ERP 426: How To Consider & Discuss End Of Life Care In Relationship — An Interview With Dr. Bob and Elizabeth Uslander

By Posted in - Podcast May 28th, 2024 0 Comments

Navigating end-of-life conversations can be emotionally challenging and riddled with uncertainties. Many individuals and families struggle to broach topics surrounding preferences for care, leaving them ill-prepared for crucial decisions during times of crisis.

In this episode, we embark on a journey to explore practical strategies and insights aimed at facilitating these delicate discussions with compassion and clarity. By providing actionable guidance and fostering a deeper understanding of end-of-life care, this episode equips listeners with the tools needed to approach these conversations thoughtfully, empowering them to honor personal values and preferences with confidence.

Dr. Bob and Elizabeth Uslander co-founded Empowered Endings, a unique palliative and end-of-life care model addressing the physical, emotional, intellectual, and spiritual needs of patients and families. Bob Uslander, MD, received his Medical Degree from the UCLA Geffen School of Medicine and practiced medicine in Emergency, Palliative, and end-of-life care for over 30 years.

Elizabeth Uslander, MSW MTS, received her BA cum laude from Georgetown University and earned her Master’s degrees at USC and Wesley Theological Seminary.

In this episode

03:49 Bob’s transition from emergency medicine to palliative care and the founding of Empowered Endings with Elizabeth.

09:12 Elizabeth’s journey in spiritual care and social work shaping palliative and end of life care focus.

11:47 Integrating end-of-life doulas in comprehensive care planning and support.

18:48 The importance of having proactive, intentional discussions about end-of-life preferences within couples.

32:54 The role of spiritual practices and emotional connection in navigating end-of-life conversations within relationships.

38:29 Cultivating readiness and practical tools for end-of-life conversations.

Your Check List of Actions to Take

  • Start end-of-life planning conversations early on to ensure clarity and alignment with personal values and desires.
  • Utilize tools and frameworks to improve communication within relationships and support difficult discussions.
  • Seek external support or an advocate to bridge communication gaps when necessary in relationships.
  • Create detailed end-of-life plans, including wishes, concerns, and desires to provide clarity to loved ones.
  • Explore and understand your own relationship dynamics before engaging in shared relationship discussions.
  • Respect individual choices and meet people where they are in regards to end-of-life conversations.
  • Provide wraparound support for patients and families to address uncertainties and ensure safety in relationships.
  • Offer holistic end-of-life care through collaboration with doulas and healthcare professionals to support patients and families in their journey.

Mentioned

Relationship Map To Happy, Lasting Love

Connect with Dr. Bob and Elizabeth Uslander

Websites: empoweredendings.com

Facebook: facebook.com/empowerendings

YouTube: youtube.com/@Empowered-Endings

Instagram: instagram.com/empowered_endings_

LinkedIn: linkedin.com/company/empowered-endings

Connect with Dr. Jessica Higgins

Facebook: facebook.com/EmpoweredRelationship 

Instagram: instagram.com/drjessicahiggins 

Podcast: drjessicahiggins.com/podcasts/

Pinterest: pinterest.com/EmpowerRelation 

LinkedIn: linkedin.com/in/drjessicahiggins 

Twitter: @DrJessHiggins 

Website: drjessicahiggins.com  

Email: [email protected]

About Today’s Show

Bob and Elizabeth, thank you for being here with us.

Thank you for having us.

Thank you. 

Yes, this is an important topic that I know doesn’t probably get enough attention in the way of the end-of-life phase, and you both have a way in which you support partners and couples in approaching this topic. Before we get started into that focus for today, would you be willing to share, with people who maybe don’t know you, a little bit about yourselves, what got you interested in this focus or this area? 

Sure. Do you want to start? 

Sure. I’m Bob, of course. I started out as an emergency physician, I started my career in emergency medicine. I chose that field for a number of reasons, primarily because I felt like being an ER doctor would allow me to really be what I thought of as the true comprehensive Doctor, who could deal with anything that came up at any moment, practicing in the emergency rooms. But also, if I was out in a movie and somebody collapsed, I would know what to do and I’d be able to just support. 

I had a long and pretty successful, I thought, career, as an emergency physician. But after a while, one of the things that started really just troubling me was the way that people were being cared for as they were older, and when they had complex illnesses. I felt like the system just wasn’t being very sensitive, that we were barreling ahead and trying to save people who really would never want to be saved; they would never want to have all the resuscitation and hospital admissions and be brought into the medical conveyor belt. 

I ended up helping a good friend of mine go through the end-of-life journey about 10 years into my practice, and it really opened my eyes to a different way. I saw hospice care for the first time, and realized that there was a different way that people could approach the end-of-life experience. That planted a seed in me, and then about 10 to 15 years later, I was looking for a transition. I was ready to transition out of emergency medicine, and I just fell into palliative care and hospice. I say I fell into it, but really, I was called to it. I had sort of a clear epiphany that it was my calling, that was where I was meant to be. 

One thing led to another, and about 10 years ago, I was hired to help develop a palliative care program and work in the Hospice Arena in San Diego. So I started going to people’s homes and helping them navigate their complex and challenging illnesses, and supporting them as they were dying. I became aware of so many gaps in the system that were causing people to suffer unnecessarily and needlessly. Both of my parents went through their end-of-life journeys, and I helped support them. Just understanding what it was on the other side, to be a family member, through that journey. 

I got inspired to start my own practice in 2016, and a short while later, I met Elizabeth and she joined the practice. Then together, we really transformed it and created what is now Empowered Endings, which is a collective of several entities that all share the vision of supporting people in having the best possible end-of-life journey, and empowering them and supporting their loved ones. We’ll share more about that. 

But that’s my story. I couldn’t imagine being in a better place. I couldn’t imagine doing anything that was more meaningful and fulfilling. I couldn’t imagine doing it with somebody who I had more respect, compassion, and who inspires me more. What about you?

Yeah, Elizabeth, I would love to hear from you. I just also want to say, Bob, as you’re describing, it sounds like you and your company and your business is offering an alternative to what they may have been exposed to in more allopathic medicine. Also, how you’ve come through it, it’s been very comprehensive, and your vantage point. Then also, Elizabeth, you bring such value here too. So would you be willing to share a little bit more here too?

Of course. My journey is a little bit more of a long-winding road, not so much a direct shot into medicine. So my journey started actually with a personal journey. At a really young age, I was exposed to and had the opportunity to explore a wide variety of spiritual practices, which really shaped my life and my work and my passion. I had my first Hindu guru when I was four years old, my first Lakota Sioux shaman when I was 12. I studied Buddhism in Sri Lanka when I was 16 on a fellowship, and just on and on and on from there. But I didn’t realize that I was going to go into spiritual care or social work. I was always really interested in social services, and that was the focus of my work. But through a series of life events, I was redirected. I ended up going to seminary, and not going into serving the church for a variety of reasons. So then I went looking for how I could be really of service to people one-on-one, and went into social work. In the intersection of spiritual care and social work, is how I ended up in palliative and end-of-life care. 

Everything that I went through in my life—a major health crisis, the loss of my daughter’s father, subsequent loss of many friends and family—helped me to really understand what it is to be in those valleys of shadows of death, of deep loss, and of feeling isolated and confused and scared and disconnected. Really not knowing where to turn, or who to talk to, or how to move through those things, in a way that was healthy or safe. 

That shaped my focus in this space on family members in particular. So supporting patients and navigating their journey and transition, especially with my interest in spiritual care transitions and practices. Because the end-of-life transition is certainly one that focuses on the veil, and different kinds of things that can happen. And what we now understand as spiritual, which I think is probably just immeasurable, scientific things that we haven’t figured out how to understand yet. But the focus on partnering with the families and supporting them and supporting their loved ones, and partnering with the providers, like my husband, in supporting the whole system, and partnering with all of the people who are part of that system. It was really shaped by my personal experience as much as my professional experience.

Wow, I’m just impressed about what all you’ve brought together. As you’re describing, Elizabeth, both the understanding of the spiritual context, and then also the system’s perspective of social work, and the interconnectedness of relating and families, and also just this very profound time in one’s life and the end-of-life. Also, just again, the medicine and the providers and the care that’s offered and how that’s treated. It sounds like it’s just quite special what you both are offering. 

Before we dive into this topic, I’m just curious, are you assisting people in a greater way? Or is this more localized? You’re in San Diego, California. Is this something other people in other regions can access?

The direct care that we deliver is predominantly in Southern California; LA, Orange County, the Palm Desert areas. But I am able to care for, and we do provide care for people throughout California in some capacity. We’re building an educational institute and programs that will be able to support people in various ways throughout the country, and then, hopefully globally.

So it’s almost as if you have a model that others could replicate, and/or you consult and that helps provide this path for people who maybe don’t have it as an option. 

Exactly. So we have a medical practice in San Diego that’s been operational for seven or eight years, and we have been recognizing the transformative experiences that patients and families have had. So we actually started systematizing the practice, so that we could identify how other people could create these same transformative experiences. So that is something that’s going to be possible for people to do. Doctors and doulas throughout the country could recreate the model that we have. We also have the institute which offers programming, but also a resource library and an online community. So people of all places and interests—like-minded professionals, community members who are interested, care planners, providers—anyone who really wants to connect and explore these topics will be able to come together and do that together, with different topics and resources and experts who can help guide them and connect with them and share their experience too. 

Well, you mentioned doula, and I know a lot of people know doulas as it relates to supporting a birthing, a person being born. Then there’s also death doulas, which are helping people transition. It’s sounding as if with this comprehensive wraparound systems, multiple providers, like people have birth plans, I’m wondering if there’s even a way in which someone wants to. It might not be so clearly done, but that there’s an intentionality to it. Am I hearing that?

Absolutely, an important part of our model is to offer planning for people. Not just the planning that a doctor might do in the 15 minutes that they’re allotted when the patient comes to the office. But to really sit and explore, with the patient and their loved ones, only if the patient is open to engaging them at that point, and just exploring the things that are most important to them; what they value, what they’re afraid of, what they’re excited about. 

Then help create a plan that gets documented clearly and in great detail, and also communicated to their loved ones, so that we can open up a conversation that allows people to question some of the things that have been identified in that plan. So that as things unfold, it doesn’t come as a surprise that mom might want to go through medical aid and dying if she has a terminal condition and she’s struggling. Or that she might want to stop eating and drinking and allow herself to die naturally if she reaches certain thresholds. So those are the valuable conversations. It also looks at what kinds of rituals they might want around the time of death, what kind of celebration they might want, how they would want their remains to be disposed of, and all those things. So the doulas, we work very closely and we’re engaging in training doulas and helping build partnerships between doctors and doulas, which is something that’s really exciting and novel, I think.

Yeah, one of the unique things about the practice is actually that, to our knowledge, it’s the only medical practice that partners with doulas. It’s the only space in the field of medicine where doulas are really legitimized and have an opportunity to do what they do. Right now, like you said, the birthing movement is a bit of a model, where it used to be a doctor and a pregnant mother in a hospital, and that was it, and it was a very medical experience. Well, long before that, it was not a medical experience. So the birthing movement was to really bring back the holistic and what’s possible, and to help people understand that they can choose what it is that they want that experience to be, and create different spaces, like holistic birthing centers, and having midwives and doulas be the primary planners and providers through that. 

Similarly, there’s a giant movement of people who want to provide that kind of holistic, attentive companionship and guidance, through the end-of-life journey, who are really passionate about being present with patients and families. Some hospice nurses who have been working in the field for decades, who have become disillusioned with the way that hospice is about now more the bottom line and the documentation and the billing, instead of about being with the people who are in this journey. Those people are really passionate, and they don’t really have anywhere to practice. They can be hospice volunteers, or they can have private businesses. But there isn’t really a referral mechanism, and there isn’t really a way to partner with healthcare professionals. So that’s part of what we are trying to change. We really want to help integrate doulas into end-of-life care, because they bring such extraordinary value, and in particular, the companionship and the presencing—like you said, a system of people who are going through this journey—is so important.

Absolutely. Well, I want to back up. I know the show is geared towards people in relationship who are navigating partnership and long-term intimacy. As we’re talking about end-of-life stage, there are many people that have the awareness that it’s coming, whether or not it’s through some diagnoses or illness or indicators that alert them too, or just their age and sense of things that that phase is approaching or is coming. There are other people where this doesn’t happen, it’s more sudden or accidental or unexpected and tragic. One of the things that it sounds like you both do is to help people, or just even through this educational piece, to give honor to end-of-life. Also in couplehood, to have these conversations, where typically, like you’re saying, maybe the first time someone is talking about it is with their doctor, when really, we could be having these types of conversations in couplehood much earlier. Can you say a little bit more about just the conversations and how couples might be able to approach this or discuss this?

Well, I think it’s really important, first of all, for people to explore. I think one of the things that’s really important is to understand our own relationship with who we are and what we want, and how that might look. Sometimes those are things that we process in couplehood. Sometimes those are things that it’s important to self-reflect before we bring to the relationship. I think one thing that’s really interesting is that a lot of people might have different ideas; a spouse might want to do something some way, and their loved one might want to do something a different way. So I think that’s one of the main reasons that it’s really important to talk about these things. If we’ve lived together for a long time, we may assume that we know and understand what our loved one wants, and we may be surprised. We may be surprised at what thresholds they have in terms of treatment care and options. We may be surprised at what options they may want to engage. It can be, I think, really challenging to make those decisions on someone’s behalf in a crisis moment if we haven’t explored them in advance.

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“I think the most important thing is actually being able to understand what it is that we want, and communicate openly with our partners about that. So that they don’t get caught by surprise, and aren’t stuck in a position of having to choose something that maybe feels misaligned for them, because they haven’t come to totally accept or understand it before they have to do that one.”

One of the services that we provide for people is support through medical aid and dying, which is legal in California and in 10 states now. When we meet with people who have been diagnosed with a terminal condition, and their life is coming to an end, and they choose to explore this option. When often, we meet with people whose families are very aware and ready for this, because they’ve been having these conversations for a long time.

You can see a big difference between families that have and families that haven’t.

Totally. It’s like, they’re not happy that they’re losing their loved one, the spouse or the children. But it doesn’t come as a surprise, because they’ve been talking about it. They’ve said: “If I ever get to a point where I need to be on pain medication, to the point where I’m not able to communicate. Or I lose my ability to do X, Y or Z. I’m just going to check out.” There’s different ways. But when that’s a conversation that’s been present, it’s a different experience. Than, when somebody just springs it on their family and says: I just heard about this thing and this option, and everyone now is having to figure out how to accept that. 

I met with a family yesterday, a gentleman who’s gotten bass liver disease and is really struggling. They’ve been told that it’s possible that he could get a liver transplant, but it wouldn’t be able to happen for a few months, and he’s been hospitalized several times. You could tell that he’s just done with all that he’s suffering, one complication after another. His wife of 35 years and his daughter are wanting to support him, but there’s a part of them that’s also wanting him to push forward and do everything possible to get more time. One of the things that I often hear is that the patient says: “I’ve done so much, I’ve lived my life, there’s nothing else left for me to live for.” I hear him say that, and I understand what he means. But I also look at his family, and I can feel what it would be like to have somebody say I have nothing left to live for, and wanting to say: what about me, what about us? Aren’t we enough to want to live for? 

It could take them off track. That when the focus is around the way in which somebody has the capacity and the functioning to engage, that can impact the quality of connection. So it’s not so much that you’re not worth living for, but how I’m able to engage in function greatly impacts my ability to experience that interconnectedness. Thus, it informs the lens. But that’s not at all spelled out, just even that first language.

So that’s exactly the thing, I think in terms of these conversations, is sometimes people say things that are understood a certain way, but actually what they mean is something very different. That’s one of my favorite things in terms of providing support to families in these journeys, is when I hear these stories or when I’m in these spaces with these families, I hear the words that this person is saying. But I know that he’s not saying, my wife and daughter are not worth living for. 

So if that’s what they’re hearing, then it’s really valuable and important to have someone there who can catch that and actually mitigate the impact of it. That on the off-chance that that is what they’re thinking, being able to, in the same way that you are, reflect back. I can understand that this feels like an amount of suffering that you don’t feel like you should have to live with, and exploring maybe what are the things that bring quality of life. So that that can evoke the articulation of his love for his family, and evoke the articulation of the things that he has enjoyed and the legacy that he feels like he has, and all of the wonderful things that are also there. But that’s not the focus, because of the pain and suffering that he’s experiencing.

Well, it sounds like you’re assisting and allowing that connection and nurturing that bond through these very tough conversations, so that it doesn’t become an injury and that it plays a disconnection, that then creates a layer of separation through this very profound time.

Then more complex, grief and guilt and regret. So when I’m with this family, I note these things. Sometimes I’ll dive into it, and other times I will send in Elizabeth. So now, I met with his family yesterday, and today a couple of our doulas are going to be reaching out to go and deeply explore these.

You might have to earmark it, as you’re maybe doing some of the medical health. Not that you’re not able to go there, but that if you’re staying focused on some of the more physical and medical, then you can say, here’s some places to revisit.

I can go there, but I can’t do it at the same depth at the same level as people who are trained grief counselors and spiritual counselors. So I recognize I have my role and my place, and I will not do more damage, but I rely on my team.

Well, and it takes away from your expertise to be able to offer what you’re doing. If you go a different route, then maybe you’re not able to provide what you would provide as a physician. 

It’s fascinating, because it happens the other way as well. I often hear patients say, because they’re struggling, they’re needing more care and more attention: “I’m ready to go, I don’t want to be a burden to my family anymore.” That’s a different area of potential conflict and challenge, because we don’t want the families to feel like the reason the person is choosing not to continue living or to accept certain treatments or go a certain route, is to not be a burden to their loved ones.

Or not having these conversations. I’ve heard so many stories where they are worried about being a burden, and then they don’t even initiate a conversation, or it’s a little too late and their loved ones are in this position of like: “Had I known, and we could have worked together or there could have been something.” Not to say that it would maybe have changed the result, but that the quality, and you’re giving me the eyes that maybe it would.

I think that’s one of the things that’s so valuable about having this wraparound support, is that those opportunities are not lost. 

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“No one has ever died before. There are people who may have near-death experiences, that’s a fair point. But the vast majority of people have never died before, and for the vast majority of people, every death and every loss is different. So you can’t really be informed in advance about what it’s going to be like, even if you’ve been through it before.”

So not knowing is really one of the key issues that families, and particular patients as well, experience the uncertainty, not knowing what to say, not knowing whether to say this or that, not knowing how much to share, not knowing how exactly where those lines are, how it might impact your loved ones. Having that wraparound support, from people who’ve been through this with hundreds and hundreds of families, really helps to create the space and gently—very, very gently, in a very nourishing way—draw out those things that are common experiences. Draw out those things that might be evident to us but just under the surface for them, and help to create a sense of safety in exploring these really touching, and sometimes really painful, things that people are living with or thinking about or wondering about or dealing with. 

I think that’s one of the most important things that’s really missing in the medical healthcare approach to this, is the safety. The ability to connect deeply with your doctor and have that really intimate and trauma preventative doctor-patient relationship. The ability to connect deeply throughout the journey, so that when you have questions in the middle of the night, you actually can reach someone who knows you and knows your family and knows what your goals are. So the uncertainty is lifted, and the sense of security is created. It’s extraordinary, the healing that really happens just through that connection. It’s not necessarily about curing a disease in a lot of cases anymore, because a lot of these people are living with a terminal illness. But there’s still so much healing that can happen, and much of it is around that relationship with themselves and the relationships with their loved ones.

Absolutely, thank you. So as we’re talking, I’m curious, as you’re recommending people to have these conversations, at what point? I mean, how young would you recommend, and to what extent? I know there’s a depth that you’re offering that’s obvious when one is approaching the end-of-life. But if one doesn’t foresee it coming, these are still good conversations, but perhaps won’t be as deep. But what would you say about when and how much to cover? 

It’s never too soon. I think one of the things that’s really valuable about starting young is you start to explore these ideas. Of course things change over time. 

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“If you start having these conversations in your 30s, even younger if you want, but in your 30s or 40s, by the time you’re experiencing your end-of-life journey, you’ve processed through things; you’ve learned more about yourself, you’ve learned more about your relationships and how you want to live, which is what really informs how you want to die.”

So I would say it’s never too soon.

I agree. Certainly when people are reaching, they’re entering into their 50s or 60s, it becomes a bit more timely. If you’re diagnosed with a particular condition, even if it’s not a terminal condition, if you have a heart attack, or if you’re diagnosed with a neurologic condition, certainly at that time, having a deeper conversation exploration with your family, for sure, and ideally with a healthcare professional who can guide you through this exploration. But even in your 20s and 30s, people get in car accidents and things happen. There’s no downside to it, and it really can prevent it. To me, I see it as a gift to your loved ones, as a gift to your family, to give them the information that they might need in the case of an unexpected, tragic situation.

Well, and also as you’re both holding the relationship, the love, and if one feels connected and has a spiritual practice, that there’s a frame. That even in a tragic crisis event, there’s still this frame or context to hold with the person that’s died or passed. That could be some support, even amidst the tragedy.

For sure. So my daughter’s father died in a car accident when she was nine. Having moved through the grief, that was years ago, and certainly not being on the other side of it, because it stays with you forever. But she’s now 19, and I’m 41, and we talk about it. We talk about what happens if something happens to me or to her. We talk about it less in terms of what care options we would want, though we talk about those things too. But we talk about our relationship, and we talk about what it means, and we talk about how we might feel and what would be important. That’s the same thing with my mom, who I won’t say her age, because she really never tells, but who is closer to her understanding of her sense of mortality, and talking about that with her as well. Knowing and understanding that some of her treatment thresholds have to do with just wanting to say goodbye, and wanting to make sure that there’s an opportunity to be connected one last time with her loved ones before letting go. 

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“I think the conversations, as you’re describing, they’re not just about understanding what should happen. They’re also about understanding how to integrate the experience, and how to deal with that emotional impact and what to do with it, and helping our loved ones get a sense of how the evolution of relationship could happen, before it needs to.”

Yeah, I know we could go down this road, and I know we don’t have time for it. But in my experience, and some of the people that I’ve interviewed who really work in the grief space, there’s such a connection between grief and love. So to be able to support this end-of-life, in whatever form that takes, can be a real honoring of that love and relationship. I’m touched by that. 

I also recognize, you’ve mentioned, just to pivot back to supporting people and having these conversations. If a couple are in disagreement, or perhaps there’s fear that prevents people from even wanting to have these conversations, what are some recommendations that might assist people? I mean, the way we’re talking about it is like, we’re just all in support of each other, and it’s just got a natural flow. Sometimes it doesn’t work like that. Sometimes there’s little blocks or interferences that sometimes make this difficult.

I think the first thing I’ll say, and I’ll let you speak a little bit more to that, is just how important it is to meet people where they are, and to let them have the choice that they deserve in whatever it is that they are experiencing or choose to experience. So some people who don’t want to talk about it have the right to not talk about it. As wonderful as it would be for their loved ones, or for whatever it is that we’re exploring to have that opportunity to discuss it, everybody gets to choose their path, and meeting them where they are, is really important. Exploring if there is a way to talk about it, if there’s a way that we can help them. But if they choose not to, I think it’s also really important to respect that some people are not open to, ready for, or able to communicate about those things.

I agree 100%. I haven’t come across many situations where with time and additional conversation, we’re not able to get to a place of alignment. Each dynamic, each relationship will have its own facets and challenges and gifts. There may be times when because of religious beliefs, or because of some other previous life experience, there is an unwillingness or a fear in exploring certain things or being supportive of certain things. 

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“When you get to the point where you really can’t bridge that, one of the things that we’ll often recommend is, for the person to find another person, somebody else who can be their agent, their proper attorney, who will be able to honor them in the face of things unfolding where the person can’t communicate or make their own decisions, and they need somebody to step in and be their voice and make those decisions.”

Because sometimes a spouse can’t do it, and that doesn’t mean that the person shouldn’t have the support that they want. So we can find a friend or a child or somebody else, and allow the spouse to sort of bow out of that role. It doesn’t happen often, it’s pretty unusual in our experience.

Yeah, it sounds like there’s a recognition of readiness. Maybe even just before launching into the conversation, there could be this query of: “I want to discuss this. Are you open or do you feel ready to have this conversation?” At least that just starts planting the seed, and then with enough time and space and consideration, that perhaps there could be an evolution around approaching in a gentle paced way, and people can share and explore. I really like, Elizabeth, your recommendation of just trying to get clear individually, so that there’s something to reveal or show and some ownership of that. Then in the couple dynamic, perhaps there’s a way in which they evolve, how they can support each other. You’re saying if that doesn’t end up getting to a place that feels workable, then there are other supports to give one what they’re needing, even despite their partner not being available to participate. 

Yeah. I mean, your work is in transformational relationships. So you know I think, and probably have explored in a great number of podcasts, about what are those tools that help people communicate, like the language of the eye. There are tons of different frameworks and options that you can use to really more effectively meet each other where you are. I feel that’s part of why starting as early as you can, is so helpful. As you said, the evolution over time, the pacing when it’s gentle, so it doesn’t feel abrupt or assaultive if you have different perspectives. It’s really just to give and create that space, so that you can gently, in nourishing, nurturing ways, move through those things that are more challenging or painful. 

One of the services that we’re very excited about that we’re building into our model, we’ve been doing this already, but we’re looking to expand it and do it in a richer, more robust way, is doing this planning with individuals and families. We’re developing a platform that we can go through with them, and create this very detailed and meaningful digital document. So they’ll go through this exploration with one of us or one of our doulas, to explore their wishes, their concerns, and get everything documented well. If they desire, we will also have a follow-up conversation with their family system, so that these things can be explained and explored. They can create a video that expresses their wishes and desires, even more detailed, it gets uploaded. Then they get a card with a QR code on it, so that anywhere they are, if that QR code is scanned, it will provide those documents and access to that video. So that if they end up in a hospital in some area while they’re traveling, whoever wants and needs access to this really well-thought-out, really well-documented plan, has access to it. That’s something that we can do for people anywhere, so we’re very excited about that. 

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“Those conversations can sometimes be the spark for some other really deep, meaningful deepening of the relationships, and appreciation for things that were not known before or were not explored before.”

Yeah. Even in this share around how people can start to engage with your work and what you’re both working on, it’s almost like the way I’m imagining is, I’ve heard people have the ICE contact in their phone, and maybe even in the note section, or even under their actual, depending on what type of phone. I have an iPhone, so I have my own contact. But there’s a note, and you could have the QR code there, how practical that is. Then also, just what it provides in this interconnected relational way, it’s really powerful. 

Well, I know you have another appointment to get to, I want to honor that. Tell people a little bit more around how they can connect with your Empowered Endings business and what you want to share here.

Sounds great. So our website is EmpoweredEndings.com. It’s a robust repository of information resources. It’s actually building, being added to on a regular basis, as we develop more of the content for our Institute and the resources. But there’s information about the medical practice and the services that we provide. There’s information about the institute and the community that we’re preparing to open up and launch and support; a community of healthcare providers who are interested in engaging with others who share their passion and their belief that end-of-life care needs to be done better. We need to be able to give people what they need, not just what’s covered. So we’re building a community. Then we have the foundation, the Empowered Endings Foundation, which is providing free resources and support for people.

Is that a different website? 

It’s on the same website. 

So you can get everything; our history, our team, the medical group, every service that we offer, the institute. Some of it is already built out, like we have a webinar that’s coming up in April that talks about end-of-life options and models of care. The resource library, which we’re actually also building out. The online community, which we’re about to launch. Speaking opportunities, so being able to connect with different members of our team and how we educate in the community. We provide a lot of free education in the community, which we really love to do, building connections and exploring. Then the foundation is also on the website, and healthcare partnerships as well. So not just teaching, but really working together and finding ways to connect more with people who are in this field and wanting to make changes. 

Wonderful, I’ll make sure to have those links on today’s show notes. It’s been such an honor and a privilege to meet with you both. Thank you for what you’re doing.

Thank you so much for having us. This was a real nice connection, thank you. 

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