Shaking The Taboo and Embracing Hospice: Expert Insights from Social Worker Tiffany Carroll
Feb 29, 2024Season 2Episode 28
Sherri Lund & Tiffany Carroll
In our 28th episode of The Probate Podcast, I chat with Tiffany Carroll, a hospice social worker who spills the beans on what hospice is really about. We bust myths about it being a death sentence, explaining how it can actually help people live better. Tiffany shares nuggets on why families sometimes struggle to embrace hospice, the vital role of social workers in this space, and why having open talks about end-of-life wishes is a game-changer.
I am so grateful to hear about a day in the life of Tiffany and share her hospice social worker tips and insights with you.
🌟 What More People Should Consider About Hospice Care:
Hospice isn't just about counting down; it's about getting good care and maybe even thriving a bit.
Start talking about hospice early, so decisions match what the person really wants, and there's less chaos later.
Hospice social workers don't just handle medical stuff; they're like ongoing emotional and practical support.
Ask real questions about how people live, respecting different ways of doing things in hospice.
Palliative care kicks in with any serious illness, focusing on curative strategies.
Get a real estate person involved to help plan around hospice care and housing needs, and help fund costs through the equity of your home.
People often want hospice earlier than you'd think! Don't assume.
Families, just talk openly about what someone wants at the end, so everyone gets it without the stress.
🤝 Contact Sherri: Sherri invites you to explore her toolbox of resources on the Willow Wood Solutions website and encourages you to reach out to her through the contact form. For direct assistance, call or text Sherri at (832) 640-2997.
No one should navigate life's transitions alone. Let Sherri be your guide through probate, senior transitions, and beyond. Connect with Sherri today.
Disclosure: The information shared on The Probate Podcast is for educational and informational purposes only and does not constitute legal or financial advice. We strongly recommend consulting with a professional for advice specific to your situation. If you need help finding a professional, feel free to reach out to us at www.willowwoodsolutions.com/contact.
Please consider kindly rating this show so others can find it!
In our 28th episode of The Probate Podcast, I chat with Tiffany Carroll, a hospice social worker who spills the beans on what hospice is really about. We bust myths about it being a death sentence, explaining how it can actually help people live better. Tiffany shares nuggets on why families sometimes struggle to embrace hospice, the vital role of social workers in this space, and why having open talks about end-of-life wishes is a game-changer.
I am so grateful to hear about a day in the life of Tiffany and share her hospice social worker tips and insights with you.
🌟 What More People Should Consider About Hospice Care:
Hospice isn't just about counting down; it's about getting good care and maybe even thriving a bit.
Start talking about hospice early, so decisions match what the person really wants, and there's less chaos later.
Hospice social workers don't just handle medical stuff; they're like ongoing emotional and practical support.
Ask real questions about how people live, respecting different ways of doing things in hospice.
Palliative care kicks in with any serious illness, focusing on curative strategies.
Get a real estate person involved to help plan around hospice care and housing needs, and help fund costs through the equity of your home.
People often want hospice earlier than you'd think! Don't assume.
Families, just talk openly about what someone wants at the end, so everyone gets it without the stress.
🤝 Contact Sherri: Sherri invites you to explore her toolbox of resources on the Willow Wood Solutions website and encourages you to reach out to her through the contact form. For direct assistance, call or text Sherri at (832) 640-2997.
No one should navigate life's transitions alone. Let Sherri be your guide through probate, senior transitions, and beyond. Connect with Sherri today.
Disclosure: The information shared on The Probate Podcast is for educational and informational purposes only and does not constitute legal or financial advice. We strongly recommend consulting with a professional for advice specific to your situation. If you need help finding a professional, feel free to reach out to us at www.willowwoodsolutions.com/contact.
Please consider kindly rating this show so others can find it!
Hey there, this is Sherri Lund with the probate podcast sponsored by Willowwood solutions. That's a company that I created to help families in process as they're moving into this end of life season, and I'm so glad you're here today. My guest is Tiffany Carroll and she's a social worker at a hospice company here in the greater Houston area. Tiffany. Thank you so much for joining me. Yes, ma'am. Thank you so much for having me. So Tiffany Carol has a passion for helping people in hospice. She's been working with patients and their families in hospice for nearly five years. She's always been a person that wants to help people in need. Now she's providing patients and their families with emotional support through this end of life process that includes hospice. But she's also a guidance and an educator through guidance and education patients and families and hospice have a variety of needs that can crop up. Knowing others in the community is a big part of what Tiffany does. So she can refer other people to the families, depending on what their needs are. She sees her role as a hospice, social worker, as an honor and a privilege as she supports those that are in her care. Tiffany, again, thank you for joining us and thank you for sharing that little bit about yourself. We're going to drill down a little bit more and talk to you About Tiffany, the person, so if I said, Tiffany, what.. Who are you as a person outside of social work outside of the labels of grandma mom, wife, who are you as a person? I would say first and foremost, I'm a godly woman. I, I love my God. I lean toward God. He is what guides me and has blessed me. That's first and foremost for me as a person. When you ask me like outside of family, grandmother, social worker, and things like that, it's just really hard because those are what parts that do make me who I am. I'm a hard worker. I love people. I love to help. I've always been a helper by nature. I've always been that friend that would listen that would be there night or day. You know, I always kind of had a passion for wanting to, in the back of my mind as a kid when I was thinking what I want to be when I grow up, a counselor always kind of came to me and kind of led me there is as a young child of a dysfunctional family, divorce and alcoholism and the family and things and such that I had counselors, school counselors that would come and visit with me and provide me a lot of support and It was really, really nice to have that support and to have someone to listen to me and to not feel judged. You know, I remember telling her I wanted to be just like her when I got grown but did I think it was a possibility, you know, being from a small town mom and dad, you know, they had jobs working in grocery store, waitressing, things like that to be where I'm at today. I really couldn't imagine what that would be until now. But I just say I'm a big person with a big heart. I love everyone. I, and if I can help someone, that's what I want to do. If I can take a relief or stress off someone that's huge for me, just even one simple thing. So that's, that's what I would say I am. I'm a helper. And I also like to encourage people and lift people up when they are in a time of need. Yeah, and when you've experienced that yourself, you know, you know what it feels like before they helped you and you know the relief that you felt afterwards. And that's what you're trying to replicate in that giving that you're doing every day. Yes, ma'am. Can you talk a little bit about what's involved in becoming a licensed social worker? There's the educational piece of it, but then you mentioned a couple times in your bio. That there's licensing to acquire, and then you can begin to practice. So can you talk a little bit about that? Yes, ma'am. I sure can. Of course you just stated there, there's definitely college, you can become a social worker at a bachelor degree level, you can get your license at an, which is separate from your degree. Once you get a degree, and then you can qualify to take an exam, and you would register that through the state, and once you have gotten your license, you pass the exam, then you are considered, at that time, a social worker. If you have carry a license, then you're just a social worker with a degree. You're you just have a degree. Excuse me. You have a degree in social work. You're not a social worker without the license. Yes, you spend a lot of years in college. There's a lot to become a social worker just with the degree itself. I wish that we could just graduate with all that work and not have to worry about state licensure because it brings a lot of anxiety to people to take that exam or to take an exam period. And they're not easy. It costs money for these exams to take on. So that puts a lot of stress and pressure. Right now, I'm currently in that situation. I am a licensed master in social work, but I now I've done my supervision for my clinical. I now have to register for the test, and I have to pay all those fees to become a licensed clinical social worker. So I am right there, what I'm talking about, and it does bring a great deal of anxiety. Am I going to be able to pass this? And am I my ready, that's huge. I mean, especially with the clinical license. We had 2 years of outside of school. The supervision is amazing and the working in the field is amazing to get us everything we need, but to hold that knowledge of 4 years college and then hope it's still all up there. You know, it's so broad of what you have to know to be a social worker in order to pass those tests as well. Right. And it's a state license. So if you were to move or come in from another state. For them to practice at that same level, they would have to take the exam. There's a possibility, but they also have started as something with the licensing so that we can go online and and apply. You can, because right now, in crisis, when COVID happened, there was so many social workers needed. Right? And so they couldn't just move a social worker to Texas to go work in Oklahoma. Or, you know, another state. So they're making it if, if social workers are wanting to broaden their field and to help more people and online, you know, online is very broad. That's other states. So you have to go on into the state and you have to apply for that. And but every state has different requirements and laws and regulations and all that stuff that you have to follow So you really need to base it off of that state and off of you know The state's website on what the qualifications and stuff are necessary to work there So what did you do before you became a social worker and and you were also teach just to be clear You are also teaching in the community college for people that are currently wanting to be social workers or Investigating the idea of becoming a social worker. What did you do before all of that? Well, I had many roles before all that. You know, I'm from a small town, so I've worked at Walmart. I've worked at McCoy's. I was a certified nurse's aide at one time. I love that job. You know, when I lived, that was when I lived in Brownwood. When I moved down here, I got to be a barbarium technician, which was for a pharmaceutical company, and I did that for seven years. And then there was a gap period where I had got my department got laid off because they don't longer need that department. So I was without a job for a couple of months and it was kind of scary. My husband was working for a company and you know, his boss came and said, I heard your wife used to be a nurse's aide and, you know, she seems like she'd be a great fit for helping take care of my dad and mom. They're looking into hiring somebody. And I said, okay, so I went interviewed with his father and I worked there for nine years taking care of a couple. First, I took care of the lady for five years and she was on hospice. I saw the whole process through for three years that she was on that as the caregiver. And he as well ended on hospice later on. And I was with him so it was a big blessing how that all fell together for me to have that opportunity to take care of those people. I would like to say that the gentleman I was talking about, you know, that hired me to do that, he saw, he saw a lot in me. He was like, you're very intelligent. You're so sweet. You have helped us so much. You could really help, you know, further help people. I would really think you would be really well if you just go to college and pick something you're interested in. At that time, I thought it might be nursing. You know, kind of leaning towards more nursing than social work. But I just didn't think I was capable, smart enough to do it. But he just kept on and encouraging and encouraging me to just give a try. So I went and so I'll just go take the test and see where I'm at and, you know, whether I can go to college, you know, and I did that stuff and then, whoa, I did fairly well. Okay, well, I'm just going to do a semester of school. Right? So I did a semester and hey, okay, I did well that semester and that's just how I kind of took it day by day, semester by semester and I only focused on one thing at a time because if I had thoughts that today I would be a licensed master of social work and I'd have a master's degree and all that, I would probably run the other way. There would be no way I could take that amount of stress and to think of how many years of schooling that would take. So I just took it day by day. But as I was going working there, not working, excuse me, going to school there, I saw that I wanted to maybe do something different than nursing. Usually like I told you about my childhood, you know, having that counselor and stuff and kind of what I'm wanting to do. So I met with a guidance counselor at school. And she had told me about the chemical dependency track and, you know, with a dysfunction family, I grew up in and alcoholism and how I wanted to learn more about that. And I would love to help people with that as well, you know, and I could start counseling with associates degree. I can start doing my passion and that could lead maybe into something else. So that's when I train trade you know, tracks from nursing to more of a social work type build. You know, after, I did that. And switched over this person I've been talking about just continued to pat me on the back and was so proud of me and so..You were still working, you were working for them the whole time while...the whole time I was going to school and he also paid for my education, but if wasn't for him. I wouldn't be here today. That was part of, he asked me, he's once he got me convinced that I could do it. He was like, you know, I could give you a raise every year, or I could help you go to school. And so he's which one would you want? And I was like, you know what? It'd just be a blessing because this just doesn't come every day to be able to go to school. So if it weren't for him and his family, I would not be the person I am today. I would not be sitting here having this conversation with you. I am very, it makes me teary, very blessed. Yeah, I love that. I love how someone approached your husband, you know, like your husband was in the right place at the right time. And I love those serendipity kind of stories. Those are my favorite. We've had people talk about hospice before, but for those who might not be familiar with hospice, can you talk a little bit about what just hospice in general, what that is? So hospice is something that it comes at end of life and what that means is it usually takes a doctor to have a diagnosis of a prognosis of a patient to say they have six months or less to live. Now that does not mean, I stress this to my families, that does not mean somebody is going to pass away in six months. That means they have a high probability with what they have for their illness that it could happen. So that's something that they, that the doctors look in some of our patients I've had on for three years, two to three years, of course, they have to qualify in order, you know, have a decline and stuff like that. They can't be doing well, they'll end up graduating off hospice, which isn't a bad thing, right? It's not a bad thing. So there's definitely qualifications for that. Hospice is so much to me when a patient needs hospice. I feel like it gives them such a quality of life and I've seen it over and over and time and time again. I've had patients that very frail when they come on service. And the families are stressed. They, they don't know which way to go. They just need the help and support. And once they get on hospice, then they get the support of a nurse coming to them. There's no more going to the hospital. A nurse is coming to them to provide loving care in the home. And they get that nurse once, two times, three times a week, depending on the need of the patient. And they get that support from the nurse. You know, that's huge. And they have a doctor in the background that's working with that nurse and in helping and guide. And so with that, they also have a social worker like me who kind of comes in and provides that emotional support. There's so much emotional support needed, not only for the patient, but for the patient's family. Along with that were a book of information were a lot of resources. There's so many ways to help different families, and how I do that is when I go in there, I kind of paint a picture for them. I kind of just say a list of things that I've helped other families with. And it kind of gets them thinking, you know, either, oh, you know what? That's a good question. I could ask you about that. Or, I didn't realize you helped with that. You know, and we're actually been talking about that and it was actually yesterday with the family that when I did that, there were several, it guided them for so many more questions and answered so many of their questions and they felt so much better after all that. And so outside, so you got the emotional support, right? For the social worker, then you also got a chaplain. You know, and that chaplain doesn't have to be, it is spiritual, right? But not all our patients are spiritual. Not all of them have a Christian background. Some are atheists and things like that. So it, a lot of times they'll have the chaplain come in and they'll realize, you know what, this is just somebody coming in to love on me and to say, how are you doing, and that really care for me as a person. and he's not or she he or she is not talking about bringing a Bible and opening up and reading it to me because that's not where I'm at. That's not what I need. They're actually in there. Providing, you know, just support just an extra support system. And and then you've got nurse practitioners that oversee the care as well. So that's very helpful to in reassuring to our patients when they actually could see a nurse practitioner kind of in there and they're seeing how Each of us work together and how that makes the system whole and you just don't get that when you go to the doctor's office. You don't get that necessarily in the hospital. I know hospitals have social workers and things, but I have had family in the hospital and talked to a social worker and they're wonderful. So I'm not knocking that, but they don't have the time, the quality of time because the hospitals are so big and there's so many patients and they got a long list of things to do. So they can't spend the time and come to your home and get to love on you and get to know you and get to meet you where you're at as much as a hospice social worker gets to and I get the privilege of doing. That's awesome. Yeah, when I think about a hospital floor, and I'm imagining the people walking quickly, you know, from room to room, as opposed to creating an environment. That's quality of life. The description to me is night and day, just the thought a while ago when you were talking about the nurses coming to the family, 2 or 3 times a week, you know, I don't I'm assuming anybody listening that would be interested in social working or hospice care is familiar with someone who's very sick who may have issues getting in and out of a car or getting dressed; to drive to be able to sit in a car and then get out of the car and make their way into wherever the office is. I mean, it is a lot to have the nurse come to them and they can be in their pajamas and they can be in bed or they can make their way to the couch. But wow. What a difference. It really, really is. Yeah. It, it, it's makes a tremendous difference. It also depends on one family. Exactly. It's not just for one or the other. It takes a big stress and relief. As like I was saying, I mean, I'm only speaking of yesterday. It's just fresh in my mind, you know, I met with a family who was very, very overwhelmed. She just moved mom and dad nearby and has so many questions and everything and, and didn't quite know about hospice and how they could help until she went and visit her family doctor and he referred them to us. And we got in there and she's I just did not realize the amount of support that we would have. I have the nurse coming in here answering my medical questions let me know, you know, how dad or mom's doing. They let me know these things. And then here you're coming in and I'm needing these resources and I'm needing the support because, you know, I'm feeling overwhelmed and I don't feel like this is a, you know, it's always a safe place to talk to someone or about these things. But, you know, here you're coming in here and You're really listening to us and you're helping with resources and you're helping us to there's a solutions that I didn't think just last week were possible. They got referrals from their neighbor later on about hospice and how it had really helped them. So that made them even feel better about making decision to bring us on. Yeah. Yeah. Love it. what are some of the myths associated with hospice? You know, a lot of people kind of cringe when they hear that word or if someone suggests it. What can you say about that? And that is true. We even still have when I visit with patients, families asking me not to use that word with the patient. They just worry that that's gonna make their loved one feel like they're just gonna die soon. That, so a lot of times when you hear hospice, it's like that six month period everybody hears about that really sticks out right with hospice. They're thinking, you know. Oh, my loved one, if I put them on hospice, it's definitely six months. That's just it. The six months the doctor says, but they don't realize the quality of cares we've been talking about how that really helps a lot of the times the patient to actually thrive and, and live longer. And then, you know, we're not God, right? In my personal feelings and God's timing so sometimes, you know, a patient doesn't live six months. But they're still got that good quality care, right? They're not going in and out of the hospital. They're not getting poked and prodded on. They're not getting x rays. They're, they're not getting all those things, you know, being like you said, hard to get in the car, going by ambulance, all that thing drains people. And it takes a little bit out of them each and every time. Right. As I was speaking to a family yesterday, debating their loved one had. Fallen and could possibly, you know, have some broken bones. They were really like, if I take them to the hospital again, it's going to set us back more. You know, and they, they've already done the hospital thing several times, and they really just don't want to do it again because every time they go, it sets that person back. A lot of times, it's just people are not wanting to let go, and it's understandable and they don't want to feel like they just wipe in their hands and say, you know what, I give up, let's just go with hospice, you know. But once they get hospice in there, because no one's going to be put on hospice unless, It's needed, right? If a doctor says, and they have qualification factors, which I can't go through all that because I'm not a nurse, right? I can't get too deep in the medical side of things on the factors and reasons why people would qualify exactly for hospice on the medical realm of things. Right? Because it is a holistic service, right? We're talking about person and we're talking about the family, the emotional support, right? The spiritual support, if that's important to them being able to hear them and affirm them as a person when they're feeling most vulnerable and overwhelmed. Yeah, and there's not going to be any case that's a duplication of another case. They're all unique in their, in their circumstances and their personality makeup. And I just love it too, because it really supports the family unit. And if there's not a family unit, then it brings community to the person to the patient when they need support from various resources. And yeah you know, I'm a big proponent of of hospice and what it can do. Can you talk about what social workers do. In the hospice realm, as opposed to the hospital realm. So if they're, if they're thinking about hospice, maybe they have met a social worker at a hospital already. So the way that I can explain it best, I've never worked in a hospital as a social worker, but I have worked with social workers in the hospital. You know, and I've been that family member with social workers and stuff like that. And what my experience has been again, they're wonderful. They have a heart. They wouldn't be in there helping people if they didn't. Right? Right. Right. I think they, they're wonderful help to getting families home and with some resources and stuff like that. Yes. But as I stated earlier, I don't feel like they have the time as we get to, right? Once you're out of the hospital, they're done. You are set on to the next resource, whether that's home health care, whether that's at a SNF, a skilled nursing facility, or whether that is hospice. That social worker's goal in the hospital is to get you in a safe place from discharge. And again, continue your care, and you're not probably going to be calling that social worker back and getting more services from them. I know if you did, I know if you did, they would, you know, we all have bleeding hearts and social workers. It would help you the best they could, right? They, it's not like they would ignore you and not take your call. That's not what I'm saying. It's just, they referred you out, right? So they're expecting you to be more dependent and everything on the services. Outside of the hospital, correct? You know, and and they are the ones who would say you're the how the situation as it is right now. We're not allowing mom or dad to leave until that's different. There is time if there's safety issues regarding the patient going home., Yes, they do. They do want these steps to be first safe discharge, right? That is our goal for their patient to have a safe discharge and to have the resources available to them. That's going to help continue with that patient's care. Um, what does palliative care mean? And that's a really, really good question. So palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. There's differences, right? So the differences is like we discussed earlier, you would have six months, you'd have a diagnosis from your provider that your prognosis is six months or less. So that would be the big difference, right? Somebody who's on palliative. Yes, they can start palliative as soon as they get a diagnosis of anything. It doesn't mean they have to be terminally ill. They just have to have a diagnosis. Okay. So that's the difference. And like I said, hospice, you would have to have a prognosis of six months or less to live. You, the other difference is the curative care, curative treatment would stop on hospice. You would no longer be seeking curative care or life prolonging treatment. All that would stop. On palliative, you could still receive those things. Hospice is also offered to you anywhere. It can be offered to you in a hospital, it can be offered to you in a nursing home, a care facility, it can be offered to you in your own home, and it can be, and this is for both of them, it can be at any age. There's not a age limit on when you can receive palliative care, and there's not an age limit of when you can receive hospice. Okay, just you have a diagnosis. And again, if it's hospice, you have a prognosis of 6 months or less. So those are some differences. And then we do have the same goals. We want to give quality of life. We want to keep your pain comfortable and managed. But there is some hospice companies that do provide palliative care and they provide hospice care, they provide both and, and one in the palliative care is for curative, you know, people who are still seeking treatment that has a diagnosis and things like that, but they get the same support system as hospice, they get a social worker, they get a chaplain, they get those things, right? Oh, wow. It's really, so it's a nice, yeah. So it's hand in hand, there's just the difference. That's why I really wanted to point out the differences of what that looks like. But somebody who has a six month prognosis and wants to continue to seek aggressive treatment, they, they have the option for palliative care. They don't have to be on hospice. Can you think of a challenge that a family would have in for their family or their loved 1 on hospice and how you've been able to either refer that to someone who was able to help them overcome that challenge or how you were able to help them navigate that. I don't have no idea what the challenge might be, but.. We got families and patients When they come on service, not all, some, some are really good, but one is lack of support. There's just not any support. There's a a child who don't have siblings, they're an only child, and they're taking care of mom and dad. And that's a whole lot of weight on their shoulders, right? So when I kind of come in, they, in the, you know, they have to work, they have jobs, they have things that they still need to do. And mom and dad need all this care at home. So a lot of times when I come in, I give them resources for in home care providers, or if it's getting to be too much at home, then I help provide resources and referrals for maybe a personal care home, or maybe a nursing home, a facility, a community. For that person to thrive in and to live in to help that support and sometimes it's financial, they need that are struggling financially, they don't, they might say, you know, all that sounds great, but I just don't have the funds. Then part of my job is to hook them up with people, including myself and, and get on, maybe, maybe they qualify for Medicaid. To get some extra help there and some services they provide. So then I'll connect them with someone there. Maybe they need food stamps Maybe they're you know, because they've taken off so much time from work They're with mom and dad that they haven't been able to bring in a whole lot of income right now and when you're on fmla You know, which is family medical leave act. A lot of my families are on that and they're using almost all data. But they're not making any income. They're not. Now that says is that they're going to hold their job for them. That doesn't say they're going to pay them. Right? So they're behind on their bills. So I'm going to come help provide resources and connections within the community to help them with those things. Sometimes just getting an in home care provider if they can afford those things is a big help because, you know, it sometimes takes somebody coming in and from the outside and kind of looking at the whole picture and kind of saying, you know what? It's okay. You need help and it's okay. And it's okay for you to, to get that. So you can have that rest because what people don't realize is when they're taking care of somebody else, it's taken a lot off of them. I mean, there is they're tired. They're, they're stressed. It's wearing them down. They're irritable. They're, I mean, all the feelings and emotions we have as humans so there's just so many ways that we kind of go in there as social workers and, and help kind of sit down with them and, and paint a better picture of how we can help better their situation and support them through this. And so many things are outside of our control. You know, the fact that they, they are even in this situation to begin with is difficult. And then they don't want their parent or their spouse. Whoever the patient is to feel like a burden. They don't want to put that on them. So they take more on themselves. How do you, how do you approach seniors that don't want to talk about where they're at their end of life season? What I do is the 1st thing I try to, especially my patients, you know, I build rapport with them. I want to build that rapport with my families as well. The first thing that you need to, you know, for them to feel is that you really care. They don't need a person just coming in there and telling 'em what to do and how things should be, that it should never be that way 'cause you're in there because you care, right? You're in there because you want to meet them where they're at. And if they're not ready to have those conversations, I, I likely, I'll bring them up. For example, when I told you I paint a picture for my patients and families on all my services I help with. So one thing I do want to leave, even on my first visit, is that I help with end of life. You know, when we get to that point and that's how I put it to them, I bring up that I help with funeral and I help with, you know, these kind of things, answering these questions and referrals and things and such like that. So that sometimes we'll just get them and the thought, you know, okay, they put me with that box when the time gets closer and it makes it a little more comfortable for me to bring that topic up again. If a patient is having a decline but it's never forced on anyone to have that conversation when I'm with my families, you know, because a lot of times families don't want to speak in front of their loved one about death and dying. And I just really encourage them to talk about it with their loved ones, especially while their loved one is coherent and can say their wishes. Yeah, you know, I really wish our families would talk about these things way before hospice. I've seen so many times that this conversations are not had within families, and we're at end of life, and we're in denial about the patient's progression, and the nurse is trying to go in there and educate, you know, this person doesn't have much longer, you know, please utilize our social worker, please utilize us and let us help and support you. And then a lot of times I get from families is, I just don't know. We never talked about this. This wasn't something we wanted to bring up, but now that I see that mom, dad, my spouse is in this situation, I really wish I had these conversations. And a lot of times families realize if they do utilize my services and help and talk about these things, that they can plan ahead. And if you can pre plan, that's wonderful. You can make those decisions. So your children and loved ones don't have to make those decisions for you. You have all your boxes checked. I had 1 lady that had everything down to the dime for her family and I'm meaning she had her furniture given away. She had her funeral was going to be paid for the day she passed away. They had the card number for it to happen. She had all her heavy stuff out of the apartment, Um, so she was an only child and She also had a granddaughter she was very close to that was very young So she really wanted everything just to be taken care of because of how close she was to them And she just wanted them to Have everything done already and I mean that just gives me chills still talking about it You know that how she did all that for her children just so they wouldn't have the stresses. Now It doesn't have to be all the way to that far, right? It's just having you know those Conversations checking those boxes if you can now while you can make those decisions and having all that in place before you're you know Your loved ones and if you do have someone who is terminally ill you Or, going through something. I don't think it's a bad thing just to ask them their wishes. I think a lot of times they more want to talk about it than you think. Maybe they're not talking about it with their loved ones because they don't want their loved ones to hurt them by talking about it. But a lot of times, they would actually like to have that conversation. And that's a lot of times when a social worker comes in. There's so many times I also offer to sit with patients and families and they can have those hard talks and I can just sit there and just be that kind of mentor, during that time, mainly it's them talking, right? I'm just kind of there for support. It's, it's hard, but it's also sweet. And you feel more connected to your person in that moment you have a connection that. You've taken advantage of that opportunity, and then once they're gone, you lose the option to know what they wanted, but you also miss the opportunity to connect with them in that way. It's okay to admit that this is a hard conversation. But it's an important 1 and so sometimes just acknowledging the fact that, you know, we need to talk about some hard things. but it's important that I know what you want so that I can carry that out. I can't read minds. And.. Exactly. And it keeps the family from second guessing themselves in the end, did I really do that right, would dad be or mom or spouse be okay that I, we did cremation, you know, that's a big one, you know, you know, what was their feelings about that, you know, another thing and families run into is cremation is so much cheaper than direct burial. That's a financial, it's huge. So a lot of times if you can get a social worker in there with you, they can really break it down to different places that we have utilized with our other patients and families that we know the pricing could be a lot less. Not always, but sometimes and that that helps families to take that burden off because they always have a typical number in their head, or maybe they only talk to 1 funeral home and they said 10,000 or more and they're like, that just overwhelmed them. They're done looking or searching and then a social worker kind of comes in there and says, you know, I know this, these 3 or 4 places and, you know, and here, look at this website that shows what they charge and they're like, oh, my goodness. That's 7 less than what. I was told before I didn't think it could be that reasonable, So this podcast is called the probate podcast. And so people come thinking that they're going to hear things about probate and how to help them through that process. How does planning for this end of life conversation and this end of life process, with the idea of you and I both want to minimize the stress for the people that we work with. Can you talk to that a little bit? It's kind of a weird question, but. Someone like you, Sherri, would be a great, great help. I would definitely involve someone who understands real estate, someone who understands what that end of life process, that steps kind of outside the rim of hospice, right? So I would do a referral and I, and I do have, and I deal with the process and I do give a list to my patients and families or, you know, of things to check off the boxes once one passes. But to get down to really wanting to know exactly what that's going to look like for them. So then I encourage them to go ahead if they have an attorney family friend that they know and If it you know And if they don't know anybody then I'm someone like you who's been there and actually has seen that in the process afterwards right after hospice care is Complete. The services you offer, I think are amazing. And I'm so glad we have connected because you just don't know how many times I've run into, I'm not going to be at this stage and who do you have anybody and I'm referring them to probate attorneys, but I don't know I'm on the level as I've gotten to know you and right and the compassion and the care that I can see that. You, you would go in there just like I would and love on people and, and really walk them through something. It wouldn't be just me and candid on paperwork and saying, this is all the checkboxes you need to do. You would actually explain those checkboxes to them and how that would look. And then you and I also, you know, cause care continues after hospice. The support does. We're still available if a family ever has any kind of questions and if I can help with a referral or something like that, I'd be more than happy to. And it's also called a bereavement program that hospice offers. And that's just reaching out and connecting the families to see how they're doing after a loved one has passed. Not all attorneys do probate. And even some attorneys who call themselves a probate attorney may not do it very often. You know, they may do this and then the very next thing they might do probate or whatever. And and even within attorneys that do probate, some of them will go to court if there's a family issue that comes up, and they call that litigation when there needs to be some determinations made by the court to settle a discrepancy between the families. But there are a lot of probate attorneys that do not do that. Even though they're called a probate attorney, it may be able to practice that part of law. So, it is helpful to have the right attorney for the right situation, and that's where you and I can work. Exactly. Exactly. And that's why I love that. I've gotten connected with you and stuff. You're just going to be a wonderful asset to my company and hopefully if people, you know, other social workers on here from hospice be like, you know what? Miss Sherri is going to be an excellent help for us. And then, like you mentioned earlier, if they need help in funding care, if they need to move from home or hire more care to come in, that's expensive or if they need to relocate to a community to care for them there, they might need access to the equity in the home and I can help with that as well. And I run into a lot of that as well. Yeah. So, what about cultural differences? Tiffany, how do you handle? I mean, Houston is 1 of the most culturally diverse. Cities in our country, and and I think that's awesome. But as a social worker, dealing with end of life and and different cultures have different ways of approaching end of life scenarios. What what is the hospice stance? What is your stance as a social worker in dealing with those differences? So in hospice, the biggest thing that helps us as social workers, our nurse goes assesses the situation. They're the first ones in. And a lot of times I've based our assessment off of our nurse, because she's kind of kind of let us know what's the situation with a religious background, the family dynamics. We got kind of a picture painted for us before we're going in, right? For example, we had a family that likes their shoes to be taken off before you come in. You know, don't, don't make eye contact, and some families do, and things like that. But what I found is people in this situation, they, as I said earlier, they want someone to come in who cares, right? They know when you come in, you're not going to know everything about their culture. They know you're an outsider. I hate to put it that way, but they know that you're someone from the outside coming in. There are things that works with me when I go in, because I definitely try to be mindful and read up about my patient and family before I go in and see them. But at the same time, they're okay with you asking questions as long as they're respectful, right? They're respectful and it's because you care. You're not being nosy. You're not, you're not prodding and things like that. A lot of families appreciate you asking those questions, how things work and how, how end of life, what that looks like for them is very interesting. Some of it, and like I said, if you're coming from a good place with a good heart, and you're really caring about them and their loved loved one, they don't mind at all educating you. And you know, and helping you to provide them better care And you know, when it's all said and done, I mean, human emotions are pretty much the same and and feelings of loss and grief and despair and overwhelm, you know, those are the things regardless of what religion they practice or, or don't practice or whatever, what color their skin might be underneath all of that is this human being who is feeling vulnerable and lost and needing support. And I love that. Do you see some emerging trends or some new services? being offered in hospice or palliative care? So hospice companies are getting more where they're thinking more outside the box, right? How can we get out in the community? How can we help people before they need help? And it's also providing love and support for people in the community, regardless if they or their loved one needs hospice, you know, just to see the kind and caring hearts into and then kind of educate them about what hospice is, should they ever get to a point that they personally may need it or a loved one might need it, they feel a little more comfortable about that topic and knowing where to go to talk to someone that they can get, you know, a good kind of feel from them. Yeah, that's why I love having you on the show today, because you know, at 2 a. m. when someone can't sleep and they're trying to figure out what in the world they're supposed to be doing, hopefully they'll come across this, you know, and learn something new and find a new resource of help and support that they may not have known before. Yeah, that's the whole point of this podcast. And what a beautiful thing that is to have helpers in our community and people. So maybe you may not see us so much because we tend to be quieter and, you know, in, in someone's living room helping them. We're not out there movers and shakers maybe, but when you need us. You know, it's important to know that we're here. And and that's why we're trying to talk so much and educate people so much to keep this conversation going. What do you feel like should have been said and wasn't. Is there anything that you feel like is on your heart that needs to be talked about that we didn't get a chance to bring up yet? I would like for people to know that a lot of times our patients when they're towards end of life, they're much ready for hospice before the families are. And a lot of times the families pull back our patients and I don't mean that in any kind of way because, being on that side is really hard. But I have a lot of times when I meet with my patients alone that they will talk, you know, I've done all this chemotherapy, I've done all this radiation. I keep going to the doctor because my husband wants me to, but, you know, and that's usually when we're talking to them, you know, regarding hospice and things like that. But yet the family's not on board with hospice. Right? They're still talking about, well, if she keeps continuing like that, then I think I'm going to probably maybe go ahead and take her back for a 2nd opinion or something and come off hospice. So, When we're meeting with our patients, they're ready. A lot of them are just like, you know what? I did it all. I'm just tired. I just want to be with my family in this moment and love on them and have whatever quality of life I have left. And to do that instead of going to continuous treatment because I'm just tired. I'm worn out. I hurt. I'm in pain. And I'll ask them, you know, why don't you share this with your families? And they say, because I don't want them to think I'm giving up and so sometimes, you know, so I just wish that families would, you know, be more open to talk to their, their loved ones about their wishes, like we've been talking about. And really get them to talk because a lot of times they're not going to talk to families on their own about it because they don't want to hurt their loved ones. How can people find you? And, and where can they find you? Well, I work for a small hospice company, which I love. They're, they don't plan on growing to be real big. And what I like about that, and the reason I say that, is because I can give quality care to my patients and families. A lot of hospice companies are really, really big, huge, and you start to lose. You know what you need to do for that family or the time that they actually need because you have so much Patience you still got to go out there and see. So our website is www dot aspire home, HOME hospice.com, and our office number is 2 8 1 7 4 1. 8106 and they can contact that number if they have any questions, just maybe just wanting to know if they qualify or if their loved one qualifies, or maybe just wants to just ask questions. Our team, everybody on the team, including myself, are happy just to answer questions. You don't have to sign up to get help from us. And that's not our goal to get a bunch of patients. Our goal is just to help each individual patient and family that we possibly can help and reach out to and support them during their time of need. So that's, that's the biggest thing. I would say so they just want to call that number. They can ask to speak to me. They will direct them for me to give a call. And if they want to speak, I mean, anybody on our team is very knowledgeable. There's very few of us. So you're not going to everyone you talk to, you're going to see again. And that's what I love about it too. You're not going to get another social worker. I am the social worker that works for that company. And We have a chaplain and he will be your chaplain and we have three or four nurses, you know, but each of them you will grow to learn and love and, and we try not to move our nurses and staff around. We try to keep our, our same crew with the same patients, because we understand about building rapport means for our families and our patients and how it's important for them for us to see them through everything uh, it's important work what we're doing. And so I so appreciate. What you're doing for our community to make it better and to make people feel loved when they're in this situation and and you're educating people to go on and and do similar things. And so I really value Tiffany and I'm speaking from the heart here, I really value what you're doing in our community and I thank you so much for that. I hope that you have enjoyed our conversation here today on the probate podcast. Tiffany. I both want you to know that you matter and that your questions are not too much. And we are here to help you take the next step, whatever that might be for you or for your spouse or for your loved one. Even if we're not the ones to have the final answer for you, we probably know someone who can help you in the next step of your journey. Please reach out to Tiffany at the the information that she shared. It will also be in the show notes if you're running or driving in the car as you listen. And come back next time and visit the Probate Podcast again. I'd love to see you in the future until then. Take good care and thanks for being here.