S2E21 with Archer Gray - The Heart of Hospice: Care, Comfort & Compassion

In this heartfelt episode, I welcome back my friend and former guest Archer Gray for a deeply moving conversation about the profound benefits of hospice care—not only for patients nearing the end of life, but also for the families and loved ones who walk alongside them. Together, we explore what hospice truly is, how it prioritizes quality of life, and why it’s ultimately about living fully in each moment rather than focusing solely on the end.

You’ll gain an intimate look at the remarkable individuals—like Archer—who feel called to this life changing work. From deep empathy and unwavering patience to resilience and emotional strength, we highlight the qualities that make hospice workers true unsung heroes. Their unique ability to combine medical expertise with heartfelt human connection creates a safe, loving space during one of life’s most vulnerable chapters.

Whether you’ve experienced hospice care firsthand or are simply curious about how it works, this conversation will open your heart and your eyes to its powerful impact—and to the extraordinary people behind it. My sincere thanks to Archer for sharing so openly and courageously about a topic that is often difficult, yet so important, to discuss with those we love.

To follow Archer on Instagram, visit https://www.instagram.com/archer_fit757/

To learn more about Hospice Care, visit https://www.medicare.gov/ and remembet to get educated and talk to your health care provider. 

Thank you for joining us and we can't wait to welcome you back again next week! New episodes drop every Thursday and can be found wherever you find your favorite podcasts!

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Want to learn more about our host, Eric Nicoll? Visit: https://ericnicoll.com

Transcript

0:05

Hello everyone. Welcome to the Just To You Podcast. My name is Eric Nicole, and I'm your host. If you are a first time listener, welcome to the conversation and if you're a regular, I'm honored that you've decided to join me for another episode. The Just Do You Podcast is centered around a network of conversations, which are meant to connect us, to inspire us, to find our own confidence, our own voice, and to live our own truth. And who knows, we might even learn a little something new that ultimately allows us to live in the sweet spot that I like to call the Just do you space of being. Each week, I have the privilege of sitting down for unscripted conversations with friends, family, colleagues, community leaders, and influencers that all share their own personal journeys. I hope that you enjoy our time together as much as I have. We are certainly gonna laugh, and yes, we might even cry a little, but in the end, we are gonna know that we're not alone during our life's journey. So are you ready? Great. Let's do this. Welcome to the conversation. All right, everyone. Welcome to today's episode of the Just You Podcast. I am really excited to welcome back one of my favorite guests, Archer Gray. Hey Archer. Hey. How are you? I'm fantastic. Thanks for having me again. Good. It's good to see you. We were chatting a little bit before we hit record today and I realized that it's been quite a while actually since you've been on, but you are actually now winning the title of the guest who has been on our podcast the most as of today. So I'm super excited to have you back for your third visit. So for our listeners, I just want to quickly introduce Archer and then we're going to get into our conversation today. But I met Archer actually in a roundabout way through social media. I think as we find our friends and followers these days is by searching social media. And I came across Archer's platform last year, and was really taken by Archers presentation, if you will, of himself and his authenticity and really sharing his journey as a trans man. And I invited Archer to come on to the podcast and he graciously spent some time with us, sharing about his journey. I then invited Archer to come back in June. So he came back and joined us for a second episode where we checked in after the election, and it was a really powerful episode. And I'm super grateful for Archer's honesty and his candidness, and mostly for your way of sharing your life with others in a way that leaves them in a better space to learn about what it means to be trans, what it means to be part of the L-G-B-T-Q community and what it means to live a life of authenticity and a life out in the open. And I'm really proud of you for continuing to do the work that you do and sharing that journey with us through your social media. So thank you for that. You've come on today, there's a whole other side to you that we didn't really get a chance to talk about in our first two episodes, and that is what you do for your day job. So I wanted to spend a little time with you today because I found it really fascinating and I'm gonna let you share your journey of how you got to work in the hospice field. But it is a really beautiful and remarkable. Journey and you're gonna help us dispel some myths about hospice and you're gonna share some of your experience and why it is not only important, but it's something that can be incredibly beneficial to not only the individual but also their family. So thanks again for coming on today and sharing with us. Yeah, I'm really glad that I could be here and share a little bit about something else that I'm, passionate about. And it didn't start that way, everybody has this possible roadmap of maybe what they want to do when they grow up and I was like any other kid and had 15 options and then had went into healthcare management, was my degree and I was like, I'm just gonna work business side, in an office or whatever. And never thought about working long-term care. Never thought about working with the elderly. And then it literally landed in my lap. My brother and I both were waiters at different restaurants at this point in time, and he happened to be serving a group of people who came in and they were like, Hey, you're really good with like customer service. Would you be interested in maybe working for a hospice company? And my brother was like actually my brother has the healthcare degree, so maybe, and we do the same thing as far as customer service. Sure. So I was like, hospice. I was like, oh, that's, oh. Everybody's reaction when I tell them I do hospice. Ugh. But I was like, all right, let me call. Like at this point I had just graduated and. No one, everybody wants you to have so much experience with so much school. It was like all right, I'll just give it a chance and see. I don't know. And so this particular person had told the company that I was going for that, they were gonna hire me and the administrator at the time who I owe pretty much everything to everything that I've learned. She's an amazing human. I don't think I'd be where I am, really without her and her support not only for hospice, but, accepting me, sure. Really. But was like, I'm not hiring this person and had it in her mind that she was not gonna hire me. So I go to the interview and sit there and she jokes with me now and says, like halfway through the interview, she's damnit, I hire him. Was, but dang, I guess I'm, she gets this one on me, she's telling me who I'm gonna hire. And so I did. And yeah. Before you go down that route though, I want to back up just a little bit. So I'm curious,'cause you mentioned something. So what were some of the other options that you were thinking about before you took this opportunity in care? What were some of'em? I was gonna do I wanted to do like hospital administration. Okay. Very acute care, very not dealing with families or people or anything very long. Just get'em in, get'em out. Okay. Whatever that looked like. Okay. My professor for school was old hospital administration, so he made it sound kind of fun. Either. And you got your, either that or just like a doctor's office. What did you get your degree in? So I have my bachelor's in healthcare management. Okay. And then I have my master's in, it's a master's in business with a concentration in healthcare administration. Okay. So I went a totally different route. In my head I was thinking maybe firemen or, it's like a fireman. Oh, marine biology. But then I marine biologist. So we went healthcare right after that because was like, okay, there's no going anywhere. I was going, healthcare, staying, but I was going down some very different paths with you. I was like, gotcha. Wonder what that would be? No Marine biology. I want to work at SeaWorld. And then found out I got seasick and they're like, now you gotta do like research on the ocean before you ever get the option to maybe work at SeaWorld if you're lucky. This is not feeding Shamu. The fish on the side of the, on the side of the walkway. Step back a little bit and just'cause I forget, I know you so well now, but I forget some of our listeners don't. Where did you grow up? So I grew up in a town called Harrisonburg, Virginia. Okay. If anybody knows colleges, it's the James Madison University area. Okay. And were you only child or did you have siblings? No, I had a younger brother. Younger brother, that's right.'cause you both were waiters. Okay, I remember that. Yep. And then where did you go off to school? So I decided to not go to JMU'cause I was marine biology, so they were like, you probably need to go somewhere near the water. So that was a good point. So I came down here and went to ODU. Okay. When I found out I couldn't do that anymore I switched to a college that was like the more accelerated program and it was called South University. Okay. And so I got my undergrad and my grad from there. Okay. And then you've been there the whole time, so you've stayed in that area, okay. And. When you shared with us before you told the story you transitioned, give us a little bit of background on that. When did you trans start your transition? I transitioned in 2021. Okay. Was when I first changed my name, socially. Transitioned that summer and then started hormones that fall in November. Okay, so I'm gonna encourage our listeners to go back. If you haven't heard both of Archer's podcast episodes, to go back and listen to those. You can find those on our platform's. Really remarkable story and when I sit and talk to you today even over the last year and a half that you and I have been friends the transformation of who you are in the world has just been remarkable to watch. And so I'm super proud. I want people to go back and really take in the story. And why I think it's important is because a lot of times on our episodes, I talk about how our experiences, when we're young and growing up shape us for what we do in our future. And the more I listen to my guest stories, whether they're, male, female, part of the L-G-B-T-Q community figuring it out, thinking about it, working it out a lot of their experiences in their younger years, I. Remarkably translate into what they do in the future, right? In their adult years. And so when we talk about hospice and you talk about what it really means to take care of someone, I want you to share a little bit about that. But I think it's really interesting. I think that a lot of what you shared in those first two episodes really showed your compassion for people and not only your passion for life and for living a life that's authentic and living a life that is your truth, but your compassion for other people and your community is really it's visible. I can really sense it and feel it. Did that have a lot of play into your desire to go into this healthcare field, whether it was administratively or ultimately with hospice? Did you think about that or no? Not in the beginning. Because I think I was the, I think I was really lost and I don't know how to word it. I feel like I very much was just like, I just want to do I always wanted to help people. I had that in the back of my mind. But I really wasn't sure how or what to do. But then feeling not helpful myself at one point. Because I didn't really know who I was. I would say that I've gotten better at my job since doing that. Since discovering myself. Yeah. And so I don't know if that helped where I, like you truly fall in love with something and become more passionate about it. But I think. There was always just this, I like helping, I liked making people smile. So even as a waiter, that's what I did through school. When I had the tables where I made them smile, I, they had a good experience. We had, a good time. We both laughed back and forth or whatever. And it wasn't necessarily, it wasn't really like about the tip, it was like the experience. And if I had that, then I felt like I did something. That I was useful, even if I was just a waiter and, hopefully just made an impact for an hour over their steak and, or pasta dish. And just made it memorable in that so that they'd want to come back. And I think that's always something that I strive to do. But I just don't think I had it figured out that it would be healthcare. Because when I went into the thought of healthcare, I was like, I'm gonna sit behind the desk and not talk to. Which I find, but that really wasn't what I wanted to do either. No, I no. I, there's no way you sit behind a desk with your personality and your energy and your positivity. You've gotta be, was that when you were at Cheesecake Factory? Yes. Yep. I love Cheesecake Experience. I really, I love the story because when you shared about, the first time you put that uniform on and really felt. In your body and felt like you and how it completely changed you. I would've loved to have seen the difference in your service prior to that. Then when you made that realization that you finally felt like yourself would've been cool.'cause I only know you as now. And I know, and I would think that I said, if you were the waiter at Cheesecake Factory, I'd probably be 400 pounds.'cause I'd probably come back and, dine there all the time. Because I, I'm a big people watcher too, and I love to watch servers and it's it's always interesting to me when you see certain people that are in the service industry, not just in restaurants, but service industry as a whole. And there are some where you go, how did you get into service to helping people? Because I don't think it's your strong suit to other people who are like, oh my gosh, this is so you, so I get that. So jumping back to where you started. So you were sitting in this interview. And the person you were interviewing with was like, oh, damnit, I'm gonna end up hiring this person. What happened after that? Like where did you go from there and tell us a little bit about what that's as you enter this world of hospice. Because I would imagine knowing what I know of end of life and what I've experienced, which unfortunately hasn't been a lot lost obviously both sets of grandparents and recently my dad, but, very different circumstances. But I, I would think that's gotta be, it was tough for me. That would've had to have been an interesting conversation to have in your head about what that process is like. What was that like for you? I was able to go through something. About a year prior, so a year prior to the interview for hospice my mother, my aunt and my uncle were all three diagnosed with cancers within about two weeks of each other. Wow. And fortunately they're all still here, so I am very grateful for, their treatment and everything that they were able to go through. But I had that realization of I could possibly lose my mother. And so sitting in the interview, it was if that had been the route and or if her cancer comes back.'cause that's always in the back of my mind, if it comes back and if there's no positive outcome this time, what's that look like? And so I knew that I would want her to have a. Care with people that are going to be genuine and authentic. And love on her and make sure that she is not in pain. And that was my first introduction to hospice of we take care of people and make sure that they have quality of life and comfort. And I hadn't really known that. And so when I thought about the fact that could have been my mother or could still be her in the future in however long, or my aunt or my uncle, I wanted that for them. And so I really wanted to then learn anything and everything that I could about hospice. Yeah. De define what hospice care is.'cause some people may not know. So hospice is a Medicare benefit. It's actually paid for at a hundred percent underneath people's Medicare benefits. And then commercial plans usually, sometimes they'll have. End of life benefits, sometimes they don't, but then you can have them based off like your deductible and stuff like that. But for the most part, we're looking at your 65 and older Medicare, or if you have a terminal illness prior to 65, and sometimes you can still be on the Advantage plans which would still then revert to traditional Medicare Part A, which pays for hospice. Is there a difference between hospice care and palliative care? Yes. So palliative care is more like somebody that's not quite ready for hospice. So the way that I always describe it is somebody still doing treatment. They still want to do a couple more rounds of chemo, a couple more rounds of radiation. They're being managed, pain management usually, and they're managed by a nurse practitioner. And that nurse practitioner is usually, it falls under the home health umbrella. So palliative is not under the same umbrella as hospice. Okay. Okay. So it's a. Precursor to hospice then. So it's more of a precursor to hospice? It can be, or, okay. It can be most people. I say that the only time it's really a precursor is if it's like we have these five rounds of chemo left and we really want to do them, then absolutely you should, and then you should still be managed by that nurse practitioner who can make sure that your pain is where it needs to be. Or if there's still like a little bit of hope for these treatments that you're doing, then that's where I would like, say palliative. So that you're not alone, you don't have, nobody would be your best bet. A lot of people say they want palliative when they're hospice eligible, because palliative is a much easier word to swallow than hospice. Sure. What are some of the myths about hospice care? So a lot of the big myths is that hospice, that means that you're giving up, that you're just. You're gonna be put in a bed and fed morphine through a vein and we're gonna put a pillow over your head and smother you. That hospice is somebody's last day or two of life. I would say those are some of the big ones that they stop all of your medications. You can't keep your doctor. You have to be a DNR. So there's a lot of big ones that people go through when they hear hospice. But in addition, it's just gonna have that black cloud around the name. But if they changed the name, that eventually when people realized that was end of life, that would also have the same Sure. Kind of black cloud. So it's predominantly though that black cloud because of a conversation, right? Or not being educated about what it really is, because it's difficult to talk about, that time in your life. It's difficult to talk about, people who potentially could be near the end of their life and what that care looks like. I have a couple friends that are going through that with their parents and they don't know how to talk about it or even how to begin the conversation because they just don't want to think about it. I am guilty of that. I, my mom's very healthy by the grace of God, but I don't want to think about what that looks like down the road and, would she need care and what would that look like and how we would handle that. So I'm even, that's why I was interested in having this conversation with you today? It's because it's something that I think we all need to be aware of and what that process is and that it's available. And it doesn't always necessarily mean somebody who's elderly. It doesn't mean someone who's in their last years of life. It could be someone who's younger, like you said, going through, cancer or going through some other type of illness. Correct. Like it's not just an elderly person's next step. It's anybody with a terminal illness. Yeah. Or terminal diagnosis. And I find that, so my role specifically is sales and marketing, but I'm not really marketing hospice.'cause you've paid for it, so I'm not marketing you to give me any money or stuff like that. Sure. I market my company. And then I market the knowledge that I have from the education that I want to share. So really I just try and educate these facilities, but. A lot of the facilities know, about hospice and so if they're sending or feeling like somebody might be eligible, then it's my job to sit down with the families and help the families understand what it looks like and what's next for their loved one. Because you don't want to have to think about it. And I recently did an event where people would come up and they were like, oh, hospice, I hope I never need it. And that's the biggest thing that I always hear is, I hope I never need you. And I'm like, but everybody's gonna die. That is the one thing we're never gonna just skip. All of us are going to go through it. And unfortunately the just, I hope that I'm just gonna go to sleep and pass away in my sleep is super rare. Where you're just gonna go. And honestly, it's almost something that I don't know that everybody would really wish that they could have that if they got to choose, because that just means that you don't ever get to tell your loved ones really goodbye. You're just gonna say goodnight and then never wake up. You don't have things set in place for what's next after your passing. You don't have the goodbyes and the stories and the hugs and the time that you can still have while being on hospice. And that's where I find it to be important because then you do get to say goodbye, you do get to have, and then maybe you're ready too. If you just go to sleep one night, maybe you're not ready, yourself ready. And I don't know that anybody's ever ready, but I think at some point then you become ready and it's in like an acceptance. But if you're ready and then your family's ready and they're made ready by having this team come in and take care of so many things. Yeah. I think that helps. Yeah. The process be a little bit more smooth. Yeah. I had a beautiful experience with it, with my grandmother, my dad's mom. I was her primary caregiver through most of her later years. And I had to make the difficult decision to move her from her apartment. She was in her nineties and she was living on her own. And I would come over and visit and the stove would be on or, things like that. She was still trying to drive and was hitting, trash cans in the alley. And so I had to take her car away and, it was a very difficult process to, to help her through that'cause she was so stink and independent and very stubborn. But I remember we had to make the choice to find a beautiful place for her to move where she could be cared for and. I knew something was not right. I was intuitive enough and had spent enough time with her to know that there was a decline, that there started to be some issues and some problems with her health, and it wasn't just her memory, and I found this beautiful. Facility in Montrose near where I grew up and where she lived. And it was five rooms and they were beautifully decorated and the woman that owned the facility was lovely, and the other people that were there were all women. And it was like walking into a house of five of your grandmothers and it was just this beautiful spot. And I remember helping her move and we moved her in this one afternoon, it was near Christmas, and got her all settled and she was sitting in bed and I was able to hug her and I said, I'll see you tomorrow. I'll come check on you. And said goodbye. And I got in the car and there's a whole other part of the story where it was a couple days before Christmas and I ended up going into a major huge mall here in, in Los Angeles. And she unfortunately had a massive stroke about 30 minutes after I left. And I was, actually found by my partner at the time coming up the escalator of this massive shopping center, and he said that your grandmother has had a stroke. And we unfortunately had to bring in a team to help her. They couldn't care for her there. And I remember the team that took care of her and the decisions that we had to make and the. Difficulty in which, you know, the struggle, obviously she was struggling, but we were struggling as her family as her primary caregiver and as the executor of her estate to make those decisions that are not always easy to make right. To sign the those documents that, that will make her most comfortable. And we knew we probably didn't have a lot of time with her, but if it wasn't for the caregivers that were there to take care of her, I don't know what I would've done because I wasn't ready to say goodbye to her. And yet I knew it was her time. And I think sometimes, and maybe you've experienced this and you can share a little bit about it, but those that are left, living can be a little selfish. I self admit it, that I just, I wasn't ready to say goodbye to her, and it wasn't until I sat with her one night. And she had very labored breathing and they had gotten her through that process. And she had started to say her she couldn't say her goodbyes, but people were coming in and saying their goodbyes like my dad and other members of the family. And I remember sitting with her and holding her hand and I said, we love you and it's just been so amazing to be your grandson, and I just want you to know that we've got you. And the caregiver walked me through this process of how to say goodbye and to give her permission, to go if it was, if she was ready. And I remember saying those words to her and left her that evening. And, next morning at work at nine forty five, I got a phone call that she had passed peacefully. After this very. Tumultuous couple of days. And I remember saying to my mom, I don't know what I would've done if it hadn't been for those people that cared for her. And I'm so grateful to them. So grateful because they held it together where I was not in that space of being of clear mind and being able to handle that. So I give you all just massive kudos and angels how I feel in this world to help those of us go through those processes of saying goodbye to our loved ones. Are there any other myths or any other kind of conversations that, that you want to share, that you hear that would help people understand this process a little bit more? I was like, there's always like myths that people have in there. That it's like a place to die or that you go somewhere and it's just kind death. I feel like it's just so much more to that. Really what I try and have people understand is, like you said, it's people that are gonna come in and take the reins of focusing on quality of life and comfort. And that's really the goal. But it's just, it's also something that they deserve to have and they deserve to have a good team that comes in. So it comes down to the clinical team that's gonna come in and educate the families on what's happening and what it looks like while also, if the patient is still able, alert enough to understand, to also help them through the process. As well as, I have AIDS that come in and they give phenomenal baths, even bed baths if they're bedbound. Because being clean is dignity and being clean is a sign of comfort. It's not a washcloth across the face. And then, getting upset that you have to clean up somebody and like throwing the wash cloth across the floor and leaving, it's about showing up with this like pure love for this human that also just maybe just needs to be cleaned up a little bit and have a clean shave if they're a guy or their head scratched for a shampoo for, if they're a woman or whatever they need. And I think that's really where then having the right team comes in. Because you can have a hospice agency, but that doesn't mean that you're gonna be providing this wonderful hospice care. And really what I truly believe in and is that it is. Truly about taking care of the entire person. We're not just coming in and going, here's your medication. Please take your medication and lay down in bed and don't do it. That's not quality of life. And it should be for whatever time is left. So Medicare says that it's a six month benefit, and I say that, yes. For the most part, we look at where somebody was six months ago, where they are now, and then based off the, where they've been, where they are, they could possibly not be here in six months. However, we don't have a crystal ball that says, oh yep, you are gonna be here, exactly six months or that we kick you off if you live longer than that. You're still, we're with you for whatever your journey looks like. And I think that's where. When you take care of a whole person as a person and you see them as a person, and that includes body, mind, and spiritual then the person's able to pass more peacefully. Yeah. If you can talk to family members and say, Hey, I made your grandma comfortable, she's now sleeping peacefully, or, I made your mom comfortable or we didn't just do it with medication, but talking to you through it so that you can say, I'm gonna be okay when you're gone. Then, the passing is a lot easier on the patient, but the family and something that we've recently talked about that my boss finds to be something that's like a driving force. I feel like we start coming up with new driving forces of why we do what we do. And it's really coming into really that I. Not only what they deserve, but then the family that's left, you know how they grieve that loss is going to affect their day-to-day life. Yeah. So if we don't show up in the way that we need to with compassion and kindness and really take care of this person, but only, but being able to do that for a longer period of time, not coming in, in a whirlwind tornado last days of somebody's life. Because, we didn't want to do hospice sooner. We get that time with the family and so then their grieving after passing is gonna affect their life, how they are as their own mother to somebody else. As a daughter still to somebody. As somebody that's still working as a coworker, as a friend, as other family members like that grief is going to be something that shapes them afterwards. And I say that because my biggest why is my grandmother. So I'd been in hospice about seven months, and she was one of the first people to catch COVID, and she's the one that died in a facility. It took 23 people when it went through her facility, and I watched her through a window choking on her blood from her lungs as she was dying. And I didn't think to get hospice for her because, and I'm that family member then that was like, I didn't think to get it. I didn't, I was going through the motions of grieving and she died in pain and she died alone. And those are two things that I don't want anybody else to have to go through. And so my biggest get up and go in the morning is so that nobody else has to go through what I did and I had the knowledge. So trying to educate so that that this person's not, you're not gonna die alone. They're not gonna die alone. But that they're gonna die peacefully and not in pain is the biggest thing. Because how my grandmother died affected my mother. I watched it and I've still watched it. Yeah. Yeah. How she has moved through life losing her mom, and her mom were very close has been, it's affected a lot of her day to day and things that she's done. And so I think that had she had the opportunity to have hospice, to have somebody sit with her and talk with her and know that she was taken care of and wasn't in this place of pain while she choked I think my mom would've been a lot better on the other end. And I think she still holds her grief. And my grandmother died in 2020, so that's something that when my boss said that, I was like, no, that hits home. Very much because it's an entire piece that you're given and it's. A whole team that comes in that helps you move in this transitional period from life to death. But it also helps you transition as a family member. On how your life is going to look like next. And what that's gonna look like. Yeah. And one of the big things that I talk about is we have this mindset of birth being so beautiful. We talk about birth all the time. Beau birth is beautiful and this baby's here. And it's such a beautiful experience and this child then, I'm not saying that it's not, it definitely is still a beautiful process, but this child has been here for five minutes. That's it. So why are we not also treating somebody's end of life that's been here for 80 years, 90 years, 60 years, whatever. With the same dignity and respect that we're giving to these humans that have barely been on earth enough to do any like these have, they have memories, they have stories, they have families. And I think that if we approach it differently, yeah. There's a stigma that comes with death. There's a total stigma. And it's, again, because we don't talk about it I admit it, I am terrified of it. Not my own, like I, but like I am, I don't want to die, but I'm terrified of it. And with my mom and the people that I love and that I care about, and I have not through my life. I'm 59 this year. I was thinking about this as we were getting ready to record this episode today. I have not experienced death to the extent that some of my contemporaries have people that I know in my life grandparents have passed. Friends have passed. Yeah. A par a parent has passed, but I. I haven't experienced it in, in, in the quantity that other people have. And so it, it scares me and I don't like to talk about it. And I was thinking as you were sharing, and you were talking about that right before you said, we take this birth and we celebrate it. I was thinking in my head, the team of people that are there as you come into this world, right? It's from everybody. From Yeah. The doctors to the nurses, to the NICU people, to all of the people that are there to help and assist you and to guide the mother through the birth and the father and the, all of that, or the significant other is enormous. And then there's this stigma around the passing. And when I was listening to you talk, I was thinking about. Even through movies and television, there is a way that death is portrayed that is, as you are sharing it, completely different than what we experience in the movies or in television. There's always this morbidity, I, for lack of a better term around it. And I was thinking about what you said about the person, it's difficult for the family members who are watching their loved one through this end stage. But there's got to be a conversation for the patient that we will never know what that conversation is that they're having internally. And I've noticed through a couple of friends and a family member who I can see the process and I can see the conversation starting. My mom, for example, a lot of her friends. She'll be 85 this year. She'll probably kill me for saying that, but she'll be 85. Very healthy, knock wood. And yet she has friends that are quite a bit older, she's lost friends this year in the last couple of years since COVID. And I sit and listen to her, share that experience of what it's like and what it's doing to her and what it's doing to her willingness to get outside and to be active and to be engaged. And I see, and I hear that a lot in my friends who have parents that are aging. And so to think about that conversation that's going on for the person who may be in that position of hospice or needing hospice, but to have a team of people that's there to help walk'em through that process has to be. Lessening the difficulty of that conversation to a magnitude that I don't know that we can measure. I think it would be so beneficial. Again, still hard and still difficult to process, but what a gift that is to give someone that conversation of we're here and we've got you and we're gonna be here for you. Yeah. Comfort I think is, I'm still lacking on the word, but am I off on comfort? Good word. Comfort. Yeah. I was like, I think comfort's a good word. I was like, that's what I usually use and that initial conversation, really starts with me. Where I'm asked, answering all those questions. But if I told you, okay, your loved one is eligible, for this benefit and this benefit looks like that we're gonna bring in a hospital bed. We're gonna bring in oxygen, we're gonna bring in a bedside table, wheelchair walker, jerry chair. I'm gonna cover all medications that your loved one is gonna need. We're not gonna just stop medications to make them uncomfortable, like blood pressure or thyroid or anything like that. And I'm gonna come in with a comfort pack, so that way if they struggle to breathe or they are in pain or they have anxiety we can help make them comfortable with. These other medications as well. But we don't start them right away, but all of those are gonna be covered. If I tell you that your whole team of people, your nurse, your aide, your social worker spiritual care is gonna come in and talk with you and make sure that you're comfortable is included. And then if I tell you that all of your supplies, all of your incontinence supplies, chuck wipes, barrier, cream, gloves, that's gonna be covered. And then if there's any wounds, some people have wounds from being bed bound and laying down consistently, all of those supplies are gonna be covered, and you're gonna have somebody that's gonna come and change those because, just'cause you're on hospice doesn't mean that you get to be uncomfortable and you get to lay there with, wounds that are gonna cause you to go into septic shock. Because nobody's doing anything about it. So if I tell you all of that's covered. And if I tell you that you're not gonna pay a dime for it. And if I tell you that you're gonna be supported and held and you go through whatever that looks like, when I tell people like that, they're almost like I want that. And then I'm like that's hospice. And they're like I had no idea. And then I always joke,'cause then I say, hospice is super generous, but they're not that generous. So it's a use it or lose it benefit. So it's not like the military where you can pass it on to somebody else if you don't lose it, if you don't use it. But it's a good penny, that our working life we've paid into our whole life. And you're looking at a good, like double digit thousands that pays for this. Sure. That it just goes away. Medicare just goes, thank you. We're gonna keep this, if you don't use it. Yeah. If you don't use it. And then people are like, wait, so I'm so here's the other thing. So what if I told you that not using your hospice benefit. Is like going into a car lot, buying a brand new car and then walking out without the keys. Yeah. So I'm that's not who's gonna do that? Who's gonna be like here's my down payment on this car, but I'm out. Keep the keys. I'm good. You guys can do whatever you want with it. Then people are like I don't want to do that. So then it still comes into the, how can I make it more digestible? Is how can I make it and statistically people actually do live longer on hospice versus not sure. Because we're able to have the trajectory of our health go in a sliding versus a big chunks being taken out. And I think when people hear that and they hear that, we're gonna do everything we can to make them comfortable, we're gonna focus on quality of life and comfort. We're gonna, we're not just gonna come in and be like, here's your morphine iv, which I always try and educate on morphine. Morphine is actually the most gentle opioid that you can take. People are like, I'd take Dilaudid all day. And I'm like, that's destroying your gut, but morphine's actually not gonna do that. And then it actually helps you breathe. I didn't realize that was something that I'd learned. And so I always try and educate that, but at the end of life the smooth muscle that goes around your midsection becomes like a girdle. And so it's, it starts to squeeze and so they can't take a deep breath while morphine relaxes smooth muscle and allows somebody to be able to then take a deep breath, and then it also helps the oxygen and the blood go further. So instead of making people pass out like they think it would, a small amount actually could help them. Sure. Be up, be alert, have those last conversations with people, tell them that they love them, what they want, what they're feeling, et cetera. And leave people then to be like, okay, I got to say my goodbyes. I got to say I'm good if you leave. Go be where you are and have that conversation. And then when they leave, then everybody can go through the grieving process Sure. And hopefully a better better than what they thought that it would be. Yeah. Kind of experience. Yeah. And I've heard more often than not, I've been doing this six years now. That still seven out of 10 people say they wish they'd called me sooner. So interesting time to ask this question in our current environment is, so it's automatic with Medicare. It reverts. It reverts. And is Medicare automatic for everyone that qualifies? So if they have advantage plans, then it reverts to Medicare Part A. And what's the advantage plan? So what we use would be like your your Anthems, your Humanas, stuff like that. And what type of policy. So our listener would understand that. So like when you say it reverts, what type of policy would they have that would revert to Medicare? So any of them, if they elect their hospice benefit, any of their advantage plans will revert to Medicare Part A. Okay. So when it reverts to Medicare part A, we actually, then when we go in and they sign paperwork, what happens then is we replace Medicare Part A with that hospice. So it's like we become their insurance. Okay. And we bill that way. Okay. Now if they get better and they graduate off of hospice, then it just reverts back to whatever they had. So somebody who let's say, super healthy in their fifties, maybe late fifties, is obviously looking towards the future. What do they need to do or what, where do they start inquiring about that type of policy? Because don't think fifties. Yeah. They don't teach that. So if they have a commercial plan, I would look into whatever commercial plans they have and make sure that they have hospice benefits. Okay. And that's something they can ask their insurance provider, right? Their agent. That they have hospice and that falls under their general healthcare. That falls under their general medical plan. Like their health insurance for basic commercial insurance. So basic I don't think that I have one, but I should probably get one. That's why I'm asking because I know for a fact that there are friends of mine that we've talked about this and that don't have it. So I'm encouraging them to talk to their insurance companies. Yes, and be clear. And it's about education. And I think that's really important is that we need to be our own advocates. We learn that through the pandemic. We need to be our own advocates and fighting for our own healthcare and our own health benefits. And so we need to also be prepared in knowing what potentially comes in our future. And I think we think there's time to do that down the road. We can do it down the road. There's time. And I think we learned very quickly during the pandemic that there isn't time that we need to be aware of this now. And so I encourage and I think why it's important to have this conversation is my circle of friends, for the most part, are dealing with aging parents and are also dealing with, potentially looking for towards our future, what that looks like. And so I want to be the advocate to talk about these things in such a way like you're doing today. I learned three things today just in what you shared, that I had no clue. No clue that hospice came with all of those elements that you talked about. No clue. And I've been through it. I had no clue there was a social worker or a spiritual component of that. I had no clue. So I'm hoping that through these conversations, people will wake up and go, oh, I should take a look at that. When I was getting ready for the podcast episode, I started to do some research and you can go down a rabbit hole of information on hospice care and palliative care and all of these types of things. And it's important to get educated. And so I'm gonna really encourage people to do that. So thank you for sharing all of that. A question for you, so how do I ask this question and not go down the rabbit hole, but is it something that is potentially at risk in this current moment? Is hospice care something that could eventually be affected by. No policy. I don't know. But I want to say that, I would say that that wouldn't go over well if there were cuts made to somebody's end of life care. Nobody really wants to touch. Cutting end of life. However, they may do it in other ways. There may be more difficulties, there may be more loopholes. Sure. Restrictions, I don't know, restrictions, what they plan on doing. With it I think for now people are good. Yeah. But, it could be that by the time I need it, it's not available. And, I hope that we don't come to that. I hope that's not something I take away. I think it's very important. Yep. But if you even have, but also Medicaid will mirror Medicare for insurance if they have that. And then, if you're under 65, but you have specific terminal diagnoses. You can also be on advantage plans because my mom had her cancer. She's not 65 and she does have a Medicare Advantage plan. My biggest educational piece is anybody that is going into turning 65, close to 65, they're calling and saying, the advantage plans are so much better. You can get gr a hundred dollars here and a hundred dollars here. We'll buy groceries, we'll do that. They're lying. And I highly recommend having traditional Medicare over an Advantage plan. I could not stress that enough. So say that again. So you recommend traditional Medicare? Traditional Medicare as opposed to the Advantage plan? Okay. Yes. I had a family recently that I talked to and she's they, I didn't mean to switch, but they talked us into, we had. Groceries that they gave us. They said that we would get money back for groceries. And I was like I understand that. And then she's yeah, but they lied to us because then in the little bitty fine print, it was cut after so many times they're like, oh, we're not doing that anymore. So then get people to switch.'cause once you switch, then it's either harder, you can't go back. And how are they making money off that? Is it, are they making money off that because it's a subsidy and then because you're not paying that. So it's, they're obviously upselling you because they'll get more money in return from the plan. They don't pay as much depending on what you need. So really it's not gonna affect you for hospice. Where it's gonna affect you is gonna be in like your home health rehab, stuff like that. Where they want you to get better instead of coming to hospice. Sure. And the only reason I know that is my grandfather. My grandfather had a super bad issue with his urinary. Splatter, stuff like that. They were trying to figure out what was going on. He had talked about going to the Advantage plans and I told him, I said please just stick with your regular Medicare. I promise you it'll be worth it. But he's but I'm healthy. I could use the a hundred dollars grocery things. I said, no, I hear you. Please stay with regular Medicare. And he's fine. Not even six months after we had this conversation, he developed a huge UTI huge issue. Like they were truly trying to figure it out. Had to have a catheter in him for a couple of days, and he went through all of these testings,$0. Had he switched to an advantage plan either A, he wouldn't have gotten those, or B, he would've paid hundreds for that. And he's I couldn't have afforded the hundreds. And I said, see, that's why I told you to keep that medi. And he's okay, I'm not, I believe you now. I'm not gonna switch. I said, because just'cause you might be healthy in this moment doesn't mean something's not gonna happen later or where you need the rehab'cause you fall and break a hip. Or you need the home health and PT to come in. You're not gonna get the agencies that are good because the reimbursement rate for a physical therapist on advantage plans are poor. And so then you're not gonna have as many or good quality versus having your Medicare. Then they can have the good PTs that are come, gonna come in. You can have the good visits, you can have all of these things. That can set you up for success and not need any. Does the patient have the choice of which agency they go with or is it the agency assigned to the patient through Medicare? No, it is always patient choice. Oh. So in our area here, they will go into the hospital system and the hospital will try and push their own. I always say, please educate yourself, do research, reach out to them. Having a conversation with five of me with five different agencies is totally acceptable to do. We all have our Medicare guidelines, we all have our Medicare standards that we should be following. And I will say that my company is very compliant. But outside of that, it's what? What makes us different and what makes us different is gonna be my clinical team. I don't have somebody that's working a nine to five because they need to pay bills. I have somebody that wants to take care of those people and wants to treat them as people and wants to show up with kindness and compassion. And I think that's gonna always set us apart from other agencies. So what are the top three things that someone should look for when they're looking at the agency? Authenticity, which you can tell very quickly within the marketer. Because if the marketer is there just for money. You're gonna tell in the way that they talk to you. If you're good at reading people let's face it, if they're pushing that used car salesman approach on all the things you have. Yeah. They're gonna come off as a used car salesman. Yeah. And not asking questions like I'm sure you do. And really looking into the needs of the patient and the family as opposed to, here's this plan with this shiny benefit and this little bell and whistle and this little upgrade. That's what I would think would be a big red flag. Is there something else? If it sounds too good to be true? Then it might be some agencies can promise certain things in the moment to get you to sign paperwork and then under deliver. So something that I always say for myself is I was like, I'm not gonna over promise and under deliver. I'm gonna give you exactly what you need. And that's really what sets us apart. So I was like, you're gonna get what you need Medicare, but then what you need within the agency. So having somebody that you can tell is that used car salesman, that person that's gonna be like, if you're like, can I have, and they're like, oh yeah, you can have whatever you want. You can have this, you can have that, you can have that, and we'll bring you Burger King every other day. Promise, probably not. And then they're just trying. And then also I would look for figure out too, like where your staffing is. Whether or not they are over understaffed or if they're staffed accordingly. I would say I'm staffed accordingly. But if they don't allow you to choose, to, I would look at that. Allow you to choose your staff or your team. Allow you to choose the agency. Oh, the agency. Yeah. If they are, there's times where there will be the hospital liaisons are like the me of that company and they will push their own. And so saying that you want a list and to research then you can also go into medicare.gov. And you. The three agencies that you see, and then those are all scores that are given to the agencies based off family's feedback. So there is an agent, sorry, it's important. Didn't mean to interrupt. So there is a resource for you to check. medicare.gov. Okay. So you can check the agencies.'cause obviously the agencies have to be registered and listed. If they're not registered and listed, if they're new, they may not show up yet. Okay. So those would be where I would want to, so if they don't have a score, then it means that they're probably less than two. They might be a little bit behind. So two and a half-ish years. Okay. But you also have to have a census of 50 before these like surveys will go out and these surveys go out after the passing of a patient. Okay. And so once these surveys go out, they're sent out by Medicare. It doesn't matter. So my agency, every other agency, every patient that passes, they all get the same questionnaire, they all get the same survey, and it's sent within six to eight weeks after your loved one passes. So really when you're still like raw in grieving, that's Hey, did you like your team? Were they good? Were they this, did they give you this? Did they do that? So there are like questions to answer and a lot of those scores then are generated based off of family feedback. Okay. So then you can really know where they stand. So for those agencies that maybe knew, if you don't see the rating, is there a way to make sure they're legit? I would still call and sit down with ours. Like ours took a while. We were newer to the AR area and so they just had to talk to me and we just, it almost had to be like a kind of can you trust us? But I would assume you, you have to be licensed. So I would assume there would also be ways to check licensing and permit, not permiting, but licensing. And we were accredited, accredited. Thank Youc. Yeah, thank you. I knew it was, I knew there was a word in there somewhere to you. Yeah. So you want them to be accredited? Yes. Accredited surveyed certificate, something you, they have to have that to be an open hospice. But just'cause they're not on Medicare go.gov, that just means they're a newer agency that has maybe popped up in the area. And so their scores haven't come through yet. I have a couple final questions for you. Fascinating conversation. Thank you so much. My head is spinning. Sorry. No, in a good way. In a good way. It just gets you thinking, right? It gets you thinking. That there are questions to ask and preparations to make to ask your mom, like even if you don't want to have that conversation, it's mom, if something happened in a week from now, like do you want all of these things in place? Do you want me to get a hospice? Do you want to sit with me right now and go through the ones that are here? And that if that happened three years from now, I know which ones to call. If they fall off, then you have two others. But being like, you both looked at different things and agreed on'em together and there's no saying that you couldn't have somebody like me and be like, hi, she's healthy, but I want to sit and talk. I want to feel your vibe. They may not be there when she needs them, but you could know about the agency. Yeah. Yeah. And I think that's important because even, like I said, mom's super healthy, not good. It's interesting'cause I have somebody come in. Yeah. We have somebody come in and helps her once a week after she fell and she's now been here a couple years and they've got this great relationship and I love that they're together and the owner of the agency is amazing. Patty, we talk all the time. So there's that comfort level. But it took me a while to convince my mom Yeah. To allow this person to come into her home.'cause my mother's very independent and there was even a moment where. She didn't work there anymore. And then my mother needed her again and brought her back, and then my mother was like, I'll never have her leave again. So I was very grateful for that. But I, it's one of those things that you think about sitting down and just having that conversation. It's the same thing about, we talk about what are your wishes in terms of your burial? Do you want to be cremated? Do you want to be buried in the cemetery? It's what are those kind of questions that you have to, and we had to ask those questions when we did the family trust. And so if you could look at it from a way, and how I look at it is I just want us to be prepared. I don't want to be caught off guard. Should something happen to you. And I even told her what I want. I travel so much. Who's to say, God forbid, but we have that conversation what I want as well. And so if we can come from a place of just the preparedness, not of the, let's just, be Debbie Downers and have the conversation. I think it's really important. I'd rather be prepared. We recently were thinking about all the people at the fire as my mom was evacuated and so didn't have all of her paperwork together of just the basics. And so we now have that handled. So there's just things that you don't expect. Banking. Banking I've come into that, like banking, there's been so many kids that like all of a sudden this happened and they're like, I can't get into my parents' account. I can't pay for this, I can't do this, I can't get this. And I'm like, okay I'm one part. I can give you resources. But I got off the phone like having that meeting and I called my dad and was like, yeah, I don't need any of your passwords, but you have it written down in a book somewhere. And so if something happens, I need to know where that book is. Yeah. I don't need, and I said, but you need to put me I told my dad, I said, I need to be on all of your checking. I don't need to know anything, but my name needs to be on it. Yeah. Yeah.'cause if I go to call, yes. I was like, who's to say you don't get an accident and you're unconscious. Mom was with you. She's unconscious. I still have to pay your mortgage while we're figuring things out. Yeah. How am I supposed to get in and do that? Yeah. Yeah. And so after that, he's oh, I didn't, I just thought you wanted access to my checking account. I was like, absolutely not. But my name needs to be on it. So when I call, they'll talk to me. We just moved my mom's financial institution after 30 years and the same conversation. And it's, I now, after that fire, because when my mom left and was evacuated, she had 30 minutes to get out and. Was not thinking I need to take that box that I have that has all my paperwork in it. And so we had this really funny conversation and she's very sarcastic. As am I, and she's you're trying to steal all my money and lock me up. I'm like, lady, if I wanted to lock you up, I would've locked you up a long time ago because I have all your passwords. Yeah. Okay, but we can joke about that. And it's done in a loving way. And but it's important because again, I, my dad's not around. She's by herself. And if something were to happen, I need to be able to take care of her and care for her. So I encourage people to meet with an attorney, to put the things in the trust. It's interesting too, after the fire I was. Spinning through Instagram, watching some of the news stories, and someone came on and said, if you have a family trust and you have homeowner's insurance, your homeowner's insurance has to identify the living trust as additionally insured on your homeowner's insurance, or they won't cover you. And we're going through huge issues with that here in California. Huge. The insurance company does not necessarily have to pay you if you don't list your trust as additional insured. So I went to the insurance company, took my mom's trust, went in and we added it and the guy sitting behind the desk said, we have done hundreds of these in the last couple weeks since the evacuations because people realized they didn't have this. And I thought, isn't that your job as the insurance company when you set the insurance up to tell us that it needs to happen? Yeah. So I share that only because it's just another set of conversations that you can have to be prepared. Archer. I can't thank you enough for this conversation. I think it's really. Empowering to sit with somebody who has the experience. There's a whole host of other questions that I could ask you. I want to invite you back another time to maybe further the conversation, but then also talk about a few other things that have popped up as a result. But I'm really grateful that you were able to share this part of your life that's so important. And I just want to say, I said this to you originally, that there are angels in this world who simply are out to make a huge difference. And not only are you making a difference within your own community and the trans community, and you're educating people about what it means to live an authentic life and to be yourself. You spend your life dedicated to helping others, and it just. Number one, it just makes me love you more. But number two, it just shows just how important it is that we are here on this earth to be of service to others. And it doesn't mean that they have to do what you do, it just means that we have to be cognizant of the people around us and what they might need, especially now more than ever. So I encourage people to reach out and to connect with people and to have those difficult conversations and to be able to speak freely and to speak passionately about your care for someone else. I think it'll make people's day. So I want to, again, thank you for all the information that you've shared. Anything you want to say in closing as we wrap up this conversation today? No. If anybody has any questions, I don't care where you are. If you know any of my socials, you can send me a message and I'm more than willing to answer any of your hospice questions and help point you in the right direction. We're gonna make sure, I think it's important. So yeah, we're gonna make sure to put access to your Instagram account. I encourage people just to go. Check you out and follow you and be part of that positivity that is really infectious We'll make sure we do that. Thank you for being here, and thank you for sharing again, and I can't wait to have you back on another episode. Can't wait. Thank you so much. You're welcome. Talk to you soon. Bye. Bye. Alright, everyone, thank you again for joining us on today's episode. I hope our conversation resonated with you like it did me, and I cannot wait to sit down with you all again next week. Remember to subscribe to the Just You Podcast on your favorite platform so you can make sure not to miss a new episode, which drop every Thursday. If you like what you hear, you can easily share the podcast and episode. Directly with your friends and if you would rate us and leave us a review, we'd love to hear from you. You can also follow us on Instagram at just Do you pod as you go out into the world today. Remember to just do you. Alright, talk next week.