Katie Koepke and Amanda Edwards

00:05 Hi, my name is Katie. Koepke. I am 43 years old today's date is Wednesday, February 10th, 2021 and I am recording from my home in Santa Cruz California with my friend. Amanda Edwards who is both a co-worker and very close friend of mine.

00:30 Hi, my name is Amanda Edwards. I'm 40 years old. Today's date is Wednesday, February 10th, 2021. I am recording from my home in Santa Cruz, California with Katie. Koepke who is my coworker and very good friend, and we've also been called to work wives.

00:53 It's okay. So Katie koepke.

01:04 Amanda Edwards, why did you become a nurse? And what did you envision your work would be like

01:15 So

01:20 I actually initially started out in college with a business degree. So my initial intention was not a nurse. I had gotten a finance degree and while I was getting that however, I started becoming interested in nursing. So I decided I was at University of Florida, Gainesville, Florida. I decided to start volunteering at Shands Hospital to see if that might be something I'd like to do and it was a really good experience. I volunteer in the NICU I got to hold this small babies. That was a lot of fun and then I switched over to volunteering night and the emergency room at Shands Hospital.

02:12 And it was really interesting got to see a lot of different patients come through and that, you know really initiated this interest I had in the medical field, you know, I would say that my personality. I tend to want to help caregiving felt like a natural thing for me to do as well. So I didn't actually pursue nursing career at that time. I graduated and moved out to Colorado so I could have a little bit of fun after college and just ski and enjoy living in a beautiful place and then after working for a couple years it became really apparent that I wanted something more in the work that I did. I had to write a paper for nursing school. I can't exactly quote the quote.

03:12 But it started my paper out kind of talking about having a career in life that grounds us to life. And when I read that I actually was trying to figure out how do I start this paper? I walked into a bookstore. I was on Pearl Street in Boulder Colorado found this book that looked interesting opened up the page and I found this quote and I was like, yeah that that is that's what I feel with nursing. I just I felt like I wanted to be more involved with people and with something that yeah, it was kind of like rounding to life something that you know, just fell richer more involved with with people so that

04:00 Started my career with nursing. I applied to nursing school and went to Regis University in Denver, Colorado. And

04:11 Yeah in and now it's been that was in 2004 that I went to nursing school. So now it's been 17 years. I guess it's been a bit of time.

04:24 How long is a nursing program?

04:28 So typically at that time most of the nursing programs once you have your prerequisites done, it was about two years and luckily. I done a lot of my prerequisites when I was at University of Florida, but this particular program right about that time. A lot of the colleges are coming out with the accelerated programs and Regis University where I went to school had been doing it for about 12 years so they can have it dialed but you had to have a previous bachelor degree. So it was really interesting actually going to nursing school with a pretty relatively small group of people who had some of them have been in the medical industry. But some of them had been had done totally different jobs. You do engineers business-related jobs. So it's a really diverse group of people, but it was it 11 months and it went straight to getting that are bachelors and nursing.

05:28 That was pretty quick and intensive that was a really great experience.

05:36 And Amanda, can you tell me how long you been a social worker for?

05:47 Officially

05:51 Officially, yeah. Yeah, you know, it's such an interesting question because like I got my degree, you know, and I did all those things but I feel like the work that I've done has always been around so short so I can tell you that I got my Bachelors in Social Science in organizational leadership in mm.

06:12 Three think I finished my undergraduate in 2003 and then did my graduate Social Work Program masters of social work between 2005 and 2007.

06:26 And

06:29 But prior to that I was working in a women's shelter doing Community Education doing crisis and and Jen even my my first work back in high school, you know working at at the summer camp was with high-risk kids. So like by no means what is a social worker then but I've been like working with populations that you know, kind of like marginalized underserved populations since I've been working since I was a teenager but undergraduate in 2003 graduate degree in 250 2005 to 2007 and then I guess I would like an official social worker. Then you are social worker in training for a long time like 35 years. I mean, I remember as a kid like I would come home from school and I would have liked given my jacket to someone and my mom's like where are your things? You know what I mean?

07:29 I would like to have given my lunch box to somebody because I knew that we could buy another one and they didn't have one, you know, or like.

07:39 Used my towel. This is kind of a weird story. But like I would go to Lake YMCA day camp and this poor kid got cars that we would let go on field trips or whatever this poor kid got car sick and I was like here use my towel like clean up and do whatever and likes, you know, he went home with my towel and like just things like that where my mom was like, you have to stop just like giving your things to people. You know what it's like I feel like I've always had the thing of like

08:14 Where is the need?

08:17 And and going and I'm being drawn to that.

08:21 Yes, I see that in you to present day and we've known each other for how long 5 6 years 5 years now that's on yeah, I I see your you have from what I see and you is a natural instinct tube to plan and also to take care to make sure all the pieces and the people are taking care of so it's been really great to watch you in your work to with hospice. Which brings me to another question. Did you initially think you'd ever work in hospice?

09:02 Now they did that wasn't even on my radar.

09:08 When I was working at the Women's Center at which was in Modesto, California where I was born.

09:15 I had actually started the teaching credential program after this was after a my undergraduate degree and started the teaching credential program and knew that I wanted to work with kids, but you know in the credential program like

09:32 Focus on testing like standardized testing and lesson planning and at that time I was working at you know, volunteering at the women's center working with kids, you know who had been exposed to violence in their home there had been sexually abused and there was just a really specific demographic of kids that I felt like I wanted to work with and teaching felt so big teaching felt like I'll have a room full of 30 kids who will all have different needs and different styles and different speeds and I'll be I could already feel like I'll be trying to teach them this like teach to the standardized testing and not having the space to really like get to know these kids and know what their needs are and really pay attention to the more specific pieces.

10:21 So that's when I I stopped doing.

10:26 The teaching credential program and at that time the therapist that I was seeing was an LCSW. She was a licensed clinical social worker and I'm talking to her about like it just doesn't feel like this is right fit for me and I really want to work with these kids who have more specific needs and she was the one who said you're a social worker like this. That's what you need to be doing. And she was like one of the people in my life where I feel like that was a shift in energy like that train change to get rid of things. And so

11:03 In graduate school, my focus was on child welfare.

11:09 And so at that point I still thought I was only going to be working with kids and families and I did that for like 5 years before it just got really really overwhelming and like all consuming and I felt like I was working in this system. That was just swallowing me up and swallowing these kids and families up and I didn't really feel like I could have an impact and so I was moving away from that field when I found hospice and I got two of my grandparents had died on service with hospice in Modesto at that point. So I knew that they were wonderful, but I never thought you know, I never envisioned myself working for hospice, but the opportunity became available and another one of those moments that we were really serendipitous where the opportunity came available and I was called for an interview and hired and that was almost 9 years ago.

12:05 That's a good portion of your career to be in one area.

12:12 So so you've enjoyed it and that is that a safe assumption that you won't miss ya comparatively like compared to working with child protective services. It's so much gentler and and just on my soul and my spirit, you know, it's it's more in line with the kind of work that I want to be doing in terms of

12:41 Being a support two people making their own plan as opposed to like so much of Social Work is like coming in and giving people plans from the government or from the criminal justice system or front, you know, it's like we're giving you this plan and and you better do it.

13:03 You know in County systems in criminal systems as opposed to hospice coming and be like, let's just chill at 8. Let it let's have a conversation about how you can make your own plan and we can support it based on the values and your goals and your life and what you want this transition to be like so it was a it was such a different approach than working for the county. So that felt really lovely and specious for me.

13:33 Yeah, I would have to agree a lot with with what you said about that and just how seriously that's taken into account and hospice like what what is your thoughts of your quality of life right now? Yeah, what what do you want, you know?

13:53 Despite what treatments are out there, you know, if so just patient autonomy and honoring choices and you know, who do you know if if quality of life for them is to be you know, sitting outside in the sunshine everyday, like what do we need to get in your home to make that happen? So I feel like I resonate with what you say may in terms of of that, you know, there's a lot of joy that comes with that and being able to help provide that for folks and make that happen in honor that and take that seriously and have that supported.

14:34 And I never really do you know this is indicative of how we deal with like death and the elderly and folks who are terminally ill like I never thought of it. I've never seen before hospice. I never thought of the end of life.

14:50 I think like speaks to me about how we treat that population in our in our society. Like they've served, you know, they've been here their whole lives so much of our popular so much of our population right now, we're veterans and like, you know working with the VA system now and like just seeing how we treat people as a society who are mostly elderly terminally ill no longer Thor course no longer raising children, you know what I mean? Like, we just don't consider them and I was definitely in that category and so it's been really beautiful to be part of hospice and

15:35 Work so closely with its population and get to like honor them in the way that they deserve to be honored and respected and cared for

15:44 Yeah, and so on that note, it's making me and it's bringing me to another question that I had.

15:55 I've been pondering on.

15:59 In terms of just what you seen in the years. You've been a social worker and more more. So in the Years you work with hospice.

16:09 What do you feel like our Healthcare System could do better for patients or seriously ill and approaching death.

16:28 Do you know we talked about this before and I feel like hospice is a very comprehensive benefit and the way that you know, the multidisciplinary team is structured so that we are designed to like meet the physical needs. The emotional needs spiritual needs psychological and so forth.

16:51 I like the multidisciplinary approach and also care for the you know, the family and the patient as a unit and not just the patient's physical body. So I think hospice does a good job at that. I think more than focusing on the last six months of life if we could take that hospice model and a quiet to a person's whole life. I think it would make things so so different.

17:22 You know the questions that we ask in hospice like what are your goals? What?

17:31 What are your hopes for the end of your life? What are your fears? What are you scared about if we could start integrating those questions?

17:45 Even into childhood a developmentally appropriate level like if we could incorporate a discussion about death way way earlier upstream and just make it a more normal part of the conversation. I think that's would be the the most in service of a peaceful painless passing an end-of-life transition. I think so often like you and I see this all the time that people are totally blindsided that their loved one is going to die or people themselves are like feel totally unprepared for the end of their life like sometimes you and I walking into a hospital room and asking these questions. It's the first time that someone has ever considered any of these things. No one's ever asked them that before

18:34 Night interesting. Do you find two? I mean, I know one thing that I've even noticed before is how at times I think some people have never really been asked the question.

18:53 I like it. Just kind of wore the psychological side of things. Like how about what are your goals for death? But what are your goals for life, you know, I think about our mainstream Healthcare System and you know when folks go see a primary care physician. I wonder sometimes, you know kind of speaking to what you're saying about bringing that whole whole care model that kind of holistic model interdisciplinary approach to you know, maybe you don't have an illness or something. But you know, have you thought about these things in life and goals for life and in a course leading into as you get older and goals for death, but I've noticed before that people are so surprised at you know, just at those questions or even ask that. We care because that's not been the norm. I I feel like in the Western Medical system that I've seen it's a little more focused on kind of the labs in the

19:53 Numbers and what's the illness? And then how do we fix that?

19:59 What do you think like do you feel like or how do you feel like we could do?

20:06 You think better?

20:39 So I think one of the two me the most obvious.

20:46 Areas that I see our healthcare system fail folks when we're looking at this hospice. Peace and end-of-life is caregiving you mentioned before Amanda how

21:01 You know, our culture is in terms of taking care of elderly and Oregon honoring elderly. There are other areas of the world other cultures where I think elderly are held very high, you know, and as someone's like the older you get the more support your given and family comes together and you know, they bring elderly folks as they, you know need more care into the home and there's just no question that they'll be cared for, you know in the United States.

21:42 We've just had a different approach to living which is kind of isolated people in some ways. Everyone has their own big house and we move all around and we're not necessarily with our family and then we go have our own families and then our elderly parent is now needing more help and we can't move our whole family back. So we wind up you no pain for them to be in a facility and you know, it's just kind of the culture that we see here but caregiving isn't sheep care giving us Skilled Nursing Facility, you know, I think about when you're older and you need more carrots like you need higher caregiving in your home or you're going to go to Skilled Nursing Facility or assisted living or unless family is able to take you and her come come help and you know, our system doesn't cover that. There's a very small percentage of people that have long-term care insurance which may give some money to

22:42 For that but you know what I'm talking about, we see this all the time and the cost a month for caregiving is Ludacris in my eye and it's like it's not realistic. You know, it's 6 to 12 to 13 to $15,000 a month. So that's where I really feel like the system fails an end when these things happen fast and families are in a bind trying to figure out finances and accounts and and you know, I mean up with the the finances to pay for stuff like that. I think is really really challenging, you know with us Amanda working in the hospital to we're seeing a lot of you know cute changes. So someone's come in because they've had a stroke like a very very significant change. They were maybe living at home completely independently before, you know, things like

23:42 And it's it's really it can be a lot to try and figure it out. It can take days sometimes weeks.

23:51 So that comes to mind, you know, I've always had this Vision in my head of getting older and teaming up with my good friends in my life and their Partners or whomever and kind of like getting to a certain age where we all sell our houses and we put our money in a pot and get a big house and get a shaft. Maybe you know, whatever we can you do you put your money together and you can do so much more skilled nursing facilities. If you know, it's what we have. I don't think it's like I think they're overcrowded and

24:33 People are still really lonely even though there's a lot of people around and so I really had that vision is just always so clear in my head of just, you know, being in a smaller community of people and really putting the resources together to set it up the way that's going to best support and serve everyone. So I'm hoping and in our lifetime maybe as our generation gets older will be a little more creative with that but we'll have to see how that goes. But maybe Amanda what's on the village approach Village approach? Yeah, and it's so interesting the way resources of money gets used.

25:18 And I just think there's other ways we can do that.

25:23 You know and the way cuz everyone needs different things to so doing it in a way that's going to serve you.

25:31 Yeah, I I think about having even you know, it's like even a doctor or a nurse practitioner that comes to the house and everyone pays a monthly fees so that you know as they need stuff they can just come right to the house. So I'd like to see that be a reality at some point. I mean maybe Amanda will be in a house together as older folks. No not surprised at all. I had a question that I pulled from Vanessa's list that I thought was interesting.

26:06 What have dying patients taught you?

26:15 That just gave me like shells from the head to head to my toe and in a good way shows one thing.

26:26 One thing that I've always had with hospice I get chills sometimes talking about having conversations with people about death and dying because to me there's this really there's this magical piece of it and I've had conversations many times where I just get this feels like I just got but you know, I would say what it's taught me, you know, it's it's it's a real part of our life. You know, I said mama told me that elderly folks and kids are the most kind of like spiritually in tune because they're the closest to Source, you know, however you want to think of that the kids kids have just come from there and elderly are going you know, so it's just this Continuum, you know in my perspective and

27:26 I find it really interesting cuz it is very much a mystery on hospice. We are coming and you know integrating with people and there's sometimes gets to be the point where you're no longer integrating with a patient. He's dying they've now gone inward there in a different place and they're going through this journey and so how and the outside, you know, do we support them? And you know, there's all these different things we do to connect him with family and assess, you know, as a nurse we're looking to see if there's any signs or symptoms of discomfort and how we can you do use family to provide Comfort or medications, you know, Sunshine whatever it is and so

28:13 You know that's been really fascinating to go through this journey with hospice, but I would also say the biggest thing about death and dying it's absolute but it's it's absolutely part of our life and I feel like the more people

28:31 Can just bring the awareness in about a lot of people are scared of death, or they don't talk about it ever. We've seen us with families. They don't talk about it. They don't want to talk about it. So families, you know in the end, sometimes it's difficult. They don't know what their goals are what they actually want cuz they never wanted to talk about it. So to bring it into life and that it's part of life somewhere. We're all going and it's also okay and it's something it's very beautiful and something to be honored to be a part of it's just I just find that so I don't know it's it's a really inspiring and you know, I get this weird sense of excitement because it's just really beautiful to me and in the experiences I've seen but you know Hospice of Santa Cruz County we had

29:25 A speaker come in our company paid for all of us to take a full day and listen to him speak Frank. Dr. Frank ostaseski who started the Zen hospice project in San Francisco and he wrote a book called The Five invitations and our lovely company provided a book for all of us to have and we got to listen to him speak and that is the big take away from you know, reading that book and listening to him was Chyna the richness and in the color in all this this kind of unexpected beauty that comes up from allowing death more into life, you know, bringing it in and recognizing it and seeing it and it's Beauty and and then really knowing you know, yeah. Yeah, we really are going there and so it kind of in a way up provide this contrast.

30:24 That provides all this gratitude gratitude for the present moment in the present day and just really as a real thing, you know, making the most out of life that we have in every day and I found that to be true. So that's a lot of what I've gained, you know, it's like I've heard him talk and read that in his book and then seeing it actually play out and he has been really really cool to see

30:54 You got to see him speak right? And did you also read the book?

31:00 I don't cover to cover sometimes it's hard for me to do this work all day and then go home and like spend my free time reading about it. You know what I mean, but I would like to pick it up and and look at it more closely.

31:17 Perspective, you know, and I think that's something that I that I've learned from our patience is like the perspective when you're at the end of life and the decisions that you made your whole lives and your whole life and why you made them, you know, like

31:34 The idea of I think that there's been a big ship Trooper tricoli when I first started working with hospice and being at the bedside with dying patients of I so often felt like I made decisions

31:48 And not do things out of fear or out of anxiety or nervousness or what might happen or what might people think and like this shift happen with is that really going to matter?

32:05 You know, like like things that have come up just in.

32:11 You know in the last Almost 9 years like to try out for the play, you know to like be the first one on the Dance Floor to do things something that might be embarrassing to initiate a conversation with someone to make a scary, you know decision in your life when you're at the end of your life. Do you really want to look back and go I didn't do that because I was scared of what might happen or scared of like I might look silly or whatever. It's like this shift happened between

32:47 Not doing things because of fear and or or the fear of not ever having tried.

32:55 Do you know what I mean? Yeah. Sure. Sure. I mean it brings a lot into perspective.

33:02 In my experience in working with hospice and coming home and being in everyday life kind of how you approach or how I approach life can be very different based on that.

33:20 You know it brought it was I die. Another question I was thinking about

33:27 I got a lot of different reactions from people when we meet with families, you know, some that are like thank you so much for the work. You do to The Other Extreme where I've had someone say, I'm sorry. I'm sorry that you have to do this work, you know an in this was someone who is clearly struggling having a very hard time and in probably feeling I would guess maybe some frustration and anger.

33:56 You know an inn in my in my head. I I felt well I just you know, it's okay. I feel drawn to this and I'd I feel honored to be here. I feel honored that I can help with us, you know where John I think two different things that we can be helpful with but a question that was lingering in my mind for you. Amanda is I do people ever you feel like friends or maybe a family that you talk to.

34:29 Do people seem to understand why you work with people near end of life or ever ask you? You know, why why you do this job or how can you do this job lot, how can you do that? And I'm fortunate to have so many good friends in hospice who work in hospice and so like there's a community there that where it's a common understanding but for people who don't

35:02 I know what your response to that again. I mean it kind of depends on who I'm talking to. But but for people who know me, I think that they know like I go where there's

35:17 Don't waste darkness is the right word. But almost like there's a lack of lightness. There's a lack of open free communication or the lack of acknowledgement. There's a lack of space to talk and he'll and explore whether that's you know, now it's hospice and my previous job was child abuse and Substance Abuse and Mental Health and sexual assault and domestic violence and you know all those faces and now, you know, I have sex and intimacy coaching practice and Trauma that's there or secrecy and darkness and shame, you know, whatever. It's like, I think that

35:57 I think that people who know me know that I go to where the conversations aren't happening. That should be happening.

36:07 And right now it happens to be around death and dying.

36:10 But it's been a number of different things throughout my life. You know what I mean? So when I expect for someone who doesn't know me who asks me that I think that I try to explain I'm not I'm not scared to be in that space with other people, you know, I mean my own my own mortality in my own death is is something that you know, how do you say I have to hold and consider and and all those things but I'm not scared to go be with other people when they're in that space and to have those conversations or should also just be silent in that space is okay, too.

36:50 But that it's going to happen.

36:54 Not optional we're all going to be in that place at one time or another and being able to go in like

37:04 Shine a little light and give a little perspective and like or maybe even give a little guidance of like here's what we need to do, you know, here are the things to accomplish or like in our work get home from the hospital people are just incomplete trauma brain where they don't know what they don't know. They don't know the questions to be asking and they don't know what they need. And so, you know being able to come in and be clear-headed in and hopefully compassionate and say like, okay, here's what we need to get done so that you can get your loved one home.

37:37 That feels really good to me. And so I think I'm able to convey that when people ask me like why do you do this work?

37:47 It's being drawn to the places where there where they're typically isn't attention.

37:55 Yeah.

37:57 Yeah, you're sure you feel like you can help in that area. I think I feel like I'm pretty.

38:07 I'm pretty clear-headed in those spaces where it can be potentially like scary or overwhelming or unclear what needs to happen.

38:20 Yeah, yeah and you would mention that before like the fear and you know, just talking about scary and then that can be really scary for a lot which is why a lot of times people don't talk about it. Have you seen that a lot in your work where folks are scared of death and have you seen where folks are not like do you feel like you've seen a a range of that? Yes, totally interesting like walking into a room and not having any idea where this person is in terms of acceptance or peace or even consideration like, you know, you and I have often shrooms before and it like literally hasn't occurred to someone that they could die.

39:07 Weather going to be like nothing. They could that they're going to die at some point like there hasn't been any acknowledgement or thought given to that and like what I would but I would want as a person in that position what I would want for my family, but I want myself all the way to the other end of the spectrum where people are like, I'm great I could go tomorrow and be totally at peace. I've said everything that I need to say to everyone in my life. I know what my wishes are Eno and that to me speaks to like that the the conversation around

39:45 Like I like I like what you said about not even around like what my goals are for death, but what my goals are for life, like if we've lived in a way where where we know the people who are in our lives know how they how we feel about them. Like if we've said all the things that we want to say we can be at Pete but whatever happens I'm good. I'm not holding anything that I need to release, you know until it's like more around goals about how you want to live and how your you want your life to be.

40:20 Well goes hand-in-hand with like having a peaceful.

40:27 My gracious. You know and there's some people who are just clawing and scratching and like not wanting to go and that's very weird when they're when they're death eventually happened. So the other such a wide spectrum of people the patients themselves and their families and their acceptance or acknowledgement or he send them their feelings around the end of life transition.

40:50 Yeah, yeah, it's I don't know about you. But I feel like I honoured is the word that always comes up like just seeing some of these experiences with patients and families and watching them go to the process. It's it's so insightful and just I feel like it's such a gift for for myself and just everyday living of having that perspective or having someone tell you they're their thoughts before they die. You know, it's kind of like these like mind-blowing thoughts of like, this is just this is what matters of yeah, yeah for sure. I had a really interesting experience of I played a few different roles, but I had an experience of admitting a woman on to hospice. I was the admitting nurse. I was the first one in the home.

41:46 Really beautiful family. She was a retired on teacher, you know, her family started making plans and all the grandkids were able to get there. It was kind of like this really beautiful picture of the way you do you think like I'd love to see it go this way, but it was you know, the family there was a lot of acceptance she was accepting of her and life she had but I admitted her she said I want you to go in the hallway and look at the urn that I made in pottery class for herself. Just I know I'm going to die and that was really beautiful. The family was all very they just seemed very connected. It was really beautiful to see Justice acceptance. Okay, we're moving into this process. I had visited her one time as an on-call nurse.

42:35 I done a visit and then I wound up being the nurse that was on it was a Friday night for the time of death visit and having that full circle was really cool to see and the timing and getting chills again the timing as I walked into that house. I got there knocked on the door the daughter gave me just a lovely hug and embrace and then hold me right in and they were all circling around her bed the whole family holding hands and they brought me right in and I felt so grateful to have been there.

43:19 It was such a beautiful experience, you know, and the family was just they were crying and they were celebrating her and and you know speaking, you know speaking words about her and you not remembering stories about her after that. You know, I was taking care of some stuff with the family and we were making some calls and and they were laughing and just sitting around telling stories about her and her for me seeing that I was like you yes, this is what it's about like this is this is I were to Envision my end-of-life, you know, it's it seems that looked really lovely to me. So yeah, I just got one of my favorite stories. I like about my hospice experiences.

44:11 Great, seeing that I really like you said in an honor to like.

44:18 Be part of the whole Ark when that when that happens.

44:23 Yeah, do Amanda. Do you have any stories that stand out from hospice or?

44:31 Yeah stories that I said out or things maybe that patients have said to you that's really stuck with you, you know or something that's significant that you take from working in this role with hospice.

44:48 Cash and feels like there are so many, you know, the first the first four years I worked at hospice I did patient care. So I was in the home at the bedside and then now for the last five being at the hospital at just such a different speed. So this is interesting now that I just said those words out loud of the four years that I was in patient care I had of ascent

45:14 For about a month shy of three years. I worked with the patient. I saw him every week.

45:20 Or

45:22 Maybe two years. It was like 23 months or something.

45:27 And

45:31 The connection, you know that I built with him and he didn't have any family in town and you don't coming to rely I think both of us to became a really interesting like Mutual, you know, I would go every Tuesday afternoon. They would be on my last visit of the day so that I could you do have some flexibility if I need to stay a little longer and and just like getting to know him.

45:58 In learning about his life and learning about like how he raised his kids and where they are now and his beliefs and

46:08 And you know what he died, but on December 23rd of 2000.

46:17 15 because I had gotten this job as the hospital liaison and was starting like after the first of the year after the Christmas holiday and I could not bring myself to tell him that I was had gotten a different position and was not going to be visiting him anymore and he and I never had to because he died a week before I made the transition to this position.

46:44 Why was nice that it kind of did not feel complete then the whole two years. He never had a hospital bed. That was something that his nurses were always telling him. He should do he had this excruciating pain and he was set against taking the certain kind of pain medication do to like religious beliefs and he never did it and he never did the things that he didn't want to do and it was just such a lesson for me in the self-determination and autonomy autonomy and sovereignty piece of hospice like that. It's not my job to come in and tell people what they need to do.

47:27 You know they get to make their plan and I get to support it and there were times when I would come in and he's in pain and he's in this old king bed with a big old dip in the middle is rolling to the middle. You can't get out. No one can help him take a bad bath like

47:44 I just felt so sure and then I knew better what he needed and what would be good for him? And I just had to let it go is really really challenging.

47:54 Yeah, that's funny. That's all star golf cuz that's what you really talked about in the beginning is how you were coming in with an agenda Rick. I'm not being able to kind of release that that like controller not need to control and Anna Lau.

48:09 Like I'm serving observing allowing asking. How can I be a support? Right? And that's a thing. I find interesting with hospice to that's like we do have our ideas of what we think is best for everyone and then we're also saying what do you want? What are your goals? And so yeah, I think that is a very interesting when you locations are are saying this is what I wanted to tell her like, okay? Okay, how can we best do this together? You know, we just want to make sure you're cared for in your safe. Of course. Those are like priorities and then it's just kind of Honor really a practice of honoring someone else's space.

48:54 Do we need to wrap it up or can we just I mean deserve are there wrap up questions or can we just see complete?

49:02 Well, thank you. Katie. Koepke. Thank you. Amanda Edwards. It's been such a talk with you. Yeah, yeah.