When Care Becomes Calling

Laurel & Ed New-auphonic(0:00 - 1:22)Hello, I'm Laurel Nicholson, the creator and founder of the Death and Resurrection Doula Training Program. Welcome to this conversation on my podcast. I'd like to introduce my husband, Ed Nicholson, and we have decided to take some time and share on my channel a little bit of his mother's story.I was an end-of-life doula to his family before we became engaged and got married, and she died about two weeks ago. And so we have had quite a journey together, and you'll hear by the end of this podcast, it's a beautiful journey, and God's faithfulness, even when things are overwhelming, His faithfulness is present. And despite some of the challenges that the family faced in getting the right amount of care for their mother, with her increasing dementia, she had a really, really good end of life and was surrounded by Christians in not just her family, but also in the assisted living facility and with the hospice care team.So we just thought this was something really that we should share and another way to highlight the value of hiring an end-of-life doula, particularly a Christian end-of-life doula. So I'm going to give Ed a minute to introduce himself. Hey, Ed.(1:23 - 1:49)Hi, honey. My name's Ed Nicholson. I grew up in New Jersey.I've been a musician most of my career as a professional musician. I've toured and played in lots of different places. I have been blessed to have that kind of a career.(1:51 - 2:28)And I lived in New Jersey most of my life. And I met Laurel a couple of years ago. A couple of years ago.I was living in New York City. She was living in New York City, and we were introduced. And at that point in time, my mother was living in a house, which was owned by a church.And the church was a church parsonage, actually. And my mom and dad had lived there for about 30 years. My dad had passed away.(2:28 - 3:04)My mother had been without my father for over 30 years, but my mother had still lived in the same house. And her living conditions were not really the best. I, at one point in time, ended up moving back in with my mother.And at that point in time, just realized how dire her situation was. She was living on one floor of her home. She wasn't able to go up and down stairs.(3:05 - 3:43)The people that owned the house, there really was no way to modify her living space to get her upstairs. So she was basically confined to one floor of her house. She was using a commode for a bathroom.And she was basically just washing herself in the sink. I remember there were tons of times I would wash my mother's hair for her. And so it was not a good situation.(3:43 - 4:00)So at that point in time, my brothers and I were kind of looking for, how do we find a better living space for my mother? And we were really struggling with that. I was going through a challenging time in my life. And my two brothers don't live in New Jersey anymore.(4:00 - 5:37)They live at opposite ends of the United States. One lives as far south as you can go, and the other lives as far west as you can go. So it was very difficult for them to kind of comprehend.So I was kind of, even though they were helping me, I was kind of on my own. So when I met Laurel and was introduced to her, she told me about her ministry, that she was an end-of-life doula. I had no idea what that was.I didn't even know what the word doula meant or anything. I was like, kind of curious. I thought that was kind of like a new age thing.And so I was kind of confused by it. But she was able to explain that to me. And I ended up going back to my brothers and saying to them, we actually had a Zoom call one day.And I went back to them and I remember telling my brothers, like, you're incapable and you're incapable. And I'm definitely incapable of figuring this out on my own. And I've met this woman.She is very skilled and knows a lot about end-of-life and just what we need to do, even as far as transitioning my mother into assisted living place, which at that time, we didn't even know how to do that. We didn't really, my mother had kind of managed her estate on her own. So we didn't really know like her plans or anything and had never really discussed that.(5:39 - 6:28)So that's where Laurel kind of came in and she was able to help us right away. So we hired her on a monthly basis to meet with my mom to help us get all of her paperwork and everything in order. She helped us find a lawyer.We ended up hiring a lawyer because we needed some legal things done. And so it was a blessing. 00.50 It was a blessing.And I do like to tell those who I train, when we form a relationship with a family, Ed and I had no romantic relationship at that time at all. But God is good. And through the work that I did with them, we formed a friendship.(6:28 - 7:28)I had been through a rough divorce. He was in the middle of a rough divorce and we were able to be very, very friendly with one another and supportive in things around faith and God's faithfulness to us, even in difficult circumstances. And his family was facing multiple difficult circumstances.And I felt really blessed as a family and helped them navigate the challenges that come with having an aging parent at home. And moving into an assisted living facility isn't always the next step for a family or moving your parent into a facility when things at home seem a little bit tough. But the specific circumstances for this family and boundaries that were in place, it was really the only option for Ed's mother.(7:29 - 7:56)And that was not really a difficult thing on behalf of an end-of-life doula to find a couple options and to coordinate visits. And at that point, Ed's mom was still somewhat mobile. With assistance, we were able to get her out of the house, into the car, and take her to tour a few facilities and even go out for lunch and make a day of it.(7:56 - 11:37)And so that was relatively the easy part. Getting his brothers on board was the easy part. Once we selected what seemed like the best facility through the tours that we had been on, there were several parts that met that criteria.And one, that it was during COVID. And the way that some of the facilities felt was a turnoff to Ed and to his mother. His brothers weren't there at that time in person.But we kept them updated on everything. And of course, what is the cost? One of those things that was tough around COVID is staffing. What are you guys doing with your staffing? What are your long-term goals with your staffing, with hygiene? So those were really important questions to think about, particularly during COVID.What are your requirements for residents? And so we did. We selected one of three that we toured. And I made a fantastic relationship with the director of sales.And it actually took the entire family one whole year to make the decision that it was time to move his mom. And she did not have any real signs of dementia that her sons noticed when we were first beginning that investigation of what are the next steps for her and her living situation. But the place that we chose had a full spectrum of care.When she did begin to show signs of cognitive decline, according to her assessments, they had a room available for her for an upward level of care with memory care. So it really seemed to be that everything was moving in a good direction with having found a place and having the family have these conversations and making a good relationship with someone on the staff at the assisted living facility. And so when the time came that things really began to become dramatically clear that it was time for no matter what his mother wanted, she really didn't want to go into a facility.So that makes the decision for the family extra hard. But everyone came to an agreement and the grandchildren were the ones that actually were able to talk with your mom and say, hey, grandma, we care about you so much and we want better for you. And they got the job done.They really helped your mother take that next step. And everyone was involved in some form or fashion with the move, whether it was filling out forms or actually doing the heavy lifting or helping pay for the move. So everyone really got involved and we got your mom into a better situation where something we might not think about very often, which is the showers.Sink bathing had its limits and she had some infections that were recurring and getting her out to the doctor was a challenge. Actually, when I think about it, I mean, we actually first got her some in-home care, but the expense of that was so much that we just decided, everyone decided that still wasn't working, even though they did a good job. We weren't able to get the frequency.And then that's when we. They did a good job, but your mom was canceling them. Yeah.(11:37 - 12:38)She would call the aid that was coming that day and say, I don't need your help today. And with these in-home services, typically there's a minimum that you have to meet in order to have these services. So it got complicated, but even with extra help, the plumbing probably was the biggest issue, was not having a bathroom in the downstairs.And so I think maybe one of the biggest reliefs of getting your mom into the facility was to be able to have caregivers who could really shower her and help her with her hygiene and have meals and have company with those meals. Because many times she would receive meals on wheels, people would just leave it on the doorstep and she'd have to get herself out to the step and pick these things up. So it really did change her quality of living in a dynamic way overnight.(12:38 - 14:24)Yeah. When she got into the facility, even though she did not want to participate, there were people around. If she went out to breakfast or lunch or dinner, there were people there and she did make some friends at that first facility that she was in.She made some friends there and she would, you know, when I would come to see her, I would find her with the friends. Mm-hmm. Well, and there was a piano and your mom was a skilled pianist and organist, and there were some points at which she was able to play and, you know, enjoy that.But she really retained the attitude that she did not want to be in a facility. Yeah, she did. Telling us that she wanted to go home.And I think that's just a typical reaction. But, you know, I mean, it also showed me, like, looking back now on the whole journey with my mom, it showed me how important, like, your services were at the beginning. And I don't think a lot of people realize that when you're trying to navigate, you know, a lot of families just don't have the time or the knowledge or the resources and the dual, you know, the dual services are, you know, kind of more of an inexpensive way, in my estimation, to kind of streamline bringing everything together so that it makes the end of life easier when, you know.(14:24 - 16:23)Well, one thing I think your family would agree upon was it was really hard to have conversations with your family, with one another about the fact that mom needs some care and attention on a new level. And it's uncomfortable, oftentimes, because that conversation means my mom is aging, my mom's not going to get better, things are going to continue to be challenging, and I really don't want to talk about it. I really would like to push this to the side and say, things aren't so bad.But they were, and they weren't terrible at that point, but they could have gotten to that point. So it was a good time to have a conversation. And then also, just collecting documents.You know, your mom was really organized. She had worked for a lawyer at some point in her life, and so she loved files and to be organized. And so she had a great binder already put together with end-of-life documents, such as her advance directive, which you had seen because you were on, you were your healthcare power of attorney.But when I was sorting through her things, I found she had further discussions with her physician and filled out something called a Pulse form. And it was in opposition to what you knew that care that she wanted, she had originally put on her advance directive, and you as her healthcare power of attorney would have clarified, you know, her care wishes for the care team in the event she wasn't able to. And so that came as a surprise to you.Your mom had not had that conversation with you. And so just diving into some of these particulars will open up, you know, a lot of blind spots that families might not be aware of. And one thing I really love about my work as an end-of-life doula, and particularly as being a Christian, is that, you know, with grace and with faith in God and the hope of heaven and the hope of resurrection, you know, bringing the context of Christianity into these conversations.(16:23 - 16:46)And you have a very strong Christian family. Your father was a pastor, and your brothers are strong believers, and you guys were able to rely on your faith to have these conversations. And as, you know, a private doula that your family hired, I was free to be able to have these conversations with you guys about these difficult subjects with the context of faith.(16:46 - 17:57)Yeah. But even navigating the faith journey, knowing that my mother was had, that that was a strong thing for her, even when we were looking at facilities, especially up in the Northeast, we found that a lot of the facilities just had no level of faith-based attention, you know, programs, anything like that. So that was difficult because we went to a couple different facilities and there were no, you know, we asked them, do you have chapel on Sunday? And they looked at us and they were like, we had three heads, you know.And so it was interesting navigating that. And then with having my mom down South more, it was interesting because, you know, we see a total difference. And I don't know whether that's regional or what that is, but it was helpful to have you there to help us navigate, you know, that.(17:57 - 27:24)Let's get to that, her move down South. But first, I just want to clarify that, you know, once we had her settled, you know, which was a family effort and a big effort on her part, she was able to have some visitors from the church and you, you know, could come by. But still, you know, I think there's a little weight that you felt on your shoulders because you're the son that lived locally.And so you were primarily a caregiver. You weren't doing the incontinence care and showering, but you were, you know, a caregiver to your mother. And so that posed a heavy burden for you.And I, you know, still we were in, you know, close friendship and professional relationship of, you know, talking through, you know, these experiences that you were having. And I just want to, you know, encourage anyone who has a parent who's aging and perhaps because of proximity, you're the closest one to them. And it feels like a heavy burden that it is, you know, it may truly be.And, you know, how does the Lord work in that? He has not abandoned. He's not abandoned us. And He has provided people for us.And sometimes we need to, you know, reach out and find those people or make sure they know they need to reach out to us and get in to our community. And we saw a beautiful thing with your mom's community. A few people she had taught piano with and another man at the church, you know, would help with some visits and, you know, picking her up and taking her to a doctor's appointment.Because no matter, you know, how expensive you find the assisted facilities to be and the skilled nursing facilities, some things you still have to pay for outside of that, like, you know, being picked up and taken to the doctor's office. I mean, there are certain things that just overwhelming to a family. So that, you know, that's another thing that falls on the caregiver is who is going to do this? I have a job and I, you know, am at work and I live, you know, 30 minutes from my mother's, you know, residence.So all these are a lot to balance with the caregiver. Maybe we'll pause on your mom's story for a sec and talk about our story a little bit and how the Lord began to work in our friendship and move towards something, you know, more serious, towards marriage. We were both surprised at that, even though I think you were, maybe you want to say something.No, I mean, I just think it was, you know, our relationship evolved out of a friendship, like you said, that we had built, you know, we both were divorced. My divorce had just become kind of finalized when we even, you know, of course you're an attractive woman and I, you know, I was interested in you and I had a close friendship. We had, we had, you know, we talked a couple of times a week and a lot of that discussion was about my mother and we were involved in some other things that, you know, ministry opportunities that God was doing in us.And then one day... Right. You invited me into some things with your ministry. I invited you into some things and you really began to be a supporter of what I do as a man of God.You had received the, you know, the benefits of hiring someone who does come along inside to serve families, alongside to serve families and these difficult challenges, particularly because as we talked about from the beginning, where do you start, right? Do you start with talking to my sibling who doesn't live here and then they don't necessarily see what I'm seeing? And that was a little bit of the response you got was, I think she's going to be okay. And you're like, well, I'm seeing it, you know, many times a week and this is going to have to change. Right.So getting people all on the same page is delicate often. And so you really fell in love with my ministry and being a believer and, you know, having spent years in the church as a worship minister, you saw, wow, families could really use this. I invited you into some part of my ministry, particularly in relation to moving towards setting up a training program and you had some, you know, other things that I could explore as well as I, you know, worked on building my ministry.And so anyway, we made the decision that the Lord was calling us to, you know, the blessing of marriage. And so we decided to move your mom to Virginia before you moved down to Virginia. That's a special doula.That was a special doula thing. God really kind of laid the groundwork for us, for our relationship. And we both saw that, but my mother made it down here before I did.She did, yeah. And she went to another facility that was associated with the facility in New Jersey. And once again, the family did a great job of kind of bonding together and working together to get my mom here.And then I was able to come a few months later when Laurel and I got married. And then, you know, that journey began here in Virginia. And that was a challenge too, but you can see the steps that were taken to get my mom into the facility down here and then to get her adjusted and then to have the support mechanism here because of my relationship with you and your family being here and have that support mechanism.I was still in a very fluctuous environment in New Jersey. I basically became homeless at one point in time and didn't have anywhere else to go. And we had planned on getting married anyhow.So we just kind of moved things up a little bit. We got married and the rest is, you know. Well, when your mom arrived in Virginia, if she had stayed in New Jersey, they had said the next step would be to move to a memory care.Yeah. And she was actually, thinking back, my mother was in hospice at that point in time. They had to put her into hospice in New Jersey and she had entered hospice and she was declining at that point in time.She had dropped a lot of weight. And so it looked like she could be entering the end. And they were thinking about moving her.Her dementia started at that point in time. So they were thinking about moving her into a place there. Right.Memory care. Memory care. To the memory care floor.Same building, just different floor. It would have been a different team of staff. But it was a good time to move her to Virginia.Of course, they do another assessment at the new facility and they also assessed her for memory care. So she moved into a memory care room, went from a private apartment and assisted living into a shared room. But they took her off of hospice.They took her off of hospice because she was rebalancing with weight. Well, and I think because the criteria is different for from state to state. And now that I am in the hospice business, I've learned a lot about that.But we can talk about that later. But but it was interesting because my mom got here and we didn't know a lot of things. And now that we're dealing with my mother's estate, there's a lot of things that are financially burdens, but on the family, which is why you really need to once again, just really be communicating with the facility, talking to people and and be careful because the the facility that we moved my mother into down here did not have they we I kept asking them, do you guys have Medicaid beds? Because my mother was basically using her estate to pay down like to finance her living in the facility.And this was very expensive, which was very expensive. And I knew she was going to run out of money at some point in time. So we really wanted to know that there were Medicaid beds because she would have to transition from Medicare to Medicaid at some point in time.And what ended up happening was my mother ran out of money and then the facility said, we don't have any Medicaid beds. Let's not get there yet. I want to talk about while she was at the memory care.(27:25 - 27:52)She continued to decline because moving is hard. And she moved across states. I mean, I don't think she really fully understood.She was she became a Virginia resident. And then actually, we really you realized when you were enrolling Medicaid that all of the complex things going on your family, you guys didn't she didn't really become a Virginia resident. You know, we changed her mailing address and, you know, on the forms.(27:52 - 28:04)And that was really it. She wasn't voting and she wasn't didn't need a driver's license. So so that detail was was left out amidst the, you know, complications of everything going on.(28:04 - 28:13)But she she continued to decline. And then it seemed like she plateaued a bit. And she just said that plateau was sort of just in being pretty, pretty miserable.(28:14 - 28:36)And because she she she she might have gained weight, but her dementia set in a lot further in when she moved down here. And that's a declining thing. And knowing what I know about hospice now, it's not weight gain or loss that it just dictates whether or not you're on hospice.(28:36 - 29:06)It's a lot of it is are the other onset things that lead to decline, which are dementia, heart problems, breathing problems, which my mother had. And so a lot of that plays a factor in it. Well, your mom being, I mean, miserable is not a great word, but I think it's the right word.(29:06 - 32:47)It is the right word. And and that was really hard to know that, you know, your mom seemed to be declining towards end of life in a way that you you know, she never would have wanted. You wouldn't have wanted that for her.But with the logistics of your family, you know, having her in a member care facility was was was the only option that seemed, you know, to be available for her health, safety and and hygiene and all of all of those those important things. And so it it tests your faith, tests your family faith. Like, why is my mom lingering? We know she would rather be with the Lord.We know she misses my father. But it kind of seemed like there was this period where it just seemed like, will this go on forever a little bit? And and, you know, we know the Bible says that we long to be with with God. And so it's really hard to see someone that you love so much enduring the decline and, you know, dementia and her irritability and and just total misery about, you know, being in a place that she really didn't want to be and didn't really, you know, know where she was.The staff was really sweet. You know, she seemed to get along with her roommate like those weren't those weren't, you know, the challenges. It was just the the emotional and spiritual challenge of of hardship.I mean, a trial in her life, you know, our trials and tribulations continue, even if, you know, we're elderly and in a memory care unit. And so it was a real trial and tribulation for her. And, you know, watching that and not having, you know, the capacity to, you know, financially to to make it to make it better.And and so she runs out of her money and, you know, challenges around that. You got to hire a lawyer to get help with with the Medicaid application. And again, that fell on your shoulders, became your burden.And at that point in time, I was getting doula services for free. Yes, you were. Because my doula had become my wife.And that was very helpful because a lot of those things that I would have had to have navigated on my own that I didn't know the answers to, you were able to help me. Well, the emotional support is a huge factor. And particularly when the burden falls to you, you know, and you've still got work and, you know, family obligations and, you know, stressful things on on top of you and and your own trials.Right. And then to take on, you know, the burden of your mother who cannot do these things for herself. And sometimes, you know, you walk in her room and she's not happy to even see you.Yeah. And, you know, that's hard. And, you know, so the whole the whole journey of, you know, aging along with your parents is they're aging and bearing that responsibility.And then and then the pressure that comes with being, you know, I was the caregiver at that point in time and I was the one who started I was kind of left on my own. The facilities make you feel like you're going to have some help, but then they kind of abandon you when it comes to what your parents had to hire a lawyer to deal with the facility. Boy, that was your your family situation is there were some increases on the bill that were not explained and the money did drain faster than you expected.(32:47 - 33:28)And then there was no Medicaid bed. And and so then. So then we had to scramble to find a Medicaid bed.And the wait list everywhere where we were, 100 people, 50 people. That was the answer. We got we have a two year wait list.Right. And you think, what am I going to do? You know, and the facility was sending letters saying that if you don't have your mother move to a new place, like we cannot keep her here. Right.So that becomes, you know, another burden. And in your case, you know, hiring a lawyer was really the the right step. And she was fantastic.Yeah. And praise the Lord. And I don't remember why you decided to call 45 minutes away, but you did.(33:28 - 37:13)One day I just decided I'm looking in the wrong place. So I looked in the opposite direction. And as soon as I called the facility, they said, we have a bed.We have plenty of beds. And, you know, not as nice a place, a more state run facility. It's still a private facility, but more Medicaid beds and, you know, long term care patients that, you know, didn't have the resources to do private pay and stuff.So but great people, great stuff. That's one of the things I would tell people to watch for is just because a facility looks good doesn't mean the staff is good, because I, in my opinion, if it looks good, the staff is probably not that great. If it doesn't look good, then that means they really care about their staff and they really care about having a good staff.And that's where they spend their money on. And so it might look like a hospital. It might not look like much, but the level of care is going to be there.And that's what I found when my mother moved to this more state run place, which actually was in a beautiful, beautiful town, beautiful town in Virginia. And, you know, the people there were local people. They cared for my mom.They took better care than the facility she was spending fourteen thousand dollars a month at. You know, they actually took better care of her at this facility. And to this day, I have a great relationship with the people there.So that's right. That's a real that's a real right. Well, and your mom perked up a bit.She was more mobile. Yeah, she became very I remember I at at the one facility she wasn't she would stay in her room. She would never go to meals.She would everything was brought to her. You know, they complained about her, actually, because they're like, she won't come out to meals. She won't do this.She won't do that. And and then she moved, you know, an hour away from us. And the first time I came over there to visit her, she said I was like to the nurse.I went to the nurse's station and I was like, where's my mom? She's not in her room. And they're like, oh, she's never in her room. And she was actually way far down the hall.And I was like, how did you get there? And she they go. She just scoots herself around in her wheelchair and she gets to where she's got to go. And that's pretty much the way she was for the nine months she was there.And, you know, as her dementia advanced, we began to notice she was less for a period. She was a little bit, you know, less miserable about her surroundings. And you would think, you know, we took a step as a, you know, book cover might be judged, you know, took a step down and in the facility.But your mom actually became a little bit more social, social. She definitely social. She got better care, way better, way better care.I mean, my mother was showered. Her hair was done. They even, you know, she would do her nails the best she could do in the activity room.They had things going on for her. She was, you know, eating and, you know, they were just it was just a better environment for my mother and a more faith-based environment too. So, which I thought was important.(37:13 - 37:16)It made a difference. It did. It really made a difference.(37:16 - 42:13)And then just, you know, toward the end of my mother's life when hospice came in. Let's talk about that because I want to say, you know, one thing you really struggled with prior to hospice and how the Lord worked that out. And you share power.You shared the healthcare power of attorney with your brother. So, you guys were, you know, communicating about any changes in her, in her health. But one of the things that was like ethically challenging was the question, my mom's been on these medications, some of them since she was 60.And you don't want to, you know, she was used to palliative care, palliative care. And you said to the palliative care doctor, are these sustaining my mom's life? Right. And I was really surprised at her answer.And what she told you was that, she told you that, no, they weren't sustaining your mom's life, but that they were preventing a stroke, for instance. And that with dementia, you can live a really long time bedridden after having a stroke. And so, your mom being social again and a little bit, you know, able to get herself around, that for her to remain on those medications to prevent a catastrophic stroke or something that put her in the bed and she could still live for, you know, many years, was better.And that's pretty much, that was better. She stayed that way. And so, we said, okay.But still, it was a challenge for you. Like, you know, am I keeping my mother? Yeah, your question, am I keeping my mother alive? You know, you want the transition to be peaceful. I never wanted my mother to be in pain or you wanted her to be peaceful.You wanted it to be a good transition to eternity. I mean, basically. And that's really what happened at the end.So, your mom started refusing the medications. Yeah, she started actually hiding the medication. Hiding, right.And then you got a call. Yeah, I got a call from them and they said, hey, we think it's, your mom's starting to decline. She's hiding the medication.She's spitting it out. We're finding it in her room. Her dementia had really fully kind of kicked in toward the end.And she could still, she still knew who I was. She still knew who Laurel was, but she was not happy. And she just kept talking about, like, wanting to go to heaven.They increased her antidepressants, they told you. And she seemed pretty lethargic on our visit. And so, the move to hospice was swift.I don't think we were, you were expecting it. We kind of just expected it. We don't know how much longer this will go on, but we're here.We're on the journey with her. And then you got the call and you had just started working for hospice, taking on a role of music therapist, which is really special. And we should come back and do a whole nother episode about that.But let's talk about getting her into hospice. And that was really, really, it probably went better than anything we've done with your mom at all since I've known you for, you know, four years. For sure.Yeah, my mother, the transition, I got the call from the facility and they said, we think it's time for your mom to enter hospice. She's on the decline. We see weight loss.We see her dementia really, the confusion and everything really coming in. They have all these, you know, gauges that they keep. Now that I work for hospice, I see those gauges of, like, where the progression is at.And so, yeah, it was a quick process. I mean, they asked me, we're going to put her on hospice. And they asked me who I wanted to use.And I was like, well, you better use the people I work for. So, which actually was an advantage for me because I got a lot of updates and things, the nursing staff and the aides really kept me in the loop as far as what was going on and stuff. And they do.A good hospice company will keep you in the loop. You know what I mean? They'll be very communicative and very responsive. That's one of the things.Medi Hospice, if you hear the name. Medical Services of America. Medical Services of America.I'll give them a plug right now. But they are very, very good at response. And from the top up, from the doctors, to the nurses, to the staff, everybody responded.It was a matter of days. And my mother was in hospice. She was.(42:13 - 42:30)Kelly Cervantes She was getting her regular visits. They started morphine. But they kept you up to date on all of this.And that's often, you know, really hard for families because morphine seems scary. Dr. Justin Marchegiani Yeah. But that even didn't happen right away.(42:30 - 42:36)They started out with my mom. I think my mom had two aides and a nurse every week. Kelly Cervantes Right.(42:36 - 43:09)Dr. Justin Marchegiani And during that four, I think it's five weeks that she was on hospice. Kelly Cervantes Total. Dr. Justin Marchegiani Yeah, total.And the other thing is to let people know, a lot of people think hospice is the end. It's not. We have clients that work, that are part of our hospice, part of hospice for our company.Some of them have been on hospice for years. They're just in decline. Kelly Cervantes And they're not seeking Dr. Justin Marchegiani And they're not seeking curative treatment.(43:09 - 44:48)Kelly Cervantes But it doesn't mean that their quality of life is not first and foremost, what's what's important. And they can actually have extended life with a higher quality. Dr. Justin Marchegiani Yeah, because the rebound and that's something that I could add is even when mom was in New Jersey, when she went on hospice, there was a rebound because she was getting extra care and it helped her life get better.So and so a lot of times that is but I will say our staff did a great job. Yes, when my mother went on had to start going on morphine. They were very explained it to me.It's about comfort care at that point in time. A lot of it seems very scary. And I will tell you, I made the mistake of at one point in time, I wanted my mother to wake up because I wanted to have a conversation with her.And I, the nurse from the facility had come in, not our hospice nurse. But she said, you know, do you want me to give your mom morphine? And my mother was sleeping at that time. And I was like, no, wait, you know, we'll see how.But then my kind of woke up and the hospice nurse came in and my mother was very agitated. She was trying to throw herself out of the bed. And it was scary.It was not something I wanted to see. And so I remember Sarah, our nurse from hospice, got my mom calmed down, got the medication working again. And my mom went back to sleep and she stayed sleeping until she passed.(44:48 - 44:57)And hospice explained to you. The doses of morphine were small. They were really small doses of morphine, but they keep my mother comfortable.(44:57 - 45:13)And that it was okay for her to sleep out the last day. And she was, you know, well, she was sleeping, but that doesn't mean that she didn't know you were there. And she didn't hear your voice and, you know, wasn't aware of some of the things going on.(45:13 - 46:38)She wasn't sedated or anything. She just was sleeping comfortably. And at that point in time, we were going to see my mother every day, pretty much there.And then I was able to go the day that my mother passed. And, you know, I was able to go and sing for my mom. And then, you know, it was just a quick story about that.My mother, I sang for my mom, the hospice nurse came in, our weekend nurse, Natasha, came in and my mother, um, her heart stopped beating for 15 seconds. And then all, and I was, my eyes welled up. I thought she was gone.And all of a sudden she started breathing again. And Natasha looked at me and she said, sometimes that happens. You know, and she said, sometimes this could go on for hours.So at that point in time, Laurel and I decided we'd go grab some lunch and maybe come back to the facility. And, um, so we did that, but then we decided to go home. We prayed about it.We said, should we go back? And we decided to go home and perhaps come back in the evening because the hospice nurse, she came by and was, you know, beyond explaining about the morphine, which is oftentimes hard for families. She, you know, showed you your mother's feet and what she was checking to see how close is your mother getting towards her last breath. And she said she was getting close.(46:38 - 46:47)And she showed you, right. She showed you her feet and the modeling and it was just really clear about it. And, um, I think you really appreciate it.(46:48 - 48:24)No, I did. It helped prepare you emotionally, spiritually that, you know, your mom was really nearing. Yeah.And then we, we decided to go home and we were driving over the mountain and Natasha gave me a text message and she said, you know, my mother had passed and, and so, but it was peaceful. And that's another thing that they, that information to share with people is, um, Natasha told me, she said, they, this is just surmising death that a lot of times with parents, if you're in the room, your parent doesn't want to die. They don't want to leave that covering of being a parent, it's still there.And so they will fight to stay alive. And, and so who knows? I, I left the facility and my mom passed at that point in time. And so then I was able to grieve and came back and spent some time with my mother there.You know, they had dressed her body, which is another thing that facility did a great job. They, I, I was, her roommate was moved out of the room. I was there with my mom alone and Laura was able to come in with me and we were able to just pray and spend some time with my mom's body.And so that was a lot of closure there. And it was evident that your mom wasn't in, you know, that was her body and that's what you bury, but that she is no longer there. So, you know, you bury her, you know, that's, that's her body.(48:24 - 49:04)You were surprised when you walked in the room and I was just kind of cleaning up stuff and Laurel's like, are you okay? It's okay to be with a dead body. And I was like, yeah, that's just flesh and bones. It's, it's not, you know, that's, you can even see the, the, the life had just come out of my mom.And I remember I had taken a series of pictures with my mother leading all the way up to that point. And at that point, she is a lifeless, her soul is not there anymore. And so for me, that, that gave me peace and closure with God that my mom was okay and that she was starting her eternal journey.(49:04 - 53:05)And that, that was a great thing. I want to share a few highlights that I noticed and had in conversation with her, the aid that worked for the skilled nursing facility. He was just so wonderful.And, but you know, your mom's Christian and played the piano. He, he told you that just a few days before that she had, or maybe within the week, a couple of weeks, pushed her up to the piano and she had played. And he said, her muscle memory was amazing that she was playing these hymns that he knew from church.And he was like, I couldn't believe that your mother knew all these hymns and she was playing. So yeah, you don't, you know. And then there was one of the days before, I think it was a day, two days before she got in bed.Right. And you did receive a call that your mother hadn't gotten out of bed that day. Right.And that's always a little bit of a surprising call as well. And I think around that time they were increasing the morphine. So there was a lot of change right there, but, but we had been to see her and you took your guitar and her roommate was adorable and a believer and, and told you that all she wanted you to sing was, I'll fly away.And we had a concert and, and your mom was more clear that afternoon than we had seen her in years. I mean, you in years and, and, and she, she didn't sing, but she was, she was there and she was paying attention and then she wheeled herself out and we were leaving where she was crying. And she said something about heaven.I remember that. And we just timed it so well that your, we made a phone call to your niece who had just had a baby. So she got to see her great granddaughter who was born premature and wasn't able to come out of the house and drive over.But she was able to see her. And then my nieces were able to, family came during the week because they realized that it was close for my mom. And then she was kind of entering that time of, of her life coming to a close.And, and so that was a, that, that part of the journey ends and the eternal journey begins. So it's, it's, you know, that's the hope of a Christian is that we, our hope is, is that death is conquered and that our life will, you know, our life goes beyond the grave. That's right.And just, you know, we've shared, we've shared a lot here. We've shared about, you know, the, the, the difficulty from the beginning, you know, your mom really never wanted to move into a facility and it was hard to get the whole family on board. There were another, no other reasonable options for her care, you know, presented or considering anyone had the capacity to, to execute other options.You know, and it was, it was, as I mentioned, it was a trial for your mom, you know, it was, it was a hard part of her life, a hard part of, of, you know, of everyone's life in the family and, you know, times of close to despair that, you know, why is it like this? You know, the, the expense that I don't feel like my mom's getting as good care that we're, we're hoping for, that we're paying for. And then the, the difficulty of, you know, moving into state care, you know, state paid care and, you know, all of the hurdles that go with that and, and, you know, hiring, getting an attorney on board, you know, all of that is, is really, really difficult. And you can just think like, this is futile.This is just futile. Like why do we outlive or why do we live for so long and, you know, rely on these medications that do keep us alive to a reasonable age if we have some condition, but then, you know, where are the ethics? Where do those begin? Where, when is it okay to say no? But all these questions, I think were really answered so well in your mom's last few weeks, because we just saw how God beautifully worked things out. And even her roommate, I said to her roommate, I said, you know, we can't be here all the time.(53:05 - 53:32)We live 45 minutes away and we're working and, but you're vigilant with her. And I don't, you know, the roommate didn't really think of it like that, but it's true. She was in that room at every moment.So your mom was not without another person ever in that room and the aides were in and out. And so everything was really summed up and I think it couldn't have gone better. No, I mean, it's a peaceful, you know, transition.(53:33 - 53:47)Yeah. And you have this memory now of spending one of the last hours of your mom's life ministering to her through music. Your mother, who was a musician, taught you how to sing and play.(53:47 - 54:19)I get to do that every week with all the patients that I get to sing to. So you said to me just the other day, I see why you're so passionate about the work that you do. Because being with people at the end of life is just a really special time.And I believe that, that, you know, we never need to doubt that God's faithfulness will be there. And that Christians are really special to have around at the end of life. It really makes all the difference.(54:19 - 54:39)And we saw that through, you know, the hospice. Everyone on that team was a Christian. You have a Christian family.You had a Christian end of life doula. You know, some of the staff members at the facility were Christians. The roommate was a Christian.Your mom was a believer. And God's presence was there. And the promise of resurrection was there every moment.