Redefining Aging: A New Perspective on Hospice

"Every birthday is important, right?" - Stacey Zerban


In this episode of Aging Today, Mark Turnbull and Stacey Zerban, VP of Health Services at Friendship Village, discuss the complexities of aging, caregiving, and hospice care. They explore Stacey's journey in healthcare, the traits of effective caregivers, and the differences between transactional and relational caregiving.

Friendship Village is a community that celebrates all that life has to offer in retirement years. The people they serve can buy memberships or live on one of our resort-style campuses where they have access to an active lifestyle filled with spiritual growth, security, connection, and adventure.

The conversation delves into the importance of hospice and palliative care, addressing common misconceptions and emphasizing the need for early enrollment in hospice services. They highlight the holistic approach to patient care and the significance of education in navigating the healthcare system with an emphasize on the importance of family involvement in advocating for seniors' needs and breaking the stigma surrounding hospice. 

Learn more about Friendship Village

Thank you to our sponsor: Royal Hospice Oregon

Episode Transcript

(00:00):
And I always say that there's maybe one percent of our population, maybe less,

(00:04):
that are what I call the true caregivers, much like yourself. I mean, this is a gift that was
given to you. You were bred with it. But it's also, it's even beyond that. It's a true gift.
Yeah, and you, I think, you're an operator as well. You know the people that intuitively have it,

(00:26):
and the ones that try really hard and just don't, but I think at the heart of it, it's looking at
people as people, not as tasks, and really somebody that wants to impact another's life.
Those are the people that show up today when it snows, right? There are people that look at the
weather and call in on Friday before storm on Monday. Yeah. And then because I can't, because I can,

(00:51):
I can call in and still have an excuse not to show up. And yet, I'm calling in because it might
snow and I'm forecasting I'm not going to be able to be there. And there are people that would take
a cab and Uber, you know, have a brother pick them up, have a brother pick them and their co-workers
up that will get there. Those are the people I want to surround myself with. Those are the people

(01:14):
I want to create a business model around because those are the people that get it.
And now the podcast we're together, we discuss proactive aging on your terms, connecting to the
professional advice of our special guests while creating better days throughout the aging process.

(01:40):
Now here's your host, Mark Turnbull. Hello everyone and welcome back to another lively discussion on
aging today. We are the podcast where together we're exploring the many options to aging on your
terms. You can find aging today and our past eight years of programming on our website. All you
got to do is dial into aging today.us and I just want to say thank you all of you that have been

(02:06):
following us and if you haven't started following us, please click the follow button and begin
following us because we have so many great guests and conversations on aging today and the whole
process to what it means to age and that is no different for today. In fact, I do know one thing is

(02:26):
for certain they used to tell us that two things were for certain and that is death and taxes.
I know that there are people that avoid taxes but I don't know anybody that has avoided death.
So there's only one thing that you cannot avoid and that is death and that's what we're going to be
talking about today. We're going to be talking about the type of life that you want to live

(02:49):
as you approach the last chapter of your lives and here to join us in the conversation
and to lead us into that is Stacy's servant and she is the vice president of health services
at the friendship village and Stacy, I'm delighted that you're on and especially today because

(03:10):
it sounds like you guys are snowed in. Yes, we are snowed in but if you're in health care,
you're never snowed in, right? So you know, the show must go on and so we're here. It's a little
colder than when I left work on Friday but nonetheless, we're here and excited about the conversation.
Yeah, me too and it's near and dear to my heart. I know that you've been doing this for a number of

(03:34):
years. We have as well. We own an in-home care agency and a hospice agency. So I am delighted to have
a conversation with a fellow sojourner along the road and today we're not going to just talk about
hospice but we're going to talk about the new vision, the new way of looking at hospice and the way

(03:57):
that hospice really is meant to be. That's where I hope that we can go and not a traditional conversation.
Are you in? I'm all in. All right. Sounds good. But before we do that, we always like to hear from you
what's in your story and what, how did you, where were you brought up? What did you want to do with

(04:21):
your life and then how did you end up where you are today? Yeah, sure. For me, I was raised in long-term
care buildings. My mother was a registered nurse for 50 years. The majority of that time she spent
being a director of nursing for several nursing homes in the St. Louis area. So when most of my friends

(04:44):
were going to the beach on spring break, I was alongside my mom, volunteering in activities,
calling Bingo, and really just felt automatically in tune with the elderly. You very young that I
have to do something with the senior population. And so I went to school and studied, graduated with

(05:08):
a communication disorder degree. And back before Medicare was what it is today, I was told that you
really are going to only work with kids with a speech therapy degree. And quite frankly, at that
age, kids scared me. They still scare me to some degree, but it wasn't the space in which I envisioned

(05:29):
my career degree. So started right out of college as an activity director, just kind of getting my
foot in the door in a small facility in Springfield, Missouri. And then slowly started to take advantage
of other opportunities that came my way. I was a nursing home administrator for 20 years,

(05:52):
six of that at Friendship Village. And then later became the vice president of Health Services
for Friendship Village. So that always-- I'm sorry for family business, I guess.
Yeah, absolutely. How did that impact your life? You mentioned that while everybody else was going
to Disneyland and developing their own Disneyland and you were going to senior centers with your

(06:17):
following your mom. What kind of an impact did that have on you? Well, I mean, she was the general.
As far as I saw her, she really taught me at a young age where the bar needed to be as far as
taking care of people. What can passion and empathy look like as a young person taking care and

(06:41):
spending time with seniors? And I believe that's kind of a trade I've been able to pass on to both
my children now, one's of freshmen in college and wants to go into the healthcare space. And
the other one is the big teddy bear who loves to be around seniors. And so I feel like
empathy and compassion is not something that people automatically have, but we have to actually have

(07:05):
to kind of put them in landscapes in which they'll be exposed to different things because, you know,
not everybody has grandparents, not everybody sees their grandparents, but, you know, in any given
facility or senior living community, there's 500 potential grandmas and grandpas that you can

(07:27):
show love to and the love you get back, I think is tenfold. But for me, it's always been a personal
journey really holding my mom with the highest regard as far as keeping me on point, making sure I
don't personally accept less than because she would not be happy. She would be looking down at me

(07:49):
with that look and you don't want that look for my mom. So, you know, for me, it was very, it's been
always a personal journey and really just working the way that I saw her personally work and the way
I think she would expect me to work today. Do you see this as a calling for you? Yeah, for sure. I do. I

(08:11):
think that not a job, not a job, not a place for a paycheck, but a calling. What does that mean
to you? Yeah, I think it's what you just can't get away from, right? So, it's a calling is just what
you think in your spare time. I mean, I think people that are really invested in their profession and

(08:32):
in their callings never take a break about thinking how we can do something better. I mean,
I'm always kind of challenging myself or talking about what about this? So, I don't like this.
So, why is it like this? And just trying to continuously push that that bar higher. And I think
I can't imagine doing anything else, you know, if I won the lottery, I would still want to do

(08:59):
exactly what I'm doing. Maybe a little differently, but, you know, if you had money to impact a lot of
things that might look different, but certainly I don't think I would ever do anything different with my
career or my career path. Yeah. And you've probably come across a lot of people who consider themselves
or have tried out being a caregiver and some get it, some don't. And I believe that all of us

(09:28):
have that capacity to care for another human being, but to do it on a professional basis day after
day after day after day to complete strangers. That's a whole other level of a caregiver.
And I always say that there's maybe one percent of our population, maybe less, that are what I

(09:50):
call the true caregivers much like yourself. I mean, this is a gift that was given to you.
Yeah. It was, you were bred with it. And then, but it's also, it's even beyond that. It's a true gift.
Yeah. And you, I think you're an operator as well. You know the people that intuitively have it and

(10:11):
the ones that try really hard and just don't, but I think at the heart of it, it's looking at people as
people, not as tasks, and really somebody that wants to impact another's life. Those are the people that
show up today when it snows, right? There are people that look at the weather and call in on Friday before

(10:33):
storm on Monday. Yeah. And then because I can't, because I can call in and still have an excuse not to show up.
I'm not showing yet. I'm calling in because it might snow and I'm forecasting I'm not going to be
able to be there. And there are people that would take a cab and Uber, you know, have a brother pick
them up, have a brother pick them and their co-workers up that will get there. Those are the people I

(10:56):
want to surround myself with. Those are the people I want to create a business model around,
because those are the people that get it. And you're going to be successful when you surround yourself
with people that get it and are like-minded. Yeah. And it creates a lot less stress in the long run
when you have people like that. And my grandfather always told me he said he was a successful

(11:18):
businessman and he said, I said, what was the reason for your success? And he said, oh, it's easy.
And he pulled out his little tattered little saying and it said never be associated with failure. And
what he meant by that was surround yourself with people that are better than you or that are gifted
that that you don't have to, you know, spend a lot of time holding their hand. They just are driven.

(11:44):
They get it. And that's what he did. And that's what we're attempting to do as well.
Yeah. And that makes the job fun, right? And that makes doing things like this fun.
Because you're around people that look at it is not hard, but it's a privilege and it's
an honor to take care of people. And when you're around that every day, that's infectious.

(12:08):
And so that's exciting.
Truly is. Have you ever stopped and pondered about what is the definition of a caregiver?
Because I believe it doesn't matter if you're an owner or if you're an RN, a doctor,
CNA, you know, just a regular caregiver. I mean, you don't need a degree.

(12:29):
Right. But what is a caregiver?
What you ever thought about, what, you know, what are the traits, you know, that you've noticed about
those people? And such a great question. I joke that I'm not a nurse all the time.
So, but to your point, I'm a caregiver and all the important stuff I think I can do, you know, the

(12:55):
the gifts of patients, kindness, human touch, you know, the gift of giving time, you know,
where you're not always looking at your watches, you have to move on to the next thing. I think
in really having the gift of being interested in who you're serving, because they all have a story,

(13:17):
right? And so if you just are trying to figure out like, what, what, what,
come, what is something deeper about Mary Smith that I can maybe connect with, that brings light
joy to her life and makes my job, which the jobs are hard. We're asking people to do hard things.

(13:38):
It can also bring joy to them. So, yeah, I would, I would think all those things are important.
Yeah, yeah, I think curiosity is one of my favorite words and, and you have to be a curious person.
What is it that makes Stacey tick? Who, who are you? And when you are a caregiver, you should be able

(13:59):
to walk into a room and begin to take a special interest in that individual. I always tell my caregivers,
think of yourself when you're a host of a party. What's your role at that party? Your role is to
wander with your eyes all around the room to make sure everybody is comfortable. Yeah. And that's

(14:22):
a true caregiver. And, and I came up with a definition and I want to throw this at you to see what
you think. But a caregiver is someone that can spontaneously recognize the needs of another person
and act upon it. I think that's spot on. I mean, it's just like, wow, spontaneously
recognize that takes awareness, that takes a presence. And I think so many caregivers as I watch

(14:50):
caregivers, some get it, like you said, some don't, those they get it are present. Yeah. And just being
aware of your surroundings and connecting the dots, right? And so like when you enter a room and you're
like taking care of somebody noticing things, noticing pictures, noticing books, maybe noticing that
their water, they can't get to it. You know, it's all the little things, it's all that, like,

(15:14):
just being aware of your surroundings and connecting the dots so that you can better
pronounce. I think it's huge. Yeah. Yeah. Finding, finding ways to make their life more,
you know, easier finding their ways to make their life more pleasurable, more comfortable.
All of those things that go into that. And then I've noticed that there's different types of

(15:37):
caregivers. There are the caregivers that are really good with companion care, but they may not
be so good with personal care. And then there are, there are what I would say that there's many
caregivers out there that are more transactional as opposed to relational. Have you noticed that as well?

(15:59):
Yeah. For me, transactional caregivers, I'm not a fan of necessarily. Yeah. You really wouldn't
want transactional caregivers orientating any of your new hires because you're just going to
breed more transactional caregivers. Explain to our audience what we mean by a transactional caregiver.

(16:20):
Sure. So, you know, what I would say that kind of goes in lines with is like just looking at a person
at all the tasks that they have to do for them. Yeah. And so for instance, if you walk into a room,
you're looking, oh, I have to, they marry, dress, marry, you know, change her clothes, clean her room,

(16:40):
make her bed. Those are all the things that go with taken care of Mary that day. Yep. They're transactional.
They're, they are. Every relationship has a transaction to it. But what is the motivation behind that
transaction? Yeah. And I think it's just to get done, you know, and just to get done the quickest.
And when you have a transactional, can you imagine being on the other end of that? Where, I mean,

(17:07):
usually it's pretty obvious that you have a transactional caregiver. They don't talk as much. They
don't engage as much. They don't make eye contact as much. All the fluff things you don't get.
I would much rather have the slower relationship type of caregiver because that's what's going to be
so much more impactful for the residents that we serve. You know, I, I had residents tell me when

(17:33):
I was an administrator, you know, I had my aid walk in four times and she did all the things great,
but she never once said hi. She never once asked how my day was. She never once, you know, asked if I
was in pain to me. That's a failure, even though her care was spot on the important things that are
going to make her feel like I chose the right place. Those were not present that day. So having

(17:58):
somebody that's on task and is going to do all the things, but also can be human when they do them.
That's the that's the optimal employee that that we look to have. Yeah, absolutely. And,
then there are those caregivers that not only are maybe maybe gravitate more towards companion

(18:19):
care or personal care, but then there's hospice care, another type of care. What kind of a caregiver,
because not you know, I've got some exceptional caregivers that are in those other two categories,
but when it comes to hospice care, oh my goodness, you know, not for me and they go the other way,

(18:41):
which is fine. We wait. There's a place for everybody. What kind of a caregiver is a hospice caregiver?
So I mean, I think they have to be really comfortable with a death and dying process, number one.
And they have to be comfortable in their own scents so they can make somebody be comfortable

(19:06):
that they're taking care of. I think that's number one. Number two, really sizing up the room
in what you're doing care. You're really trying to make sure, you know, a lot of times families are
present, a lot of time you're going into somebody's home, really just making sure that that resident has

(19:26):
everything they need, whether it's an electric hospital bed, whether it's a wheelchair, so they can
get up and maybe play cards with their grandchildren, you know, making sure all their pain medicine is in,
so that they never have to go without a, you know, medicine. I think they have to really

(19:46):
size up the room and look for potential issues that may come and be totally proactive in that.
That would be the one thing that I think is often forgot about when we train our staff
and we do both in facility rotations and in the homes, we tell them that you're the eyes in that

(20:09):
home for the day. Tell us what you see, tell us, you know, ask our patients how they're feeling is
it, you know, is all their needs being taken care of? Can we do anything that we haven't done yet to make,
you know, your day better? And then, you know, all of it still goes hand in hand with being compassionate,

(20:30):
taking our time, communicating appropriately, both with the patient and the family, all of those things,
I think, really help us give really great care at the bedside. Yeah, and that's that going back to the
observed, the role of a caregiver is to observe and report and just exactly what you were describing.

(20:51):
What is it that I'm observing? What is it that I'm reporting back? And it's with the goal of, you
know, creating a better day for your patient. And that's the bottom line. Whatever that means to them.
Yeah, it's meeting them where they're at and trying to make sure that anything in a very,

(21:11):
what seems to be uncontrolled time in their life, that we can bring some control back to the patient
and really try to make sure that anything that they need, want or desire we can get for them.
Yeah. And today we're going to focus on hospice care. We're going to talk in specifics about that.

(21:33):
And I really want to start just with some of the basics. What is hospice care? And I think there's
so much confusion out there. And in relationship to palliative care. And so maybe we can kind of lay down
the definitions if you will, because as I understand it, palliative care is used twice. It's used as an

(21:58):
umbrella term, but it's also used as a specific type of care. So explain that to our audience.
Sure. So palliative care is when you have chronic diseases. And by that, you know, an example might
be COPD, CHF, that there's no cure for. So it's really an approach to those diseases. How aggressive,

(22:23):
how passive you want to be, giving yourself kind of an advanced care plan, sitting down with,
you know, your family members and talking about what right looks like in treating that disease,
when don't you want to treat it anymore? Palliative care can be hospice, but hospice can't be
palliative care. So palliative care is those first initial conversations with the patient, the

(22:49):
physician, family members, when there's a new diagnosis or when a diagnosis is just being a little
bit more cumbersome to deal with. Maybe there's more frequent hospitalization, maybe medicines that
were working, aren't working as well. It's really that conversation and that discussion about what is

(23:10):
what does right look like when we go and we treat that chronic disease? Do you want to go back to
the hospital? Do you want to, in some cases have chemotherapy and radiation? Maybe the other two
times didn't work. And so do you really want to do that again? Really also, and you and I kind of
talked about this briefly, it's taking the time to really educate the patient and the family

(23:36):
about what these diseases look like in today's state and then what will they look like as they progress?
I think we all know that our primary physicians are very busy and those office visits are very
busy, you know, 15 minutes is the average that a primary doctor spends with with their patients.

(23:58):
It's really hard to have those heartfelt conversations in 15 minutes where you can really have some
dialogue back and forth and get people to really start asking themselves questions or maybe, you know,
daughters or sons start talking to mom and dad a little bit more real like, okay, how are you going
to stay in the home by yourself if these things continue to be progressed? Do we have a plan in place?

(24:23):
Even as broad-sacred is, is, do you want to be a full-code or do you want to be resuscitated?
Having those conversations before chaos is always the best time, but sometimes those important
conversations don't happen in the physician office like you might think, and so I think that's when
positive care can be super, super helpful to have a practitioner that works with the family,

(24:50):
visits the family, monitors how that disease is progressing and continuing to educate that family.
I think, positive care is awesome and I hope to see it used more because I think it really can
alleviate a lot of chaos and confusion down the line. When we talk about hospice, that's a little

(25:12):
bit more defined. You know, hospice is a doctor, actually two doctors, a primary doctor and a hospice
medical director. Both say, okay, we're looking at the movement of your disease process and we both
agree that if it moves in the normal medical textbook way that you have six months or less to live.

(25:40):
And so that is certified by two medical directors and then you would
be eligible for hospice services and hospice services. Did you want me to explain that part, Mark?
Oh, sure. Yeah, absolutely because I think there's a lot of confusion as to that and why a lot of people
don't, one of the my biggest pet peeves is that people wait too long to get on to hospice care.

(26:06):
And eventually we're all going to need, we should need hospice care at some point, but many people
miss that opportunity to have those services and take advantage of those services and they're all paid
for. Right. So for the most part. Yeah, for the most part. And I will say this, we both have talked

(26:28):
about what people think hospice is. Yeah. And I've, and through this journey of creating a hospice
program for Friendship Village, you know, I've had even friends of mine say, well, you know, hospice is,
you just don't feed them anymore, right? I'm like, no, they can eat whatever they want in fact. Well,
they're just going to starve to death. No, no. Oh, so they're going to die right away once, once again, no.

(26:52):
So there's a lot of really negative outlooks on hospice. And just that word, you know, is just,
really that word makes it hard to even break through the wall to even have further conversations.
So palliative care allows us to kind of have those conversations, a little bit easier, those walls are kind of

(27:14):
down for a little bit. But has the shares of great benefits? It's, um, 24-value Medicare,
benefit, benefit, benefit, benefit, your older, obviously commercial insurance plans have cost
the benefits as well. And just done correctly, you really can set the table for a, a, a, a,
a real quality, a real quality, dignified passing of your loved ones. Um, we always want to get in as

(27:41):
soon as possible because we want there to be ample enough time to talk to the chaplain, um, people
to plan their own funeral in some cases or celebrations of life, which is big on, on my books. I don't
know why we wait for a funeral to celebrate somebody's life. Why can't we celebrate them? Why they're
living? It's not a really new idea, but some, something that, you know, I feel like we should

(28:05):
challenge that a little bit more, um, because the people that are being celebrated want to see all
those people show up, you know, sometimes they haven't seen those friends for a long time. Um, and so,
you know, hospice care gives us the ability to provide a nurse, a chaplain, a social worker,
a personal caregiver, um, you know, we have a medical director that oversees their care as well,

(28:32):
volunteers, specifically for us. It's been super impactful here at Friendship Village.
Um, so it gives us a, a nice amount of time. It's done right to really get in there,
to spell the rumors, um, and that's due consistency, um, and making them feel like the sky's not
gonna fall down, you know, sometimes there are imminent passing that occur really quickly,

(28:55):
but ideally you would want enough time to be able to really bring in the services that make
hospice a really special program. And so most of the people that we do palliative care visits are
appropriate for hospice when we do them. So it's, our most of the hospice patients we bring in probably

(29:17):
would probably would have caught by six months prior to, um, enrolling them. So education, education,
education, um, and not only to families, but certainly to, to practitioners and physicians,
um, to really look at, you know, the diagnosis, lab results, and really look at, yeah, this person's

(29:38):
been failing and sometimes they only look at them how they are today, but if you look back for three
months, they've lost 25 pounds. They're not doing well. And so really there's just a lot of education,
a lot of conversations that need to be handled, you know, handled around the kitchen table about
how we want to live our last, our last once days or years. Um, it's, it's really super important to

(30:03):
have those. And, and I think it's important that you mentioned years, and I know that many of the
patients that we've cared for can last a year or two. Yeah. The most famous case being, you know,
our president, Jimmy Carter, and he was in hospice. What was it? 12? Was it 14 months? Yeah.

(30:24):
Something like that. And so you have the article, um, it's on my desk and it's stand-inses, and it's his
quote to say hospice is not giving up. Yeah. Think about that. That's, I mean, come on. That's awesome.
Did you know that that over 1.7 million people access hospice care each year and their

(30:45):
average length of stay is 70 days? Most people have a preconceived notion about what this kind of care
means, but Stacey's urban says it's time to rethink the negative connotations. We need to focus on
the experience of living. We need to empower people to have the conversation before they need care
so they can make their own choices and remove the stress from family members so everyone can focus

(31:07):
on their time together. We should help them celebrate their life and celebrate the care and
love the receive. Learn more about friendship village in St. Louis and call today at 314-270-7700.
This did you know moment is sponsored by Royal Hospice, Oregon.
Yeah. And there's a lot of negative attitudes towards hospice and that we're trying to overcome and

(31:36):
it's difficult to overcome some of the stereotypes that are out there because a lot of these stereotypes
are not being addressed by the medical community and physicians in particular. And sometimes I feel
like a fish swimming upstream and it's not an easy road to change the paradigm on how we look at

(32:02):
hospice and we don't need to look at it as a descents. In fact, I think you're in agreement because
when I was reading some of the things that you wanted to talk about is, yeah, I lost you there for
a minute, was that hospice isn't about how you die. It's about how you're living. Comment on that.

(32:28):
Yeah, that's really kind of our mission is it's not about focusing on the end game because as you said
earlier, we're all going to go there. We all have the same end game. It's the one thing that connects
if it's unites us. Yeah. Whether we like it or not, we all have that in common. And so what is

(32:50):
different is how we live. And hospice services is only going to bring more life if that makes sense.
You know, like we think about hospice as so many families as soon as they sign paperwork, they're
really visually, you know, for like the first week. You know, there are lots of visitors sitting by

(33:15):
the bedside because in their mind, they're dying in one or two days. And so when we show them that
through different interventions, different complimentary therapies that we offer, music therapy,
massage, you know, our volunteers and guests actually more care. People start to feel better. They
start to eat more. They start to, you know, participate in conversations that maybe they didn't or

(33:41):
were able to before. And there are some cases that people graduate for hospice. We have two graduating
this month. That's a success story. You know, that means that when you say graduating, what does that
mean? So when we have our team meetings, which is every two weeks, we are looking for hospice

(34:03):
appropriateness. And so we are looking at who sets the stage for hospice. So our medical director
in their primary. Yeah, but at the, but who holds you accountable to that Medicare? Medicare.
And so we have to, you know, turn in all of our documentation, et cetera. And so sometimes in COVID

(34:24):
was a perfect example of this. There are people that had COVID and COVID and took a very, very,
very big decline. And so a lot of families, a lot of doctors said, okay, come in with hospice
because we don't think they're that about that. And so we bring our services in. And with time
in the right level of care and the right services, they're able to get their strength back.

(34:53):
They're able to, you know, take in more calories and they're able to get a little bit better. It
does take time for that. But, you know, sometimes a doctor might say, yeah, this is the trajectory that
this person is on. I don't see them, you know, changing. So they're appropriate. But then

(35:16):
there's only one man upstairs that really knows when your time is. And sometimes, you know,
when we look at the patient holistically, the whole patient, we realize that, oh, they're not
losing weight. They're not asking, they're not in any pain. They're labs, you know, they're
actually stabilizing to the point that they're no longer hospice appropriate. And so we will then

(35:43):
take them off the services and monitor them from a palliative care perspective moving forward.
So we do graduate people. We do graduate people from hospice because, you know, sometimes,
you know, the body is an amazing thing that when it's given enough time of healing and the right people

(36:04):
around them, they do get, they do get better. They stabilize to the point that they're no longer
qualified for hospice. Yeah. The other thing too is that, you know, our healthcare system is in such
disarray. And it takes two, three weeks for mom, dad to get an appointment to go see their primary
physician and they are, you know, starting, they're declining whether they're weight loss and,

(36:28):
and on and it goes. And, and that goes to show why people, you know, either graduate from
hospice when you put them on hospice because now all of a sudden, they're not having to get in the
car, go down to, you know, three, four weeks after a symptom has developed to get the attention from

(36:49):
their medical doctor. With hospice, you get it immediately. You get it that week. Right. And, you know, we
we go out often. So if there's any decline, we're there. We do daily visits, we up visits to three
times a week if we need to. We're really monitoring those changes of condition and some are long lasting

(37:10):
and they indicate that somebody might be transitioning or it's just a little bump in the road and
they get over that hurdle and, you know, they're stabilized again. So I think extra eyes are always
great eyes. And I think too, back to the practitioner, it's not, it's not their fault to some degree

(37:32):
because it's just the way that the business has changed for those doctors. It's just that they
usually are interested in solving problems. So when you go to a doctor, unless it's your physical,
there's your routine appointment. You're there to solve a problem. And so doctors get in that tunnel
and they solve that problem and that patient is good to the next problem occurs. And then that problem

(37:56):
comes and they solve that problem. But we don't see a lot of holistic practicing, meaning have we
looked at how many problems and how frequent the problems are occurring to really then be able to
get a better picture on how this person is doing. You know, if I look at my wake for today,

(38:19):
it means nothing, but I look at it for the last six months, it may tell a different story.
And so I think that sometimes in this busy, busy world where these appointments happen and we have
to get them in and, you know, hospitals aren't with them used to be either, that we've got to,

(38:39):
we've got to slow down and really look at these people holistically to be able to forecast and
help them in the best way. Yeah, absolutely. And the other thing too is that doctors, like you said,
they're in a curative mode frame of mind. And there, and a lot of times seniors, when they do go in,

(39:02):
I've seen this with my own parents, I've seen it with others that we care for when they get in
front of a physician or a medical professional of any kind, they always paint a better picture than
what's really going on. Yes, yes, I have an 86 year old father and I go to every appointment
because of that, right? They're always given best case scenarios. They're, you know, painting a

(39:28):
picture because they don't want anyone to think they can't live where they're at, they can't be
independent. So I, I, I do you think that's valid and so I, I always preach to children of seniors as
I've got to be involved, they've got to be an advocate for their loved ones because otherwise,
they're going to get really missed and just, they're just becoming a number at that point.

(39:54):
And then when, when somebody is considering going on, you know, maybe it's the adult children
of mom and dad that are considering hospice and they, they have that, they have to get over that
fear of bringing up the H word, right? Okay, so how, how do you have that conversation with mom because,

(40:18):
or dad because there is that stigma that is out there that have, oh, you mean I'm going to die.
If I have this conversation, I had this, I mean, I'm a hospice operator and I had that fear
with my mom and my dad, especially my dad and, and I had to have the conversation with them and

(40:41):
explain the whole process of this is just these are additional services that are going to help you
live your best life possible. And, but there's some caveats to that. Like you have to give up going
to the hospital, you have to give up. There's some, some things you have to give away.
Yeah, I mean, I, I can remember having the most specific conversation with my mom,

(41:07):
she hears an earth, she's been in the hospital with COP duty for every month and, and every
visit gets worse and it takes longer to get out of the hospital. And for me, I just kept seeing a
more exhausted version of my mother coming out of the hospital. And so really just to talk to her,
in the context, call it anything you want to call it, but it really gets down to how,

(41:36):
the why? Do we know why we're doing this, mom? Do we know why? You know, how, are you want to go to the
hospital? You've been to the hospital three out of the last four months. Do you want to be on oxygen?
Do you want, how can I, is your daughter, is your advocate? Help you live the life you want to live?
All things considered with your diagnosis. That was hard. That was, that was a little bit. That was

(42:02):
not something that I was really trained or prepared or there was really no in service for that conversation.
A lot of times. Do you think, Stacy, do you think that it's harder for you than it was for your mom?
Because I often, yeah, I want to, because I go back and I, it was harder for me

(42:29):
having that conversation with my dad, then I think my dad was inheriting it. But you do have to use the right
verbiage, like, okay, dad, we're, by being on hospice, the one of the myths that you talked about was,
oh, being on hospice means you stop eating, so you can't feed anybody anymore. No, no, no, that's not,

(42:50):
that's not hospice. Right, right, right. Yeah, I mean, so sometimes I think,
for residents understand, you know, if they're of a later in age, and obviously there's always more
horrific stories of younger people and, you know, different circumstances, but if you take your basic

(43:10):
84 year old senior, they've had people pass away. Death is not new to them. Yeah, they've lost
friends. They've lost maybe a spouse. They've lost family. They're still going to protect the children
from the thought of losing them. They're still the protectors. And so I do think there is this kind of

(43:40):
you know, where the daughter doesn't perhaps want to have that heart to heart with mom,
but the mom doesn't want to leave the daughter. You know, it's that kind of thing. The mom knows
where they're going and the mom, you know, sometimes they miss their spouses so much they want to be

(44:02):
reunited with them, right? And so, but they don't want their children to be in any pain
after they're gone. They're okay with the plan. They're okay with hospice. And I always say that,
you know, my mother is in a better place. We might not be in a better place without her,

(44:22):
but she for certain is in a better place without the suffering and having the hardship she did with
her own personal disease process. But I do think parents always still try to protect their kids from
that pain. Yeah. And so I do think that's why you see people where when you look at their records,

(44:44):
it doesn't make sense whether they continue with chemotherapy or radiation, everything basic
resets that these things are, these things are no longer curative. But if you ask them, it's well,
my my daughter wants me to keep doing it or my son, you know, doesn't want me to give up. And so,
you see kind of that yin and yin and so boy, advanced directives are pretty helpful at that point

(45:10):
to refer to and just kind of talk about what they wanted for themselves before there was
this crisis or this big decision that needed to be made. But I agree that those conversations are
tough. But I think once you just start healing back that on in and really focus on how you can really

(45:32):
be impactful from a quality perspective with your hospice program, I think you get there and you get
there well. Yeah. The other thing too is that I think we don't give enough credit to mom and dad
for they understand and know their situation probably better than we do. And they're just grateful

(45:53):
that you took the time to acknowledge that so that that takes a little bit of the pressure of
them having to have this conversation with you. Yeah. I'd say it's almost like giving permission
to be okay to pass away. Yeah. And how many times have we around a bad, when somebody's in their

(46:18):
final moments have said, why is this person hanging on? Why is this person hanging on? And really,
it's that permission to pass. And, you know, I think my goal would be let's have those conversations
ahead of time. So we're not at that point, right? Let's have these open conversations like these are

(46:40):
the disease processes. These are the treatment options that we have for them. Where do you want to go
with them, mom? Where do you want to go with them, dad? And really have those at a positive care
level. So you're not trying to give somebody permission at the bedside in a very imminent stage.
Yeah. Yeah. And sometimes it's easier to have those conversations when there is a life

(47:04):
limiting, you know, illness or disease. But a lot of times, you know, my mom is a case in point where
she doesn't have any long-term chronic illnesses or diseases. But she's 95. And, you know,
the engine is burning out. Yeah. So we made a, and then she's been falling. She's been losing weight.

(47:32):
And so talk a little bit about how to have that conversation with when the fuel is just running
out in the body. And the body is just saying, you know, I'm tired. And so we took, and she had chronic,
the biggest thing she had was chronic UTIs. And she looked at me the last time she went to the hospital

(47:59):
and they put her on IVs. And she says, I'm done. I don't want to do this anymore. She knew, you know,
and I said, okay, well, then there are some additional services that we can provide you so that you
don't have to mom come back into the hospital or go see the doctor and wait another three to four weeks
before you get in. And let's consider the hospice services. And she said, okay.

(48:26):
Yeah. I mean, I think they, they do always say, I'm tired. I'm just, I'm just not what I used to be or,
you know, things aren't as easy for me as I used to be. And I think as we tell our caregivers,
right, kids are caregivers, be aware. Those are, those are introductions to a bigger conversations.

(48:50):
And in fact, you could look at them as guests because they really are opening, cracking that door for
a bigger discussion without you having to bring it up. But you can certainly dive in to say, well,
tell me more about that, mom. You're tired. What, what, what does that mean? Are you, are you just,
is it harder for you? Are you struggling? You know, maybe let's, let's see what we can do. So it's not

(49:14):
so obtrusive for you anymore. You know, let me use on my contacts and see what we can do to make
things a little bit easier for you. I think a lot of people say that to their kids. And then I think
a lot of kids say, well, mom, you're fine. You know, everything will be fine, I'm tired too. But really,

(49:36):
we need to use those little things, those little nuggets as gifts because they're really telling you,
I'm there. Yeah. And I need help. And I need you to be okay with it. And I think that is so huge. And

(49:57):
that's why I think I'm such a really proponent. Not only, you know, as I think hospice is such an
amazing thing that we can do for people that we love, but that positive care conversations sure
sets the table for those deeper conversations. And the hope would be you start having more of those
palliative care conversations. So you're not just waiting for somebody to tell you they're tired

(50:23):
or they're kind of done, you know, and so I do think they go hand in hand and I hope more and more
people are just open to learning more about both. Yeah. Yeah. The, the, the other thing that we noticed in
with my mom's health is that once we did put her on hospice, we went through her regimen of medications

(50:45):
and she, she had very little compared to most seniors. And I think she had maybe three,
three medications and then some, you know, occasional Tylenol or, you know, some vitamin E and all
that kind of stuff, you know, but the one medication in particular was a memory medication. And I

(51:08):
always said, I'm not a huge believer of that stuff anyhow because it, they're, there really isn't a
medication to, you know, correct somebody's memory. They're, they're usually, they're,
there are other medications that were used for something else. And when we took her off of those
medications, her UTIs improved. So maybe, not always, but maybe the amount of medications that,

(51:36):
if you've got a loved one that is experiencing a lot of UTIs, it could be that the medications that
they're putting into their bodies is what's taintening the well. Well, and this goes back to, you know,
what I would tell a friend that's a daughter or a son to somebody and get involved. Start,

(51:56):
start looking in the medicine cabinet. You will be amazed at what they keep and what they're taking.
And we don't have a healthcare system that speaks to each other, meaning everybody comes out of the
hospital now with a specialist and every specialist prescribes different medicines. And not all the

(52:18):
doctors talk to each other to say, well, does this make sense? Or why are we doing it?
You know, and sometimes there's interaction. I mean, there are some people that are on 20 medicine.
They're 99 years old. What? And so we really like have to continuously,

(52:45):
you know, pro versus card risk reward when we talk about these medicines. Your mom was falling.
I would go to medicines right off the bat as I'm sure you did and say, is there anything in this,
in this list that could be contributing to that, you know? And so you sound the UTI problem. You
also probably sound the fall problem problem, but these practitioners because they don't have a system

(53:10):
to speak to each other and to stay in the loop with each other as much as we think they should be able
to. We've got a lot of different people prescribing a lot of different things and there's drug interactions.
And sometimes we're moving some of those people feel better. Yeah, the other thing I want you to
come in on too is that one of the myths that is out there with hospice care is that that individual

(53:34):
needs to be bed bound. And there's this idea, it's kind of like with the stop eating type thing,
but it's, oh, you can't walk around. You're too healthy for hospice care. And my mom's been on hospice for,
was it about four months now? And her life just keeps improving. I mean, she is declining. She is

(53:59):
losing weight. She is, you know, she's all the traditional things that go along with the body declining.
But we try to keep her as mobile as we can because think of it in terms of
you're giving, you're helping somebody to live their best possible life with a quality of life

(54:22):
and keep the body is designed to move. So if you can, keep them as mobile because there will be a time
when she won't be mobile, but if you can, keep them mobile and create an atmosphere of living,
living life, the way she has always wanted to live life. And we try to create that atmosphere. I had

(54:43):
family members come in and say, well, you can't be, you can't be taking her on trips to the beach or,
yes, we can because that's where she wants to go. And we're going. And we're going. Yeah. And my family
is looking at me like, what are you doing? You're going to kill her. You know, I mean, that's the,
that's the way it comes across and I go, oh my goodness. Doesn't that get back to what the picture of

(55:08):
hospice looks like? Yeah. That the stigma, right? Yeah. We think hospice doctors think this way.
I think caregivers to some degree, they're not qualified for hospice. They just went down at the
dining room with their walker. Yeah. Okay, but that doesn't mean that they have great
heart function, lung function. Doesn't mean that they don't have a cancer. Doesn't mean that their

(55:32):
dementia is any, I mean, so yeah, that just goes to the stigmatism that surrounds hospice, which I
think is sometimes why people don't get that prescribed or referred for hospice because they're not
bad enough yet. Yeah. They're not, they're not on their deathbed. They're not, yeah. Yeah. Yeah. Well,

(55:54):
nothing I'm going to do today, I want you to cure X diagnosis.
Hospice isn't going to cure a chronic disease, right? Yeah. Or somebody that's just frail,
failure to thrive, all the things. And so, yeah, we've got a lot of work to do. We need more
conversations like this to really just say, why wouldn't we want them to be able to go to their

(56:20):
daughter's wedding? Yeah. Why wouldn't we want them to go to their granddaughter's graduation?
Does that mean they're not dying? No, doesn't. It just means that we have a gift still that she give,
we can give her those moments. Yeah. You know, and so people get really kind of scared
to operate on those guidelines, but the guidelines specifically tell you when somebody can qualify

(56:46):
for those services. And we've painted our backed ourselves in a corner that it has to
look like something and it really doesn't. And so I hope that these
members can help that because if you could take your mom to the beach, you'd escape her the best gift
ever, but you got one too. Yeah. So why can we, right away? I tell that, I tell that to my siblings

(57:09):
all the time. Take her, go, go, go do things, go do what she wants to do. And they, they've come
around. And because when we first put her on hospice, it was like, oh, put on the kid gloves,
we have to treat her now, put her into bed, you know, and say good, your go buys and the family would
come over. Like I think you mentioned it earlier when you first put somebody on hospice, all the families

(57:34):
come over and they're ready to say goodbye. Well, in some cases, that may be true, especially if the
physician and the family has neglected to observe really what's going on and they wait until the very end.
Yes. Yes. Because a lot of times, another one of my pet peeves is that, you know, people don't get

(57:55):
to take advantage of the services because they wait till their last week of life.
Yeah. And we, we then have a very chaotic situation that we're expected just to go make right
in a very small amount of time. And it's just not, it's not how it was supposed to be. It's not

(58:16):
designed that way. And so I am just hoping that the work both of us do, the conversations, both of us
are having starts to change that narrative around hospice. Yeah. It's really such a great gift we can
give somebody. We just got back from the beach and she wants to go back. And so we're going to go back

(58:38):
and this later this week. And then, and I look at it as an opportunity to give her the gift of life,
living, living the life that she wants to live. And if she dies in the process, then she lived her life.
I mean, I'd rather, what better way to pass away? Oh, I'd rather pass away in the car or

(58:59):
at the in front of the window at the beach than to be sitting in moping at your own home,
you know, saying, whoa is me? And whatever else goes through people's minds, no, stay active.
If you can't, not, not everybody can. Yeah. I think you can't be afraid to have those moments. Yeah.
I mean, today is, I mean, I think we've learned through COVID and other things that you can get a,

(59:23):
you can get around, even if you're real chair bound. Yeah. Absolutely. There's buses, how there's,
there's vans, what get them, go share some experiences. You are creating the lasting impression.
And that's what I like to think that we create with hospice is that truly lasting impression.
And if we can give a family that with their, with their loved ones, that's a gift. That is just a gift.

(59:48):
And we need more gifts like that. Planned celebrations. Like my mom's birthday is coming up.
It's February 28th. Celebration of life. Life celebration. And so I told all my siblings, I said,
we're having, we're already starting, mom and I are already starting the planning of the
her birthday party. It's going to be at the home. It's going to be a Mexican theme because mom and

(01:00:10):
dad used to love to go to Mexico for, you know, for playtime. And so last year we did Hawaii. This year
we're doing Mexico. And I said, come prepared to celebrate, to celebrate her life. And that's one of
the things that we are trying to talk to our families about. Like why, every birthday is important,

(01:00:35):
right? It's our day. It's that person's day. And so make it a celebration. I mean, this is a time
to be happy and let them plan it. Let them have some, you know, say in a voice in that, how awesome is that?
I am really big in celebrating birthdays. And like I said, doing celebrations of life,

(01:00:57):
when people are alive to celebrate their lives with everybody that is important to them. So kudos,
kudos to you because that is definitely something I feel very strongly about. Yeah. Now let's shift
years a little bit. So we've talked about, you know, living, you know, your best life possible day to day,

(01:01:21):
there will be a time when, I'll use my mom as an example where she will be bedridden. She will be so
weak and tired that she cannot get out of bed. Talk a little bit about the stages. I don't know if
you're prepared to do this, but this, if you can, talk a little bit about what goes through the last

(01:01:46):
moments of somebody's life. And I think that's an important conversation to have because it helps to
prepare us. And it's, it's also a part of the natural process of accepting death that we're all
going to face at some, some place somewhere along the line. And we're all going to experience it

(01:02:08):
a little bit differently. I understand that. I've seen many, many people pass my dad passed in front
in my arms, my grandfather passed in my arms. I'm assuming my mom will pass in my arms,
assuming I'm here, you know, if I'm that fortunate. But there's a process. Explain what that looks like.

(01:02:31):
So and I think if I would go back and say the myths about hospice is that they don't eat anymore.
If your loved one is referred to hospice and they're not eating anymore, like on day one,
they were not referred soon enough. I do think that somebody can be mobile like your mother and then

(01:02:52):
not get up out of bed, stay in bed longer. Maybe their appetite starts to decline. And then it ultimately
will diminish just like we don't feel like eating when we have an illness, right? Cold the flu.
That happens when somebody is transitioning as we like to call it. So the three big things that

(01:03:18):
I always say to people when they call or even friends because I think once your friends know that
you're involved in hospice or any senior care, you then become the expert whether you have any
business being the expert or not, they call you and I'll say, "Oh, okay. Well, have they ate today?"
And they'll be like, "Well, just a little bit." I'm like, "Okay. Have they drank anything?"

(01:03:42):
Yeah, they're still drinking, just not eating. I go, "Okay."
Have they are they still going to the bathroom? Yes. You've got some time.
Now what does time look like? Time isn't months, you know? It might not even be longer like the
week, but I would always say that those are signs that the body is swirling down. And I always

(01:04:04):
then reiterate what we know. There's a misnomer that they're going to have hunger pains,
that they're going to dehydration is painful. And I think that, you know, it is like to reiterate
that studies have shown that, like, you know, there's a euphoria that goes kind of on when somebody
hasn't ate. They're not in any pain if they stop eating. They're not in any pain if they stop drinking.

(01:04:31):
And so, you know, just really kind of let them look for those things. So when you're with your mom,
you know, ask the staff how many times you went to the bathroom. You know, really focus on
not so much the food, but the drinking, you know, water. And just kind of spell out kind of those

(01:04:51):
steps that lead us to believe that they are going to pass away sooner than later. So, I mean, you
know, there's always respiration. There's always the use of pain medicine. Do they look more anxious?
Are they more anxious? Are they having to use routine pain medications? Whereas before they were
using them as needed, I think those are all the things that kind of paint the picture that

(01:05:15):
somebody is transitioning towards, you know, death and passing away versus maybe being a stable
as they once were. And then is there bodily? So like when my dad passed, I mean, he was gurgling
with what they call gurgling, explain what so that somebody that is with their loved one,

(01:05:41):
that they're not going to panic and they're not going to, you know, and how you approach that whole
thing. Yeah. And I think that that is where that hand holding by the nursing staff of the hospice
team really has to be visible and they really have to make sure that they understand what the dying
process looks like for this particular patient and where they are in that process. So definitely,

(01:06:04):
you know, the rattling, the gurgling, you know, we may have to use suction, we may not have to use
suction. You know, there's different smells that occur. There's, you know, sometimes wounds develop,
you know, so just really educating that family as to this is what you should expect. Let's not

(01:06:29):
hide because deaths can be angelic and they can be very calm and peaceful, but they're also our
deaths that you can do a lot of things. You can do everything right and they're still very hard
to be a part of and to watch. I saw that firsthand. And so I think, you know, and I'll say I'm not a nurse,

(01:06:54):
I know enough to be dangerous certainly, but you know, there's certain things that the body is telling
you that the organs are shutting down, you know, the respirations are slowing down. You know,
the breathing, the gurgling, the smells, the urine output, all those things, paint a picture,

(01:07:16):
that yes, we are nearing, you know, this person transitioning and passing away. And this is where
you talked about earlier about being observant, observant and report. So pick up the phone, call
the hospice team so that they can come in and provide the kind of support that they're trained to do.

(01:07:38):
Yeah, and I've read, I mean, I read a lot of just different notations for our team and it is constant
education, provide about what next steps look like, what the process looks like, what to expect in
the next couple days. If you aren't educating your families before those things occur, and then as

(01:08:01):
they're occurring, you're really missing the boat. You're really missing how impactful you can be,
because there is really no reason why a family should be going into a deathbind without having,
now every death works different, but they should have a little bit of information that they can feel

(01:08:22):
like, oh, you know, nursery told me to expect this. No, but I talked to my nurse the other day. She
said probably in the next couple days, be looking for these things to occur. That's when you've done your
job to just to relieve that family of fear and really chaos. So I hope that there's a lot of

(01:08:45):
conversations going on around the bedside about what to expect. Yeah, and I think that's where,
you know, your motivations or what is it that drives a hospice team? And I think that
from my perspective, life is sacred. Absolutely. And if you don't have a team around you that doesn't

(01:09:12):
believe that life is sacred, you've got the wrong team because they're not going to have the
compassion to walk you through those steps. And to make this an angelic experience for not only the
the individual, the patient, but also for the family. It is, it's the why. Right? You were given the

(01:09:38):
privilege of taking care of them at the most imminent stage. And it is a privilege that should not
be taken lightly. And if you aren't kind of doing all those things that we just discussed,
then to me, you're not mission driven about what what hospice, what right hospice looks like. And

(01:09:59):
it is a sure way that you won't be in business any longer because the families are going to be the
ones that brag about what Nurse Terry did to make their experience better. And who do you mean?
Sometimes their experience is is better that they're talking about maybe not so much,
remember dad. So I really think that every residence we can be impactful for what right looks like

(01:10:30):
when they need it when they need it most. Yeah. And I think bringing it full circle, we started out
the conversation with caregivers. And every hospice team member is a caregiver. And if you're a
transactional caregiver, you're going to miss the boat, especially when it comes down to hospice.

(01:10:51):
You've got to be relational and you've got to look at life as being sacred. And you have to have a
perspective of that social awareness and that presence. And it's that is such a simple thing being
present. But I've seen and witnessed many, many hospices that are not present. And that's sad.

(01:11:14):
That's something I can't say what that is, but that is that's just,
yeah, it's not it. It's just not it. Yeah. So anyhow, I think, you know, coming full circle, I think,
that's where we need to probably leave this conversation unless you have something else that you

(01:11:35):
want to say in particular. But I think it was a great starting point. Obviously, there is more to
the union that we could unpack layer by layer. But you know, this is a great conversation. And I hope
that many that were listening will begin to ponder and ask all the difficult questions. And

(01:11:55):
you know, a great place to start is your physician, but maybe not. I mean, not all physicians get it,
not all physicians because they're more what we talked about. Curative. So, but there are a lot of
resources out there. And are there any resources that you could share with the rest of us that you

(01:12:17):
found to be inspirational or impactful in shaping your vision of what hospice should be?
I mean, so, yeah, there's a lot of great national hospice,
powder care associations out there. You know, when we went through our accreditation, we learned a lot
from those organizations, podcasts like this help us, you know, understand what's out there,

(01:12:42):
we're in the Midwest, you know, what's what else is going around in the country. Sometimes you
think you're so fast and a mover in a shape, and you realize that somebody else has been doing
the same thing for 10 years. So, I really think really checking out your local,

(01:13:03):
palliative care and hospice organizations in your state as a provider, but if you're like a potential
family member that needs help, you know, maybe ask, it's not so much that doctor that may have
the right resources, but I for sure know, their nurses usually know who to refer to and who to ask

(01:13:24):
questions or sometimes they have case managers in the physician group. But really, you know, my only
final thought is, and sometimes as providers, we're the worst for our own families, but to really
lean into what's hard, and sometimes what hard is, is to sit down with mom or dad and ask, what are
their wishes? You know, what is concerning, you know, tell me how to handle this mom, if this were

(01:13:50):
to happen, do it before the chaos starts because it's a lot easier to take care of mom or dad's wishes
when there's no chaos and know that they've told you exactly what to do versus the opposite. So,
you know, lean into what's hard and really hospices and hard hospices again.

(01:14:10):
Yeah, absolutely. Then everybody should be able to have.
And if somebody wanted to get in touch with you, what's the best way to do that?
Sure. So, I'm with Friendship Village. So my email is zerbanzirb.org.bz.org. And boy,
A.M. Stacey, [e-mail]. You can look up Friendship Village, St. Louis,

(01:14:34):
Google us and we'd love to hear about your story or help someone out that needs some direction.
All right. Stacey, what a pleasure to have you on and to meet you finally.
And let's do it. Let's do it again because like I said, we've only touched the surface of what is
hospice care and I think that there's so much more that we can talk about.
Yeah, I look forward to this not being our last conversation, Mark. So thank you so much for having me.

(01:15:00):
All right. And this is Mark Terrible. Your host and I want to thank all of you for tuning into
Aging Today. We are the podcast where together we're exploring the many options to aging on your
terms. Join us every Monday when we release a new conversation on Aging Today to your favorite podcast
channel. And remember this, we're all in the process of aging and as we age, we really are

(01:15:24):
better together. So stay young at heart. You make me feel so young. You make me feel like spring
as spring. And every time I see your face, I'm such a happy individual, the moment that she's
being. I want to go play hide and see. I want to go and bounce the moon just like a Torre

(01:15:51):
Balloon. Well, you and I are just like a bullet. Running across the metal.
They can have lots of forget me night. So you made me feel so young.
You made me feel there are songs to be sung. There will still be wrong and wonderful things to be found.

(01:16:15):
And when I'm old and grey. You've been listening to Aging Today, where together we explore the
options to aging on your terms. Join Mark in his guest next week for another lively discussion
on proactively aging on your terms, connecting you to the professional advice of his special guests.

(01:16:36):
With the goal of creating better days throughout the aging process, your host has been Mark Turnbull.
Join Mark in his guest every week on Aging Today, your podcast to exploring your options for aging
on your terms. And you went all in grey. You make me feel the way I feel today. Cause you make me feel so.

(01:17:01):
You make me feel so. You make me feel so young.
♪ It's all young ♪