pull off ofthe internet and be able to
express what's so important toyou and how you want to die.
And so that addresses themedical piece of it.
I do think it's important totalk about how you want to be
remembered.
(27:14):
So have you talked about, haveyou made arrangements as far as
your final arrangements?
Have you talked about what youwant your If it's important to
you, what does your funeral looklike?
Um, you know, I, this alwaysends up being our topic of
conversation at the Thanksgivingtable, but it's so important to
be able to talk about thesethings.
(27:35):
And so, when you have thosethings in place and people are
very clear on what your wishesare, then there's not the burden
of maybe somebody else having tomake these decisions for you.
Cause at that stage, you may notbe able to communicate.
There may be that piece of it.
(27:56):
But there's still opportunitiesto be able to connect, with, so.
All the way through.
Yeah.
Leslie (28:03):
Yeah.
Yeah.
So write down your wishes, notjust medical, but also how you
want to be remembered and havethose conversations with your
family around the Thanksgivingdinner table.
If you want.
That's right.
Just have the conversation.
Brandi (28:23):
That's right.
Actually, we had a grant fundedprogram that we were going out
and talking about.
This is called the gift program.
And it was, we would go talkabout how at after the age of
18, you really should starttalking about what your wishes
are.
Um, and any life change youhave, you need to look back and
(28:45):
make sure that the people inyour life know what you want to
happen?
Yeah.
Leslie (28:52):
Well, and in my head thinking of what's the
connection to purpose here?
Like, why are we talking aboutthis?
And this, you said a big part ofit is how you want to be
remembered and, as someone whois searching for my life's
purpose.
(29:12):
Um, thinking and answering thatquestion now about how do I want
to be remembered can help meuncover.
How do I want to spend my life?
What do I want to spend my lifedoing?
What purpose and meaning do Igive to it right now?
So that, afterlife I can beremembered in that way.
Brandi (29:36):
That's absolutely.
Yeah, and I know that this is,you know, talking through
advanced directives and funeralplanning is not anything anybody
wants to think about when we'retalking about purpose.
Um, but it is so importantbecause part of how you're
remembered is, is how you tookcare of other people in your
(29:57):
life.
And by being able to.
Take care of life's business,and be able to relieve that
burden from your loved ones, canreally help you leave a legacy
where the people who you lovethe most are in a good place,
Leslie (30:14):
right?
Yeah.
You just put an idea in my head,Brandi.
I'm envisioning having thisconversation with my family
about, how I want to beremembered and me asking them,
what can I do this year to beremembered in this way, it's a
(30:35):
way of living as well.
Yeah,
Brandi (30:38):
absolutely.
I, I think that's so important.
And just like we were talkingabout my kids in the beginning,
you know, that's me talkingabout this.
Like I said, I'm a work inprogress, but how do I make sure
that they will remember me inthe right way?
Even now, even with youngchildren, right?
Leslie (30:58):
Yeah, absolutely.
It's good.
Purpose Project exists to helppeople discover and realize
their purpose in life.
Is there anything else thatcomes to mind as, advice or tips
based on your experience?
Brandi (31:15):
So for me, I've been fortunate in that my career has
afforded me the opportunity tospend time with others who are
Who have lived their life, whoare maybe reflecting on their
life.
And I think that has helped melearn, learn a lot and I'm still
(31:36):
learning, but I think spendingtime if you can, in any way,
with seniors, with people whoare facing end of life, if
there's a way to volunteer, Ithink the, what you will get
from that is, is.
immeasurable compared to whateven they will receive from you
(31:59):
helping them out.
And not that you are trying todo something for yourself, but I
think the way that we learn inthis life and we discover our
purpose is through ourconnections and, learning from
seniors is something that Ithink we all should do, because
that generation, I always say itwas just the generation that is
(32:21):
currently seniors, there's somuch to learn from them.
So any way you can get involvedin your community and learn from
those, I think is going to,Ultimately just, um, help you
live a very fulfilled life.
And that's something I knowpersonally, I hope to continue
to get to do.
Leslie (32:41):
Yeah.
Are there places for people thatare listening to this?
Where might they go to findvolunteer opportunities?
Brandi (32:52):
I would definitely recommend looking into any non
profit hospice in your area.
There's always volunteeropportunities with non profit
hospices.
There also are, for profithospices as well, but I would
start with your local nonprofit.
And then I think at any of thecommunities, any assisted living
communities in your area,finding out ways to help support
(33:16):
them.
And what they're, just beingable to support their daily
operations.
You're going to get to be,you're going to get to involve
yourself and experience otherpeople.
Um, and I think that's, what'smost important.
Leslie (33:28):
Yeah.
Awesome.
Okay.
So, parting advice from Brandiis let's learn from the
generation that has a lifelived.
Go out, find the nonprofithospice care in your area and
see, how you might be able to,support them and know that
(33:52):
you're going to get far more outof it, as well.
I heard that from you thatthere's so much that you're
going to gain in doing that,volunteer work for others.
Absolutely.
Brandi (34:03):
Absolutely.
As well as supporting them.
Being able to help others inthat space is is so needed.
And there's such a void therethat needs to be filled by
people who, Want to help.
Leslie (34:15):
Yeah.
Yeah.
Brandi.
Thank you so much for being onPurpose Project.
I am taking a lot away from ourconversation.
And I know those that arelistening are as well.
Thank you for being here with ustoday.
Thank you so much.
It's a pleasure.
As I reflect on thisconversation with Brandi, one
(34:37):
thing is clear to me.
And that is we need to haveconversations with our loved
ones about the end of our lives.
But those conversations don'tneed to be about death.
They're really about living.
They're about living the lifethat we want to live so that
(34:58):
we're remembered in the way thatwe want to be remembered.
Brandi, thank you forhighlighting that for us.
Thanks to all of you for tuningin.
I hope you have a wonderful day.
Purpose Project is brought toyou for education and for
(35:22):
entertainment purposes.
This podcast is not intended toreplace the advice that you
would receive from a licensedtherapist or doctor or any other
qualified professional.
Welcome to Purpose Project.
My name is Leslie Pagel and I amso glad that you found us today.
I knew when I started PurposeProject that I wanted someone on
the show who has experienceworking with individuals at the
end of their lives.
And I found the perfect person.
Her name is Brandi Combs, andshe has spent a portion of her
(00:27):
career as a social worker inhospice care.
On the show today, she talksabout how purpose comes up at
the end of life.
Let's take a listen.
Brandi.
Thank you so much for being herewith me today.
I am looking forward toexploring this topic of purpose
(00:48):
with you and learning from you.
Brandi (00:52):
Thank you.
Leslie (00:53):
I think a good place to start is to start with you.
Who is Brandi Combs?
Brandi (01:00):
Thank you so much.
Well, first and foremost, I am amother of two children.
I have a four and a seven yearold.
I live just outside of Austin,Texas, and I have been a Texas
girl my entire life.
so I grew up in Texas.
I have a love for the outdoors.
(01:20):
Anything from fly fishing tocamping, which most of the time
is camping these days, don't getout as much with the kiddos.
and I have had a career, a veryinteresting career, actually.
I am a licensed social worker.
and I worked for the last 15years in hospice care, and had
the privilege,at bedside withprobably, I was thinking about
(01:45):
it before this podcast, a couplehundred patients.
And so, getting to hear theirstories and learn a lot about
life.
Um, so that's, I think what'sbrought me here today and I'm
excited to talk about it.
Leslie (02:01):
You were the first person that came to mind when I
thought I need to speak withsomeone who has been in hostess
care, who's been around peopleat the end of their life to
understand what comes up in theconversation.
But before we get there, Brandi,we'd love to explore your
(02:23):
purpose in life.
Would you say you have?
A purpose in in your life?
Brandi (02:30):
I think that's a really good question.
you know, I, I do feel thatthere are individuals who have
purpose.
and I do feel that in life, youknow, each phase of life brings
a really unique purpose, to, foreach of us.
And so, I, I do feel that Ifound my purpose in my career,
(02:52):
maybe in a different phase inlife, when I was, in hospice
care.
currently I would say my, thisphase of life, my purpose is to
provide the best life for myfamily.
However, that be by being agreat example, and, and
connecting with others andteaching them how to connect
with others in their life.
but I do, I do think thatthrough my journey in hospice
(03:16):
care, that I really did find thepurpose.
For me is ultimately thoserelationships, that we build
throughout life and how I wantto leave this world is actually
something that I've thoughtabout.
and I want to be able to havethose relationships and I do
feel a calling, towardssupporting, supporting people at
(03:38):
that time of life.
Um, but I think my purpose isalways evolving.
Leslie (03:44):
Yeah, it sounds that way.
It sounds like as you.
Gone through your life thatthere are times where you've
connected to what you're doingfor, for a sense of purpose.
and right now, where you're atyour stage of life, that
connection is to your family andto your role as a mother and
(04:08):
being there for your kids andproviding the best support that
you can for them.
Brandi (04:13):
Absolutely.
Leslie (04:15):
Absolutely.
Yeah.
You're the first to say, I'vethought a lot about the end of
life.
Um, and I think that would benatural, you know, given your
experience in hospice, but whenyou've thought about that, what
are some of the things thatyou've asked yourself and how
(04:36):
have you thought about that?
Brandi (04:39):
Yeah, I think it's very interesting in that stage of
life to when I've gotten to walkthat journey with patients and
families.
Um, you know, we use the termdying well in hospice care, and
that is my goal when I wouldwalk into a situation with a
(05:00):
family is to help them figureout how to die well.
And, it looks very different forevery patient and every family.
Um, what that means to them,different goals, things they
want to accomplish during thattime.
You know, there's a lot ofthings that a lot of that
families may not be aware ofthat is going to have to happen
(05:22):
in order to take care of theirloved one.
And so we want to be able toprovide as much dignity.
As is possible for, for thatpatient who is passing away.
,but I do see common themes,that we can definitely dig into
that I saw across all thefamilies and all the patients,
and that was, Really, again,those connections, resources, I
(05:46):
was talking with a good friendof mine, a colleague before
this, to get her, her insight onwhat, how she felt patients and
what their purpose was.
and she and I were talking aboutresources and I think everyone
comes to, we all are going todie.
We're all going to get to that.
Um, that's something we don'tget away from.
(06:08):
And what kind of resources do wehave around us?
And that's not just financial,there's, of course, financial
resources are very helpful.
but I would say that, I've seenfamilies without resources that
do it so well.
Because they've talked about it.
They've figured out how they'vehad those connections.
They've made this lastingimpression and and have a
(06:31):
legacy, with people around themin a community.
And so I think it's really thatthat is something, that I think
is so important, in life andgetting and that those are the
things that I've thought about,is how when I get to that stage
of life, will I have thoseconnections?
Will I have prepared my familyenough for what to expect?
(06:52):
Um, and I think, you know, it'sinteresting that I've thought
about those things so much, Iguess, at my age.
but I think it's such animportant we come into this
world and we plan so much forthe birth of our children and
how is that going to look, butwe don't do a lot of discussing
or talking about how do we wantto leave this world.
(07:13):
So, given that quite a bit ofthought and just, you can only
hope that things turn out well.
Leslie (07:19):
Yeah.
Well, and, thinking about it interms of Kind of those resources
at the end of life, that youhave, is a new way of thinking
about it.
For me, I hadn't thought of itthat way.
I, part of the reason whyPurpose Project started is
because I was thinking about.
(07:43):
When my life is all said anddone, did I do everything that I
could to contribute the way thatI want to contribute or to have
the impact that I feel like I'msupposed to have?
And the answer to that was no.
And, and I didn't know what towork on.
(08:03):
I didn't know what I wassupposed to do.
And so it was.
I want, I'm going to study this.
I'm going to study purpose andreally understand how do people
find their purpose in life andthen how do they realize it.
And, this idea of at the end oflife, having those resources
(08:24):
around you, whether it'sfinancial is important, but
really those connections is.
is something that people at theend of their life find valuable
and meaningful for them.
Brandi (08:41):
And I think, when you're saying making an impact, and how
do you make an impact, I thinkhow that translates at the end
of life is in those people whoare there.
for you and who are availablefor your family.
and so I think too, that wedon't always know the impact
that we're making.
(09:02):
it's hard to, it's hard todefine that.
but it is, it is, it is allabout how you make others feel.
Leslie (09:11):
Which you had talked about, as a core part of your
purpose now is buildingrelationships and the
relationships with your kids.
What are some of the things thatyou're doing that you do to live
out that part of your purposewith where you are?
Today.
Brandi (09:31):
I, I, you know, I think I'm a work in progress for sure.
There's intentions that I have.
But I think what's mostimportant in the lessons that
I'm teaching is how to treatother people.
How to treat other people withrespect.
And so.
I'm still in the early stages,even though it feels like the
kids are growing so fast, ofwhat I want to accomplish as far
(09:52):
as what I want to teach them.
I do.
Interestingly enough, I, youknow, we've had a couple of
family members pass away and Iwant them to be able to see
that.
Experience.
I think a lot of times childrenare sheltered from that, but I
think it's important that weshow, what it looks like to die,
because I think that's somethingwe're missing as a, as,
(10:13):
culturally is mm-Hmm, how do,how do you do this and how do
you take care of, others?
And so, there's been people inour life, that I want them to be
able to see that.
And I, you know, I.
Definitely am in no way, um,saying that I do that.
I do that.
Well, I think it's somethingthat I want to do well and live
(10:35):
out.
so
Leslie (10:37):
how does that pursuits?
with your family and and yourkids.
How does that make you feel?
Brandi (10:48):
How does that make me feel?
I think that I think that's agood question.
I'm just such a person who whonever feels like I have done
enough.
And so it does make me a littleanxious that I haven't done
enough.
To really do really accomplishthose things, which I think is
what we're talking about todayis, how do you discover your
(11:10):
life purpose?
And I was even just saying thata little earlier is that we
don't really truly know theimpact we're making.
So, I think it's a very, it's agreat ambition and I think it's
always an ambition to strive foris to make this impact and to do
things with intention.
But I also, uh, I always feellike I could be doing a little
(11:32):
bit more if
Leslie (11:33):
that makes sense.
Well, I appreciate you sharingthat because I do think that.
When I talked with people aboutthe topic of purpose, that it
can seem like, oh, it just makesme feel so good and I'm
motivated and, but there'sanother side of purpose and you,
(11:57):
you talked about.
Anxious, it makes me feelanxious.
I feel like I'm not doing enoughor, I could be doing more.
And, there are some, negativeside effects of purpose.
I, that's not the right languageto use, but some uncomfortable
feelings that arise as well.
Brandi (12:17):
Yeah, I think we're just, we're all always striving.
And if you're not keeping youreyes open for opportunities to
live with intention, then you'remissing.
And if you're so closed mindedto think that there's just one
thing that you're supposed to bedoing, then you may miss out on
other opportunities in life.
Leslie (12:37):
And
Brandi (12:38):
that's a personal opinion, I guess.
Leslie (12:41):
Yeah.
Yeah.
You talked about the feeling ofanxiousness, but what is the
most challenging as you set outto be the best mom that you can
for your kids and as, thepurpose that you're living right
now?
Brandi (12:58):
The most challenging.
It always feels like time, youknow, just having that time to
be able to do those things.
And I'm sure, everyone is busy.
Everyone has time.
And I do think, going back towhat we were talking about
earlier, those humanconnections, finding the time
(13:19):
and the space, and to be able toreally make heartfelt.
Connections sometimes feelsalmost impossible and that's
outside of family.
Cause I feel like my world is myworld is work and my world is my
kids.
And, so then making sure thatyou're making those connections
and being of support to otherswhen they need that support is
(13:42):
challenging.
Leslie (13:43):
Yeah, yeah, absolutely.
Yeah.
As you, you talked about howyour purpose.
Has evolved through stages ofyour life, and you've also
talked about thinking about yourend of life when you look
forward, let's say, 10, 15, 20years, have you considered what
(14:08):
your purpose might be?
Then that is it a version ofwhat it is now?
Does it change evolve?
What do you see as you look outin the horizon?
Brandi (14:20):
Yeah, I like to keep my mind open to what that might be.
I think family is always goingto be very important as far as
my purpose.
But then, I know things willchange.
Like you said, in 15 years, I'vestarted to dabble in, how can I
support other women?
And in health and wellnessactually is actually a passion
(14:43):
of mine.
So that is something that I, Iwould love to see my life take
that, take that route.
And how can I support others, ontheir health journey?
So that's, a vague thought, butagain, I'm just trying to keep
my mind open to what we'retalking about, and opening my
(15:05):
mind to opportunities to connectand talk with people and, see
where life takes me.
So,
Leslie (15:11):
yeah, I love that.
Like being open and accepting ofwhat comes your way.
And then you also talked aboutyou use the word passion to
describe, connecting with womenand helping them and their
health and wellness.
And I've often wondered.
If passion and purpose are oneof the same, I don't know if you
(15:37):
have thoughts on that or not.
Brandi (15:40):
I, I, I do think so.
I mean, I think that what wespend time thinking about
learning about is a passion andthat does translate into
purpose, but I do think we alsohave some purpose that, we don't
necessarily.
That we don't, we can't exactlyvocalize.
(16:03):
I do think that there is more tothis life than what we think
we're passionate about and whatwe think we're doing well.
Um, I do think that life has apurpose that we may not be able
to see right in front of us.
And the opportunities that wehave to, keep our mind open to
and just do the best we can.
So I, that's my belief.
Leslie (16:24):
Yeah, yeah, and when you say, the purpose right in front
of us, or is that because whatyou talk, you talked earlier
about how we might not alwaysknow the impact that we're
having.
Is that is that what you'rereferring to when we might not
see it in front of us becausewe're having this impact.
(16:47):
That's unknown.
Absolutely.
Brandi (16:49):
Absolutely.
Yeah, you just don't know.
You don't know the people whoyou've touched and I think
that's 1 thing that you see andend of life is, is, is the, is
the people that actually do comeout and support.
Um, and you just don't know whoyou've touched.
But we're all trying to just dothe best we can.
(17:10):
And that stage of life is verytelling and how much of an
impact or how much we've livedour life with intention and
purpose.
Leslie (17:20):
Yeah.
Yeah.
Let's talk about that.
This is shifting into yourprofessional experience, in
hospice, but first, could youjust, so you're a social worker
working in hospice care, what,what does a social worker and
hospice care do?
Brandi (17:39):
So the social worker is there for.
psychosocial well being.
So the whole premise aroundhospice care is it is an all
encompassing care of somebody atthat stage of life.
So in order to if you want me togo into what hospice care is
because I think there's somemisconceptions.
(18:00):
I can definitely go there.
Go there.
Okay.
So hospice care is meant forpeople at the last stage of
life.
And medically, what that meansis the last six months of life.
It's hard to determine if youhave six months to live.
But is, is this going to be, isyour disease going to end up Is
(18:23):
your life going to end becauseof this specific diagnosis?
And is it expected that it willbe potentially in the next six
months?
We always, the doctors wouldsay, would you be surprised if
they were still with us in thenext six months?
So it's kind of a vague.
guideline, but it is medicallynecessary.
(18:43):
And so the idea around hospicecare is that we are supporting
the whole person.
So that's not just physical, butwhat is pain, at the end of
life?
Is it social pain?
Is it spiritual pain?
Is it physical pain?
And so we have professions, thatsurround the individual and
(19:03):
their family to help address,maybe what might be causing pain
or some, or need symptommanagement.
And so the role of the socialworker is to, a lot of times
what I was doing was reallysupporting the families.
And so I talked about how whenyou come in to meet with a
(19:24):
family, is asking the question,how could we help you do this
stage of life?
Well, and what does that mean toyou?
What are your, is it caregiving?
Do we, is it, is it talkingthrough maybe, their life's
purpose and, and like what we'retalking about talking review and
(19:45):
helping them talk through that.
Is it getting, advanceddirectives in place?
It's addressing the psychosocialneeds.
And then we lean on, we work asa team to be able to address the
patient's needs and the family'sneeds so that they can die.
well
Leslie (20:03):
are you, you mentioned that a lot of this is focused on
the family versus the patient.
Is there a difference betweenthe family and the patient or
Brandi (20:18):
I think a lot of that more has to do with care.
And so how do you help themunderstand the resources that
are available to them?
How do you help them understandhow to take care of the end of
it, of the patient who is dying?
And also help them support thememotionally with the path
(20:40):
they're walking.
Because as I had mentionedearlier, there's so much that
goes into taking care of apatient.
That a lot of times there's amisunderstanding from the
beginning of what all that'sgoing to entail.
And it's, they need thatsupport.
Leslie (21:01):
And you mentioned these categories of care, um, is there
a category that is more commonthan others?
Brandi (21:13):
So, um, there is, I know, I think we all go, we all
experience at that time of life,All aspects of ourselves.
So we experienced dying from aphysical perspective.
We've we experience it from anemotional and psychosocial and
spiritual perspective.
(21:35):
And so that's the reason for ateam, um, is to be able to
surround that the patient andfamily and help them to walk
through those different aspectsso that the patient dies symptom
free.
With all, what, considering allof those aspects.
Leslie (21:51):
Yeah.
Brandi (21:53):
And what is psychosocial?
So that would be more, in linewith the social worker's role.
So that is how they are coping,with the situation, how they
are, coping what it entails asfar as caregiving and resources.
So psychosocial more has to dealwith how an individual is
coping.
Leslie (22:13):
Okay, and so you are working with families and
patients at the end of life tounderstand how can they die well
and what care across thedifferent aspects do they need
so that the team canappropriately serve the patient
(22:35):
and the family.
Right.
And I imagine there's.
a lot under there.
I'm curious about the role ofpurpose.
I don't imagine that that wordpurpose comes up.
I don't know.
It might.
But how might the topic ofpurpose come up at the end of
(22:56):
life, whether from the family orthe patient or both?
Brandi (23:02):
So one aspect of my role was, life review with the
patients and family.
And that is therapeutic in andof itself, to be able to share
your story, to share the impactyou've made on others in your
life.
And it helps.
It helps not only, take care ofthe patient, but also the family
(23:26):
to be able to share and, and tofeel, feel heard and to feel, be
able to express what you wantothers to remember about you.
So I think that that correlateswith purpose.
You, ideally for every singlepatient that I had, we had the
opportunity to do life review,but I think A lot of times,
(23:50):
there's so much going on at thatstage of life that it's hard to
get to that, that piece.
And so it goes back to all ofeverything we've talked about is
being able to be prepared forthat time of life.
So that you can reflect on thesememories and be able to give
your family, that gift oftalking through everything
(24:13):
that's happened in your life andhow you want to be remembered.
Symptom management is the pointbehind hospice care.
And, When there are othersymptoms like lack of resources,
lack of caregiving needs,physical pain, we don't get the
opportunity to do this in veryimportant step.
Leslie (24:35):
Okay.
Okay.
So let me make sure Iunderstand.
So there's a part of the processwhere, there's a life review
that you do with the family.
And, depending on the situation,that piece.
Might not always happen or is itthat it is happening, but the
(25:00):
families have a hard time doingthat.
Brandi (25:04):
I think,
Leslie (25:06):
yeah,
Brandi (25:08):
I think both, I think we want our families and we want
everybody to understand maybewhat we feel our legacy and our
purpose has been.
But I do also think, you know,as we talked about, and this is
my perspective, as we talkedabout, that purpose changes,
(25:29):
throughout our life, I thinkwhen you are facing end of life
and what you want to beremembered for may change from
what you thought your whole lifepurpose was.
Um, and it really becomes aboutthose people that are around
you.
Um, yeah, yeah.
(25:50):
And, um, you know, it's such animportant time that we can spend
with family and that we canspend, and we can do dying well.
And I hope that for all thepeople that I meet and, we have
to, I think we have to talkabout it before we get to that
stage.
Right.
Leslie (26:11):
Yeah.
What advice do you have forthose who are listening on what
they can do To die well and, andto equip their family with this
life review conversation.
Brandi (26:30):
Yeah.
Advanced directives are soimportant.
So important.
What is that?
What's advanced directives?
is actually putting in writingwhat you, your wishes are.
And that's not just financial,it's medical.
And I think there's amisconception out there that to
do these advanced directives,you have to have a lawyer
(26:53):
present, but you really don't tobe able to express what your
wishes are.
Um, there's, um, directives thatare in place that you can
actually even just pull off ofthe internet and be able to
express what's so important toyou and how you want to die.
And so that addresses themedical piece of it.
I do think it's important totalk about how you want to be
remembered.
(27:14):
So have you talked about, haveyou made arrangements as far as
your final arrangements?
Have you talked about what youwant your If it's important to
you, what does your funeral looklike?
Um, you know, I, this alwaysends up being our topic of
conversation at the Thanksgivingtable, but it's so important to
be able to talk about thesethings.
(27:35):
And so, when you have thosethings in place and people are
very clear on what your wishesare, then there's not the burden
of maybe somebody else having tomake these decisions for you.
Cause at that stage, you may notbe able to communicate.
There may be that piece of it.
(27:56):
But there's still opportunitiesto be able to connect, with, so.
All the way through.
Yeah.
Leslie (28:03):
Yeah.
Yeah.
So write down your wishes, notjust medical, but also how you
want to be remembered and havethose conversations with your
family around the Thanksgivingdinner table.
If you want.
That's right.
Just have the conversation.
Brandi (28:23):
That's right.
Actually, we had a grant fundedprogram that we were going out
and talking about.
This is called the gift program.
And it was, we would go talkabout how at after the age of
18, you really should starttalking about what your wishes
are.
Um, and any life change youhave, you need to look back and
(28:45):
make sure that the people inyour life know what you want to
happen?
Yeah.
Leslie (28:52):
Well, and in my head thinking of what's the
connection to purpose here?
Like, why are we talking aboutthis?
And this, you said a big part ofit is how you want to be
remembered and, as someone whois searching for my life's
purpose.
(29:12):
Um, thinking and answering thatquestion now about how do I want
to be remembered can help meuncover.
How do I want to spend my life?
What do I want to spend my lifedoing?
What purpose and meaning do Igive to it right now?
So that, afterlife I can beremembered in that way.
Brandi (29:36):
That's absolutely.
Yeah, and I know that this is,you know, talking through
advanced directives and funeralplanning is not anything anybody
wants to think about when we'retalking about purpose.
Um, but it is so importantbecause part of how you're
remembered is, is how you tookcare of other people in your
(29:57):
life.
And by being able to.
Take care of life's business,and be able to relieve that
burden from your loved ones, canreally help you leave a legacy
where the people who you lovethe most are in a good place,
Leslie (30:14):
right?
Yeah.
You just put an idea in my head,Brandi.
I'm envisioning having thisconversation with my family
about, how I want to beremembered and me asking them,
what can I do this year to beremembered in this way, it's a
(30:35):
way of living as well.
Yeah,
Brandi (30:38):
absolutely.
I, I think that's so important.
And just like we were talkingabout my kids in the beginning,
you know, that's me talkingabout this.
Like I said, I'm a work inprogress, but how do I make sure
that they will remember me inthe right way?
Even now, even with youngchildren, right?
Leslie (30:58):
Yeah, absolutely.
It's good.
Purpose Project exists to helppeople discover and realize
their purpose in life.
Is there anything else thatcomes to mind as, advice or tips
based on your experience?
Brandi (31:15):
So for me, I've been fortunate in that my career has
afforded me the opportunity tospend time with others who are
Who have lived their life, whoare maybe reflecting on their
life.
And I think that has helped melearn, learn a lot and I'm still
(31:36):
learning, but I think spendingtime if you can, in any way,
with seniors, with people whoare facing end of life, if
there's a way to volunteer, Ithink the, what you will get
from that is, is.
immeasurable compared to whateven they will receive from you
(31:59):
helping them out.
And not that you are trying todo something for yourself, but I
think the way that we learn inthis life and we discover our
purpose is through ourconnections and, learning from
seniors is something that Ithink we all should do, because
that generation, I always say itwas just the generation that is
(32:21):
currently seniors, there's somuch to learn from them.
So any way you can get involvedin your community and learn from
those, I think is going to,Ultimately just, um, help you
live a very fulfilled life.
And that's something I knowpersonally, I hope to continue
to get to do.
Leslie (32:41):
Yeah.
Are there places for people thatare listening to this?
Where might they go to findvolunteer opportunities?
Brandi (32:52):
I would definitely recommend looking into any non
profit hospice in your area.
There's always volunteeropportunities with non profit
hospices.
There also are, for profithospices as well, but I would
start with your local nonprofit.
And then I think at any of thecommunities, any assisted living
communities in your area,finding out ways to help support
(33:16):
them.
And what they're, just beingable to support their daily
operations.
You're going to get to be,you're going to get to involve
yourself and experience otherpeople.
Um, and I think that's, what'smost important.
Leslie (33:28):
Yeah.
Awesome.
Okay.
So, parting advice from Brandiis let's learn from the
generation that has a lifelived.
Go out, find the nonprofithospice care in your area and
see, how you might be able to,support them and know that
(33:52):
you're going to get far more outof it, as well.
I heard that from you thatthere's so much that you're
going to gain in doing that,volunteer work for others.
Absolutely.
Brandi (34:03):
Absolutely.
As well as supporting them.
Being able to help others inthat space is is so needed.
And there's such a void therethat needs to be filled by
people who, Want to help.
Leslie (34:15):
Yeah.
Yeah.
Brandi.
Thank you so much for being onPurpose Project.
I am taking a lot away from ourconversation.
And I know those that arelistening are as well.
Thank you for being here with ustoday.
Thank you so much.
It's a pleasure.
As I reflect on thisconversation with Brandi, one
(34:37):
thing is clear to me.
And that is we need to haveconversations with our loved
ones about the end of our lives.
But those conversations don'tneed to be about death.
They're really about living.
They're about living the lifethat we want to live so that
(34:58):
we're remembered in the way thatwe want to be remembered.
Brandi, thank you forhighlighting that for us.
Thanks to all of you for tuningin.
I hope you have a wonderful day.
Purpose Project is brought toyou for education and for
(35:22):
entertainment purposes.
This podcast is not intended toreplace the advice that you
would receive from a licensedtherapist or doctor or any other
qualified professional.
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