Your Lawyer for Life

Radio D

Radio D Transcript

 
 

Dustin:             Hello Sacramento. My name is Dustin MacFarlane and we're here on Talk 650 KSTE. Thanks for tuning in this morning. I'm an elder law and an estate planning attorney. What the heck does that mean? That means I focus my practice really on wills and trusts. A lot of times, the primary focus of my practice is working with seniors. I love working with seniors and their families. I just have a great time with it. I appreciate you joining in today.

                        The point of this show, and really what I emphasize on this show are senior issues. A lot of it are legal issues, some financial issues, healthcare issues. Today we're going to talk about death and dying and that process. That affects all of us, old and young. Really know one class goes to deal with that but after the break we're going to have Jeff Douglas from Advanced Home Health and Hospice. He is the chaplain with Advanced Home Health.

                        He's just going to talk about what he does and the services he provides, but I want to let you know that again the focus of my practice is helping people take care of their loved ones when they start to get old and frail. It's really common. A lot of us have family members who are starting to get up there in years.

                        When you do an estate plan, when I say that I mean you need to plan for your incapacity and plan for your death. Most of the time when folks go to an attorney, the primary topic is what assets do you have and who gets them when you're dead. That's just what they talk about. As we go to attorneys, as people come into me, that's on the front of their mind most of the time. I'm getting older, it's time to get this done, I've got houses, I've got kids, I've got spouses, I've got issues.

                        We want to know how the people really are focused on how property passes to their children after they pass away. I want to tell you that should not be your goal. It should be part of the process, but to me, the number one goal is to make sure that you can be well cared for for the rest of your life. It's very common for us to live a long time and usually the end of our life where a lot of us are in some sort of healthcare facility or at least receiving some type of care.

                        We have whether it's a non-medical home health aid, whether we have a family member move in with us, whatever it happens to be, we've got people who are helping us live, helping us stay healthy, helping us get along and just do the things that we've done our whole lives. I want to make sure that that happens for you, that you are well cared for through your whole life. I'm less concerned about who gets the money. Yes, that's important and we need to talk about that. That is part of the process, but more importantly it's who is going to take care of you, what can they do? What decision making and power do they have? How are they put in the power?

                        If you think about it, right now, you are in power, and according to the state law, you have capacity to make all your own financial and medical decisions. At what point are you no longer capable of doing that and someone else is? Let me tell you folks, that has to be written down. You've got to have all of that in place. Then you've got to address things like, when somebody comes in what is the process to remove you or at least to elevate someone else to be your primary decision maker?

                        Those types of things don't happen easily. Normally, it's a hurdle or there's a red tape or there's things that have to happen before you removed. Yes, we want to abide by the law. We want to follow the requirements and at the same time we want to make it easy for family to take care of one another. That is crucial because at the end of the day, most of the time, family wants to take care of family. They're not out to get each other. That does happen. We want to guard against that as well. We want to guard against people who are praying on the old or the weak or the helpless and those who can't say no to that child or grandchild who's always asking for money. Yes, that is crucial.

                        That's all part of the process of making sure that you'll be cared for, that you will be warm and safe. I know that's always the goal. I want grandma and grandpa, mom and dad, you and your spouse to be warm and safe to and I want your money to outlive you. That's not meaning I want to leave a legacy for your kids. I've said on the radio before, my dad has always told me, "The check to the undertaker is going to bounce." He plans to spend it all. That last check is going to spend it all as he goes out, right as he passes away.

                        That's a great plan, but because we don't know what I'm trying to do is setup a system for families so that they don't have to spend everything. We want you to be able to stay at home, to have your family take care of you and make sure that you are warm and safe. There is no one I've ever met who wakes up or who walks in and says, "I want to spend my dying days in a healthcare facility that I'm unfamiliar with, surrounded by people I don't know." Nobody says that. Those are my goals.

                        My goals are to care, provide a written plan to care for seniors through their life, to involve family members now and to make sure that mom and dad, grandma and grandpa, that you are warm and safe. My phone number is 855-588-5887. The other thing I do, I'm an accredited attorney with the VA, which means I can help families get the aid and attendance benefit to help pay for care. That is a fantastic benefit that can go a long way.

                        We're going to take a quick commercial break. We'll be right back. My name is Dustin MacFarlane, I'm an elder law attorney. My phone number again, 855-588-5887. That's 855-588-5887. We're here on Talk 650 KSTE. We'll stick around, we'll be right back with Jeff Douglas.

                        We're back. This is Dustin MacFarlane here on Talk 650 KSTE. It's great to be here. I've got a great guest in the studio today. His name is Jeff Douglas. He's a senior chaplain with Advanced Home, Health and Hospice. Let me give some housekeeping things out of the way. My phone number again, if you want to get a hold of me is 855-588-5887. I'm a huge fan of the old radio guys clicking clock on national public radio.

                        I always got such a kick out of it was, "How did Tommy say it?" I'm, "It was eight triple five, double eight five, double eight seven." I can't even follow. 855-588-5887 if you want to get a hold of me, leave me a voice mail. I want to talk to Jeff today. Jeff, welcome. Thanks.

Jeff:                 Thanks Dustin.

Dustin:             Tell me a little bit about what you do and who you work for and let's just start there.

Jeff:                 I'm the Senior Chaplain at Advanced Home Health and Hospice. We help people live until their end of their life, live fully until their end of their life.

Dustin:             I really like that. Advanced here at Sacramento Company I think you're one of the largest home health companies that's not ... You're largest independent home health company in the area?

Jeff:                 I believe that's true, yes.

Dustin:             When you say live independently, what exactly does that mean?

Jeff:                 I think a lot of people have the misconception of hospice meaning death [disseminate 00:10:11] and it may be but the bigger thing is it's helping people come to terms with what's important to them, what matters to the, and living as fully as they can for as many days as they have whether it's 110,000, 10,000 days, whatever that's going to be.

Dustin:             As the chaplain then, what are your responsibilities?

Jeff:                 To help people come to a good death whatever that looks like for them. I know that's like, "Oh my gosh, how could that possibly be?" It can be sweet, bittersweet, pointed, it could be difficult. We've had patients that have gone to Tahoe for a wedding. We've had patients on hospice go to Hawaii to say goodbye to family, patient went to Vegas for one last trip. He's on hospice, took his oxygen and we had a hospice company in Vegas to help him while he was down there. It's about asking the question, we ask the question, "What matters to you? How can we help you be as comfortable and as fulfilled as you can until your last days here?"

Dustin:             I guess we should start maybe at the beginning. Before we started recording we were talking before we came on the air about having the talk. I always joke with folks that having the talk with maybe your parents is worst than the sex talk with your kids.

Jeff:                 I think that's true. It's harder.

Dustin:             It is way harder, and I think this is where at least from my perspective as an elder law attorney, I'm constantly working with adult children that 50 or 60-year old son or daughter of an 80-year old parent who's starting to decline and saying, "We got to know some things. It's time to have that conversation." That's really a tough thing to do.

Jeff:                 It is. It's usually important. One of the things I just finished the book called, "The Conversation" written by a Harvard researcher and physician Angelo Volandes. It goes through exactly that encouraging folks to have that conversation with the spouse, with their adult children or the children bring it up, "Hey, mom, dad let's talk. What's important to you?" What matters if this or that were to happen, what would you want to happen at the end of your life?

                        In that conversation, it is really difficult but oh my gosh, my work at also at the local hospital, I've seen where people come in and they did have the conversation and now it's too late and it's very difficult to make a decision in a crisis.

Dustin:             For me from my perspective and this is one of the I guess solutions that I try to offer to folks is I want not only to have that conversation but let's go a step further and let's write it down. Then let's assign people to execute those directives or those last wishes, if you will. They're not always just that death bed, "I'm dying in three days so do this." It's, "How is that last two years of life going to look?"

Jeff:                 Yeah, absolutely. It's like, "If I was in this condition, this is what I would want or this is what I wouldn't want." It's a lot easier to have that condition if you're not in a critical health condition. You can sit down and amazingly, you can laugh about it. When my own father, God rest his soul, he died in 2010, when he was diagnosed with lung cancer and realized that he didn't want to pursue treatment, he sat down with us and we had that talk all of his children and we laughed and we cried. It was difficult, but we knew what he wanted and how he wanted to go and we were able to honor that and it was a lot less difficult than it could have been.

Dustin:             That's great that your dad did that. I joke about my family and I think I've even said it here on the air that when my dad came to me and he said, "Listen, when I pass away, when I die ... and this was not even about the end of life, this is after I'm dead, I want to be cremated." My sister came up and she said, "No way. No dad of mine is being cremated." It was this little family battle. Then we started talking more with him about what that end of life. If he got sick, if he was incapacity in some way, what would we do? I think that's what you just said, "What's important."

Jeff:                 At Advanced Hospice, that's one of the questions that our social workers or nurses or chaplains will ask, will talk about, ask you, "What's important to you? What matters to you? How can we help you be at peace through this process? How can we assist you?"

Dustin:             I guess you're not only working with the sick person but you're probably also having a lot of interaction with family members.

Jeff:                 Oh my gosh, yes. Everyone's involved and the whole family unit or friends, whoever is involved, who was ever close to the people, the patient, those were also our patients as well. We visited and talk with everyone, especially the chaplains.

Dustin:             It must be a pretty fun job though. You really get an opportunity to help people who are in need?

Jeff:                 It's probably the most satisfying work that I've ever done. On the one hand it's difficult, it'd be heartbreaking. I cry plenty of times. I've laughed with people. I've had people tell me things that just have brought me to my knees laughing and it can be incredibly sweet and it is rewarding.

Dustin:             It just sounds like a lot of fun. I don't mean to be weird about it, but it's great to be able to help people when they're in need.

Jeff:                 It is. It's really satisfying. I've done a lot of work in my life and there's nothing that comes close to satisfaction that this work gives me.

Dustin:             Just for folks who just tuned in, I'm Dustin MacFarlane. I'm with Jeff Douglas who's a Senior Chaplain at Advanced Home Health and Hospice. Maybe can you share with me, I don't know an experience without identifying anybody that you've been able to help somebody enjoy that last time of their life, maybe a story that comes to mind is some patients that you ... ?

Jeff:                 Sure. There was a man who lived up in the foothills and early on the conversation when I was getting to know him, I talked about the four important things and that's from Dr. Ira Byock. He's a hospice doctor in Monatan who wrote book, "Dying Well." In that book, he identifies what he calls the four important things and those are, "I forgive you. Please forgive me. I love you. Thank you, and then goodbye."

                        I talked with this gentleman, let's call him, "Pete." I talked to Pete about those things and he did had an issue with his ex-wife, his two sons' mother that he had said some things after they split up, told his boys things that weren't true about their mom and it really alienated. He talked about that, he called me back and he was able to get his two sons who lived on opposite sides of the country. His ex-wife who lived long ways away to get them back and he had that talk in his house and asked for forgiveness and it was the sweetest, most beautiful loving thing that I think I'd ever seen in my life. He was able to actually say, "I'm sorry for what I said. I'm sorry for what I did. Please forgive me." They were able to come to a place of healing and they were all there through his dying process. It was one of the most valuable things that I've ever done.

Dustin:             What a great opportunity. Again, I just like being involved when family members can patch over wounds and come back together, because like you who are dealing with really sick people and a lot of elderly but a lot of sick people, that's why I'm dealing with as well and hopefully it's not so much at the very end stages of life, but it's just time to suck it up and say, "You know what, none of that past matters." I wish more people could understand that the war and the bitterness just doesn't need to go on.

Jeff:                 It doesn't. The people that I see struggling at the very end of life, usually there's some unfinished business and usually it relates to forgiveness or asking or giving forgiveness. They're struggling with those issues. Something's undone. The people that can heal the divisions like you're talking about, the people that can do that, they can let things go. It becomes much more peaceful, it's not a struggle.

Dustin:             Then so if we go back to having that conversation, some of the things that need to be included in that conversation, what do you recommend some, the people make sure to include when they're saying, "When I get sick or when I pass away, this is what I want to have happen."

Jeff:                 You talk and it's great to have the conversation with the family first and then that needs to continue with the primary care physician and talk about things like, "Do I want a breathing tube? Do I want a feeding tube? Do I want to be resuscitated?

Dustin:             Those are really real issues, right?

Jeff:                 Very real issues. I see it in the hospital all the time. One of the things that's actually funny to me that the misconception about what a DNR, Do Not Resuscitate, a lot of people have the misconception that if you have a DNR and you're having a heart attack say in the paramedics facing the door and like, "Oh, we got a DNR sorry we have to let you die." No. The DNR the way I put it is whatever state you're in, they're going to leave you that way. If you've already died, they're going to let you be dead. If you're not dead, they're going to try to keep you from getting dead.

                        That's what a DNR is, it's to keep you in the state that you're in when the paramedics arrive. It's a simple thing. The horrible misconception, television paints a real amazing picture of what happens, a guy gets his heart stops and he gets resuscitated and later that evening they're going out for dinner. It's not the way it is and especially if you're elderly and frail and ill, the odds of it ending well are very poor. I think people need to have that conversation. That's an important part of the conversation with your doctor, asking the question, "Tell me about CPR doctor in my condition, my health state today if my heart stopped and I had CPR what would that look like or what are the odds of me resuming life as I know it," and have that frank discussion.

Dustin:             That's a real interesting point. Probably not one that I really encourage folks to have, I've told them in maybe softer tones that they at least need to talk about that with their family and their physician but that's pretty specific. What would happen if I coated on the gurney, because it's not pretty.

Jeff:                 No, it's not pretty. The odds are really not very good that you're going to be back the way you were. It's really poor if you're in poor condition.

Dustin:             We're going to take a quick commercial break. We're going to be back in just a couple minutes. My name is Dustin MacFarlane. I'm an elder law and an estate planning attorney. I'm an accredited attorney with the VA and we should touch on that. We're on Talk 650 KSTE with Jeff Douglas, Senior Chaplain with Advanced Home Health and Hospice. Stick around. We'll be right back.

                        I'm Dustin MacFarlane on Talk 650 KSTE. I'm an elder law and an estate planning attorney. I'm an attorney with the VA. I'm here with Jeff Douglas, Senior Chaplain with Advanced Home Health and Hospice. I just got to say about the VA benefit. The VA is changing their proposed regulation changes on the books. They are going to make it difficult, if not impossible to get the VA benefit aid and attendance. It is going to be nearly impossible for those who need it.

                        If you are interested, if you have a family member who is paying for assisted living or a memory care facility or a home care and you would like to try to apply for that VA benefit, come in and let's talk about whether or not you can get that benefit again. My phone number 855-588-5887. You can also swing by my office. I'm at 9701 Fair Oaks Boulevard, just a block west of Sunrise on Fair Oaks. Big two-storey building up on the top, wills, trusts, probate, elder law, you cannot miss it, I guess you could but it's really difficult.

                        Jeff, we were talking before the break or during the break about having that conversation and what's important. Some of the questions to ask, I think what you said about, "What does it look like if I coat or if my heart stops beating? What does CPR look like?" I don't think people realize, "We're going to step on your chest and break your sternum."

Jeff:                 Having been there, it's not pretty.

Dustin:             Then you got to put it in writing, "No, I don't want this to happen to me."

Jeff:                 Right. "If I'm already dead, let me stay dead. If I'm not dead, keep me alive." CPR is only done when your heart is stopped. Obviously, you're already dead. In some definitions you're dead. If your heart is still beating, you don't need CPR.

Dustin:             You said something interesting. You said that in our society now, we push death off behind closed doors.

Jeff:                 Oh gosh, yes.

Dustin:             I just spent a couple of weeks in Honduras and I was talking to some of the locals there. I didn't see any care facilities. You drive around car Michael, they're about one every 50-feet and you can see a senior care facility of some sort. In these other countries, there was none. I said, "Where are all the old people?" They said, "First, they don't get really old because they pass away. They don't keep them alive forever and ever, but it's not they're going live with multi-generations in every family. We just don't do that in our society, not right, not wrong, we just don't do it." Now, how does death look because we are hiding it? It seems like it's a shock for everybody.

Jeff:                 It is you're right. It's a shock, because it used to be that like you say, "People died earlier," and it was like stepping off a cliff. People would die from sudden events, but now with medication, someone who might have died from a stroke at 60 because they'd had a high blood pressure for a lot of years, well then high blood pressure has been managed and so that doesn't happen. Now, our dying process is over few years as we slow down.

Dustin:             That's what I always tell folks, we want to plan not only when you're dead but when you're just kinda dead, right?"

Jeff:                 Right, when you're kinda dead. We don't want to look that. We don't want to look at age and I'm glad to be here with you helping people plan for the future and that's what hospice does. It is helping you make the decisions that you want about your healthcare at the end of your life. Most people, I think 85% of people survey say they want to die at home. Only 25% of people over 65 actually die at home.

Dustin:             Yeah and almost everyone dies in some healthcare facility.

Jeff:                 It doesn't have to be that way and it's stressful and it's hard and it's unfamiliar and it's scary and all those things versus being at home, surrounded by the people that love you, that you love, that you want to be in a familiar, comfortable surrounding. It's a completely different experience.

Dustin:             I've been working on a website, "Surrounded by family," because I know that this is really important. Being at home is what everyone wants. What I love about hospice, correct me if I'm wrong because you're the hospice expert I'm not, but is that hospice doesn't mean death is eminent. It means that you're declining right and it gives you access to some additional benefits courtesy of Medicare.

Jeff:                 True. Hospice, it used to be you had to have a six-month, I'm not a physician so I could be misstating this but I believe it used to be that you had to have six months or less to live. Now it's a terminal diagnosis and your health is declining. It may or may not be six months. I've seen people for a year and a half. People sometimes graduate hospice, which means they're not declining anymore and they live long.

                        Actually studies have shown that people on hospice tend to live longer than people not on hospice with the same disease.

Dustin:             Because?

Jeff:                 Because they're in their house, they're comfortable, they're getting medications adjusted, they're getting what symptoms managed. It's not as stressful on the body. They have nurses that come to their house. They have health aids that come to the house. They have chaplains, social workers that come to their house. There are people that help them through the process. Stress is a really big thing. When you're in the hospital, it is not really a nurturing event.

Dustin:             It's not peaceful [crosstalk 00:28:41]. Yeah, exactly.

Jeff:                 Everyone says, you always hear this, "I've got to go home to get some sleep because I haven't slept for a week, because I've been in the hospital." Exactly. When you're on hospice and you're at home, your medical providers, your nurses come to your house. The chaplain comes to your house. The social worker comes to your house, helps you with the paperwork and the decisions and all those things that have to be done. Hospice is about helping you live as fully as possible for as many days as you have.

Dustin:             That's where the family is. Visiting somebody at the hospital, it's just not easy.

Jeff:                 It's not easy and it's stressful.

Dustin:             On everyone.

Jeff:                 Yes. I'm in the hospital all the time, so it's become home and that's one of the things that I counsel the hospital staff about. It's familiar to us who are there and this is home like to us because we've been there everyday for years, but for someone just coming in, it's not like home. It's really threatening and scary and unfamiliar and you got these machines and you've got all these things going on. It's hard to make a relaxed decision or to have a relaxed visit in a hospital versus being at home, sitting in your own chair.

Dustin:             Yeah, with a remote control and talking to the grandkids or whatever.

Jeff:                 Watching the ballgame.

Dustin:             That's right. We have a couple minutes before commercial. Tell me as a chaplain for hospice then, what are your requirements? What services as a chaplain do you provide for hospice families or say families with somebody on hospice.

Jeff:                 The first thing that people think I think one of the misconceptions about the chaplain is we're there to convert you or we're there to make you feel guilty and tell you, "Okay, this is what you need to do."

Dustin:             Repent right?

Jeff:                 Yeah.

Dustin:             Fire and brimstone.

Jeff:                 Yeah it's like though we don't have the agenda. We have a faith tradition, each chaplain has faith tradition that's important to them, but it's almost irrelevant when we come to the patient's house like, "Okay, where you at? I will meet you where you at." We're there to help them imagine, it's just like, "How do you experience God if you do, if you don't? Are you afraid? Are you sad? Let's talk about those things."

                        It's amazing the number of people that we need to give permission to to feel what they feel, especially people of faith.

Dustin:             Earlier you told me that you don't counsel, you listen. I really think that that's a great service that's offered and people don't pay for that?

Jeff:                 No, it's part of the Medicare benefit. It's really ironic that I've been called to this ministry as you can tell it's like I talk a lot, I like to talk, but then my greatest tool as a chaplain is sitting quietly listening, just listening and letting people tell their story. It's wonderful letting people talk about what's important to them and I've had people tell me amazing things.

                        I had a woman, she had a secret for 60 years that she needed to tell finally and she was able to leave in peace because she was able to get that off her chest.

Dustin:             That's fantastic. We're going to go to a commercial and we'll be back in just a couple of minutes. I'm Dustin MacFarlane here on Talk 650 KSTE. Today with me is Jeff Douglas. He is the Senior Chaplain at Advanced Home Health and Hospice. If you have any questions you can always track me down at 855-588-5887. That's eight triple five double eight five double eight seven. Is that easier or harder? I think it might be harder.

Jeff:                 That was harder. I lost that.

Dustin:             Stick around. We'll be right back. We're back. I'm Dustin MacFarlane here on Talk 650 KSTE. Elder law and an estate planning attorney. I'm an accredited attorney with the VA. What the heck does that mean? It means if you're going to deal with a VA, you really need to be dealing with somebody who's accredited and that specifically is ideal with the aid and attendance benefit for seniors.

                        If you want to know who's accredited you can give me a call and I can go onto the VA's website and do a search in your area and find all the accredited attorneys who may be able to help. There's not that many of them. Anyway, give me a call, 855-588-5887.

                        Today we're talking to Jeff Douglas, Senior Chaplain at Advanced Home Health and Hospice. Jeff, tell us a little bit about Advanced, what do you guys do?

Jeff:                 It's a hospice company and I got to tell you, the people that work there, first of they're scary smart. Angie Mac, our director, I call her the director of everything, because she has the amazing ability to juggle many balls and stay very calm and she is very sweet and caring and our nurses, they constantly amaze me with their depth of compassion.

Dustin:             That's prerequisite for working in a hospice.

Jeff:                 You would think but it's not always the case. These particular nurses are just amazing, they really are.

Dustin:             It's a great place to work?

Jeff:                 It is a great place to work and yeah I love being there. It's incredibly valuable and yeah the people seem like the best and the brightest.

Dustin:             When you go into a new client, what does that look like? You walk into my house, I'm taking care of my dying grandmother who's in a hospital bed in the front room or maybe even not. I'm sure some people aren't even that sick yet?

Jeff:                 No and that's true. There's many times we go and people [inaudible 00:35:57] sitting in their recliner and I introduce myself, "I'm Jeff and I'm one of the chaplains from hospice and I'm going to be your chaplain. Tell me what's going on." I might just start like that and just get to know them, "Tell me the story about your life."

Dustin:             It's not a once and done. You're there on a regular ... ?

Jeff:                 Oh yeah, we come regularly. It's like we will develop sometimes it's a very long-term relationship and it becomes almost family like, it really does. I've had people that I've seen weekly month after month. It gets pretty sweet. I get to know them really well and they get to know me really well.

                        See, the interesting thing with the chaplain is people will sometimes tell us things that they're afraid to tell to their own pastor or their priest or something because chaplain, we're not there to give advice. We're not there to tell, "Okay, you should do this, you shouldn't do that," you have to listen.

Dustin:             No pennants.

Jeff:                 No pennants. You may need that. If you need to get in touch with the church that you attended 40 years ago, we can facilitate them and we do that a lot. That's one of the things, putting people in touch with their faith community if they need a priest to come out it's like, "I will find a local church or whatever denominations thereof and find their pastor." If they want them to come out for whatever reason, yeah we'll put them in touch with that.

                        Sometimes I've read stories, I've read scripture, I've played music, I have a little dog that sometimes goes and so there's various things and it's about creating a trust relationship where they can tell me the things that they need to get off their chests so they can leave easy. It's like if you were told that you had to move out of your house, say you lived in the same house for 65 years.

Dustin:             Sure, which is not uncommon for some folks.

Jeff:                 No. Say, 65 years you got a lot of stuff. You get a notice that eminent domain, "You've got to move in six months." If you start early on the process, moving a little out, the day that it comes that you've got to be out, okay you pickup the last suitcase, you turnout the lights, and you head on out. If you wait until seven days before, you're going to be pretty stressed. Hospice is helping people clean out the house before it's time to vacate the premises.

Dustin:             With you, you're spiritually helping them reconnect with whatever they need to?

Jeff:                 Exactly. How does God speak to you or if not the divine. How do you relate to the divine? What's your sense? What gives you meaning and purpose in your life.

Dustin:             What a fun job. Maybe I shouldn't call it "fun," but I really enjoy and I just said this 10 minutes ago, sitting down and having people share and open up and that happens everyday.

Jeff:                 I love the stories. When I will ask when someone's been married 60 years or something, "Tell me how you met. Where'd you grow up? Tell me about your life as a child. Then did you go to church then? Okay, what was that like for you?" One of the things, "Tell me how are you and God doing now? Are you like neighbors that don't talk, you're best friends?" It's like, "No, I can't say it."

                        I guess like, "What's that relationship like?" It's like, "Okay." Then, "What would you like to be like?" Just help people work through and find their own answers. They know what their answers are. I'm not going to give them mine. That's not my job. I'm there to help them find their own answers.

Dustin:             I always say that everyone wants to go to heaven, just knowing one to die to get there.

Jeff:                 Exactly, yeah.

Dustin:             No, that's fantastic. You're coming and you're building that relationship and you're just really helping them ease through this process which may be a six-day, or six-month, or several-year process.

Jeff:                 Yeah, it's walking the last lap with them, is what it is. Sometimes I think that coming to the end of life, it's like you've run the marathon, in the Olympics when they're showing the marathon runner and they got the motorcycles on and that first runner, when he comes in the stadium to just the last lap and everybody's cheering? I think that's what the dying process is like.

                        "Okay, now you're entering the last lap. I'm going to run alongside you and I'll just be here with you and hear the cheers of the crowd. Yeah okay, you're about the finish line and I'll go all the way right to the end with you." A lot of times for people you've heard the things say, "Hey then, I got to go do this thing. Could you go with me?" I'm sure the people come to see you as attorney and they just want someone else to come with them because they're scared.

                        That's really a common thing and I'd have a lot of family meetings here. What the chaplain does is like, "You know what, this thing that you walk them through, I'll go with you." It's not quite as scary if you're not going by yourself. The chaplain is co-journeying that last mile with the patient.

Dustin:             I'll say this, if anybody is on hospice, they should really focus or try to utilize the chaplain service. I knew that there was nurses and there was aids, but I didn't know that the chaplain service was part of that. I think it's just a fantastic thing that it's a great regulation. It's required for hospices to provide this service, but I think that it's a great thing for families to be able to, just be prepared.

Jeff:                 Be prepared, share their souls. The interesting thing, one of the hardest things that I guess for people of faith to feel their feelings. They think if they're angry at God, that they have betrayed their faith or if they're really sad, you got to keep your joy. One of the things the chaplain can do versus their own pastors like, "No, it's okay to feel what you feel. You're angry with God? Yeah okay that's a normal reaction."

                        Then it's almost eye opening to see people, it's like, "Wow, I can say anything to this person and he's not going to tell me what I should or shouldn't feel."

Dustin:             Where family members, they're always, "Oh you shouldn't feel that way, [crosstalk 00:42:01].

Jeff:                 Yeah it's like, "We don't. We're just there to support you and what it is that where you're at."

Dustin:             What a great thing. We started with getting prepared and I want to wrap up in our last couple of minutes here. We have about three minutes or so left. We talked about getting prepared. If somebody is either just at the beginning stages of this hospice or even before that, you said your mother who just recently passed away and I'm sorry to hear that, but if you're talking to a family, what are the things that you counsel people, talk to your folks and ask them this or make sure you have X. What are some of those things to get ready for this process?

Jeff:                 The biggest thing is like, "Okay, what matters to you? What's important to you? Where do you want to die?" I'm putting that on my intake form from now on. I'm going to start being much more specific about what matters to you. I wish I could remember the exact day but there's a deck of cards that is essentially that that have all these things. I think if you Googled the call it, "What matters or what's most important cards," you could probably find it. What it has is various things that, "Okay, these are important," and you just put them in a pile, this is important, this isn't and you narrow it down there down until you get to, "Okay, these are the things that really mattered to me."

                        Okay, that's a great tool. You could do that just talking. "What's important?" "To have my family around." "Okay, where is that going to take place?" Then you have that conversation with your children, you write it down and you have that conversation with your physician and it's on paper and now you've given your children a gift because they don't have to make that decision when you can't make it yourself anymore.

Dustin:             I like that you said, "Have the conversation with your physician." I like that you said, "Write it down and make sure your kids know." I've seen families fight and actually take each other to court, because half of the kids want to keep mom on dialysis and the other half wanted to take her off dialysis. Mom got fed up with the family and just died. She was just sick of the whole thing.

Jeff:                 I call that leaving through the backdoor. Sometimes people will slip out the back door and it's like, "I've had enough [crosstalk 00:44:19]."

Dustin:             You guys can fight all you want, I'm out of here.

Jeff:                 Yeah, I've seen that happen. No, the being prepared beforehand, it makes all the difference in the world. It allows people to be fully present for the patient.

Dustin:             The decision is already made when you get there, so when you faced with that, it's, "Oh, well let me consult." "Oh, yeah the piece of paper says I'm doing this." [Inaudible 00:44:42] is what we want to have happened.

Jeff:                 Mom and I we talked about it, dad and I we talked about it, all the kids were on the same page and look this is where it's written down and in fact he even took his iPhone and he videoed the conversation and e-mailed it. Great, now we have a record.

Dustin:             We are about out of time. I hope you come back and talk again. Would you be willing to do that?

Jeff:                 Sure.

Dustin:             I am Dustin MacFarlane, elder law and estate planning attorney. My phone number is 855-588-5887. We've been here with Jeff Douglas. He's a Senior Chaplain at Advanced Home Health, and Hospice. We're here on Talk 650 KSTE. Come back next Saturday at noon and have a great weekend. Again, 855-588-5887. Have a great weekend. Bye-bye.