Influencing Death: Reframing Dying for Better Living with Penny Hawkins Smith

Penny Smith, widely known as Hospice Nurse Penny on TikTok, brings over 20 years of experience as a nationally certified hospice nurse and a unique perspective shaped by her late start in nursing at age 40. Now 62, Penny embraces the wisdom of aging, especially in her work with end-of-life care. During the pandemic, she found her voice on TikTok, where her heartfelt stories about hospice care resonated with millions. 

In this episode, Penny opens up about her journey with death anxiety, which once left her sleepless in her 30s. She shares how confronting her fears through open discussions about death transformed her perspective and how these conversations can improve not only the end-of-life experience but also the quality of life. 

Penny educates her audience on the realities of hospice care, dispelling common myths and highlighting the choices available to those facing terminal illness. She shares poignant stories from her career, such as helping a hesitant patient reconsider his full-code status through compassionate dialogue. She also critiques the unrealistic portrayals of hospice in media, advocating for honest communication between patients, families, and healthcare providers. She aims to empower individuals to approach death with clarity, dignity, and peace through her work.

The conversation also delves into the fascinating topic of deathbed visions, often dismissed as hallucinations but frequently experienced by lucid individuals weeks before death. Penny underscores the importance of designating a trusted decision-maker and discussing end-of-life wishes to alleviate family stress during critical moments. She reflects on societal resistance to discussing death, sharing stories of patients and families grappling with these realities.

Listeners will hear about Penny's journey as a social media advocate, including the challenges of online criticism and the overwhelming support from her 2+ million followers. She candidly discusses her sobriety journey and how it underscores her commitment to authenticity and growth. Penny also previews her upcoming book, releasing January 14th, which she hopes will inspire readers to embrace mortality and live ful

I have a collection of death-positive shirts featuring inspiring quotes and original designs, all created by me. These shirts are perfect for anyone who values open, honest conversations about death, dying, and grief.

 https://www.endoflifeclarity.com/store 

Transcript

[00:00:00] Penny: Death is always going to be sad, but it doesn't have to be scary. And it can be a beautiful experience despite it being sad. It can be both. That doesn't have to be mutually exclusive. 

[00:00:08] Jill: Welcome back to seeing death clearly. I'm your host, Jill McClennen, a death doula and end of life coach here on my show. I have conversations with guests that explore the topics of death, dying, grief, and life itself.

[00:00:23] My goal is to create a space where you can. where you can challenge the ideas you might already have about these subjects. I want to encourage you to open your mind and consider perspectives beyond what you may currently believe to be true. I'm really excited to have Hospice Nurse Penny on the podcast today.

[00:00:39] Hospice Nurse Penny is a TikTok star with over 2 million followers. Her new book, Influencing Death, Reframing Dying for Better Living, is coming out two days after this airs. And I read the book before our interview and loved it. You get to hear us talking about the book during the interview, and you can grab a copy yourself on January 14th.

[00:01:00] During our conversation, we explore her journey to normalize conversations about death, reduce death anxiety, and advocate for the importance of hospice care. Penny shares her personal battle with death anxiety in her 30s and how confronting her fears transformed her life and work. Listeners will hear stories from her career and learn about common misconceptions surrounding hospice care.

[00:01:22] She discusses deathbed visions, The need for honest end of life conversations and societal reluctance to face mortality. Penny also reflects on her late start to nursing, her sobriety journey, and the challenges of social media advocacy. Thank you for joining us for this conversation. Welcome to the podcast, Penny.

[00:01:41] I'm super excited to talk to you. I'm sure a lot of my listeners already know who you are. You're kind of famous in our world, but you're actually probably famous outside of our world because you are a pretty big TikTok influencer, which is awesome. I'm sure we'll get into that. Thank you for taking the time to talk to me today and sharing your story and sharing about your book.

[00:02:04] Thank you for having me. I'm happy to be here. Can you tell us a little bit of background about who you are, if you want to share how old you are, where you come from, anything like that? 

[00:02:12] Penny: Well, I'm not shy about saying how old I am. Being a hospice nurse, I recognize that being able to live as long as I have been is a gift.

[00:02:20] I'm 62 years old. I am a nationally certified hospice nurse. I've been a hospice nurse for about 20 years. So if you do the math, that means I actually became a hospice nurse in my early 40s. I went to nursing school when I was 40. During the pandemic, I decided that I wanted to get on TikTok. I discovered TikTok and I thought it was fun.

[00:02:42] I did some theater stuff when I was younger. I used to sing with a rock band. So I've always been a bit of a performance geek and got sucked into TikTok and started doing some of the trends, but. As I said, I'm 62 years old. Boomers aren't necessarily welcome on TikTok. So it didn't go anywhere for me. And one day I decided to tell a story about a hospice patient and it went viral.

[00:03:05] I realized that people wanted to know more about death and dying. Since I became a hospice nurse, I have been a passionate advocate for hospice and educating and normalizing. death and dying. I had death anxiety when I was younger. And I learned that through our discussion about death and our ability to make it more normalized and less taboo, we can help that death anxiety to really kind of calm down and quiet.

[00:03:33] Jill: Yes. And that's why I started my podcast, because I love to talk to people about death and dying. And the fact that I never had death anxiety. But there was definitely things about death that I was anxious about. My husband dying, my children dying. The reality is it happens to people every day. Being afraid of it isn't going to keep me safe from that happening.

[00:03:53] The more I got okay with death and dying, the more I appreciate my own life. I really just want to tell everybody that. I'm like, no, for real, you'll actually live your life better if you could be okay. with the fact that one day it will end. I love that you go out there. I am not a performative person.

[00:04:12] That was actually one of the things reading your book, learning that you love to get up on stage and you love to sing and all that stuff. I had a real hard time with social media. Cause that's not me. To get up there and make videos makes me really uncomfortable. Conversations like this. I love talking to my phone.

[00:04:27] Don't love it. I'm glad that somebody like you is out there doing it so that I can just share your stuff and not have to do it myself. Well, 

[00:04:34] Penny: you know, circling back to being able to live your life better. If you can talk about death and dying more openly, it helps you to die better. You have a better chance at having a good death.

[00:04:44] If you can talk about the fact when you're dying, that you are dying. You are able to communicate your wants and wishes to the people who you love to ensure that they're going to carry them out. You're able to have meaningful conversations at the end of life. And like I said, it really helps with death anxiety, which is something I wasn't even aware was a thing or that other people have it.

[00:05:06] I knew that I had it. When I was in my thirties, cripplingly, it was horrible. I couldn't sleep at night. I would cry. I was so scared about death and dying. And then when I got on social media, I had people start kind of telling me in their comment section that watching my videos helped them not be so afraid of death anymore.

[00:05:25] It became apparent to me that it is very common that people often fear death and dying. And as you say, they don't want to talk about it. It's almost like if they talk about it, it's going to make it happen. faster, which it won't. But people are afraid to even discuss it. When we discuss it, we make it less of an unknown thing.

[00:05:45] We're always gonna fear the unknown, but we make it less of an unknown thing. It's easier to just put it aside. I always say, if you accept death, you accept that you're gonna die someday. You can put it behind you. And say, okay, it's going to happen. I know I'm not going to think about it so much. I'm just going to live my life and enjoy myself.

[00:06:02] Jill: Yeah. I never thought of it that way. That once you accept it, you could just put it behind you and be like, okay, now I'm going to be here in the moment, living my life, not fearing something that's going to happen to all of us. And I understand why people do fear it. I mean, I genuinely do, but it also makes me sad that people are so afraid of it.

[00:06:22] That they don't have conversations with their loved ones and that they're not getting clear, even within themselves, what is important to them. Because not coming from a nursing background, I took care of my grandmother at the end of her life. Hospice was amazing. Some of the things that were going on.

[00:06:40] I'm now looking back. I would have done things so much differently She was 94 when she died and some of the treatments that we put her through the last few years Caused her so much pain and suffering that by the time hospice came on. She was like a shell of who she was It was heartbreaking, right? I didn't know any different and Her and I had not talked about it.

[00:07:01] Nobody talked to us about the realities of what treating a 90 year old with cancer with surgeries and radiation and all that was going to do. And so we just did what we thought was best at the time. But if I would have had these conversations, I would have for sure made different decisions. With her, of course, but, you know, it's with the saying hindsight's 20 20.

[00:07:22] Looking back on it now, I can see clear, but I didn't then. 

[00:07:26] Penny: And people don't know what they don't know. If you don't have providers guiding you with that, if you go to an oncologist, they're going to want to do treatment on you. That's their job. If a surgeon says they want to do surgery, that's their job.

[00:07:39] If somebody is saying this is what we should do, it's because that is their area of expertise, when really there should be. an option presented. There's always a choice. There's always a choice. And I feel like sometimes when people go for medical treatment for a terminal condition, they aren't told there's another way.

[00:07:58] They're told that this is it. This is all we can do for you. We can do radiation, we can do chemotherapy, we can do surgery. They're not told that we don't have to do any of those things. We can focus on the treatment. Comfort care, end of life care instead, and quality of life, which is so important. I hear that from so many people that they wish they would have known.

[00:08:17] I wish I would have known about hospice. I wish I would have gotten them on hospice sooner. I wish I would have had more information. That's why I'm on social media, because I hope to give that information, not necessarily to make people who didn't make different choices for their person feel guilty because there was another way they should have taken, but to empower for the future, because there's always another chance people are going to die in our lives all the time.

[00:08:44] Yeah. And how 

[00:08:44] Jill: we face it will make a difference. Cause that's what I try to tell people. A lot of times I hear stories where somebody will say the death of my mom or my spouse was so traumatic. It was so terrible. All of these things that we had to go through. It doesn't have to be that way. Hopefully with people like you educating and that's.

[00:09:02] The big purpose in my podcast to share conversations so that people can get used to hearing them and maybe start to think differently about these things. We can change that. So you said you've been in hospice for 20 years. Have you seen a difference in the 20 years in the way that people are approaching death and dying or doctors, even how they approach it?

[00:09:22] Penny: not necessarily within hospice, but socially. Since I've been on social media, I've seen a difference. I was the first one to be talking about hospice on social media. Now there are dozens of nurses, hospice chaplains, hospice social workers, and hospice aides creating content. Now there's also death cafes.

[00:09:39] There are death doulas. There are, you know, death over draughts where they go to a brewery, talk about death, and drink beer. So I am seeing a lot of people in the after death industry are now on social media. Funeral directors are on social media. Morticians. I am seeing that it's becoming more prevalent and probably through social media.

[00:10:01] And that's really the impetus for this because it's definitely a platform where a lot of people are on it and can see information. And are interested in learning about this because it is such a taboo topic and unknown topic and people are interested. So yeah, I have seen definitely an increase in awareness and interest in death, the death industry, if you will.

[00:10:26] I want to touch on what you were saying about People saying that their experience was awful and their person suffered and it was horrible. Another thing that's important about educating on death and dying is that some of the things that people will say was traumatizing to them to watch their person going through.

[00:10:44] are normal, end of life things that aren't harming the person who's dying. I work in hospice quality now, so I don't do direct patient care anymore. I'm getting close to retiring. But I'm still privy to lots of information about patients. We have complex case reviews, and we discuss patients, and we have complaints that I look into, and safety events.

[00:11:04] Many times, somebody will say that their person suffered in the end, they were suffocating, they couldn't breathe. Really? They're having agonal breaths that are normal. It's not hurting the person. And we know this because we're skilled at assessing somebody who's dying and we can tell they're relaxed, their face is relaxed.

[00:11:24] Plus we see this all the time. It's something that's very common or the death rattle. So many times I've educated about something like this on social media and had somebody come back and say, You know, I was really traumatized by the noise that my person was making and I didn't know at that time that that was normal for them to do that and that they weren't suffering.

[00:11:44] So that's just another layer to the importance of educating about all of this. 

[00:11:50] Jill: Yeah, and that was for me with my grandmother, I thought it was going to be like on TV, you know, they were sending her home from the hospital, and she's going to go home on hospice who takes care of her. I was like, Oh, it's me not understanding at all the reality.

[00:12:03] And really, thank God for the hospice nurses, because by the time they came in the next day, I was exhausted, practically in tears. She had been up all night. She didn't know who I was. She was talking to people that weren't there. I was like, what is happening to me? Nobody warns you. Nobody gives you any guidebook.

[00:12:20] Those hospice nurses were amazing and doing things like I know in your book, you talked about like how you have to disimpact bowels. Is that the correct? So the nurse was doing that. We'll have a conversation with me answering all my questions. And I was like, I would love to do the work you do, but I can't do what you're doing.

[00:12:39] She's like, I can do this. I'm like, no, I don't think again, but I'm so glad that there are people that do that work. And it really was such. a relief to have somebody come in and say to me that no, it's okay. It's normal. This is natural. You're not doing anything wrong. She's not having anything wrong. It just is part of the experience.

[00:13:01] And then once I relaxed, I found it fascinating. When she talked to people that weren't there, I was asking questions. I was like, what are they saying? What are they talking? Are they singing? Oh, what? Tell me what they're singing, you know? But you have to be able to sit with the discomfort first and then also have that support and being okay with the fact that she was dying.

[00:13:21] I didn't want her to die, but at the same time, Again, I was never afraid of death. I just wanted her suffering to end, and I wanted her to be at peace. And so I was okay with the fact that she was dying. And then I relaxed into it. And I'm so grateful that I had that time with her. It was such a beautiful experience for the two of us to be together because she took care of me when I was little.

[00:13:43] So now I got to take care of her on the other 

[00:13:45] Penny: end. Yeah, that death is always going to be sad, but it doesn't have to be scary. And it can be a beautiful experience despite it being sad. It can be both. that doesn't have to be mutually exclusive. That is, you know, talking about how death is portrayed and how hospice is portrayed on television.

[00:14:00] That is one area where I haven't seen any improvement on television shows or movies. Very little. Every now and then I'll see somebody dying. Usually a traumatic death, they'll show a body that's had a traumatic death and that looks realistic. They're still not very good at portraying natural death very well on TV.

[00:14:18] Definitely, people get the message that hospice is gonna come in at the last and they're gonna be there 24 7. That is not what hospice does. We empower the family and educate the family to take care of the person. Unfortunately, we don't have that kind of service. We're not able to do that. And then the whole closing their eyes and dying peacefully hands over the heart.

[00:14:37] No, and that's how they go out. It's so unrealistic. There was recently a show on Netflix called His Three Daughters. Did you see that? I'm watching that. I'm just like, really? This is not what hospice is like. It was so fake. The guy's got an IV pole with fluids in his house. He's got someone coming and sitting with him all the time.

[00:14:57] A caregiver that it was just very, I was so disappointed in that whole show. It was really, really unrealistic. And I thought, come on, let's be real and stop. It's just like CPR. It's just like, you know, showing somebody have a cardiac arrest and they do CPR and they bring them back to life. The reality is I think it's less than 15 percent of healthy people can be resuscitated and less than two percent close to one percent of people who are already sick.

[00:15:26] sick hospice patients, elderly people, very low, low rate of rescue or return to circulation for a patient who is really compromised already. And so we get people on hospice who are full code. They want to be full code and we don't say, no, you can't be on hospice. Medicare doesn't let us, we have to allow people choice.

[00:15:49] We recognize that traditional. Medical providers aren't comfortable having those conversations with them. And we are, so we just have to revisit that with them often. And sometimes be very plain about what is happening, what will happen if we do CPR. There's a story in my book about Gordon. I called him, that wasn't his real name.

[00:16:09] I think I called him Gordon in the book. I can't remember. 

[00:16:10] Jill: Yeah, I think so. The guy that was a boxer or a fighter or something. Uh, story. 

[00:16:15] Penny: He was a full code right until the end and he was so frail. And I was just like, they are going to drag you off of this bed onto the floor and they're going to start doing these compressions on you.

[00:16:28] He had tumors all over his stomach that were just rupturing already. And it was awful. He was skeletal. He was just, I was like, this is not going to be a good thing. And he finally was willing to change his code status, but it took a while before I could convince him of that. It was just me and the social worker doing that.

[00:16:48] He had never had that conversation up. stream when he was healthier. Nobody ever had that conversation with them. So that is often how it happens in hospice where, you know, we're fly by the seat of our pants because they've been told that they're going to come on to hospice and we're going to provide more care and they're not told that they're dying.

[00:17:06] You know, it's, it's, it's unfortunate and it works. It's, it's sad when two You know, entities and healthcare are working kind of against each other in a way. 

[00:17:17] Jill: Yeah. And I have seen that for me coming in to this space outside of healthcare altogether. I'm not a nurse. I'm not a doctor. I'm not even a social worker.

[00:17:25] I'm only a death doula. But previous to this, I was a pastry chef, like total outsider. It was surprising to me to see the lack of understanding, even in the medical community, of like, no, this person's dying. Why are we having this one conversation when palliative care and hospice is over here being like, maybe shouldn't recommend those things and the disconnect.

[00:17:48] And I actually working with a family right now that kind of reminds me in some ways of the story that you shared about Gordon. And the person is still a DNR and the spouse is having a little bit of an issue because one set of doctors is like, well, they might come back from it. We see it sometimes. So they're holding onto this hope of like, he's going to come out of this.

[00:18:10] He's going to come out of this. And then the social workers are like, maybe we should sign the DNR. And they're just not feeling listened to, they're feeling confused and overwhelmed by all the different things they're hearing. And unfortunately, this poor person's laying in a bed suffering and not going to get any better unless there's a miracle, which I don't know, maybe miracles do happen occasionally, but it does not seem that 

[00:18:32] Penny: that's the case.

[00:18:32] Yeah. I've been with thousands of dying people. I've had two situations that one could label a really wasn't. It was just the luck of the draw. remission for cancer and return to normal brain function after a stroke, which is your best chance because the brain can, you know, re vasculate when you have a stroke, which is what happened to the one man.

[00:18:54] That's two people out of thousands of patients. My social worker had a great way of talking to people about their code status and would say, if you go down, And you have no heartbeat and no breath, so you're dead. Do you want us to do chest compressions and try to bring you back to life? Or do you want to just allow a natural death?

[00:19:17] And that really spoke to people more. You know, they really understood what she was saying. When we are initiating CPR, a person has no heartbeat and no breath. For all intents and purposes, they are dead. And we're trying to bring them back to life. If you already are sick with a terminal disease, you're not going to come back better than you were.

[00:19:40] You're going to come back worse than you were because your ribs will be fractured during this process. It takes deep chest compressions to return circulation. 

[00:19:50] Jill: Yeah. And that's going to be dramatic on the staff to have to do that to somebody that's older or frail from an illness, knowing that. that you're breaking their rigs and you're really causing a lot of pain and suffering, but it's what you have to do.

[00:20:05] So that must be difficult for everybody involved. 

[00:20:08] Penny: Thankfully, I've never had to do it. I have always been good at really talking people out of doing it. And then I've had situations, which might happen with your person that you're working with, where they die and the family just quietly. calls hospice and says he's dead.

[00:20:24] They don't call 911. And that's the plan ahead of time. The family pulls me aside and says it's older, especially older people, people in their eighties and their nineties. They saw the advancement in medical technology and they saw that people used to die young and now we can keep them alive. We have all this medical intervention.

[00:20:45] And so they thought I think this is a wonderful thing and they can be brought back. And I remember going to speak with my girlfriend's mother had a stroke and she had no advanced directives in place. So I took a POST, which is a physician order for life sustaining treatment, and it has lots of questions on there.

[00:21:02] The first one is, do you want to be resuscitated? And then it talks about tube feeding, antibiotics, unlimited interventions, full interventions, intubation. And I sat down with her to talk about her advanced directives and asked her if you Go down without a heartbeat and a breath. Do you want someone to initiate CPR and attempt to revive you?

[00:21:21] And she says, well, it depends if I'm brain dead. No, but if I still have brain activity, then yes. And I was like, We're not gonna know that. How are we gonna know? You're in your apartment. We don't have an EEG with us that we can hook up to your head and find out if your brain dead or not. You know, you're dead.

[00:21:40] You died. Do you want us to bring you back? And she was in her late 70s at that time. She's in her 80s now. She's still alive, but it was just clear that she is from this generation that is thinking that medical advancements are able to prolong life. As long as possible and know if she's brain dead or not, even if she was in her apartment.

[00:22:02] Jill: Yeah. Well, maybe some of that's TV and movies though, too. We see these things. Unfortunately, it's not always the reality. I know because you share a lot of stuff on your social media and you shared a lot of things in your book, a lot of stories, which I love reading stories, like real life stories of experiences.

[00:22:20] Because I feel like it helps me connect with the people. And it does help me learn as well. Cause again, I'm from outside the industry, so it helps me learn. But when you're making your videos and when you were writing your book, what's the stuff that you enjoy the most? What are the stories you enjoy sharing the most?

[00:22:35] I know you've even shared, you got a facelift not too long ago. You had some of that up there. So you don't seem to be afraid to share anything about yourself, but what do you enjoy the most? 

[00:22:46] Penny: There's a reason for that too. I just want to say. I feel like There's many, many people who are anti hospice. They think we are causing people to die faster.

[00:22:56] They think that we are starving them to death. There's just a lot of misconceptions and blatant lies about hospice. I want to dispel those myths and tell the truth. I want people to believe me. This is a dark, scary subject. When I say, I don't want you to be afraid. And here's why I want them to trust me.

[00:23:14] And I feel like sharing. My life, authentically who I am, allows this more trusting relationship to build. I really love talking about, and I don't do it as much on all my platforms. I do it more probably on Instagram where I have the Instagram stories. I love sharing my life on the mountain, living off grid in the cabin on the mountain.

[00:23:36] That's fun for me. My pets, all of that stuff. As far as, The things I like to do on TikTok, I really like figuring out trends and how to do a little educational blurb with a 15 second music clip or song clip where I'm lip syncing, pointing to words, dancing. That's fun for me, coming up with these creative ways to get the message out there.

[00:24:02] And it's something that is uniquely mine. There's not a lot of other death influencers who do that type of thing. And I just really enjoy that. One of the reasons I enjoy that is because I feel like death is dark and heavy and not everybody can digest a whole one minute long diatribe about the death rattle.

[00:24:22] Sometimes having just a little 15 second clip is just enough. And, It has proven to me that, that it is enough because when I first started doing TikTok, I made a video to a song and the song was, it's just water, it's just water. And I'm dancing around and I'm putting words on the screen, something to the effect of, if your person is dying, They don't need IV fluids.

[00:24:46] They're not going to die from dehydration. They're going to die from their disease. Something to that effect. And it went viral. A woman commented that she had been feeling guilty for 15 years over not asking for IV fluids for her dad when he was dying. My video had helped her not feel guilty anymore. It was eye opening for me.

[00:25:07] I had another one recently. I think it was when I was doing about morphine. I've done a lot of the, it's the last dose of morphine. You give the dose of morphine and then they die and people feel like they just killed someone because they gave the, and there's always going to be a last dose. There's always a last dose of medication.

[00:25:21] And somebody commented that my video had helped them not feel guilty anymore about giving the morphine to their person when they were dying. So I think those are for me, the most fun. I like telling the inspirational stories. Sometimes too. I like discussing, oh, there's so many things. I like talking about deathbed visions.

[00:25:40] I love it when people start, in fact, I was just editing a video now that's in my drafts. Somebody was saying that people who are having deathbed visions are having them because they're not visions or hallucinations and their brain is malfunctioning at the end of life. I like taking that kind of comment and saying, people have deathbed visions weeks before their death.

[00:26:01] Their brain's not malfunctioning. They're not taking medications. It, it can happen when they're lucid and they're able to say to us what they're seeing. I like to dispel the myths. 

[00:26:11] Jill: Yeah. And I appreciate videos like that because I'll share them with people. I've had so many people say that to me, like, Oh, hospice came in and they gave my dad or whatever morphine and it killed them.

[00:26:24] And I'm like, I don't think that's the case. And I know you mentioned in your book. And you had mentioned it not too long ago on your social media, so I found the group on Facebook. Yeah. Yeah. Oh my gosh. All I can do 

[00:26:37] Penny: is laugh. It's sad. I, from time to time, go through their comments. It's just unbelievable to me, the things that these people believe.

[00:26:45] Do you actually think that your person would still be alive if it wasn't for hospice? At stage four cancer, you think they would have lived longer if it wasn't for hospice? It's just, I can't, I can't even. It's sad. It's sad. It's legit conspiracy theorist stuff sometimes in there. Really? That's what you think?

[00:27:04] I mostly ignore them, but every now and then I go in there and I can't even believe they're spewing this nonsense, and people will go there looking for advice on hospice. Don't go to a group called Murdered by Hospice for advice on hospice. You're not going to get good feedback from them at all. They're just going to tell you a bunch of lies.

[00:27:23] Most of the people in that group, from what I've seen did not have decision making authority over their person. There's a reason for that. There's a reason why grandma didn't choose you to be your decision maker because she knew that you weren't going to make the right decisions. And that's another thing that's really important to educate people on.

[00:27:41] And that comes back to being able to talk about death and dying, but to educate people on the fact that they need to designate someone they trust to make decisions for them and they need to tell that person what their decisions are. I've had too many situations with families where they didn't know what their dying person wanted.

[00:27:58] We're not talking about just younger people. We're talking about old people who, who their family didn't know what they wanted. We don't know what, what they want. 

[00:28:06] Jill: Yeah. And then that is really hard because it makes. The family have to make decisions that they don't know an answer to. They're just making their best guess.

[00:28:16] And it is stressful for everybody. I found that sometimes the people most resistant to talk to me have been older where they're like, Oh, I don't need to think about this as they literally try to run away from me. And I'm like, you're like 80. When do you think you need to think about? And then I tell my friends, even we're in our forties, we've got children, you know, we've got spouses.

[00:28:37] I'm like, we need to talk about this, because things happen. People in their 40s do die. It's not that uncommon. Especially if, like, I feel like a lot of us are the sandwich generation. We're older when we had our kids. I'm 46, my daughter's 10. I'm still caring for her. And caring for an older mother and having my spouse, if I didn't know what he wanted, and something were to happen, I don't know how I would navigate it, it would be, it would make an already terrible situation, really terrible, because I would have no idea what they were even trying to say to me, ask me about, 10 year old over the fact that their dad's dying or has died.

[00:29:19] And again, You know, superstition knock on wood. Hopefully I don't have to worry about that, but I'm not special. Somebody's 45 year old husband is going to die. Yeah. Why not me? It could be a lot of people die in 

[00:29:32] Penny: their forties, their thirties, their twenties, their teens, children, babies, no one's immune to death.

[00:29:38] That's why we have pediatric hospice. Little kids die from cancer. It is important to have those conversations. even younger, not necessarily putting everything in writing, but at least talking about what you want to have happen. So yeah, it's very important. And it's funny to your point about older people not wanting to talk about it.

[00:29:56] I've had patients in their nineties and even in their hundreds who seem to think they were going to live forever. They didn't want to talk about it. We had a patient who was say he was in his mid 90s and he was still ballroom dancing with his girlfriend and he fell no he was married he had married his girlfriend that he met in his like early 90s and they bought that ballroom dancing is where they met anyway he fell and broke his hip and went to the hospital and hospital said we're not gonna do Surgery.

[00:30:26] So again, going back to surgeons want to do surgery, right? So if a surgeon says, I don't want to do surgery, then you should take their word for it. That's something seriously wrong. This guy had a heart condition. The surgeon was not willing to do the surgery. So we sent him over to our care center and on hospice.

[00:30:41] And he was. He was so mad I went and sat with his wife in another room and we talked and she was furious He said those doctors should have done the surgery. It should be his choice. It should be his choice to have the surgery I tried talking to her saying the surgeon doesn't want the responsibility of a death on his hands If he feels like your husband is not fit for surgery, then he's not gonna want to do that.

[00:31:09] And they were furious. They couldn't believe that he was now going to be on hospice and that he was going to be dying. And they left, they revoked their hospice benefit and left the care center and transported by ambulance. We gave him pain meds and he went home with pain meds and I don't know whatever happened.

[00:31:27] Sure, he didn't live much longer. Once a person that old breaks something, they don't typically live very long. But it was like, wow, how could you not think that someday you're going to die when you're 90 years old? They didn't get to be that old for nothing. They have strength of will and they're able to live a really long time.

[00:31:44] And they get to a point where they think they're never going to die. I've had patients who were really old, who could not believe that they were finally dying. 

[00:31:50] Jill: Yeah, it seems like it must be frustrating to try to have a conversation with somebody. You want to give them the best care possible, but if you're not going to acknowledge what's happening to you, it's kind of hard.

[00:32:01] It's hard to take good care of people that way. 

[00:32:03] Penny: Yeah, but you know, we do what we can do and it's still their choice in the end. We educate them as much as we can. And if they still are like, no, I don't want this, then okay. You know, same with patients not wanting pain medication. Sometimes it just takes revisiting.

[00:32:18] I've had lots of situations where the patient did not want it, didn't want it, and I'd revisit. Are you sure you don't want it? Are you sure you don't want it? Each time I went, there were more pain, and finally, I had a lady with fungating breast cancer, which is really horrible. The tumor's on the outside of the breast, and it's really bad.

[00:32:34] It smells really bad. It's very painful. It leaks, smelly fluid. And she had been doing holistic stuff like natural path stuff, which was great. It actually kept that tumor kind of smaller than other patients I'd had. So that was great, but she really resisted having any kind of pain medication. And finally, in the end, she was.

[00:32:57] agreeable to getting some pain medication on board. And it was fine. All I could do was say, I'm just going to continue to discuss it with you. And you could say no, and that's okay. It's your choice. It's your life. It's your death. You can do it however you want. And if you change your mind, we'll keep talking about it.

[00:33:13] Jill: Yeah, I'm sure some of that is. building the trust to, you know, with some time and resistance on their part and having you not try to push it, having you listen and just say, okay, that's fine. Helps people trust you and then feel that whatever it is you're recommending that you are doing it with their best interest in mind, not the fears that people think of like, well, she's just trying to get me to take it because she wants to kill me, 

[00:33:35] Penny: which makes no sense.

[00:33:36] And that's another one I see often in comments is that hospice. Gets a bonus when they die. Hospice doesn't get paid until after they die. Hospice tries to kill them faster so they can take new patients on. What? We don't get paid when the person dies. We get paid to take care of them while they're alive and then when they die, the payment stops.

[00:33:56] We don't get a bonus. Why would we? purposely kill our patients when the payment stops when they die. We don't keep them alive either. We're more ethical than that. But beyond the ethics of we don't hasten death, nor do we prolong life, is the practical financial piece of it. You get paid once they're dead, so that makes zero sense.

[00:34:18] Jill: A lot of things people say on social media don't make a lot of sense, but you seem to do a pretty good job of balancing. For me, that's the thing. I don't care when people think about me, but I also don't want to hear it. I don't want to have to engage with it. I have a hard time sometimes on social media.

[00:34:33] I just don't have the time and energy. It seems like you probably put a lot of time into your social media and going through the comments and responding to comments. or not responding to comments. How do you find a balance with all of that? 

[00:34:46] Penny: So, like I said, my foot's out the door for retirement. Starting in January of 2024, I cut my hours at work back to three days a week because it was too much with the book and social media.

[00:34:58] I don't work as much at my regular job. I pay my daughter to look at my Instagram messages for me. So she screens things for me. I'm going to have her start looking at. TikTok now, they can send direct messages on TikTok too. So she's going to start looking through those. I sometimes like on Facebook, especially get a lot of hate messages and I, I block usually.

[00:35:19] Sometimes I'll answer them. Somebody the other day told me to grow up. And I said, in the comment, I said, when I was younger, I was really flat chested. A friend of mine used to say I needed to grow out. That was way funnier than your comment was. You know, a lot of times my followers. will take care of those comments for me.

[00:35:36] I don't even need to respond because they'll be attacking that person on my behalf. And then sometimes I just block people, block, block, don't even respond, just block. Sometimes I report them for bullying. They don't often get taken down. All of the social media platforms, there's an ability to report people for bullying, but it seems like nothing ever gets done when you do that.

[00:35:56] Sometimes I report them, but it doesn't bother me that, you know, you have to have, to work in hospice, right? You gotta have strong shoulders to be carrying the, the load of dying people and all the emotional stress that goes along with that. So it, it doesn't, it doesn't bother me. I used to get a lot more when I first started, people would, I was, you know, this was 2020 and there wasn't as many older people on TikTok back then.

[00:36:22] It was a kid's app. And then I was on there and there was some older people on. There's a lot more older people on there. There's grandpa Joe and he's in his eighties and got a million followers. In the beginning, people would say, Hey grandma, what are you doing on TikTok? And I would just say. Well, if you're trying to insult me, I am a grandma and I love my grandkids, so that doesn't work.

[00:36:43] I don't get those comments anymore. It just doesn't usually bother me. Once in a while, it gets to be a little overwhelming. It's a little bit much. It really bugs me when the Murdered by Facebook group takes my videos out of context and posts it on their, their page and says horrible things about me. And, and then recently I posted a video about them and it was the first time I had ever done it.

[00:37:04] I got an email from someone one time from that group that That actually wish said she wished I would die because I was a horrible person. Hospice kills people. Hospice killed her husband. I hope you die. Hope you die with the ham sandwich. They call it Haldol, Ativan, and morphine. They call the ham sandwich and that's what kills people on hospice.

[00:37:25] At first, I was really ready to go after her, find out who she was, talk to her employer, all that. Then I thought, she's just grieving. I just wrote her back, said, sorry, your husband died. I didn't kill him. 

[00:37:37] Jill: Wow. 

[00:37:38] Penny: Good for you, because 

[00:37:40] Jill: most people, I don't think we could do that, but that's good. 

[00:37:43] Penny: Also, it helps to keep perspective.

[00:37:46] I have over 2 million people following me across my platforms who love the content that I put out, who appreciate the education, and that is far outweighing those who leave me nasty comments once in a while. So 

[00:37:59] Jill: that helps a lot too. Yeah, I'm sure. So now you have your book. Is it out now for people to purchase?

[00:38:05] Oh, I love the cover. I think it's so neat and beautiful. I 

[00:38:09] Penny: hear that all the time, but the cover is amazing. I love the cover too. Uh, I don't know when your pod will air, but it will be available for order. It's available for pre order now, and it will be out on January 14th. 

[00:38:22] Jill: Yeah. And I was going to put this out right at the beginning of January.

[00:38:25] You're going to be my first episode of my Next, I don't call them seasons anymore. Now that I've been doing it a couple of years, I don't really break it up into seasons. Take a little break around Christmas, come back in January, so it'll be coming out right about then. 

[00:38:38] Penny: It'll be available for pre order and then on January 14, it releases and it's available in all formats.

[00:38:44] It's an ebook, paperback, hardback, and audible or audio book on audible and all the audio platforms that I recorded myself. I narrated it myself. That was something I really wanted to do because People have always told me ever since I've been on TikTok that they like my voice, and I'm a big time audiobook listener.

[00:39:02] I hardly ever will open a book and read it. I don't have time for that, but I listen to audiobooks when I'm driving, so I really wanted to put an audiobook out, so I'm really happy I was able to do that. 

[00:39:13] Jill: Oh, it's so exciting. I'm excited for you. I really did enjoy your book. It was cool because you told stories about hospice and then you told some stories about you and your life.

[00:39:22] You're super real and honest about your life. I don't know if I could be that vulnerable with everybody as somebody that can look back on periods of my life and just really want to shake my head and be like, Oh man, I can't believe I survived it. It's nice for me to look at it and read it. And you're a little older than me, but to see that.

[00:39:42] We can do things we regret when we're younger and still have an amazing life. I appreciated that about you. Thank 

[00:39:49] Penny: you. That was kind of the main reason why I included those things is because I, I want, like I said, I want to be authentic, but also I hope to inspire others. That is another thing I talk about on my social media platform all the time, my sober journey.

[00:40:04] And that's really helped a lot of people. I, as you know, read the book, started drinking again after eight years of sobriety when I was younger, and then it got out of hand. I stopped drinking in 2020 during the pandemic. I knew that if I announced that to my then 100, 000 followers on TikTok, that would hold me accountable.

[00:40:22] And it did. And so I have shared that part of my life along too. I hope to inspire younger people. To know that they are not the sum of their mistakes. They are able to rise above and do good with their life. And then also that death happens to all of us in the end. Being able to accept that does help us to live better.

[00:40:45] Jill: I agree. And do you have any new things coming out? I know you said you're going to be retiring soon ish. So what's your plans for the next couple of years? 

[00:40:52] Penny: I really love doing keynote speeches. I've got a few keynote speeches lined up for next year. Hope to do a book tour, continue my social media, and I do have a podcast also called Death Happens, an Insider's Guide to Dying.

[00:41:06] We just completed our second season. I do it with the a hospice social worker and we're like, you were like, let's take a break for a while, . I said we need to take a break. It's a lot of work to do this podcast. 

[00:41:19] Jill: Yes it is. 

[00:41:20] Penny: That's what I have in my immediate future and beyond that, I'm not sure. I would love to go back to doing patient care as a per diem nurse.

[00:41:28] I live in a rural area in a sparsely populated county where only one hospice agency serves. Patients and it's not my agency that I work for ever since we bought our property out here and started coming out here to vacation about 15 years ago or so more than that, 17 years. I think I've always dreamed about living in an area like this and going out to do patient visits where you're just driving in the countryside.

[00:41:55] And because I, I was a home hospice case manager in Seattle in the, the commute was horrible. horrible. The traffic was terrible. And so I used to just be like, I'd really love to do hospice visits in Ferry County, where you drive for an hour in beautiful countryside. I think I might end up going back to that at some point.

[00:42:14] Jill: I'm sure whatever you do, you're going to be great at it. I'll put links in my show notes to your podcast to of course, your Tick Tock, Instagram, all that stuff. I'll put a link to your book. If there's anything else you think that you want me to link, I will for sure. Thank you so much for coming on today.

[00:42:30] I appreciate it. And I'm definitely a little fangirl because you're a kind of famous in my world. So, you know, I appreciate you taking time this morning. Thank you. Thanks for having me on. My next episode, which may or may not come out next week, since I'm in the process of caring for my friend David at the end of his life, he was a guest on my podcast a few months ago, sharing his life story with us.

[00:42:53] And now our group of volunteers has moved into full time care mode. But my next episode, whenever it comes out, we're going to switch gears and dive into the fascinating world of energy healing with Marie Miller, a medical medium and theta healing instructor. Marie shares how a near death experience as a child opened her perception of the spirit world.

[00:43:13] Her path has been filled with challenges, from encountering https: otter. ai

[00:43:23] Using theta healing to uncover the root cause of physical and emotional ailments. This episode is a must listen for anyone curious about psychic mediums, holistic healing, and spiritual growth. If you enjoyed this episode, please share it with a friend or family member who might find it interesting. Your support in spreading the podcast is greatly appreciated.

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[00:44:15] Thank you. And I look forward to seeing you in next week's episode of seeing death clearly.