206 Living Beside the Leaving: Caregiving, Hospice, and Moving With Grief with Carolyn Shelby

Host Marie Betcher, a registered nurse and former hospice nurse, interviews grief educator and Grief Clarity Labs founder Carolyn Shelby, author of Living Beside the Leaving. Shelby shares how caring for her mother through years of Alzheimer's shaped her work, including processing a complicated mother-daughter relationship and the guilt that often follows caregiving decisions. She describes her family's team approach, moving her mother from an unsafe historic home into memory care, and the importance of maintaining identity outside the caregiver role. Shelby explains how hospice was initiated after repeated ER visits for seizures and decline, and how hospice support in the memory care facility helped during her mother's 10-month hospice stay. They discuss how people may time death around loved ones' presence, and Shelby emphasizes, "You did the best you could with the information you had at the time," and outlines her coaching, virtual support groups, and free 30-minute call offer.

00:00 Welcome and Disclaimer

00:41 Meet Carolyn Shelby

03:24 Writing Through Grief

05:51 Caregiving Team Dynamics

08:31 Choosing Memory Care

11:54 Caregiver Identity and Balance

14:38 Hospice Decision and Experience

17:54 Final Visits and Letting Go

21:42 Timing of Death and Guilt

23:20 You Did Your Best

27:36 Grief Clarity Labs Resources

31:06 Closing Thoughts and Farewell

https://www.griefclaritylabs.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
Marie@HospiceExplained.com
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.

205 Hospice Explained: Chaplain J.S. Park on Grief Myths, Family Dynamics, and Self-Care

Host Marie Betcher, a registered nurse and former hospice nurse, interviews hospital chaplain J.S. Park about his work in a 1,000-plus bed level-one trauma hospital providing a non-anxious, non-judgmental presence, grief support, end-of-life planning, and family advocacy. Park describes guiding families from first contact through bedside crises and how the emotional toll follows him home. He discusses his book As Long As You Need, which addresses multiple forms of loss and challenges the myth that people should "move on," emphasizing that grief is non-linear and something people "move with." He previews We Are Made of Us (out October 20, 2026), focused on family-of-origin dynamics, inherited trauma, boundaries, and ancestry, and explains facilitating tense family situations by honoring each person's role. They also discuss therapy, self-care as "life itself," meaning beyond productivity, and multigenerational caregiving.

00:00 Welcome and Disclaimer

00:29 Meet Host and Guest

01:33 Chaplain Life in Trauma Care

05:26 The Emotional Toll and Self Care

06:59 Book As Long As You Need

10:00 Grief Myths and Reality

13:24 New Book We Are Made of Us

17:22 Family Conflict at the Bedside

24:46 Intergenerational Trauma and Treasure

28:07 Self Care Beyond Work

31:23 Worth Beyond Productivity

33:33 Caring for Elders Full Circle

37:19 Closing and Where to Buy

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
Marie@HospiceExplained.com
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.

204 Supporting Teens and Families Through Hospice: Jean Anne Menna on Education, Pets, and Legacy Messages

Host Marie Betcher, a registered nurse and former hospice nurse, interviews returning guest Jean Anne Menna, a certified hospice and palliative nurse in New York, board member for End of Life Choices New York, and author of Go With Grace and A Pawsitive Journey. Menna shares updates on her website consulting/support services and new writing projects, including an upcoming teen guide, While You're Still Here, focused on normalizing teen emotions, reducing guilt, and encouraging healthy breaks while a loved one is dying at home, potentially on hospice. She discusses a children's book series featuring Duke and Houdini, inspired by a hospice patient's neglected cat, emphasizing the need for a pet care plan in hospice. They also highlight legacy practices like letters and voice recordings, and clarify common hospice misconceptions, stressing education, 24/7 availability, and the need for a primary caregiver in home hospice.

00:00 Welcome and Disclaimer

00:29 Meet Marie and Jean Anne

01:38 New Teen Guide Preview

02:57 Why Teens Need Support

05:30 Filling the Education Gap

06:40 Where to Find the Books

07:16 Duke and Houdini Series

08:49 Houdini Hospice Story

12:27 Planning for Pets

13:25 Website and Legacy Letters

14:28 Recording Voices for Later

17:21 What Hospice Really Provides

21:19 Anticipatory Grief and Resources

22:19 Closing Thanks and Next Time

24:04 Final Sign Off

https://gowithgracebook.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
Marie@HospiceExplained.com
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.

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
Marie@HospiceExplained.com
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
Marie@HospiceExplained.com
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
Marie@HospiceExplained.com
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
Marie@HospiceExplained.com
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
Marie@HospiceExplained.com
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.