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Welcome to Healthcare Redefined: Advocating for Aging Adults and Their Families, where we empower families to navigate the complexities of aging and healthcare. Presented by Your Nurse Advocate Consulting, we share real stories, expert advice, and practical tools to help you and your loved ones confidently navigate aging with dignity.
We explore topics like creating collaborative care plans, demystifying Medicare, handling healthcare crises, and preparing for the future. Join us as we transform uncertainty into understanding.
Pam Dunwald: [00:00:00] Welcome to Redefining Healthcare: Advocating for Aging Adults and Their Families. We are already on episode number six. Hi, I'm Pam Dunwald.
Linda Kritikos: [00:00:09] And I'm Linda Kritikos. Today we're opening up a conversation that's often overlooked but so important: how to support families and loved ones at the end of life. November was National Hospice and Palliative Care Month, and we wanted to bring some awareness to this topic that is often uncomfortable to talk about with our family.
Pam Dunwald: [00:00:28] You know, for this episode, we are honored to welcome Crystal Flores, end-of-life doula and owner of The Grateful Death. So Crystal brings compassion, expertise, and real-world experience, you know, to families navigating this deeply meaningful journey. And so I'm going to give you a little bit about Crystal. She is an expert in guidance and support for end-of-life readiness, guidance and support through VSED, which is Voluntary Stopping of Eating and Drinking. We're going to get into that a little bit more in the conversation. Also guidance and support for MAID, which is Medical Aid In Dying, as well as The Grateful Mess and organizing, downsizing, and repurposing your space. And that is new since the last time I chatted with Crystal. So I'm excited to learn more about that. And also ritual, ritual and ceremony. So Crystal Flores is an experienced end-of-life doula, she's a mentor to other end-of-life doulas, and founder of The Grateful Death, as we mentioned, she has been supporting individuals and families through transitions since 2015, so Crystal brings compassion, clarity, and a grounded presence to her work. Her approach combines practical planning with soulful reflection, creating a safe and supportive space for individuals to explore their own mortality. She also articulates their end-of-life wishes by supporting others in their families and finding meaning in the process of dying.
Linda Kritikos: [00:01:52] So, Crystal, let's get started. For those who may not be familiar with this, what is an end-of-life doula, and what inspired you to start The Grateful Death? That is such an interesting name.
Crystal Flores: [00:02:03] Yeah. Thank you. You won't forget it. The first question I get is, well, are you a Deadhead? And I am really actually not. But it has a ring to it, and you won't forget it. So it's, you know, I get this question a lot about what it means to be an end-of-life doula. And sometimes it's challenging to sort of encapsulate what that is, because there is a lot of different hats you can wear as a doula. And so, I mean, this can look like, you know, for me, I'll just tell you what it looks like for me, and I'll kind of highlight some other paths you can take as a doula, because to say what it is in a nutshell, you are really holding space and being present for people during transition. And for me, a lot of what I am doing is more coaching, and it's not typically the person that's dying. It's typically the people that love them. So what I'm doing is really normalizing the process and letting them know the things that they can expect that are coming down the road, help them prepare for what's ahead, and normalize all of the things that are wildly uncomfortable to talk about and experience.
Crystal Flores: [00:03:18] And usually these things are not talked about within the family prior to this stage. So what I'm doing is kind of unpacking some things that are meaningful to the person that's dying. Some things that are sacred to them, and creating an end-of-life experience that meets their vision. You know, the one most common thing that I hear all the time from someone who's dying is I don't want to be a burden. I don't want to be a burden, means I'm not really going to voice all the things that are triggering me. I'm not going to voice all the things that, you know, I would like to have, because I already feel like I'm asking a lot of my loved ones while I'm in this process. So my job is to bridge the gap, you know, not only between the dying person and their loved ones, but also the medical side, which is hospice, which I think we're going to talk a little bit more about. But so there's a lot of different avenues you can take as a doula. You could be a doula that specializes in just the readiness factor, the, you know, the logistics, the paperwork, all of the things that you need to do to plan and prep. You could be a doula that is really focusing on, you know, what I do is I'm a huge advocate for Right to Die, so I help people navigate what their rights are legally and what their options are, you know, based on where they're at in their process and what's going on with them, and help them approach their loved ones in a way that fits their vision but also protects the relationships. That is my number one top priority as a doula is to protect the integrity of relationships.
Crystal Flores: [00:05:00] So I got into this work because I, like many people, was sort of catapulted into an end-of-life experience that I was not prepared for. My parents had just taken an early retirement, and they were starting the best years of their life, and they moved to the Oregon coast. Both my parents were nurses, so they were, you know, very aware of medical, they had medical awareness around their health and what was going on. But my mom got a brain tumor, and it was unexpected, and it was lymphatic. So after the surgery, they explained to us that because what was happening was lymphatic, it was just constantly regenerating. So basically, she came out of the surgery, and they gave her a six-week prognosis. And everything was, it was, you know, a big blur, like many people explain when they're in these moments, you're kind of filtering what you think you're hearing and what you're actually hearing.
Crystal Flores: [00:06:03] And so it was, it was a really difficult situation to be in. And my parents were very kindred spirits. They really didn't even go to the bathroom without each other, it was a little ridiculous. Growing up in this kind of household. But I do appreciate it now. But the first thing I thought is, oh, my God, I gotta teach my dad how to live without my mom because, I mean, there were only 63. So three weeks into my mom's diagnosis, I discovered my dad passed away in his bed. And he wasn't sick, and it was just, you know, it was traumatic. I'll just go ahead and throw that out there. It was traumatic. And like many families, we didn't talk about things like this. And so we didn't really even know how to acknowledge that my dad died. Then I had to go to my mom's hospital bed and tell her what happened. So that sort of threw me into this experience of, okay, here we go. You know, I took her home, we got her on hospice, and I was her 24/7 care support. And I wanted it that way, like many people do, that have a loved one that's dying. I was very protective of that six weeks. I didn't have any time with my dad to even process what was happening. And so we didn't really even talk about his death, which was really, it really set the stage for complicated grief for me because this traumatic death happened in the midst of I'm losing my mom. I've got three weeks left with her. I can't even process what's going on. So that was my experience. And when my mom died and I just remembered this surreal moment of when they took her body, and I was standing in her home, and it was just like crickets. Right? You know, like my dad was gone. My mom was gone. Hospice was gone. And I was just standing there thinking, who helps people like me in these moments? Because people were coming out of the woodwork to help. But when you are in something like that, you don't know what you need, so you can't really ask for help. I was at a place where I could probably not even spell my own name. So how can I tell you what I need? I was so grateful that people were coming out of the woodwork to offer help, but I didn't know how to ask for what I needed because I didn't know what I needed. I knew I hadn't had a shower in over a week, so I guess I could start there. But the reality is, we don't talk about this stuff, so we can't prepare, right?
Pam Dunwald: [00:08:39] Absolutely. And you know what? And I know we're going to get more into this conversation. But I just want to say one comment. What a special way to turn that grief and turn that trauma into something positive by wanting to reach out and help others that you know, that you've learned from your experience. And so what a way to turn that around. So kudos to you, Crystal.
Crystal Flores: [00:09:01] Thank you. I really look at my whole story that led me to this as the best gift my parents ever gave me. You know, at the time I didn't know it, but everything changed in my life after that, and I could not go back to living as I was, which was a fine life. I was living in San Francisco. I was working in corporate sales. I was making a lot of money. I was, you know, living the dream. But it was all empty. And when after that whole experience, which was six weeks to the day, none of that made sense to me. And so my whole goal from that moment on was if I can help one family not feel as lost as I was in those moments, then I have done my life's work.
Linda Kritikos: [00:09:45] That really leads into, you know, our next question. So what are some ways, how do you support individuals and families during this end-of-life journey? And what does your role look like in actual practice?
Crystal Flores: [00:09:57] Yeah. It's funny because when I started my business, I was working under a different name, and I had this whole different idea of what it was going to mean to be a doula. My idea was I was going to go work with hospice. And it was, you know, I had all these visions of we're going to do legacy projects, and we're going to hold hands and we're going to have all these meaningful moments together. But the reality is, my business has transformed so many times over the years. And I do hold hands, and we do have meaningful moments, but that is a small part of what I do, and the daily, you know, overall, you know, snapshot of what I do is really about helping a person create an experience that meets their vision for whatever meaningful could be. So, you know, meeting people where they're at, really actively hearing where they're at, and being able to create what it is for them that would be meaningful and sacred and comfortable and in a way that protects the relationships of their family members. So for me, that means I do a lot of coaching. I'm coaching people through what's coming next, what they can expect. When you normalize something, you take the fear out of it. And that is probably one of the greatest things that I can offer a family is, you know, and I was that person, too. I was in distress, I was nervous, I was anxious, I didn't want anybody to come into this space because I wanted this time with my mom. But in reality, when it all ended, I was looking back, realizing I missed out on so many moments because I was so preoccupied with what is the next med, what is the next appointment, what needs to be done? I need to clean her, I need to change her, I need... That's not dignified. You know, I don't, when I think about my end-of-life plan and my children, I don't want them changing me and cleaning me and doing all the things that I did for them as a mother. That's not dignified. But, you know, a person that's dying is already feeling super vulnerable. They're not really going to say, I don't want you to do that. You know, but I, looking back, I wish I would have had somebody so that I could really just do the one thing that meant the most, which was be present with my mom. So that's what I encourage families. I encourage them to if you have the financial means to get round-the-clock care. That's what I encourage, because that alleviates the stress of having to task. And when you do that, you can really be present with your dying person, and you have really meaningful moments to reflect back on, instead of what I have to look back on is I was so busy. I was so busy doing so many things 24/7, I can't tell you that I really sat at the bedside and just had moments with her until the very, very end. And that is, you know, I try to live without regret. I was doing the best I could and didn't know what I didn't know, but I know now. So when I can talk to families and sort of lay the groundwork, it's helpful because it allows them to sort of see it in real time, but also realize, oh, these are fleeting moments. I need to capture them while I can.
Linda Kritikos: [00:13:19] That's actually a very powerful statement. Crystal. Because I think people, those tasks that you talk about, I think that's a comfort zone for a lot of people because, you know, as growing up, that's, you know, our parents gave us chores. We were doing things to make people comfortable. We would feed people. We would care for them in those ways. And I think sometimes going back to that comfort zone because people don't know what they don't know, and they don't sometimes understand how they feel about these things, or can unpackage those feelings, that it makes it difficult for them to be engaged or be present because the task work is their comfort area.
Crystal Flores: [00:14:00] Oh for sure, that was 100% me and it's also wildly uncomfortable to feel all those feelings, right? So if you're distracted with busyness, you're not taking time to feel those feelings. Well guess what, they catch up with you.
Pam Dunwald: [00:14:14] Mhm mhm. So Crystal, what do you think are some of the common misconceptions about end-of-life care and dying well?
Crystal Flores: [00:14:21] Yeah. That's such a, that's a great question. And it's kind of a loaded one too because there, you know there's always going to be, you know, controversy about certain statements and certain things. And this whole dying well is one of those right now because not everybody has the opportunity to, quote unquote, die well, and I understand that. You know, what I do is really listening to somebody and hearing what's important to them and allowing them to speak their truth in a way that is not going to be offensive. I tell people, you know, the things that you are afraid to voice in front of your loved ones because you don't want to hurt their feelings or their expectations, you can say to me. And so one of the most common misconceptions is a death doula is there for just the fluffy stuff. You know, we do legacy projects, we hold hands, we, you know, these cute little moments. But the reality is, some of the most meaningful moments happen when it's just a one-on-one conversation, and I can give my client the allowance to say what's really on their heart, how they're really feeling honestly about this. Because there's a lot that we hold back from saying, because we don't, we don't want to compromise a relationship.
Crystal Flores: [00:15:43] We don't want to hurt anybody's feelings. We don't want to, we don't want someone to be disappointed if we're giving up, quote unquote, because they want us to keep fighting. And so there's a lot of misconceptions about doulas. But, you know, what it really comes down to is the doula is really the buffer and the bridge builder. So we're bridging the gap between a lot of other necessities and those gaps, those holes are where people sink. That was, that was me. And that is so many people that I meet with, that I've got so many stories of so many families that, you know, in some ways mirror my story. But every single person is different, and every single person's vision is different. And my job is to show up and hear what's on their heart and what's triggering to them. You know, what's important to them without a filter. And when you give someone the allowance to do that, it's a really beautiful moment. And it also creates a little clarity and acceptance for them too.
Pam Dunwald: [00:16:48] Crystal, and moving on to the next question, maybe what you can do, we were just going to ask how you helped prepare the family emotionally, spiritually, practically and talking about important conversations. Maybe. Can you maybe answer that? Or maybe, show that in an illustration with one of those stories if you could share?
Crystal Flores: [00:17:08] Oh, yeah, I can definitely do that. I live in Washington, and we're very progressive, liberal place to be, and we're very fortunate that we are a Right to Die state. But family dynamics are complicated. You know, mine was complicated and is complicated, and I have yet to meet a family that doesn't have some complicated dynamics. Most people that I meet with, they find their way to me because they are living through an illness of some kind that is a terminal existence, and it may not be considered, quote unquote, terminal at the time. So I'll just give you an example. A lot of my clients, a lot of clients that find their way to me are, they have dementia or they have MS, or they have something that wouldn't be considered, quote unquote, terminal from a hospice point of view. But they are living a terminal existence. So, you know, they have 24/7 care, they're being lifted out of a wheelchair and lifted into a bed and lifted into a shower. And somebody is dressing them and somebody is, you know, making sure they're fed. And it's, there's not a lot of agency in a life like this. And my clients have the bandwidth and the capacity to advocate for themselves, but they don't have agency over their body and what's happening. And so what I do with people is I help them get an understanding of what their rights are. I help them get an understanding of what their options are, and a lot of times that means they are either going to have a conversation with their loved ones, or they are going to step away and have closure with their loved ones before they start working with me.
Crystal Flores: [00:18:57] And that is the most common situation, because a person that is choosing to have full autonomy over their body and doing a choice to die, there might be family members that don't agree with that. And so I help them create a plan. I help them put the plan in place, and I help create, you know, we do, there's a lot of different avenues you can take to create a meaningful experience. But a lot of times what I'm doing is just helping to facilitate conversation. You know, there are some people in this family network that don't agree with the choice that I'm making, and at the same time, I love them. I want them to know that I love them, but I want them to respect my choice. And so my job becomes sometimes being a little bit of a mediator and letting people know, you know, I understand this is your person, and I know that you love them, and I know that they love you. And we need to respect what their choice is, whether we agree with it or not. And so that is something I bump up against quite a bit. And so what I encourage my dying person to do is to have a meaningful conversation with that person or persons in the family. And then we move into working together. So there's closure and there's conversation and acceptance before we start actively working together so that this person is going into their experience without feeling the burden of, well, what if so and so shows up, you know, which has happened. If they show up at the door because they want to try to talk me out of this decision, because they want to hold out for the next medical cure or a miracle or whatever the situation is.
Crystal Flores: [00:20:46] And so, you know, that is a really common situation that I'm in with people. Most of the time, their loved ones fully support them. Some of the time, they do not. And so facilitating conversations, creating a death plan, getting all the logistics in order. The Grateful Mess sort of came through this because, you know, one of the first things I say to people is your kids don't want your shit. They just don't. My kids don't want my shit either. And I think I have great stuff, I really do. I love my stuff. It's been curated over my life. Everything has a story. But, you know, that becomes a burden to loved ones is when we don't take care of things in advance. And now we've died. And now there's guilt attached to all of these items that my kids don't want anymore, but they don't feel like they can say no because it was mine. So I help sort of get in front of things like this so that when the person dies, the family can grieve and it can be healthy and it can be meaningful. So that was kind of a long-winded answer. But, you know.
Pam Dunwald: [00:21:53] Let's go on to the next question. I mean, that was very insightful and very informative. So how do you work with, you know, work alongside hospice and other care providers? You've explained to us how you work with the families and with the clients themselves, but how do you work with these other providers that are also involved in this individual's care?
Crystal Flores: [00:22:13] That's a great question. And what I'm going to do is sort of paint the picture of what that looks like for me because with, you know, it varies depending on the type of end-of-life scenario the client is having, really. So most of my clients are doing choice in dying. And so that looks very different than somebody who's having a natural end-of-life experience. Right? For me, what generally happens is I start working with a client four weeks to four months leading up to our quote unquote, day one, which that's most of my clients are VSED. So when I say day one, I'm saying first day of no eating and drinking. But hospice is, I'm usually the liaison between the client, the ones that are, you know, involved in their care. And I'm usually holding that conversation in advance. I'm letting the hospice know, okay, I have a VSED client that's going to be starting on February 1st. I've started working with them in November, and their day one is February 1st. So the hospice organization knows that this client is coming down the pipeline, and I am preparing them. So I have a protocol that I do with clients and I become the liaison conversation-wise. But I'm also sort of setting up the situation before it happened so that it's not, you know, hospice knows that this client is coming, and when a client that's doing VSED specifically has 24 hours of no eating and drinking, at that time, they become quote unquote, terminal. So that's when hospice can come in and do an intake interview. Until then, they're not involved. So they're not involved with the planning and the prepping. And, you know, the four weeks to four months leading up to the day, one, that's all me.
Crystal Flores: [00:24:05] But I'm always giving the hospice organization a heads up that I am working with this client. And this is where they're starting, when the intake interview happens, I'm always present for that. And it's usually that day that the hospice becomes or the client becomes a hospice patient. And when that happens, they are bringing obviously all of the medical necessity, the nurse visits, the med adjustments, the supplies, everything that hospice so beautifully does. And then I am providing the holistic support. I have a team and our team provides 24/7 bedside care. And that's sort of how we bridge that gap, because, kind of going back to my initial story, I didn't know how hospice worked, you know, until I was in these moments, I thought that they came and they were there and that I worked alongside with them. And that's just not how it is here. Our hospice teams are very, they're spread very thin, the nurses are very busy. They have a caseload. They have, you know, my client, but they also have four other clients or five other clients that day. And so they're checking in. We're in constant contact with each other. It's a really beautiful relationship, but it has been built over time. In the beginning, it was not like that. I had to learn how to have these relationships and how we would work together simultaneously and compliment each other. And I usually work with two hospice organizations specifically because they are non-faith-based hospice organizations, and those are generally the ones that support Right to Die a little more so than ones that are backed by faith-based.
Pam Dunwald: [00:25:53] Yeah, and Crystal, I think we're going to just swap a question here. We were going to talk about, you know, rituals, tools, resources. And we can include that in there. I'd like to jump into, since we already started the conversation, jump into could you explain what VSED is and what MAID is, and maybe talk about who can get that where, because that's something that in the Midwest here we haven't had a lot of experience. But you know, Linda said that they're just approving that in Illinois. So it is hitting closer to home. So if you can maybe take some time to explain what those two processes are.
Crystal Flores: [00:26:29] Yeah. So, you know, as I said in the beginning, my business has evolved several times over the years. And, this is not really what... I didn't seek doing mostly VSED support. It sort of just organically came my way. And then I realized there's a big need for this. And as my practice grew and my, you know, a lot of my business comes from word of mouth, it's sort of just evolved in that way. And it's really supporting people through refusing nourishment, which is legal in all 50 states. It's not encouraged and talked about in all 50 states, but it is your legal right to refuse nourishment when you have the capacity to do so. And so VSED is Voluntary Stop Eating and Drinking. And it is a plan that I have a protocol, and the protocol has been curated over the years by all the clients that I have served in this capacity. And so it's not, you know, one of the most common misconceptions about VSED is I could never do that, it's starving to death or oh, that's so easy I could easily stop eating.
Crystal Flores: [00:27:38] And neither one of those things are true. You know, VSED is a very dedicated journey. You have to really fully have an understanding of what it means. And the body can live a long, long time without food. We can't live a long, long time without water. And so it's more about a dehydration process than anything else. Nobody ever complains about being hungry after the first day. And the protocol that I have that I use with clients, we are going through a process where we're preparing the mind and the body for what's coming. So we do a tapering process, we do a cleanse, we do a lot of thoughtful work together. So it's not a shock to the system. When people say, oh, I could just easily do that on my own. That's not true either, because when you start to dehydrate, it messes with your brain chemistry. And when that happens, you aren't going to have the discipline to just not have water. And so, you know, I want to first also really drive home the point that we are not depriving anybody.
Pam Dunwald: [00:28:44] What types of situations are the type of clients that come to you that would like to do this VSED process?
Crystal Flores: [00:28:49] Yeah. So people typically find their way to me because they want an experience that is safe, that is comfortable, that is meaningful, and that also isn't going to drag out for a month or longer. And so the protocol that I have, we start working together pretty early on. And when they start their process, their quote unquote day one, they're generally going to pass between 7 and 9 days. And the thing is, the body is very smart, and the body knows how to hold on to any amount of fluid and to preserve that. And so what we are doing is we are really going through a thoughtful process of tapering and cleansing and preparing the body so that you have a new baseline. And when you create a new baseline, then the body is not going to go into an uncomfortable shock. And so, you know, I would never do a VSED client who was not willing to get on hospice because we need that partnership, because we need medication and we need guidance and we need medical attention, and we need to be able to adjust things as needed. And so there's a very real partnership between myself and what hospice brings to make this client comfortable.
Crystal Flores: [00:30:09] And, you know, that whole dehydration process, there are a lot of things that we put into as a care plan so that we know what comfort measures to offer a client so that they're not uncomfortable and they're not feeling like they're being deprived. And that is the number one thing that we go over and over and over daily. Is this the decision you still want to make? Yes. Okay. Do you understand that this is going to end your life? Yes. Here are some comfort measures that we have built together over the weeks and months that we've been planning and prepping, that we will offer when you are feeling thirsty. And to date, I have never had a client back out of their VSED process. There's a lot of, it's a very hard thing to wrap your head around, so getting to that place where you're facing your mortality and you're making a decision to hasten your death, getting to that point is probably the hardest part, honestly. And then with me and my team, we provide 24/7 guidance and support so that the client is never feeling like there's any unknown about what's happening.
Crystal Flores: [00:31:19] They're in complete control. They're in the driver's seat the whole time. And if they do have water in between, you know, then they do. We have a three ask policy we put into place. And so if a client asks for a drink, we offer them a comfort measure that they have established. If they still want a drink of water, we offer the second comfort measure that they have established in advance. And then the third time, we have another comfort measure, but we also kind of, we call that code red. And at that time, we have a video statement that they have made. We have a written statement that they have made. And these are basically conversations to the dying client from the dying client. So it is verbiage that they have put into place that resonates with them. And all of these things have been thoughtfully curated so that the client is feeling that they have full autonomy the entire time. And I mean, honestly, it's really been a beautiful experience to watch people be able to create a vision for themselves and their end-of-life experience that fits them and something that their loved ones can feel comfortable and find meaning into.
Pam Dunwald: [00:32:30] Crystal, could you just say what are some common types of clients that come to you that want to do this?
Crystal Flores: [00:32:36] Yeah, most of my clients are coming to me with a dementia diagnosis. And I want to just spend a moment there because not every client with dementia is a candidate for this. Somebody that gets a dementia diagnosis is, it's not legal for them to use medical aid in dying. That happens immediately. So they lose the option to do life-ending medication, and they have a short window of opportunity to make a decision to do VSED. And so what I tell people is if you get a dementia diagnosis and you know that you don't want to ride out that process, you have to get a plan in place, getting your advanced directive, having conversations, putting all this in writing so that in getting a surrogate, somebody that will establish the things that are most important to you, that would be a guidepost. So people will typically say something like, when I no longer know what to do with a fork, when I no longer can dress myself, when I can no longer toilet myself, when I don't recognize, or I'm struggling with names of the people I love, things like that. We sort of make a list and it's, I tell people that it's not, I don't advise that you get a loved one to be your surrogate, because it's really hard to receive information like this from someone that loves you and you love. You know, if I'm putting these things into place, it's because I'm not going to realize when I don't know what to do with the fork anymore, I'm going to need somebody to say, hey, you know, these are some of the things you've listed, and I'm noticing that you're struggling with these things. Who can you receive that information from and not feel offended or defensive? You know, it's usually not a family member. So there is a window of time that you can advocate for yourself, and that I could help you through this process. When that window of opportunity closes, there's not much more you can do at that point.
Linda Kritikos: [00:34:36] How can families find and choose someone like you? Choose a qualified end-of-life doula? And what kind of advice can you give a caregiver who is feeling overwhelmed or really uncertain about bringing you into this part of this individual's journey?
Crystal Flores: [00:34:53] Yeah, that's a great question. You know, if I had it my way, it would be as early as humanly possible, because what typically happens is, and this was my story, too, I can do this, I can do this, I can do this. And then we're in the thick of some of the hardest times, and you're realizing, I can't do this, or I need help, or I feel like I'm swimming upstream or I am... So I just don't know what to do or how to support my person. And it's hard for a doula to walk in in the middle of that and find their footing. Right? And so if I can even just have a conversation at the early time of the diagnosis, I can help put things into place so that there are parameters around this, so that okay, so let's say you get your dementia diagnosis. You know that, you know, you're living life as you have and you're still doing the things that you were doing, and you still have quality life. But we know this is a progressive disease. We know it's only going to go in one direction. So creating the framework around that in advance means you get to have some time to be able to be with the people you love without feeling the burden of, oh my gosh, I have so much to do, and I don't know when to do it because I don't want to invite death.
Crystal Flores: [00:36:11] And I think I've said this to you a few times, Pam, on a couple of other interviews, I tell people all the time, if we sit here and talk about sex, no one's getting pregnant. If we sit here and talk about death, no one's going to fall off their chair and die right now. So it's okay to talk about it. And that's the thing that I do the most with people that are feeling a little hopeless or a little overwhelmed. They know that they don't want to ride out the process, but they don't know what they can do. People usually find their way to me because they have either read Google reviews or it's word of mouth. They heard from somebody that someone that they know went through this process and it was meaningful, and it was comfortable, and they got to die on their own terms. That's typically how people find their way to me.
Linda Kritikos: [00:37:01] Would there be a story that you would like to share that might encapsulate, you know, a time that you've been able to help a family?
Crystal Flores: [00:37:10] I'll share my most recent client story because, that just finished with VSED because it was very heartwarming story. He was younger, early 60s. And he was diagnosed in 2021. And he was a real character. He was an actor. He was a director. He was a performer at heart. And his number one wish, the most important thing to him was he wanted to die as himself. He didn't want to die being somebody he didn't recognize. And that was starting to happen. He had full-time care. He was still mobile. He could walk around. He could go down to the dining and have dinner with his friends. And he had what we call chosen family present for him the whole time, he didn't have any of his blood family present, but he had built this friend family that they were all very close, to the point where they were all doing care roles when I stepped in, and they were taking care of everything from finances to medical care to just literally everything for him. And this was a huge relief for them to bring me in because it meant they could pass the baton and they could really enjoy their person the way they used to enjoy and laugh and talk about memories. And he knew exactly what he wanted and how he wanted it. And he was driven and motivated.
Crystal Flores: [00:38:49] And that's the one thing I will say about VSED is it's not for everybody. And you do need to be very resolute that this is not one of those I'm going to dip my toe in and see if I like it or not. You know, there's a reason why we've never had a client that hasn't finished. And that's because it takes a lot. It takes a lot emotionally. It takes a lot physically, mentally. And, you know, there's financial resources involved as well. So, you know, being able to create an experience that meets somebody's vision with the people that they choose is a big deal. And for this particular client, one thing I learned in the process, is he had seven very, very close friends, and I didn't realize till we were, you know, four days in that all of these friends were friends with him, but they were not necessarily friends with each other. So, and some of them were even past relationships, and wasn't aware of that either. So it did get a little messy. And that is, you know, some of those unknowns that I always have to prepare for because it happens. And so there were times that, you know, I had to be a little bit of a mediator or referee, but in the end, you know, he was such a joy.
Crystal Flores: [00:40:14] He was so silly and goofy and happy and just loved the life that he lived. And that is literally how he died. You know, he even in those really hard days, he was still making jokes. He was still finding humor. He was making his friends laugh. And that's how he died. And, you know, I say this a lot. We, you know, I help people, coach people how to die well, and they teach me how to live well. And that's such a beautiful gift in this whole thing. But for people like that client and so many others that I have supported, we really do die how we live. And that plays through my head every single day. And I'm not saying, you know, I like to clarify this because I'm not saying someone that dies of a very painful death, it's not that they deserve that. I'm not saying that. What I'm saying is there are so many personality traits that we bring to our end-of-life experience, and we don't realize that that's been curated over the life that we've lived. Right? And this guy was such an example of that because he lived his life being very giddy and happy and goofy and, you know, and that's literally how he died. And I see this often. And it's such a sobering reminder to me that being present is literally everything.
Linda Kritikos: [00:41:35] So, Crystal, where can listeners go to learn more about, you know, what you do, your company, The Grateful Death or VSED, what are some resources? And again, we will share these in the show notes, so you don't have to worry about writing these down. We will have those available for you.
Crystal Flores: [00:41:50] Yeah I would say, you know, start at my website, TheGratefulDeath.org. I like to emphasize the org, The Grateful Death dot org. And there's everything from resource links to also testimonials. It's, you know, when we look for something that we don't know about, reviews are important. We like to hear people's real-life experiences. So I've got Google reviews that talk about VSED and Medical Aid In Dying. Families that have been through this experience with someone that they love and they tell it from their side. So my website, also Google Reviews, social media, I'm on Instagram, The Grateful Death Seattle, and Facebook, and I try to share as much educational content as I can because that's really where the power is. If I would have had a little bit of education before going into my story, it would have been a lot more empowering, and I would have felt a lot more grounded, which would have allowed me to be a lot more present with my mom. But I didn't have those things, and I think we're very fortunate to be where we are now in this, you know, death and dying movement, because it is opening up dialogue. I mean, it's people like you that help people like me get out there so that people can find their way to me and know what their rights are and know how to die with agency. So thank you.
Linda Kritikos: [00:43:15] Crystal, thank you for sharing your wisdom and helping us bring more compassion and clarity to end-of-life care.
Crystal Flores: [00:43:22] Thank you for allowing me the time and the space to do this, because if it wasn't for people like you, we wouldn't be getting the word out there.
Pam Dunwald: [00:43:30] And it is so important. And so we're happy to share that. And so people, if you found today's episode meaningful, please, please share it with someone that you love. Subscribe, leave us a review, check the show notes for resources and Crystal's contact information. Remember, having these conversations early can make all the difference in the world.
Linda Kritikos: [00:43:50] So join us for our next episode, a special holiday edition coming December 29th. Until then, take care of yourself and your loved ones. Bye bye.