Death Doula Insights About The Importance of End-of-Life Planning

In this episode of 'Seeing Death Clearly,' host Jill McClennen, a death doula and funeral celebrant, welcomes Marni Blank, a former attorney turned entrepreneur and end-of-life doula. They discuss the emotional and logistical challenges families face regarding end-of-life planning. Marni shares her personal journey, including her mother's serious accident, which highlighted the importance of having essential paperwork in order. 

The conversation focuses on the significance of open discussions about end-of-life wishes, the role of a death doula, and practical advice for organizing important documents. They emphasize the importance of choosing the right people for roles like healthcare proxies and how preparation can provide peace of mind. Jill and Marni also address the common barriers and emotional reactions people have when discussing these topics and offer insights into facilitating these important conversations.

00:00 Introduction and Setting the Stage

00:43 Meet Marni Blank: From Attorney to End-of-Life Doula

00:55 The Importance of End-of-Life Planning

02:44 Challenges and Realizations in End-of-Life Conversations

03:50 The Role and Impact of a Death Doula

04:25 Personal Stories and Experiences

08:09 Navigating Family Dynamics and Responsibilities

10:09 The Emotional and Practical Aspects of End-of-Life Decisions

37:21 The Role of Medical Professionals in End-of-Life Care

41:05 Marni's Business and Resources for End-of-Life Planning

44:10 Conclusion and Call to Action

Website: https://beginwiththeend.co/

Instagram: https://www.instagram.com/beginwith_theend/

Book a Free Call: https://calendly.com/marni-blank/marni-blank-initial-consultation

Plan Well Organizer: https://beginwiththeend.co/plan-well-organizer

Transcript

Marni: [00:00:00] These are my wishes, and if you are not on board, let's talk about why you're having a reaction to my wishes, and make sure that everyone is clear and has the space to ask questions or disagree. Not everyone has to agree, but there has to be an understanding. 

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. My goal is to create a space 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.

In this episode, I talk with Marni Blank, A former attorney turned entrepreneur and end-of-life doula. Who shares her personal journey and professional insights into end-of-life planning. Marni tells us about her experience of dealing with her mother's serious [00:01:00] accident and the realization of the importance of having critical paperwork.

In order we discuss the emotional and logistical challenges. Families face the significance of having open conversations about end of life wishes and how preparation can provide peace of mind. We also discussed the role of a death doula, the importance of choosing the right. People for roles like healthcare proxies and practical advice for organizing important documents.

Thank you for joining us for this conversation. Welcome, Arnie 

Marni: to the podcast. Thank you for coming on today. Thank you for having me. My business is, begin with the end and. I live in Brooklyn with my Golden Doodle Penny. I'm a lawyer by background, but I no longer practice. I then became an entrepreneur with my sister, and that's where my journey into this world started.

I was. At a work event in 2018 and got a call from a hospital in Massachusetts that [00:02:00] our mother had been in a serious car accident, and the first things I thought other than is she okay, was realizing that I had a lot of her important paperwork sitting on my desk, some of which needed to be. Signed and notarized by me that I hadn't done.

I'm an attorney. I know how important these things are, and there had been some sort of mental block around dealing with the paperwork that had to do with her incapacity or death before getting to the hospital. I needed to fill some of these things out. She ended up. Making a full recovery, but you know, months of rehabilitation and figuring out how to care someone critically injured in another state while running a business of my own was incredibly overwhelming.

It really also pointed out a lot of the conversations that we had not had in our family that we really needed to be having. My parents were worse when I was in my thirties, and it just didn't really occur to me that. Me as eldest daughter would be the one sort of [00:03:00] taking responsibility for both my parents.

My sister is heavily involved and a godsend, but a lot of the practical, logistical and the paperwork things fall under my area of expertise. It is now very much a conversation. We have regularly between both my parents. One of the major things I realized when we were at the hospital was that had she died or had she.

Been unconscious. I would've had no idea her digital life and assets and you know, how to get her interns information, how to get into her house, all of these different things that I sort of needed to understand that I just didn't know about. And that's where I started my journey. I got very curious about how I could be more prepared for the next time something was gonna happen.

Ended up going to end of life doula training in 2020 to get more of a sense of death and dying and grief in our society, and then added on other [00:04:00] trainings to make sure that I felt well-rounded in how I can help support people going through the same sort of things that I had to go through. 

Jill: Yeah. I love that you point out too, that you were a lawyer, like you should have known these things and had these things in place.

Which makes it even more the, the general population that we don't understand these things. Why it's so overwhelming, because we don't even know where to start. And I have a friend who this past weekend, both of their parents died in a house fire and there was no will. Oh my God. Right there, there was nothing.

So not only are they dealing with the tragic loss of both of their parents. They also have no idea what to do. We don't even know where to start because there's nothing, every time they tried to talk about it earlier on, oh, we don't need to talk about this right now. So it's frustrating to hear stories like that because people don't understand [00:05:00] how selfish it is for them to not prepare for the end of life.

When it comes to their loved ones that are gonna be left behind, because like you said, if your mother was not able to speak, you're left trying to figure out so many different things while also trying to process your own emotions and your own feelings about what's happening in this situation. And.

Makes me feel better sometimes too, to hear other people be like, I knew better because there's times when I know I'm not even as prepared as I should be know. No matter how much I talk about it, I'm like, 

Marni: totally. It's the cobbler's children have no shoes sort of situation where you know you can. Know all the right things, and sometimes there are still things that don't get done.

I really do believe in progress over perfection. You start to get things in order. You start to talk about these things more. You make progress and there will always be something to do, and that's okay. When you're in grief, it [00:06:00] is really hard to be thinking about all the things you need to be doing, all the paperwork and the logistics or even how to find that information out.

And if you're just doing the logistics. You are unable to be in your grief, and it's not like that grief just disappears, it's just pushed down to an inopportune moment later. How can there be more space for both being able to talk to people and have some of these documents or this planning in place gives space and clarity, like you said, it's a gift to give clarity to your loved ones on what to do or where things are.

It is a societal problem. It is very normal to not have your planning in place or to not wanna talk about it, and we just need to be making this more regular part of the conversation. You know, it wasn't easy for me to start having these conversations with my parents, and now it is just part of our everyday conversation, not in a morbid way, not in a very heavy way.

By talking about it more and just asking questions and being curious. It really. Take [00:07:00] some of that emotion out of it or the, you know, the feelings behind the questions. It has brought us all closer together because I know what my parents want and I know how I can help support them as they age and as they get sick.

It gives me peace of mind knowing that it's not a decision that I have to make or my sister has to make. It's about executing on someone else's vision or plan. 

Jill: Peace of mind is one of my favorite sayings around end of life planning. I've had testimonials from clients that have sub doing end of life care planning has brought them and their family peace of mind.

That to me, is the goal. It's not just about when I die, what's gonna happen, it's that we can actually really live the rest of our lives. Better because we feel more at peace. Everybody's on the same page that we've had the conversations we need to have that we know that our family is going to be supportive as best as they can.

There will still be grief, there will [00:08:00] still be sadness, but at least there hopefully will not be confusion, overwhelm, and and uncomfortable. Situations. 'cause there's also conversations like you have one sibling, some people, you know, when I talk to 'em, there's multiple children. All the children disagree on what mom said she wanted.

Disagree on what the right path is to take. That's a terrible place to leave your children, to have to fight with each other when they just lost 

Marni: their parent. That is so sad to me. Completely. I have heard so many times that when siblings are not on the same page or haven't had these conversations, the disagreements that come up either before, during an illness or after fighting over things or what parents wanted.

It can really cause a chasm within a family unit after losing a loved one. The goal is to rally around each other and not to have these other things that get in the way. A lot [00:09:00] of what I do in my business is facilitate conversations between parents and adult children to figure out roles and responsibilities, but also share that information.

These are my wishes, and if you are not on board, let's talk about why. Why you're having a reaction to my wishes and make sure that everyone is clear and has the space to ask questions or disagree. Not everyone has to agree, but there has to be an understanding, and sometimes it's just between siblings.

How can we talk about things? Sometimes one sibling has very strong boundaries because of family dynamics. You could grow up in the same household, but have very different experiences within a family unit, and so making sure that you're honoring that, you know, some people may have a closer relationship, may some, maybe some people have more of a distant relationship.

Some children may have more money and some people may live closer to the aging parents and have more capacity to help on an everyday basis. How. Are the [00:10:00] siblings communicating with each other in advance to make sure they're on the same page so there's no resentment or disagreements that come up later when things get to crisis mode.

Jill: I like the way you put that question of, you know, let's talk about why you're having such a strong reaction to what I'm saying. I think a lot of people don't even know why they're having such a strong reaction and being able to give them that space. To think about it and to talk about it. I have found personally, as well as I think a lot of other people can agree that sometimes we come up with our own answers by talking about it with somebody else.

It's just like the process of thinking it through and then saying it out loud. Then things click and we're like, oh, I didn't realize why I was feeling that way, or why I am reacting that way. Until I was given that space to be able to talk it through, even if the person doesn't ask any questions at that point or say anything back to us, it's just that [00:11:00] process of doing it out loud to ourselves can really help give us the answers or like that way of working with people around the big emotions and reactions they might have to hearing their parents say things like, if I were to have a heart attack, I don't want.

Anything done, just let me go. And that scarce and upsets people. So let's talk about it and talk about why versus. Alright, then fine. I guess let's go through the thing. 'cause I don't think people understand what that actually looks like. I think we all have this vision in our head that it's like a movie.

Somebody gets a couple chest compressions and then they sit up and they're talking and everything's fine. And that's not the way that it works. If we understood that reality. 'cause I try to do that when I do end of life care planning with people in a gentle but straightforward way, using understandable language to explain to them.

The realities of what it looks like if you are to [00:12:00] get CPR and chest compressions, depending on the age that you're at, your health status, what intubation looks like, what some of these procedures look like, that they'll be asked, well, what do you want done if this were to happen? And people just go, I everything I want, everything done.

Without understanding what everything actually means and what the potential outcome of some of these things are, but that is a difficult conversation. It can bring up some emotions when we hear that. When you've talked with people, how do you approach the education part without scaring and overwhelming, but also being honest of you don't really understand and it's not your fault, but you don't really understand what these things are gonna look like.

So let's. Figure out the best option for you based off the reality of what some of these things are? 

Marni: It's a really good question, and I think that for many people, they just don't have the language in which to speak about these things or even to ask the questions [00:13:00] because we're not taught about it in our society.

We keep death in the shadows. We don't talk about these things and then all of a sudden. We're confused by why no one understands these options or have strong opinions one way or the other about it, because we're just not taught about it. And so for me, it's really kind of getting a baseline of where is someone in this process?

Have they thought about this? Did they experience it with a loved one? Did it go. Well, did it go poorly? What is their lived experience? Asking questions and being a sounding board, like you're saying. I am a lawyer by background, but I'm not currently practicing in that role. Even for me, if I'm talking to someone in a professional role, I can get intimidated.

A lot of people that they, they don't ask the questions. They don't ask the follow-up questions because they don't. They don't necessarily know how to ask it or they, they don't wanna be seen as stupid or, or something of that nature. And so really my role is to make sure that they feel comfortable enough that we've [00:14:00] established a relationship where we can talk about these hard topics or the uncomfortable things that maybe they've been thinking about but haven't talked about within their family or friend group.

Making sure they're comfortable enough to ask the questions and if they're confused to say that so we can work through it. There's a lot of good material out there on the internet. There are ways to talk about these things within families and so making sure that they have what they need. Some people learn differently.

Some people just having a conversations enough and some people need visual, um, things in order to really understand information. It really is getting granular and taking the time and the space. I think that a lot of this work. Need space in order to process because it is really heavy topics that not everyone wants to dive into.

Going at a pace that works for that individual and taking the time, if they come back and say, Hey, I actually that didn't sit right with me, or, you know, I said it out loud and that's actually not, doesn't, it doesn't feel good. Let's talk about. [00:15:00] Why that is, and what do you need in order to feel comfortable with the decisions that you get to make?

The goal is that everyone gets to make this choice for themselves and what feels good for them, whether that's spiritually religious or nothing at all. You get to drive the ship here. What you want, giving people a space and make the best choice, not in a moment of crisis where everything gets sped up, giving people the time to make a decision that's best for them.

Jill: As a debts ruler, one of the things that I like to do that I actually really enjoy doing is sitting with my families. When they're with a professional and asking questions that I think of because I don't always understand what's being said. Yesterday was a good example. I was sitting with a family that there's a new diagnosis of Alzheimer's and we were sitting with a Alzheimer's professional and they were talking about the treatments and all these different things.

I had a whole list of questions of like. What's gonna [00:16:00] happen at the end of life? What if they have to go into a facility? I know they don't wanna die in a facility. Can we move them back home? Are they gonna go through all these stages? Or is it like some people skip stages? What does that look like? Is there different things we could do to the home to make it safer, to keep them their, like, just all these things that I was able to think of based off of what they were saying.

So I listed them all and. Because I am not as emotionally involved in the actual situation itself. I find that it gives me that different way of viewing the situation of, if this was me, what would I be thinking of? But because it's not me, I'm not as emotionally invested. It's easier for me to come up with the questions and to verbalize the questions.

So I think that's a really important role. That death doulas could fill. That is not necessarily traditionally what people think of when they think of death. Doulas, of course, at this point, I think now there's still 90% of the population that [00:17:00] doesn't know what a death doula is. Or even if they do, they're like, I still don't know what you do.

I have no idea what you do. It's one of the things that I'm finding. I keep saying to people, and they say to me, well, when should I hire a death doula? Like when the person's dying? I'm like, no, please bring us on a lot earlier. If there's a terminal diagnosis, if there's any diagnosis, it's gonna change the way that you live your life.

Bring us on so that we can help you navigate the whole process, ask the questions, get the care plan in place so that. Even if it's 10 years from now, at least you have something set up. Don't wait until the end. But for you, do you consider yourself a death doula? Do you play that role, or was it more just adding those tools to your toolbox so that you can understand?

End of life a little bit better to support people in the 

Marni: work that you 

Jill: do. 

Marni: I love what you did with that family. It's so important to highlight that when a family is listening to a doctor or a professional, sometimes they are sort of out of body. They're there, but they're not there to [00:18:00] have someone else there who's listening, who can ask that question, and then they can get information through that.

Is a huge benefit. My father was at the hospital recently and I had him when I wasn't able to be there, have an AI note taker on his phone that was at least capturing high level things that he could then send to the rest of the family so we could digest that information instead of him taking his.

Terrible handwritten notes that I would never be able to read and no one would understand. I think there are different tools, whether it's always having a human there who's not part of the family and able to advocate or just ask those questions is a huge role in terms of me as a end of life doula. I do consider myself that I have sat with families and I continue to, it is a smaller part of my overall practice just because for me.

It is so energy driven and you know, I wanna devote a lot of time and, and you know, and love to individual [00:19:00] families. I'm not trying to grow that. I take on a very small amount of clients at any given time in that role, but it has been incredibly meaningful to walk families through. To your point, I've worked with families for six months for a year.

People who have had long-term. Prognosis or diagnoses, but want that extra time and a plan to think about their feelings and have the space to process what's going on within them and to support their loved ones. And many people that I've ended up working with have relied more on chosen family than traditional biological family and, and having that extra professional support.

I see as invaluable to making sure that they have what they need and also to give space for their chosen family to just be that for them and not have the burden of being in more of the caregiving role. My training and that work sort of informs, uh, planning with people far [00:20:00] beyond when the end is near.

I work with a lot of people in the sandwich generation who are caring for young children and aging parents to get their planning in order to start those conversations within the generations. A lot of people my age, I'm in my early forties, are worried about their aging parents and wanna start having those conversations to get prepared.

I work with a lot of people who are aging solo by circumstance or by choice people who have gone through a divorce and need to rethink who their important people are, who are gonna take on that healthcare proxy role or the power of attorney, or who will be their executor, people who are widowed, or just people who are choosing to.

To age without necessarily a partner in place. And a lot of people even who have children are estranged, so you can't guarantee that you have that support as you're aging. I work with a lot of people in that situation too, and that also informs my work with people after a death because [00:21:00] there's so much that people don't realize needs to be done.

Administratively after a death of a loved one. Having someone who understands the process and can help guide them is where the bulk of my work lies. Gives them the space to grieve, but know that there's someone who understands that practical process that needs to happen after a death. 

Jill: There's a lot to think about after somebody dies, and the idea of chosen family complicates things.

It doesn't mean that it's wrong or bad if I have a larger chosen family than I do family that I rely on, but it definitely complicates things. If you get admitted to the hospital, if you don't have this paperwork in place, they're not gonna call. Your best friend or your partner, they're gonna call your family, your immediate family.

They're gonna find your parents or your siblings and they're gonna call them. And so if you don't have the greatest relationship with them or if you don't want them involved in these decisions, it's even more important that you get [00:22:00] this paperwork in place and have the people listed that you want called if something were to happen to you.

Because so many of us. Have relationships with our family that are complicated and they don't necessarily know us, know what we want, know what we believe, and know what we care about, the way that our partners and our friends do. And they would definitely be the people that I would want making the decisions for me because they're gonna know the things that I care about.

But if I don't have that paperwork in place, some states, even if you're married, that doesn't necessarily guarantee that that person is gonna be the one that gets called. So we need to have these things in place, and I do find that I have a few people that I've worked with, whether paid or unpaid, that they were alone for whatever reason, as they were aging, as they were nearing the end of life from illness.

They really need the support. They need somebody that can come in and [00:23:00] be the person for them that can help speak for them and answer questions and get everything organized and in place. People, I don't know that there's even options out there. Who do they go to? They're not even sure, but there are people that can help support you even if you have friends.

That can also help. It is a lot of work. It's very hard work, especially if you're not. Trained and prepared. It could be a lot if they don't know there's help and support. 

Marni: Yeah, I mean, everyone needs support. Whether you have a large family, a small family, a chosen family, you're more of, you know, a solo person.

Everyone needs, everyone needs guidance. We're not taught, it's not like a subject matter in most schools, and so it really is a struggle of where do I even begin to tackle this information? Even just having, you know. Even if it's just a Google search and you're starting to get, you know, there's, you know, something.

The Conversation Project is one of the things I think about when I think [00:24:00] about these topics. Or there's a game called the Death Deck that you can start to think about these things and ask yourself these questions, or do it within your friend group, or your family is even starting to think about it before the paperwork comes into it, you know?

Kind of understanding what are even the things that I should be thinking about, and then kind of making notes about what it is and then filling it out. You know, a lot of these things, a lot of people think that, oh, I need to spend thousands of dollars on an attorney to get my paperwork done. And, and, and for some people that's the case.

But for the basic documents, like a healthcare proxy, a power of attorney, a HIPAA release. These are all things that are important to have for everyone who's over the age of 18 while you're still alive. This is protecting you and making sure that your wishes are being carried out while you're still here.

None of those need an attorney to draft them. It needs witnesses, and sometimes a notary, but every state has basic forms on their government website that you can fill out, [00:25:00] and that can be a nice placeholder and know that you're covered. Until you're ready to have an attorney do a formal document for a will or a trust and, and typically they will then also add those other forms on, you know, free of charge or part of your package.

But you know, everyone, everyone. Deserves to be covered and to have something in place saying who can take care of them and who they trust to make choices for them if they're unable. 

Jill: Do you do the paperwork with your clients or how's that part work for you? Is that something where you help them get that together or are you more the person that just helps them after death?

What's that look like? 

Marni: So we definitely talked through all the things that need to be talked about for them to get their planning in place. I'm not drafting the actual documents, but typically when you go to an attorney, they'll give you a questionnaire and you'll fill out this whole questionnaire and then they'll draft the documents for you.

A lot of people. Have that questionnaire sitting on their desk or on their [00:26:00] computer four months, if not years. Have a friend who paid for a trust. He paid a lot of money for a trust and it has been a year and a half, and he has not gotten back to the attorney with the information. And this is a very common thing.

It's very normal when the paperwork's in front of you to get stuck on a question and then put it aside. A lot of what we do in advance is talking about all those things that need to be talked about, whether it's. Who is the right person to be guardian of your children or your pet. Many people get stuck saying, I don't know who I want to take care of for my dog after I die.

And it haunts them and they don't fill out everything else. We talk about all the different decisions that need to be made so that when they get that questionnaire. They can just go through and fill it all out and know the answers to the questions they need to do. I'm not offering legal advice, but we're talking high end.

What are the important things you need to be thinking about for things like the healthcare proxy and power of attorney? I'm here to answer questions because those are very [00:27:00] standard documents. And like you said, educating people on, you know, what does it mean in a living will to talk about life sustaining treatment and what does that actually mean at the end?

A lot of people don't. You know what chest compressions will do if you're 90 years old versus if you're a healthy 45-year-old. There's a lot of good information on the internet if you know where to look. There's a lot of information 

Jill: and I do what I call an end of life care plan with people. I say right on there, this is not a legal document, but it's just a document that you could use to have the conversations with your families.

You could use it to help you fill out your legal paperwork. It typically takes me about three hours to get through the whole process because I don't just wanna ask all these questions. I wanna also talk about their life and make it a conversation, not just filling out a form. I have found that it really.

Is helpful for people to have somebody guide them through the [00:28:00] process, not just give them a piece of paper. Because that's the thing that I've found is like, yeah, you could get five wishes off the internet. You know, you could get copies of your state's advanced healthcare directives. You can get all of these things.

But a lot of times people get 'em and then it just sits there because they read the first question and immediately there's this fear and resistance and confusion, and it's easier to just be like, oh, I don't need to do this today. I'll just do that tomorrow. But none of us know when we're gonna need those documents.

We might need them tomorrow if we keep waiting. It's a year and a half later and the document's still sitting there and you're like, I haven't actually done anything with it because it's too overwhelming. And so it is. Good to have somebody walk you through it a little bit and to feel supported and be able to ask questions and help facilitate those conversations with the whole family.

If we don't have the [00:29:00] conversation about what's in the documents, you can have those documents all you want. If they're sitting in a drawer, they're not gonna do anybody any good. We definitely need the conversation to be an important part of these documents as well. 

Marni: Getting consent of the person that you're naming in these roles.

If you want this person to be your healthcare proxy, ask, is this something that you'd be willing to do? Here's what the role means. Here are my wishes. Do you think that you'll be able to follow them in getting affirmative consent? When I was younger, I think my parents just said, by the way, you're my executor.

What does that mean? What is that my skillset? Is that something that I want to do? Is that what I would be good at doing? You know, it's really important to be not just assuming that you know, just because someone is either related to you or a friend, that they would be the right person for the role.

Matching people's skillsets with the role is very important and making sure that they're willing to do it. Some of these roles have great responsibility and really hard responsibility. If [00:30:00] you think that someone. Is going to fall apart under the pressure of stress that might not be the right person to be advocating for you at a hospital.

Thinking about who are the right people for these roles and making sure that they're okay with them is really important. 

Jill: Culturally, there's definitely, I would say, like the typical American culture. This idea that it always falls on the eldest daughter, right? The eldest daughter's the one that's gonna do all these things.

In some cases, yeah, sure. I mean, maybe that is the truth, but you're right. Maybe the eldest daughter is not gonna be the greatest choice, be not gonna be able to handle the pressure. I tell people often actually, your spouse is possibly not gonna be the best person to name as your healthcare directive, as the person to come in and be the one to say.

They don't want life support in any form. They don't want any of these things because it's gonna be much more difficult for [00:31:00] them to say that when they're dealing with the fact that you're gonna die and they're gonna lose you. It might be better to have. A friend or a cousin or somebody that is still going to feel emotions around losing you, but it's not gonna be that same level of life altering.

That is an important thing to think it through and to talk to the people and really make sure that they will be okay making these decisions and doing the roles that you're putting them in. 

Marni: It's a really good point to have someone who's a little farther removed can make all the difference in being able to ask questions and think clearly and to advocate.

Whereas someone who is, who is your, you know, your spouse, you know, as an example, could be way more emotionally charged, even if they know and respect and want the same wishes as you, the actual saying of those words. Same with a parent. Could there's, there's a lot there and it can be harder to do it. What [00:32:00] we were getting at before is that you might love and respect someone and they might be making different choices from you.

Can you actually follow their directives? In some families, when I'm talking to them, they say, I'm worried about naming this person. I feel like they'll be upset if they're not this person, but I don't actually know that they will. Follow what I want. That's a red flag or at least a yellow flag. If you can talk to that person and say, Hey, I know that you strongly disagree with this decision, but can you follow what I want?

This is what I want. These are my values. These are my wishes. If they say yes, and you really trust and believe them, that's great, but if you feel hesitant, if you have that uhoh feeling in the body, that might not be the right person for the role, and it's okay to choose someone else who you know will respect your wishes.

Jill: And I think that goes back to your point earlier of asking somebody, why does my choice make you uncomfortable? Why does my choice upset [00:33:00] you so much? Because I think if we could talk about the root of it and not just the shallow surface of like, well, you know, I don't agree with. Whatever healthcare decision, especially when people stop cancer treatments, when they get to that point where they're like, I'm done.

I can't do this anymore, and family members are like, but you're giving up. How could you give up? I hate that term I do, because they're not giving up in the sense of, you know, like, oh, this is just an easy task and it's too hard. Cancer treatments can be so, so difficult on a person and. The pain and suffering that goes along with the treatments in some cases is worse than the pain and suffering that they would have from the cancer itself.

If we can talk about why that choice is so upsetting and giving somebody that space to feel heard in, yes. Why they're feeling that way, it [00:34:00] can open that door for them. Also, being able to listen and understand why somebody's making the choice that they're making. When it comes to treatments, whether taking them, not taking them, stopping them, whatever it is.

Marni: And to your point, sometimes stopping treatment is accepting what is, and that is not a bad thing. And in fact can be a really empowering thing to just say this is, this is what is happening. So many. People spend the last few months of their lives trying different treatments for the sake of loved ones, when they know that the end result is still going to be the same, and maybe that quality of life is not gonna be as good as it would've been if they had stopped treatment.

They're gonna still be at the hospital instead of being at home or by the beach, whatever they need to do to end as completely as they can. There is something powerful about acceptance that a lot of people, when they say she's not, you know, she's. Up that fight. It's really not giving up. It is [00:35:00] just shifting one's perspective of what the outcome is meant to be.

Jill: Shifting. What it is that we're doing is really focusing on what is important to the person, and that's where we need to have those conversations earlier so that while they are. A little bit more clear minded. They could say, this is what's important to me, and so that then we can guide them throughout the process.

Have you ever had a family that is maybe making decisions that, you know, in the long run was not really what they wanted because they're being influenced by the emotions of the family around them? Is that a situation you've come up against 

Marni: yet? I think that people who bring in end of life doulas or people to support in this process are typically more on the same page with the person who is dying and are there to get the support that that person and they need.

And so that hasn't been an [00:36:00] issue with me. I have certainly heard that being an issue within my friend group, within my peers, but not within people that typically go as far as to hiring someone to help guide them at the end. Does that make sense? 

Jill: Yeah, that is a good point because I'm thinking of somebody I know they're dying and spending the other life pursuing treatment after treatment, making them very ill.

Part of that falls on the medical team for continuing to give hope and offer treatments. They probably know we're not gonna do anything, but again, it depends on the person's personality. This person is probably very like, everything I want, everything just keep doing it. But they're also not working with me and they know I exist.

So I think there is that thing of people that are willing to say. Death is a natural, normal part of life. [00:37:00] I want to work with an end of life doula. I wanna prepare myself. I wanna prepare my family. They're gonna be less likely to end up in those situations anyway because they're open to the idea that this is a normal, natural part of life, even if it's happening to me at a time when I don't really want it to be happening.

It's part of life that does actually make a 

Marni: lot of sense. You also touch on something that's a bigger conversation, but this idea that the medical teams are trained to heal, right? Their goal is to get you better, not to let you. There has to be more of a shift within the medical profession. Of course, like palliative care and comfort care is, is becoming much more widely accepted and you know, part of the care teams.

But it does require the medical professionals to be clear with patients to say, we could do this, but it's not going to. It's not going to prolong much and it might even take [00:38:00] away some of the joy you have left. This is a big decision and and it's okay to not do that instead of pushing for more at the end.

That mindset shift within like an entire procession that I don't think is there yet, but hopefully will incorporate more of that feeling in that it is okay at a certain point. To allow someone to stop treatment and to be more honest about what someone has left in terms of time or prognosis, and not shy away from those harder conversations because that's not what they've been taught to do.

Jill: And there is still so much lack of understanding in the medical community around palliative care. I even spoke with somebody this week from hospice. That as we were talking for a while, finally said to me, I actually don't even really understand what palliative care is. And I was like, oh, interesting.

Okay, so let's talk about it. So we had a whole conversation about [00:39:00] how hospice is actually part of palliative care. Palliative care is a bigger umbrella and it focuses more on keeping a person comfortable and treating symptoms and helping them understand that yes, maybe we wanna try these treatments, but when would it be time for you?

To stop treatment, when is it your decision? I have found with volunteering in hospitals with palliative care teams, there is resistance to some of the other medical professions to palliative care. They don't view it in a very positive light in so many people's heads. Palliative care is, we're giving up, we're stopping everything.

I'm just gonna die. It's like, no, we're focusing more on the quality of what life we have left versus. Trying to do nothing but heal. But with palliative care, you can still do treatments. Yeah. It's just gonna help you get clear on what that means for you and help you ask the right questions. Is this treatment going to cure me?[00:40:00] 

Is it going to prolong my life? Is it just gonna slow down the progression of the disease? People might make very different decisions. But we don't think to ask it. The doctor says, get chemo or radiation, or try this experimental infusion, and they just go, okay, because it's a doctor and we are taught to trust doctors and not question, even if we have a question, like you said earlier, we don't necessarily even know what the question is.

We can't form the words in our mind to properly ask the question, and so we just go, okay, let's do it. Which is. Unfortunate because I think for a lot of people, it starts the path that leads them to an outcome that they don't want, which is in a hospital hooked up to a bunch of machines until they finally do die.

And that's what a lot of people don't want. If you were to say, how do you wanna die, that is not what people say. I don't I've ever heard anybody say that, but unfortunately for a lot of people, that is the outcome they end up [00:41:00] with. And it doesn't have to be, it really doesn't have to be. It's so true. Well, we are getting close to the end of our time, so I really wanna give you a few minutes, talk a little bit more about your business.

If somebody is curious and they wanna work with you, what does that look like? Should 

Marni: they just. Find your website. If someone is looking to have this conversation within their own family or starting to have conversations with their aging loved ones, it can be a great time to talk to a professional. I always offer a free 20 minute conversation to see.

Where you are at and what, if anything, I can do to help support you making some of these choices. And then, you know, if you're experiencing a death or in grief and still going through the administrative process, I'm here to support. I work, you know, virtually across the country. The other thing that I have on my website is a bunch of free resources, ear important documents and digital life checklists.

Legacy project ideas and a low [00:42:00] cost plan well organizer to get all of your important information into, to one, one place. You know, we have a lot of information that lives in our heads and it's important to have all of these things in a safe, secure space so that you are loved ones can help you while you're still here and understand the scope of your life, your.

Belongings and what's important to you after you're gone, and so I have that on my website as well. You can find me on Instagram and at my website at begin with the n.co. I'm always happy to have these conversations and to answer questions as everyone deserves the education and the have someone to bounce ideas off of in this space.

Jill: And the planner, is that like a paper planner? Is it all digital? What, what 

Marni: does that look like? It's a digital planner. Uh, you can download and type in your information and save it, you know, to your digital vault or wherever you keep your information. You can also print it out. I'm working on a physical copy in 2026.

More on that down the line. Oh yeah. 

Jill: That's great. [00:43:00] 'cause I know I have different resources like that where people can keep things digitally. But more and more I'm like, I don't know, paper might be a real good idea for some of this stuff. Just again, have a copy somewhere and tell your people where the copy is so they can find it 

Marni: when they need it.

Your important things in a safe, but not let people know where the key is correct. And give them 

Jill: copies even. Yes. Have copies for. Each of your family members that may be involved. Make sure your healthcare team, your lawyers, all the people have this information. Even if the lawyers might not read through all of it, but at least it can be with your other stuff.

Easy to find if somebody needs it when you're in the middle of a crisis. You're not gonna wanna be like, where'd mom say the key is I gotta try to find the key and now I gotta find the safe and go over there and I have to 

Marni: unlock the whole thing. When I made this, really the goal was for my parents to fill it out.

[00:44:00] They were the first persons to get it. To say, I made this. Would you mind trying it out and filling it out for me. Now I have both of their copies, which is the most important thing. That is their gift to me. Thank you so much, Marni. Thank you, Joel. 

Jill: If you enjoyed this episode, please share it with a friend or family member who might find it interesting.

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