203 Facing Hospice Concerns: Stories and Solutions

Host Marie Betcher, a registered nurse and former hospice nurse, shares two recent conversations highlighting common hospice challenges. In one case, a grandparent was admitted to hospice only 10 hours before death, leaving little time for family education; a caller described being told to "just give them more" medication without clear dosing guidance, underscoring the need for better instruction and repeated follow-up calls for clarification. In the second case, an only child caregiver needed a medical procedure and worried about being unable to physically care for a parent; Marie discusses contacting the hospice team for help, including respite care options such as short-term nursing home placement through Medicare, as well as self-pay adult family homes, nursing homes, or CNAs, noting costs and limited resources. She reminds listeners hospice is not typically a full-time caregiver, suggests using Medicare.gov to find and compare agencies, and encourages reaching out or switching providers if needs aren't met.

00:00 Welcome and Disclaimer

00:28 Meet Your Host Marie

00:42 Story One Late Hospice Referral

01:32 Medication Guidance Needs

02:51 Story Two Caregiver Crisis

03:47 Respite and Care Options

05:05 Keep Calling Hospice Team

05:26 Hospice Is Not the Caregiver

05:54 Finding and Switching Agencies

07:00 Closing Thoughts and Contact

If you want to help, you can donate to help support Hospice Explained at the Buy me a Coffee link https://www.buymeacoffee.com/Hospice

Hospice Explained Affiliates & Contact Information

Buying from these Affilite links will help support this Podcast.

Maire introduces a partnership with Suzanne Mayer RN inventor of the cloud9caresystem.com, When patients remain in the same position for extended periods, they are at high risk of developing pressure injuries, commonly known as bedsores. One of the biggest challenges caregivers face is the tendency for pillows and repositioning inserts to easily dislodge during care.(Suzanne is a former guest on Episode #119)

When you order with Cloud 9 care system, please tell them you heard about them from Hospice Explained.(Thank You)

Marie's Contact [email protected] www.HospiceExplained.com

Finding a Hospice Agency

1. You can use Medicare.gov to help find a hospice agency,

2. choose Find provider

3. Choose Hospice

4. then add your zip code

This should be a list of Hospice Agencies local to you or your loved one.

202 Prescription-Grade THC-Free CBD for Pain, Anxiety, and Sleep: Pulak Sharma on Cope Now

Host Marie Betcher, RN and former hospice nurse, interviews Pulak Sharma, founder of Kazmira and creator of Cope Now, a vertically integrated telemedicine, compounding pharmacy, and manufacturing platform providing prescription, pharmaceutical-grade THC-free CBD. Sharma explains their CGMP-validated hemp extraction and purification process, compounding into an oral tincture in three strengths, delivery to patients, and development of a shelf-stable nano-emulsion. He says patients most commonly seek help for anxiety and pain, and notes many consumer CBD products are underdosed, citing therapeutic ranges of roughly 200–400 mg/day and typical prescribing around 300 mg/day, with protocols for titration and liver enzyme concerns. They discuss CBD's non-scheduled status, lower side-effect profile compared with opioids/benzodiazepines, clinician and pharmacist oversight for dosing and interactions, and batch testing showing non-detect THC to avoid psychoactive effects and THC-positive urine tests.

00:00 Welcome and Disclaimer

00:29 Meet the Guest and Episode Focus

02:07 How Cope Now Works

03:06 Product Formats and Strengths

03:53 Top Uses and Proper Dosing

05:25 Hospice Needs and Opioid Alternatives

08:52 Titration and Daily Timing

12:04 Telemedicine Intake and Prescribing

13:32 Founder Story and Older Patients

16:14 Closing the Guidance Gap

17:59 Addiction and THC Free Assurance

20:47 Standardizing CBD as Medicine

23:42 Final Thanks and Subscribe

https://copenow.com/

If you want to help, you can donate to help support Hospice Explained at the Buy me a Coffee link https://www.buymeacoffee.com/Hospice

Hospice Explained Affiliates & Contact Information

Buying from these Affilite links will help support this Podcast.

Maire introduces a partnership with Suzanne Mayer RN inventor of the cloud9caresystem.com, When patients remain in the same position for extended periods, they are at high risk of developing pressure injuries, commonly known as bedsores. One of the biggest challenges caregivers face is the tendency for pillows and repositioning inserts to easily dislodge during care.(Suzanne is a former guest on Episode #119)

When you order with Cloud 9 care system, please tell them you heard about them from Hospice Explained.(Thank You)

Marie's Contact [email protected] www.HospiceExplained.com

Finding a Hospice Agency

1. You can use Medicare.gov to help find a hospice agency,

2. choose Find provider

3. Choose Hospice

4. then add your zip code

This should be a list of Hospice Agencies local to you or your loved one.

201 Hospice Explained: Margaret Montes RN, BSN, PHN on Early Hospice Nursing, Comfort Care, and Family Education

Host Marie Betcher, RN, interviews retired hospice nurse Margaret Montes RN, BSN, PHN with facilitator Cindy Cisneros. Margaret, raised in Puerto Rico and licensed in 1976, joined the new Hospice of East San Gabriel Valley in 1987 and worked 33 years, starting when the census was eight patients and she was the only nurse; her bilingual skills helped serve Spanish-speaking families. They discuss early obstacles such as recruiting nurses suited for hospice, later team disagreements resolved through weekly interdisciplinary meetings, and common family fears that hospice or medications (including morphine) hasten death, emphasizing comfort as the goal. Margaret shares end-of-life visioning stories and a case where a family called 911 despite DNR wishes. They stress educating families on the dying process (including Barbara Karnes' "blue book"), bereavement follow-up, and analogies like the body as an aging car and end of life mirroring infancy.

00:00 Welcome and Disclaimer

00:29 Meet Marie and Guests

01:49 Margaret Finds Hospice

05:26 Early Hospice Challenges

07:28 Team Meetings Behind Scenes

10:43 Hospice Does Not Hasten Death

12:14 Comfort Beyond Medication

14:25 End of Life Visions Stories

18:07 When Families Call 911

20:46 What Everyone Should Know

24:01 Family Dynamics and Aftercare

27:39 Faith Fear and Support

29:46 Analogies for Dying Process

32:08 Final Thanks and Subscribe

If you want to help, you can donate to help support Hospice Explained at the Buy me a Coffee link https://www.buymeacoffee.com/Hospice

Hospice Explained Affiliates & Contact Information

Buying from these Affilite links will help support this Podcast.

Maire introduces a partnership with Suzanne Mayer RN inventor of the cloud9caresystem.com, When patients remain in the same position for extended periods, they are at high risk of developing pressure injuries, commonly known as bedsores. One of the biggest challenges caregivers face is the tendency for pillows and repositioning inserts to easily dislodge during care.(Suzanne is a former guest on Episode #119)

When you order with Cloud 9 care system, please tell them you heard about them from Hospice Explained.(Thank You)

Marie's Contact [email protected] www.HospiceExplained.com

Finding a Hospice Agency

1. You can use Medicare.gov to help find a hospice agency,

2. choose Find provider

3. Choose Hospice

4. then add your zip code

This should be a list of Hospice Agencies local to you or your loved one.

200 Shari Brase-Smith RN, MS on Hospice Education, Facility Care, and Having Hard Conversations

Host Marie Betcher, a registered nurse and former hospice nurse, marks episode 200 of Hospice Explained with guest Shari Brase-Smith RN, MS, a hospice nurse, educator, and author. Shari recounts her nursing background since 1978 and how the rapid deaths of her husband and mother shaped her understanding of end-of-life needs, emphasizing that even experienced clinicians are often unprepared because healthcare and society focus on curing and avoid dying discussions. She describes why families and facility staff lack clear, practical guidance on what dying looks like, symptom management, and when to involve hospice, especially in nursing homes and assisted living. Shari explains her books are organized for quick, crisis-time answers, highlights the importance of conversations about wishes and forgiveness, and shares her Christian-focused poetry book on grief and hope.

00:00 Welcome and Disclaimer

00:29 Episode 200 Guest Intro

02:27 Shari's Nursing Journey

03:31 Personal Loss and Whirlwind

07:24 Why End-of-Life Education Matters

11:24 Books Filling the Resource Gap

17:02 Eating and Drinking at End of Life

19:17 Starting Hard Conversations

23:27 Forgiveness and Peace

27:28 Helping Facility Staff Work With Hospice

32:09 Poetry Faith and Grief

37:21 Closing Thanks and Subscribe

https://sharibrase-smith.com/

If you want to help, you can donate to help support Hospice Explained at the Buy me a Coffee link https://www.buymeacoffee.com/Hospice

Hospice Explained Affiliates & Contact Information

Buying from these Affilite links will help support this Podcast.

Maire introduces a partnership with Suzanne Mayer RN inventor of the cloud9caresystem.com, When patients remain in the same position for extended periods, they are at high risk of developing pressure injuries, commonly known as bedsores. One of the biggest challenges caregivers face is the tendency for pillows and repositioning inserts to easily dislodge during care.(Suzanne is a former guest on Episode #119)

When you order with Cloud 9 care system, please tell them you heard about them from Hospice Explained.(Thank You)

Marie's Contact [email protected] www.HospiceExplained.com

Finding a Hospice Agency

1. You can use Medicare.gov to help find a hospice agency,

2. choose Find provider

3. Choose Hospice

4. then add your zip code

This should be a list of Hospice Agencies local to you or your loved one.

199 At What Point Do We Say Stop? A Brother's Death, CPR Trauma, and Why End-of-Life Wishes Must Be Discussed Early with Gabrielle Elise (Gabby) Jimenez

Host Marie Betcher welcomes back hospice and palliative care nurse, end-of-life doula, and The Hospice Heart founder Gabrielle Elise (Gabby) Jimenez to share the story of her brother Ben's death and why earlier end-of-life conversations matter. After years of estrangement, Gabby spent 18 days at Ben's bedside as he was mostly nonresponsive on a ventilator and tube feeds, then briefly woke and repeatedly said "yes" to escalating life-sustaining measures, creating conflict between what Gabby believed he'd want and what he voiced. When Ben suddenly deteriorated, Gabby arrived to find a chaotic CPR code and ultimately told the team to stop, allowing Ben's final minutes to be quieter with his daughter. They discuss how traumatic and violent CPR can be for medically fragile patients, how staff must follow expressed wishes without prior directives, and the importance of advance directives, POLST/MOST forms, and clearly communicated plans so loved ones can confidently honor a person's choices.

00:00 Welcome and Disclaimer

00:29 Meet Host and Guest

02:31 Ben Hospitalized Reunion

04:16 Wakes Up and Choices

07:51 Code Blue Saying Stop

10:38 Aftermath and Regrets

12:22 CPR Trauma Explained

20:08 Advance Planning Tools

26:58 Marie's Brothers Story

32:08 When CPR Helps or Hurts

34:47 Have the Conversation

36:12 Final Takeaways and Goodbye

https://www.thehospiceheart.net/

If you want to help, you can donate to help support Hospice Explained at the Buy me a Coffee link https://www.buymeacoffee.com/Hospice

Hospice Explained Affiliates & Contact Information

Buying from these Affilite links will help support this Podcast.

Maire introduces a partnership with Suzanne Mayer RN inventor of the cloud9caresystem.com, When patients remain in the same position for extended periods, they are at high risk of developing pressure injuries, commonly known as bedsores. One of the biggest challenges caregivers face is the tendency for pillows and repositioning inserts to easily dislodge during care.(Suzanne is a former guest on Episode #119)

When you order with Cloud 9 care system, please tell them you heard about them from Hospice Explained.(Thank You)

Marie's Contact [email protected] www.HospiceExplained.com

Finding a Hospice Agency

1. You can use Medicare.gov to help find a hospice agency,

2. choose Find provider

3. Choose Hospice

4. then add your zip code

This should be a list of Hospice Agencies local to you or your loved one.

198 Hospice Explained: Eric Horwith on End-of-Life Planning and Navigating Grief

Host Marie Betcher, a registered nurse and former hospice nurse, interviews Eric Horwith, a social worker and UPMC regional director of business development who focuses on improving timely access to hospice, palliative care, and home health services and teaches at the University of Pittsburgh. Eric shares how his father's unexpected death forced urgent end-of-life decisions without advance planning, reinforcing the need for earlier conversations and legal documents. He describes his mother's peaceful death at 83 and his subsequent intense grief, which led him to write the Amazon-available guide, "Grief Exists Because Love Persists: Navigating Life After Loss," emphasizing grief as individualized and something to move through while honoring a loved one's legacy. Eric outlines his university course covering hospice, palliative care, organ donation, autopsy, cultural considerations, and advance care planning. He advises researching hospice providers, noting hospice is a benefit regardless of ability to pay and highlighting publicly reported quality metrics.

00:00 Welcome and Disclaimer

00:41 Meet Eric Horwith

02:33 Eric's Story and Calling

04:56 Sudden Loss and Planning Ahead

07:41 Mom's Peaceful Passing

09:23 Why He Wrote the Grief Guide

10:06 Grief Exists Because Love Persists

12:28 Grief Nuggets and Marathon Metaphor

15:37 Honoring Barbara's Legacy

16:42 Teaching Death and Dying

24:07 Hospice Access for Underserved

28:13 Final Takeaways and Goodbye

If you want to help, you can donate to help support Hospice Explained at the Buy me a Coffee link https://www.buymeacoffee.com/Hospice

Hospice Explained Affiliates & Contact Information

Buying from these Affilite links will help support this Podcast.

Maire introduces a partnership with Suzanne Mayer RN inventor of the cloud9caresystem.com, When patients remain in the same position for extended periods, they are at high risk of developing pressure injuries, commonly known as bedsores. One of the biggest challenges caregivers face is the tendency for pillows and repositioning inserts to easily dislodge during care.(Suzanne is a former guest on Episode #119)

When you order with Cloud 9 care system, please tell them you heard about them from Hospice Explained.(Thank You)

Marie's Contact [email protected] www.HospiceExplained.com

Finding a Hospice Agency

1. You can use Medicare.gov to help find a hospice agency,

2. choose Find provider

3. Choose Hospice

4. then add your zip code

This should be a list of Hospice Agencies local to you or your loved one.

197 Author Dr. Jerry Woodbridge on Children's Grief, Widowhood, and Writing the Loved, Lost, Won Series

In Hospice Explained episode 197, host Marie Betcher, a registered nurse and former hospice nurse, interviews educator and author Dr. Jerry Woodbridge about grief, faith, and her writing. Dr. Jerry shares her background in education and educational technology, her sudden widowhood in 2004 when her husband died one day after a colon cancer diagnosis, and the impact on her children, including her son's unspoken panic attacks and a difficult move from Florida to Indiana. She describes how journaling, faith, and ballroom dancing supported her grief, leading to her widow's devotional Trading My Sorrows for the Joy of the Lord. Prompted by a TEDx conversation, she wrote the children's grief novel Joy Overcame Sorrow with a companion Joy's Journal, and released book two, The Intersection, about twin loss and survivor's guilt. She is also researching a future book about a military family's loss and emphasizes moving between sorrow and joy through love.

00:00 Welcome and Disclaimer

00:38 Meet Dr. Jerry Woodbridge

03:21 Sudden Loss and Widowhood

05:38 Parenting Through Grief

10:15 Adoption and Added Complexity

10:53 Writing Through Grief

14:55 Joy Overcame Sorrow

19:26 The Intersection Twin Loss

22:35 Anticipatory Grief and Faith

24:38 Turning Pain Into Purpose

26:28 Final Reflections and Goodbye

https://www.drjerrylwoodbridge.com/books

If you want to help, you can donate to help support Hospice Explained at the Buy me a Coffee link https://www.buymeacoffee.com/Hospice

Hospice Explained Affiliates & Contact Information

Buying from these Affilite links will help support this Podcast.

Maire introduces a partnership with Suzanne Mayer RN inventor of the cloud9caresystem.com, When patients remain in the same position for extended periods, they are at high risk of developing pressure injuries, commonly known as bedsores. One of the biggest challenges caregivers face is the tendency for pillows and repositioning inserts to easily dislodge during care.(Suzanne is a former guest on Episode #119)

When you order with Cloud 9 care system, please tell them you heard about them from Hospice Explained.(Thank You)

Marie's Contact [email protected] www.HospiceExplained.com

Finding a Hospice Agency

1. You can use Medicare.gov to help find a hospice agency,

2. choose Find provider

3. Choose Hospice

4. then add your zip code

This should be a list of Hospice Agencies local to you or your loved one.

196 Six-Year Anniversary Reflections and CPR Considerations at End of Life

In episode 196 of Hospice Explained, host Marie Betcher, a registered nurse and former hospice nurse, marks what she considers the podcast's six-year anniversary since beginning work on it in August 2020 and reflects on how it grew far beyond the 20 episodes she originally expected. She highlights a recent Facebook post from The Hospice Heart by nurse educator Gabby Jimenez about her brother's end-of-life and CPR experience, encourages listeners to read it, and notes plans to invite Gabby back after her prior appearance on episode 168. Marie discusses key considerations about CPR at end of life, especially for elderly patients, including risks like fractures due to weakened bones and low likelihood (less than 5%) of leaving the hospital after CPR, urging families to discuss these realities in advance. She invites listeners to share personal stories by emailing her.

00:00 Welcome and Disclaimer

00:29 Episode Intro and Host

00:49 Six Year Podcast Milestone

01:42 Gabby Jimenez Spotlight

02:37 CPR End of Life Realities

03:09 Risks for Elderly Patients

03:35 Making the CPR Decision

04:28 Share Your Story Invite

05:25 Closing Thanks and Subscribe

https://cprcertificationnow.com/blogs/mycpr-now-blog/cpr-for-the-elderly-special-techniques-and-considerations

If you want to help, you can donate to help support Hospice Explained at the Buy me a Coffee link https://www.buymeacoffee.com/Hospice

Hospice Explained Affiliates & Contact Information

Buying from these Affilite links will help support this Podcast.

Maire introduces a partnership with Suzanne Mayer RN inventor of the cloud9caresystem.com, When patients remain in the same position for extended periods, they are at high risk of developing pressure injuries, commonly known as bedsores. One of the biggest challenges caregivers face is the tendency for pillows and repositioning inserts to easily dislodge during care.(Suzanne is a former guest on Episode #119)

When you order with Cloud 9 care system, please tell them you heard about them from Hospice Explained.(Thank You)

Marie's Contact [email protected] www.HospiceExplained.com

Finding a Hospice Agency

1. You can use Medicare.gov to help find a hospice agency,

2. choose Find provider

3. Choose Hospice

4. then add your zip code

This should be a list of Hospice Agencies local to you or your loved one.

195 Funeral Planning, Grief, and Hospice: Bob Arrington on Why Celebrating a Life Matters

Host Marie Betcher, a registered nurse and former hospice nurse, interviews Bob Arrington, NFDA spokesperson and longtime Tennessee funeral director, about how funeral service supports the grief journey and why planning matters. Arrington explains that families don't call a funeral director just to bury or cremate, but to begin adjusting to a "new normal," and that skipping any kind of service often makes grief harder for family and community. He encourages pausing to honor a life even with simple gatherings, and stresses that pre-planning (not necessarily pre-paying) reduces emotional stress by preventing loved ones from making major decisions in crisis. They discuss hospice as a major benefit that supports care and dying at home, grief resources through NFDA and Alan Wolfelt, the importance of individualized grief timelines, and NFDA's "Have the Talk of a Lifetime" conversation cards.

00:00 Welcome and Disclaimer

00:28 Meet Host Marie

00:41 Introducing Bob Arrington

02:47 Bob's Funeral Calling

03:59 Why Services Matter

08:57 Community Grief Ripples

11:53 Grief Support Resources

15:37 When Grief Becomes Physical

17:53 Funeral Process Explained

21:49 Preplanning Without Fear

27:45 Prepay vs Emotional Relief

31:05 Hospice and Final Takeaways

33:06 Contact and Closing

https://www.nfda.org/

Link to Bob's episode "Death It's a Living"

https://www.imdb.com/title/tt3573530/

https://www.nfda.org/your-business/business-resources/remembering-a-life/have-the-talk-of-a-lifetime/conversation-cards/

If you want to help, you can donate to help support Hospice Explained at the Buy me a Coffee link https://www.buymeacoffee.com/Hospice

Hospice Explained Affiliates & Contact Information

Buying from these Affilite links will help support this Podcast.

Maire introduces a partnership with Suzanne Mayer RN inventor of the cloud9caresystem.com, When patients remain in the same position for extended periods, they are at high risk of developing pressure injuries, commonly known as bedsores. One of the biggest challenges caregivers face is the tendency for pillows and repositioning inserts to easily dislodge during care.(Suzanne is a former guest on Episode #119)

When you order with Cloud 9 care system, please tell them you heard about them from Hospice Explained.(Thank You)

Marie's Contact [email protected] www.HospiceExplained.com

Finding a Hospice Agency

1. You can use Medicare.gov to help find a hospice agency,

2. choose Find provider

3. Choose Hospice

4. then add your zip code

This should be a list of Hospice Agencies local to you or your loved one.

194 Pet Grief and Disenfranchised Loss (with Hospice Chaplain Jessica Shannon)

Host Marie Betcher, a registered nurse and former hospice nurse, interviews board-certified hospice chaplain and author Jessica Shannon in episode 194, focusing on pet grief. They discuss pet loss as "disenfranchised grief," often experienced as lonely and minimized by society, and describe anticipatory grief that begins as pets age and decline. Jessica explains how pet grief can be as intense as human loss, may trigger cumulative grief when an animal is tied to a deceased loved one, and includes grieving routines and caregiving roles after a pet dies. She shares her experience losing multiple dogs and the impact of euthanasia decisions, notes that surviving pets also grieve, and offers guidance to acknowledge the grief as real, allow time, and not rush into getting another pet. Jessica also mentions her memoir, The Sum of Grief: A Daughter's Memoir, about "grief math," which includes animals' roles in coping with loss.

00:00 Welcome and Disclaimer

00:29 Meet Host and Guest

01:37 Why Pet Grief Matters

03:38 Anticipatory Grief Signs

05:41 Lonely Disenfranchised Loss

07:09 Stories of Multiple Losses

10:09 Pets as Connections

14:42 Routine and Caregiver Role

16:49 Rehoming After Death

19:28 Practical Pet Grief Tips

21:43 Animals Grieve Too

22:36 Book Plug and Wrap-Up

23:55 Final Thanks and Outro

If you want to help, you can donate to help support Hospice Explained at the Buy me a Coffee link https://www.buymeacoffee.com/Hospice

Hospice Explained Affiliates & Contact Information

Buying from these Affilite links will help support this Podcast.

Maire introduces a partnership with Suzanne Mayer RN inventor of the cloud9caresystem.com, When patients remain in the same position for extended periods, they are at high risk of developing pressure injuries, commonly known as bedsores. One of the biggest challenges caregivers face is the tendency for pillows and repositioning inserts to easily dislodge during care.(Suzanne is a former guest on Episode #119)

When you order with Cloud 9 care system, please tell them you heard about them from Hospice Explained.(Thank You)

Marie's Contact [email protected] www.HospiceExplained.com

Finding a Hospice Agency

1. You can use Medicare.gov to help find a hospice agency,

2. choose Find provider

3. Choose Hospice

4. then add your zip code

This should be a list of Hospice Agencies local to you or your loved one.