Lina Ridge and Tara Lupo

[00:01] LINA RIDGE: I'm Lina Ridge. I'm 63 years old. Today is March 22, 2023, and we're in Taos, New Mexico, and I'm being interviewed by Tara, a wonderful friend and colleague. We work together in hospice, and my.

[00:18] TARA LUPA: Name is Tara, and I am 61. Today is March 22, 2023, in Taos, New Mexico, and I'm here to interview my dear friend Lina, who I used to work with and I consider a friend and colleague for life. Lina, thanks so much for coming in to do this with me today. When I heard StoryCorps was coming and our hospice agency wanted to sign up and see who we could get to talk about the wonderful world of hospice, you came to mind immediately, because when we worked together a few years ago, I was so impressed with your level of knowledge, your care for our patients, your teamwork with the team, how you just. I don't know. It seemed like the agency could not have gotten along without you. And ever since then, I've told people that I think you're the best hospice nurse on the planet. I thought this was a good opportunity because I heard that you're retiring soon, and I would love to give you an opportunity to talk about what hospice has been for you in your life. So I have a few questions in mind, but we can just roll with how it rolls. Maybe you could start by telling us how you began as a hospice nurse, why it was that you were drawn to this wild, wonderful field.

[01:54] LINA RIDGE: In 1981, I became a registered nurse, and initially, I started working in an intensive care unit and a big teaching hospital. And I was part of a code team where we would, you know, when someone's heart stopped beating or they stopped breathing, you know, we would. The code team would rush to wherever they were in the hospital and start CPR. And to me, it seemed like horrible interventions. If it was a person that was getting close to end of life. I mean, if it was someone that had an acute event, such as a drowning or an accident, absolutely, that was appropriate. But someone who was elderly and had lived in a nursing home or even at home, and they brought her to the hospital, or he or him to the hospital. She or him to the hospital, and they, you know, we would do the CPR. And I remember the first time that, you know, I was doing CPR on someone, a little, tiny, tiny, frail woman, and her ribs broke. And while I was doing CPR, and I just remember that feeling. And I used to kind of lay awake at night and think, oh, that was. What. What would a good death be like? And then, you know, that was, you know, the early eighties, and there wasn't really hospice in the United States yet. It was starting to come as a Medicare benefit, but I thought, oh, I'm just not ready for that yet. But then in the eighties, of course, we started getting a lot of AIDS patients, and I used to watch their loved ones, their families, their partners kind of shone away from a lot of them. So I used to go in and kind of hold their hands and just ask, what's important to you today? Tell me stories about your life. And I thought, you know, that was good. That was good. So I started getting closer and closer to hospice, and then I guess in 1989, I became a hospice volunteer. I think that's how you started, also in hospice, as a volunteer? Yeah.

[04:06] TARA LUPA: And can you just in case anybody happens to listen to this who doesn't know what hospice is, really, just give it a little definition.

[04:17] LINA RIDGE: Hospice is about helping people live well with a terminal illness. It's a Medicare benefit, and the person has to have a prognosis of six months or less. But that doesn't mean that you have to die in six months. A lot of people live much longer, and I think they live much longer because of the interventions. They need to be heard, they need to be listened to. They have to be in charge of their own life, and they have to die on their own terms, because all of us are going to die.

[04:52] TARA LUPA: What's the difference between hospice and palliative care?

[04:55] LINA RIDGE: Well, palliative care is for people who also have a terminal illness, but usually it's a prognosis of a year or less. And while they're on palliative care, they can go. Go ahead and continue to receive curative treatment. Whereas hospice, you forego the curative treatment and you focus on quality of life. And in hospice, we don't do anything to prolong life. We don't do anything to hasten death. We take the person where they are and go with that and find out what's important to them, listen to their dreams, you know?

[05:36] TARA LUPA: And why do you suppose so many people that we're familiar with this as hospice professionals won't sign up for hospice? Or they won't sign their family member up until the very last second? Like, what do you think they're afraid of with hospice?

[05:54] LINA RIDGE: I really think that people think that if they sign up for hospice, that they're gonna. It's gonna hasten their death, but it's not that at all. In fact, it's quite the opposite. I've actually had several people that have graduated from hospice.

[06:09] TARA LUPA: What does that mean?

[06:10] LINA RIDGE: Because they're no longer declining. I remember one particular lady that I actually thought was going to die before I finished my hospice assessment. Her pulse was so, so low, and she was cyanotic, and she was just really in bad shape. So I remember calling her primary care physician and asking if we could. She just had so many medicines, if we could just stop a lot of those medications. Well, about a year later, we ended up discharging her because we only had one or two medications. And then three years after that, she came back on hospice and died within a couple weeks. But, you know, she just washing. She had gone to lots of specialists, and I think there just wasn't the collaboration between the providers. And she just had so many medications that it was not working well for her.

[07:08] TARA LUPA: That's a great example. And it brings to mind how people don't always have enough attention at that. You know, maybe we're old, we have a physician that we see periodically, but maybe we're taking all these medications that need to be reassessed and that doesn't happen. And when a hospice team comes on, they can really give that patient a lot of time and attention and care and kind of be the mediator and tell the physician what they see happening.

[07:41] LINA RIDGE: Absolutely. My philosophy, less is more. People do better with less interventions, just letting their body do what it should do naturally. Our bodies are born to die, and if we just let them die naturally, it can be so peaceful and comfortable. You know, an example would be, you know, so many people want hydration. Hydration is not going to fix what's happening to their body. Hydration is going to make them more short of breath. They will have more pain, they'll have more incontinence, which results in more skin breakdown. It just, you know, your body. Your body will do what it's supposed to do if you let it.

[08:23] TARA LUPA: Do you think families used to know more about death when it was in the home before hospitals took over?

[08:30] LINA RIDGE: Probably. Oh, yes. I mean, the old timers, you know, they will tell me, you know, stories of how their great grandmother or their grandmother did something. Yeah, absolutely.

[08:47] TARA LUPA: I wonder if you can share some highlights from your career as a hospice nurse. Like, what were some of the things you had to learn early on that allowed you to be comfortable in all situations? And then tell us some stories, if you can. Of course. Go ahead.

[09:11] LINA RIDGE: Well, it's just that the person with a terminal illness, well, I kind of explain it like this to families, you know, or to patients, you know, that when you have a terminal illness. It's part of a journey, and everyone has a journey to travel. And it's kind of like you're the driver of the race car, and your family, your physicians, your hospice team, all the people that you call your support team are your pit crew for this race, and you're the driver, and you make the ultimate decision of how you're gonna cross over that finish line. And I look at it as hospice is the one that, of course, in New Mexico, we have all the potholes that. We're the ones that fill the potholes, and we put a fresh coat of pavement down. So that last lap of the race is nice and smooth and comfortable. But, yes, there's lots and lots of stories that, you know, I could share. One. One in particular that I remembered. It was such a cold, cold day, and we were way out in the country, and I drove up to my hospice patient's house, and I looked up, and their chimney was on fire. And I thought, oh, my. So I immediately called 911. We ran in the house and pulled my patient and his elderly mother out of the burning, out of the house where the chimney was on fire. And, of course, my car is stocked with all kinds of stuff because it's my office, and pulled that stuff out, and we got in the car and put the heat on, and we sat there and watched their house burn to the ground before the fire trucks. Fire trucks got there. And it was just. I just thought that feeling that lump in your stomach was just, oh, and your throat just, oh, it was just so heartbreaking. But, you know, if I didn't pull in that time, they probably would have burned, you know, and that would have even been a more horrible situation. I mean, burns are pretty darn uncomfortable.

[11:23] TARA LUPA: So hospice nursing is really hands on and going to folks houses. It's a different kind of nursing than a lot of nurses are used to doing house calls. That adds a different layer, a whole other layer of care. Are there other stories you have like that, where.

[11:43] LINA RIDGE: Well, there was one that you and I went to. It was a very. You can. It was a very, very cold winter, and the snow was deep. And I think we went in my car and we went out to a place that was off grid, and we couldn't make it to our patient's home. And so we went as far as we could go. And I remember getting out of the car, and the snow was over our boots, right. And we were walking to the house, and I remember the sky being so blue. I think I turned around and took a photo of you. I still have that picture. And we got to the house, and of course, there's no electricity or water because that's how people off the grid live. And they choose to live that way, and we honor them as that is their choice. But it was clear that, you know, he really needed to be somewhere where there was running water and electricity and heat. Of course, the ambulance couldn't get there because the snow was so deep. He did have a neighbor, remember, that came over, and she tried to go ahead.

[12:56] TARA LUPA: Her truck got stuck. Her guts thought that she could help us out. And then she thought of another neighbor who had a bigger truck and tried to get him. And sure enough, that worked. He came over with his truck.

[13:08] LINA RIDGE: Oh, I remember that. To get him out of the house, there was so much snow. He was wrapped in a blanket, and I think we put him on a tarp and pulled him to the pickup, and we got him in the front seat of the pickup, and you crawled in the back. And then we got back to where my car was, and I followed you back into town. And I just remember in my heart thinking, oh, what a beautiful human being. The guy driving the truck didn't even know him, and he was taking him to help another human being, you know, have peace and comfort.

[13:46] TARA LUPA: That's right. And it wasn't easy for that person. They had to get someone to fill in for them. They were working from home, and they really went out on a limb. I have a feeling it was just as rewarding for him as it was for us. I'll always remember that.

[14:06] LINA RIDGE: I contacted him, actually, several times to see how he was doing. And, you know, he was very honored to be part of that journey, part of the support crew that helped him get over that finish line, the end of the race of his journey.

[14:21] TARA LUPA: It's an honor, isn't it, to be there with people? It's such an amazing time of life.

[14:28] LINA RIDGE: I remember another story. This was really early in my hospice career. We had this woman who had a very, very bad cancer and just a lot of issues, and she had had so much trauma in her life, and she was so close to the end, but she just couldn't make it across the finish line. We just thought every breath was going to be her last. And there was family, there was hospice, there was a lot of us around her bed. And something, for some reason, just popped into my head, you know, there has to be some reason that she's hanging on. She's just. She just keeps on breathing and hanging on, and someone in the group thought about a grandchild that she had never seen. And so I said, well, could we possibly get that grandchild here? This grandchild's father was her son's, who had been murdered recently. Anyway, they brought the baby. They put the baby on the foot of the bed of. And, of course, the baby's only nine months old at that point. And so we pulled up the rails. Cause I thought, oh, no, this baby's gonna fall off and cause some injury or something. But no, that baby crawled from the foot of the bed up to the top of the top, and touched her face. And she took her last breath. It was so beautiful. It's just so amazing what life can do and how you can just wait for something. It was just so beautiful.

[16:06] TARA LUPA: She was waiting to see that baby.

[16:07] LINA RIDGE: She was waiting to see that baby.

[16:09] TARA LUPA: And she died just after the baby touched her face.

[16:12] LINA RIDGE: Yes. Just as the baby put his little.

[16:15] TARA LUPA: Hand, as if he was saying, it's okay, grandma.

[16:17] LINA RIDGE: You're gonna. Grandma, it's okay to go.

[16:19] TARA LUPA: Wow.

[16:20] LINA RIDGE: But then there's funny stories, too. I could tell you a story about this other lady that was kind of funny. She. She had been my hospice patient for quite a while, and I had finished my assessment and what I needed to do. And I'm just one that has to do my documentation right away. I can't wait because I guess I can't remember. So I went out on the sofa, and I'm sitting there doing my documentation. And this woman who was my patient, she had owned a pet store. We had all kinds of exotic animals at that house. There was a pot belly pig that you had to move over to get in the front door. The koi in the pond were huge. There was an albino possum. There was just, you know, just all kinds of things. But I'm sitting there, you know, doing my documentation on the sofa, and this very large parrot was across from where I was sitting in this cage. And that bird, I think it was an african grey, started yelling at me, watch it, watch it, watch it. And I'm thinking, what's wrong with that bird? So I said to the daughter, I said, what's wrong? And I don't want to say the bird's name. What's wrong with that bird? And she says, well, look behind you, Lina. And sure enough, I looked behind me, and there was the biggest iguana I had ever seen in my life hanging on the curtain with his claws out, just hanging there. And, of course, I jump because it startled me. And then when I jumped all these little kittens that were sleeping on the floor, grab my leg and scratch me. So I'm thinking, oh, my. Take a deep breath, Lina, and get over it. It's okay.

[18:04] TARA LUPA: What have been some of the hard things that you.

[18:07] LINA RIDGE: Hard things faced?

[18:08] TARA LUPA: How long have you been a hospice nurse?

[18:10] LINA RIDGE: Since 89. So what is that? That's 23 now. So a lot of years.

[18:17] TARA LUPA: Yeah. You have a lot of stories.

[18:19] LINA RIDGE: Oh, a lot of stories.

[18:21] TARA LUPA: So what can be hard about being a hospice nurse?

[18:27] LINA RIDGE: I think, of course, it's very hard when it's a child, a child that hasn't had a chance to live their life. It's hard when, as people get close to end of life, they do what we call life review. They sleep more. When they're doing this life review, like someone that dies acutely, like an accident or something, they always talk about, you know, how their life flashes before their eyes, but as they have a chronic illness, they sleep more. And so that it's not happening instantaneously like it does in an accident, they just. They go over their life. But there is. There's some things that, you know, people just have a hard time of letting go, but there's also good things. There's a lot of. Thank you. I forgive you. Please forgive me. I love you. There's a lot of things that need to be said. There's a lot of ex spouses that actually come into the picture. There's a lot of things that, you know, people can do just to make their end of life that peaceful, smooth across the finish line, and, you know, it's nothing to be afraid of. It can be very peaceful. I mean, and I'm. I think I am very, very blessed to be in New Mexico. I don't know if this is something that we want to talk about, but, you know, the medical aid and dying, I think New Mexico, you know, I've worked all up and down the east coast, and I. Montana, Oregon, here, but I think New Mexico really does it well. They really do. They have the support, and, you know, it's a beautiful option. It's so peaceful.

[20:15] TARA LUPA: Talk about medical aid and dying. What is it?

[20:18] LINA RIDGE: Well, someone has to have a terminal illness, and it's an option where you can ask your physician or the hospice medical director to write you a prescription. And it's medication that are in lethal doses. In New Mexico. In New Mexico, the physician and the nurse are actually there, and it's a compounded powder, and we mix it with apple juice, and it's about 4oz. And you drink it actually pretty quickly. You have to make sure the person has to be able to drink it themselves or self administer it, because you can do it. Other routes also. But, you know, it's for someone who wants to end their suffering for whatever reason. And it's so, you know, I've actually been to many of them, and it's actually very beautiful. They drink it and they go to sleep actually, pretty fast. And within now it's probably within the hour. I think the longest one was 6 hours that I can think of.

[21:28] TARA LUPA: You know, do they need to be able to self administer?

[21:33] LINA RIDGE: Yes, absolutely.

[21:34] TARA LUPA: The drink.

[21:36] LINA RIDGE: Absolutely.

[21:37] TARA LUPA: And are there any kind of psychological screenings, or do they, if they have a prognosis of six months or less, do the physician and nurse just kind of take them at their word that they're really ready?

[21:51] LINA RIDGE: Yeah, there's a consent form, and they have to know that if they take this, there's no amount of Narcan or anything that's gonna reverse it. It is final.

[22:04] TARA LUPA: And I know it was passed just in last year in 2022 in New Mexico. And you say you've attended many. So there are people who.

[22:15] LINA RIDGE: Absolutely. Well, people wanna die on their own terms, and I think I would absolutely do it because it's on my own. I'm a control freak. I like to do things on my terms.

[22:28] TARA LUPA: Yeah, I know that there's still a ways to go with medical aid and dying. I have a friend who has Ms, and without that prognosis of six months or less, there are no options for them.

[22:39] LINA RIDGE: Right.

[22:39] TARA LUPA: And they are looking at the possibility of going to Switzerland.

[22:45] LINA RIDGE: Yes.

[22:46] TARA LUPA: Because there isn't that limitation. And I think there are other states. Right. Doesn't Oregon.

[22:52] LINA RIDGE: Oregon allow. There's several states. There's California. I actually have one hospice patient now who is, you know, has friends and family in California and would like to go back to California, but he's read up on the protocols, and he likes the protocol in New Mexico.

[23:13] TARA LUPA: Yeah. So some people call that death with dignity, huh?

[23:17] LINA RIDGE: Exactly.

[23:18] TARA LUPA: Yeah. Right. To die.

[23:19] LINA RIDGE: Right. To die. There are worse things than death. There really are.

[23:25] TARA LUPA: Well, what would you say to physicians who are trained to save people at all costs? Like, they've taken the hippocratic oath and they want to offer every last possibility, even if it's very slim? Like, I have known people with cancer diagnoses who've tried every chemo, and then there's that one more chemotherapy is going to wreck them because they've been wrecked by them in the past, and this one is supposed to be the strongest of all, do you think that physicians should talk more about the hospice option when it gets to that point?

[24:06] LINA RIDGE: I think everyone needs to be comfortable with their own mortality and understand that all of us are going to die. And give the person that you're doing it to the option. Let them make that decision for themselves. There's something to be said for making your own decisions. I mean, as long as you're given all the pros and cons.

[24:32] TARA LUPA: Well, that's the thing, isn't it? We've put our hands in those of our doctors and authority figures for so long that we forget that it is our decision. We want it to be somebody else's decision when it comes to our demise. We don't want to, I guess, because death has been relegated to the closet for so long now, when it was taken out of the home. Or was it like the 1950s, when we started inventing machines and technologies that could save people's lives? And we would go to the hospital, we would take a pill, we would get fixed, and then death started seeming like something was wrong. Something was going wrong if you couldn't be saved. So you just kept trying every possible.

[25:22] LINA RIDGE: I remember being so excited when they brought in legislation to get advance directives where people could put in writing their wishes, their wishes, what they wanted to be done for them at end of life. That's actually how I met my husband. His mother had an aneurysm, and she was in a persistent vegetative state, and she had actually put in place a DNR, but my father in law at the time had overrode that and had her put on the ventilator and tube feedings and trached, and that was, you know, and kept this person alive. And, you know.

[26:08] TARA LUPA: Were you the nurse?

[26:09] LINA RIDGE: Yeah.

[26:10] TARA LUPA: And.

[26:14] LINA RIDGE: After a while, I was not acutely. Cause she was, of course, an ICU. But then when they put her in rehab, I did become her nurse.

[26:24] TARA LUPA: Well, that brings a question to mind. What good are DNRs if they're gonna be ignored?

[26:32] LINA RIDGE: So you need to pick a people as your medical power of attorney that will honor your wishes.

[26:40] TARA LUPA: And a DNR is. Do not resuscitate.

[26:42] LINA RIDGE: Do not resuscitate. You know, for artificial nutrition, artificial hydration. Because if you pick someone who is not going to honor your wishes, it's pretty much useless, because.

[26:53] TARA LUPA: What do you mean, pick someone?

[26:54] LINA RIDGE: Because, okay, when you make your advance directives, you also pick a person as your medical power of attorney to make decisions when you are not able to make your own decisions.

[27:06] TARA LUPA: So you wind up in the hospital, you got hit by a car. And how does somebody know who? My power of attorney is my medical power of attorney.

[27:15] LINA RIDGE: Well, hopefully, hopefully you have that document.

[27:18] TARA LUPA: On file somewhere in the hospital.

[27:22] LINA RIDGE: A lot of hospitals do have.

[27:24] TARA LUPA: So if they. Let's say I just want to break this down. Let's say I'm taken to the ER from a car accident to my local hospital. We're in a small town, so there's just one hospital. They can't get that wrong, and they call up my name. Are they going to see my advanced directives when they call up my name in the ER?

[27:48] LINA RIDGE: I really don't know if it's on file.

[27:50] TARA LUPA: Okay.

[27:50] LINA RIDGE: Hopefully, your primary physician has a copy of your advance directive, but I think it's important to do it. What's really important is for that person that you designate to be your medical power of attorney, to be someone who won't override your original decisions.

[28:09] TARA LUPA: Right. So if your decision is, I do not want to be resuscitated, don't want artificial feeding or breathing, they have to be at peace with the fact that you might die in that er if you don't get those interventions.

[28:27] LINA RIDGE: You just want your wishes honored.

[28:29] TARA LUPA: Yeah.

[28:29] LINA RIDGE: I mean, if it's okay. So if it's something like. Let me think. So someone's eating breakfast and they choke on a blueberry or they choke on something. Yes, of course. You know, you want to do the Heimlich and get the blueberry out, but you don't want them to just keep that in there and die from asphyxiation because they have something in their bronchioles, but something that is more permanent, like a stroke or some event that will end their life. And of course, not every stroke is going to end someone's life. There's various kinds.

[29:13] TARA LUPA: I am aware that not all paramedics are going to look for instructions, advanced directive instructions. I have a friend who has DNR tattooed on her wrist, and that's not going to be followed by a paramedic. They don't know when that person put that.

[29:36] LINA RIDGE: I know.

[29:37] TARA LUPA: Tattoo on their arm. Their job is to save the life.

[29:41] LINA RIDGE: Exactly.

[29:42] TARA LUPA: And I guess each person has to do their best in their community, with their primary care physician, with their hospital, with their appointed power of attorneys, to make sure everybody knows, you know, try your best to get everybody on board, and then it's just fate from there. Right? If your life gets saved, well, there you are. You're still alive.

[30:07] LINA RIDGE: But it could be worse the second time. That's what I always say, you know, you know, I've actually had hospice patients that have had CPR and then come back and then another exacerbation of the disease process. And it seems like it's always worse. It's always worse. Cause they're never back to baseline.

[30:28] TARA LUPA: Do you think it's hard for families who have agreed to the terms of hospice, which is there will be no curative treatments if this patient gets pneumonia, we're not going to send them to the hospital. I know that's an agreement that families make. How often do you see families change their mind when it comes to, oh, let's take them to the hospital, and then you have to revoke them from hospice.

[30:55] LINA RIDGE: But not very often. Not very often at all. There are times, absolutely, there are times. But, you know, say someone gets pneumonia, it depends on where you are in the disease trajectory. So if you're very close to the end and it's just too hard for you to take oral antibiotics. No, we wouldn't do that. We always look at the risk and the benefit if it's going to make their quality of life better so that they can go to their grandchild's graduation or something. Of course we're going to give them antibiotics. I think the one thing that people revoke, because only that person or their family can revoke the Medicare hospice benefit is for like, a broken bone. But, you know, I just see so many sad stories. Cause they go to the hospital, they have a terminal illness, they put them through surgery or whatever, and, you know, something about anesthesia, they don't do well. They don't do well at all. In fact, I can't think of very many people who have done that and then come back on hospice that were happy that they did that. They just, you know, the anesthesia tends to kind of change their cognitive ability and they, they don't.

[32:15] TARA LUPA: So it might be better if they had just suffered the broken bone?

[32:17] LINA RIDGE: Yes. Well, my mom is a perfect example. She was on hospice. She had breast cancer. And I remember it was 100 degree day. And my little 97 year old mom, you know, had to go out to the garden to get a produce, and she fell and she was outside with 100 degree weather, and her hospice nurse found her. But she didn't want to go to the hospital. She wanted to be kept comfortable at home. We gave her morphine.

[32:47] TARA LUPA: She had a broken bone.

[32:48] LINA RIDGE: She did. I don't know. We didn't know if it was her hip or her femur, but she did obviously have a very broken bone. We kept her very comfortable in the home. And she actually died three days later. But it was a beautiful death. I was sleeping on the. It was up in Washington state. I was sleeping on the floor next to her. My sisters were upstairs and. Yeah.

[33:13] TARA LUPA: You've seen a lot of people die.

[33:15] LINA RIDGE: Oh, hundreds if not thousands. I mean, I've done this a long time.

[33:20] TARA LUPA: What do you think about death now that you've.

[33:23] LINA RIDGE: It's normal. It's part of life. If you talk about it, it doesn't hasten death. You know, death is a normal part of life. It's just, I just, this is my own little pet peeve. I hate it when they call people expired because it's like eggs expires, milk expire. People die. Die. There's nothing wrong with that word. It's part of a normal life.

[33:48] TARA LUPA: People are afraid to use the word death. They say pass on or. Yes, other euphemisms for death.

[33:55] LINA RIDGE: I mean, if you say pastor, they'll say, well, where did they go? You know. No, but the hospice team, you know, which is a nurse, a chaplain, spiritual counselor. Not religious. It's just spiritual counseling, social work, there's volunteers, there's AIDS, there's massage therapist. I want to be on hospice so I can get massage therapy. No, we do. It's a beautiful teacher and we work together. You know, everybody has their own individual strengths as part of that team to make it just as beautiful and peaceful. And then after the person does die, the bereavement counselor follows the family for 13 months to get them through the anniversary of the death. And they can do as much or little of that as they want. Some people just don't want any, but some people want, you know, and I.

[34:49] TARA LUPA: Think a lot of people would be surprised to hear that that doesn't cost families anything, that it's very egalitarian. Hospice is available to everyone through Medicare.

[35:02] LINA RIDGE: Yeah, and private insurances. And some hospice actually do indigent care. They have funds where they can do indigent care and take care of anyone, regardless of their ability to pay.

[35:17] TARA LUPA: That patient you talked about that you and I visited was on antigen care.

[35:23] LINA RIDGE: Absolutely.

[35:23] TARA LUPA: Yes. They were not old enough to be on Medicare, and I guess. Is it free to anyone who's old enough to be on Medicare?

[35:35] LINA RIDGE: Well, Medicare part A is what covers the hospice Medicare benefit, but.

[35:42] TARA LUPA: Oh, all that insurance stuff is so confounding.

[35:45] LINA RIDGE: It is. It is. But other insurance is paid, too. And like I said there, you know, some people have GoFundme sites and some people, you know, some hospices have foundations you know, the one hospice, I still remember, the one hospice had a Christina foundation, where so the employees could actually put money in there to help take care of people who were indigentous. And we have people that donate, so there's some for profit, nonprofit hospices, but they all have the same conditions of participation, and we try to treat everyone the same and just make a beautiful life, well lived, peaceful, comfortable.

[36:29] TARA LUPA: So what are you looking forward to now that you're thinking of retiring?

[36:35] LINA RIDGE: Well, I'm going to apply to get a parent visa to move to New Zealand in September. It'll go into a lottery, so I don't know if I'll get it or not.

[36:43] TARA LUPA: It's your daughter who's a physician, and your mom was a nurse. I love this whole matriarchal lineage of healthcare workers.

[36:50] LINA RIDGE: I'm hoping to go to New Zealand, but of course, I want to come back, too. But I think I'll still be part of hospice in some role, because I. It's just in my heart, it's who I am. I'm a hospice nurse, you know, and I just think. I mean, I don't know, but we're going to take a road trip for a month, you know, the end of May. I may come back and say, nah, I want to stay retired. Or I was like, oh, I'm going through withdrawals. I have to have my hospice patients.

[37:23] TARA LUPA: There is something very magical about being in that realm.

[37:29] LINA RIDGE: Oh, absolutely. Absolutely. It's sacred. It's beautiful. And, yeah.

[37:37] TARA LUPA: Thank you for all the years of service to all these families. And I know that you have made so many families relax around the death of their loved one because of your kindness and your care and your expertise. And I feel so grateful that you've done this work and that I've gotten to work with you. Lina

[38:02] LINA RIDGE: I've enjoyed our friendship and what we've done together, and just beautiful memories, making life special. And I just. I think as I'm sitting here, I'm thinking of all these stories that I could have told that, you know, I didn't, but, you know, every one of my patients have a special place in my heart.

[38:24] TARA LUPA: Yeah. Yeah. Thank you.

[38:28] LINA RIDGE: There.