90% of End-of-Life Care Is Knowledge — Barbara Karnes on What Families Actually Need

Die Empty — Darnell Lamont Walker on the Stories We're Still Carrying

What does it feel like when everything is finally said? Darnell Lamont Walker [https://www.darnellwalker.com/] knows. He's been in those rooms — the ones where a sweet surrender settles over everyone, where people say it was hard, but it was beautiful — and the ones where nothing was said, which he describes as summertime in the south, humid, wearing a blanket. He knows the difference in the air. Darnell is a death doula, Emmy-nominated writer, fifth-year faculty at Esalen Institute, and author of Never Can Say Goodbye — a book Trish recommends you listen to on Audible, in his own voice, turned all the way up. In this conversation, Darnell and Trish go deep on what it means to die empty — to leave nothing inside that should have been written, said, or done.  They talk about the object exercise he uses at Esalen to unlock storytelling and unblock creativity, why grief and laughter move through the same room, and what well-meaning adults get wrong when children ask about death. Seven to eight million children in the US have experienced the death of a parent, sibling, or close friend — most without a single honest conversation.  Darnell talks about small goodbyes: the end of summer, the pet that didn't make it, the best friend moving away. These aren't interruptions to childhood. They're the practice runs we forget to honor — and the tools we forget to give. He also answers six questions Trish wrote specifically for him, including the song he wants timed so the last note hits with his last breath, and what a world where children grow up fluent in loss actually looks like. "It looks like we've gotten rid of loneliness." In this episode: * The object exercise — how a memory trail always arrives at a person and a moment of aliveness * Why grief is the sequel to love, not the punishment for it * What adults get wrong when children ask about death — and the one language shift that changes everything * "Humid summertime wearing a blanket" vs. "sweet surrender" — the difference in the air * Red Dust by James Vincent McMorrow [https://www.azlyrics.com/lyrics/jamesvincentmcmorrow/reddust.html] — and why the timing has to be perfect Get Darnell's book: Never Can Say Goodbye [https://bookshop.org/p/books/never-can-say-goodbye-the-life-of-a-death-doula-and-the-art-of-a-peaceful-end-darnell-lamont-walker/c3eec4285f0215dd?ean=9780063421837&next=t&aid=110512&listref=for-graceful-transitions-an-end-of-life-navigator-a-curated-booklist] — and if you listen on Audible, turn it all the way up. Ready to start your own conversation? Start the Conversation — July 23rd [https://tinyurl.com/STC-TheOverview] In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, End-of-Life Navigator and founder of Graceful Transitions. New episodes drop monthly. Graceful Lifers are in the room live — join the community at linktr.ee/pmsears [https://linktr.ee/pmsears] About the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, an End-of-Life Navigator and founder of Graceful Transitions in Vermont's Northeast Kingdom, serving globally. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers. Join the Graceful Lifers community at Substack [https://patriciamsears.substack.com/subscribe] for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds. You can find the hub of Graceful Transitions' work at Linktr.ee/pmsears

90% of End-of-Life Care Is Knowledge — Barbara Karnes on What Families Actually Need

Barbara Karnes, RN, started her hospice nursing work in the 1970s — before hospice was even a word most Americans knew. She didn't join a movement. She helped build it. And more than fifty years later, she is still writing, still teaching, and still asking the field harder questions. In this conversation, Barbara and Patricia talk about what it actually takes to walk with someone toward the end of life.  Barbara's answer might surprise you. End-of-life work, she says, is far more about social, interactive people skills than it is about the medical. The medical model focuses on disease. End-of-life care focuses on the person who happens to have one. If there's one thing she'd want every family to understand — one sentence she'd leave behind — it's this: 90% of end-of-life care is about knowledge. It's about educating people in regard to what is actually happening. Because when families have that understanding and that resource, something shifts. They are less fearful. And the experience becomes something more sacred. Dying isn't pretty, Barbara says plainly. Neither is giving birth. There's labor on both ends of life's journey. Mom is working hard to get out of her body — and that's what it looks like. That's not something going wrong. That's the work. Barbara also shares the 3 a.m. phone call that led to Gone From My Sight, why she's still a social worker at heart, what surprised her most when she cared for her own husband, and what she wants people to feel in the room when she is the one dying. This is a conversation about what it means to really show up — for the people we love, and for ourselves. About the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, an End-of-Life Navigator and founder of Graceful Transitions in Vermont's Northeast Kingdom, serving globally. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers. Join the Graceful Lifers community at Substack [https://patriciamsears.substack.com/subscribe] for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds. You can find the hub of Graceful Transitions' work at Linktr.ee/pmsears

The Last Lesson: A Conversation with Dr. Ken Gorczyca

Dr. Ken Gorczyca has been sitting with death since he was eight years old. His guinea pig, Squeaky, died, and no one helped him. No ritual, no guidance. So he put her in a shoebox, added flowers, dug a hole in the backyard, and figured it out on his own. He didn't know it then, but that was the beginning. Ken graduated from veterinary school in 1983 and moved to San Francisco — straight into the center of the AIDS pandemic.  His very first client was a physician asking whether people with HIV should give up their pets. Ken said no.  He co-founded Pets Are Wonderful Support, the first organization dedicated to keeping people with AIDS and their animals together. He lost 300 clients. Dozens of friends. And when he finally took the end-of-life doula course at UVM decades later — yes, the same program I went through, and yes, Ken was one of my instructors — he recognized something: we were all death doulas. We just didn't have the name for it yet. When he turned 65, he went into the desert with one question: What's next? What came back was this work. In the last four years, he's been present for the deaths of roughly 2,000 animals — dogs, cats, bunnies, rats — in homes, in living rooms, in the spaces where a life was actually lived. He rings a bell. He tells the story. He smudges. He closes with a poem. Not because it's required, but because he believes — deeply, unwaveringly — that at the end of life, medicine and spirit can't be separated. In this conversation, Ken and I talk about what families most need when they're scared and don't know what to expect.  About why he spends 20 minutes asking families to tell him everything — the adoption story, the name story, whether their dog ever stole the turkey off the table — before anything else happens.  About disenfranchised grief, and why the loss of an animal is real grief, not a lesser version.  About what it means to let go. And about what he's come to believe: that an animal's death is the last lesson they teach you. "Their passing," he said, "is really their last lesson. They're teaching you about death." This one stays with you. RESOURCES MENTIONED IN THIS EPISODE: Ken and our guests touched on something that doesn't get talked about enough: what happens to your pet when you die — or when you're dying and can't care for them anymore. Here are a few places to start. Pet Advance Directives — Just like a human advance directive, a pet advance directive lets you document your wishes for your animal's care if you're no longer able to make decisions. Mine needs updating. Maybe yours does too. https://tinyurl.com/PetAdvanceDirective [https://tinyurl.com/PetAdvanceDirective] Pet Trusts — A pet trust is a legally enforceable arrangement that sets aside funds and names a caretaker for your animal after your death. Unlike leaving a pet to someone informally, a trust gives your wishes legal teeth. Your estate planning attorney can help, or search your state bar association for resources specific to where you live. https://tinyurl.com/PetTrustsPrimer [https://tinyurl.com/PetTrustsPrimer] Pet Quality of Life Scale https://tinyurl.com/PetQualityOfLifeScale [https://tinyurl.com/PetQualityOfLifeScale] My Grandfather's Cat — mygrandfatherscat.ca [https://www.mygrandfatherscat.ca/] — A free Canadian charity that helps seniors and terminally ill people find second forever homes for their pets. No shelters, no foster systems — their animal stays home until the very last day, then moves directly to a new forever family. Canada-only for now, but a model worth knowing and sharing. A Gentle Rest — agentlerest.com [https://agentlerest.com/] — Dr. Ari Rozycki's in-home euthanasia practice in the San Francisco Bay Area, where Ken Gorczyca is part of the team. If you're in the Bay Area, or simply want to see what this work can look like at its best, it's worth a visit. About the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, an End-of-Life Navigator and founder of Graceful Transitions in Vermont's Northeast Kingdom, serving globally. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers. Join the Graceful Lifers community at Substack [https://patriciamsears.substack.com/subscribe] for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds. You can find the hub of Graceful Transitions' work at Linktr.ee/pmsears

When I Die, I'm Really Going to Miss Mint Jelly — In Conversation with Diane Button

What do we reach for when time gets short? Not the accomplishments. Not the carefully managed image. Something simpler. Something we wish we'd said out loud sooner. This conversation is for anyone who has been putting off a conversation they know they need to have. Which is most of us. The conversation doesn't have to be perfect. It just has to start. Guest: Diane Button End-of-Life Doula | Author | Educator | Founder, Bay Area ELDA UVM End-of-Life Doula Certificate Program Instructor What we talk about in this episode: The mint jelly story — how a grandfather's final meal and a single sentence launched Diane's career in end-of-life work. The doula bag — what happened when Diane showed up to Floyd Barker's house with 100 questions on a clipboard and a bag full of supplies, and never opened either one. The vigil plan — why asking someone what they want their final hours to look like is one of the most important conversations you can have, and why the answers will surprise you. The gap — what it actually costs people when advance directives go unsigned, relationships go unhealed, and words go unsaid. From someone who has watched it happen. The Final Checklist — six questions Diane distilled from a hundred. She asks them of her clients. She asks them of herself. Every month. They will stop you cold. Death is just one day — why Diane calls herself an end-of-life doula, not a death doula, and why that distinction matters more than it might seem. The six questions: 1. Who matters most? 2. What matters most? 3. What is left unsaid? 4. What is left undone? 5. What are you worrying about when you're lying awake at night? 6. What brings you joy in the daytime? Diane's book: What Matters Most by Diane Button — find it on Trish's curated booklist for end-of-life reading at Graceful Transitions: 👉 https://bookshop.org/lists/for-graceful-transitions-an-end-of-life-doula-a-curated-booklist [https://bookshop.org/lists/for-graceful-transitions-an-end-of-life-doula-a-curated-booklist] The voice changes in this episode are due to 'operator error,' and I had to re-record 8 minutes as a result. I am learning a lot about editing and polishing. Onward with CHEERS and sincere appreciation. About the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, an End-of-Life Navigator and founder of Graceful Transitions in Vermont's Northeast Kingdom, serving globally. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers. Join the Graceful Lifers community at Substack [https://patriciamsears.substack.com/subscribe] for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds. You can find the hub of Graceful Transitions' work at Linktr.ee/pmsears

Street Wisdom at the Threshold: What 35 Years of Bedside Ministry Taught Me About Dying Well

What does it take to stand in a room where someone is drawing their last breaths — with no clinical training, no script, and no way to fix it? Pastor Larry Wall has been doing exactly that for 35 years. As the founding pastor of Newport Church of God in Vermont's Northeast Kingdom and the visionary behind the Living Waters Hospice House, Pastor Larry brings something most bedside training programs don't cover: street wisdom, spiritual discernment, and an unshakable belief that death done well can be sacred and beautiful. In this conversation, we go deep: * What terminal breathing actually looks and sounds like — and why families are rarely prepared for it * The 3 AM phone call that changed everything: Pastor Larry's first death vigil, what he did wrong, and what grace showed him instead * Why dying people "hold on" — and the surprising question that unlocked a peaceful death within 10 minutes * The profound difference between spirituality and religion at the end of life (and why it matters more than you think) * How advance directives do more than protect the dying — they protect the living from an impossible burden * The hymn Pastor Larry sings at the bedside when someone can't let go * Perspectives from London to San Antonio: Graceful Lifers John Goodey and Kathy Hamilton on children, hospice, and a mariachi band at a 95th birthday that brought a room to tears * Graceful Lifers are paid subscribers to https://patriciamsears.substack.com [https://patriciamsears.substack.com]/ and/or alumni of Graceful Transitions Legacy Leaders Guide [https://linktr.ee/pmsears] cohorts or Living Fully and Dying Prepared workshops. Graceful Lifer John Goodey — a former London headteacher — also shares the story of the groundbreaking intergenerational program he helped launch at St. Christopher's Hospice in Southeast London, where 9-year-olds partnered with dying patients to create art and exchange life stories. That program has since spread to every continent. If it moves you as much as it moved us, here's where to learn more: * The St. Christopher's Schools Project (the original program, running since 2005): https://musicandartsinaction.net/index.php/maia/article/view/stchristophersschoolsproject [https://musicandartsinaction.net/index.php/maia/article/view/stchristophersschoolsproject] * Studio DöBra (the Swedish intergenerational arts initiative inspired by St. Christopher's): https://www.döbra.se/en/projects/studio-dobra/ [https://www.döbra.se/en/projects/studio-dobra/] This episode is also a window into what Living Waters Hospice House [https://www.livingwatershospicehouse.org/] is being built to be — a place where laughter is medicine, love is the bottom line, and no one dies alone. Living Waters Hospice House is actively seeking community support. To learn more, reach out to Graceful Transitions. Interested in planning your own legacy before the crisis arrives?  Join Trish for a free Legacy Leaders Guide Taster Session: https://tinyurl.com/LLG-FreeTasterSession-Register [https://tinyurl.com/LLG-FreeTasterSession-Register] About the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, an End-of-Life Navigator and founder of Graceful Transitions in Vermont's Northeast Kingdom, serving globally. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers. Join the Graceful Lifers community at Substack [https://patriciamsears.substack.com/subscribe] for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds. You can find the hub of Graceful Transitions' work at Linktr.ee/pmsears