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Transcript:

This is David Abend, founder of The Bucket and your host for today’s conversation with Gabrielle Elise Jimenez. Gabby is a hospice nurse, nurse. Gabby is a hospice nurse and death doula, as well as the author of eight books that offer tools, tips, and wisdom on end of life caregiving.

She’s also a death and dying educator, speaker, blogger, and her Facebook page. The Hospice Heart has over 142,000 followers. In short, she’s a force in the end of life field, and I’m privileged to be talking with her today. Hi Gabby. Welcome to the podcast.

Gabby: David, it’s nice to have this time with you and to be here with you today. So thank you very much.

David: Well, thank you. I think it’s best to start with you giving us a little background on what you do and some details of the journey that you took to get here, because I think that’s very Bucky.

Gabby: Well, it was not an easy journey. I was always working in commercial real estate and safety and just kind of sitting in a place that felt comfortable and that was going to be the rest of my life. And I was okay with that. And then my friend John got sick and his wife asked me if I could come and help take care of him while I was in between projects. And so I said, yes, of course, because he was very special to me.

And so I spent several days with him and, and longer, maybe a couple weeks, I can’t even remember now. I just remember watching him decline. I slept in the twin bed next to his twin bed. I helped with feeding and bathing and I helped him get out of the bed and walk across the room. And I watched this man who was so strong and so vibrant and had so much going on in his life that was amazing.

And to see this was very hard for me, and it was not something I had experienced before. Despite how many people I have witnessed die in my own family. And I remember sitting with him thinking. This is what it’s like to decline. This is what it’s like to die. And I kind of like had to sit with that for a bit.

And then his hospice team came in and they were lovely and they cared for him so well, and I thought, I think this is what I need to do. So at around 47, I went to school to be a caregiver changed my whole life and financially, especially because I was making a quarter of what I was making before. But I knew I wanted to do it, and I started taking care of the elderly.

I had a couple that I really loved and I spent a lot of time with both of them, and I watched them decline. I watched one of them die and I knew that I needed to do more. And what I witnessed with them was how society, the medical profession, people in general, treat the elderly. They treat them like they’re old, like they don’t have a voice, like they don’t have a choice or decisions or independence, and that’s all taken from them, and I couldn’t handle that. It was really difficult for me. So I went back to school again to be a hospice nurse specifically because I wanted to change the way people are cared for when they age and then when they die. Now, one of the things that I shared in my first book, Soft Landing, was that I didn’t graduate high school.

I went from about my sophomore year to grownup life really quickly. I needed my diploma in order to start nursing school. So I had to go back to a program to get taught tutored to do the GED, which was really hard. So in one week I graduated high school and started college, and it was hard and a lot of things happened.

I was the oldest one in the class. I was surrounded by 20-somethings whose college tuition was paid for, and I got a loan for my schooling. I failed at the end, one of the modules and had to go back and do the last module over again. I was diagnosed with Dyslexia halfway through the program, which actually explained why I did so poorly in school in general.

Everything that you could imagine that was an obstacle got in my path. And I remember going through the whole thing and hearing my dad’s voice when I was younger. “You will never amount to anything, you will never do anything worth you. All you’re good at is remembering your friend’s phone numbers and their birth dates.”

I walked across that stage when I graduated nursing school and I just looked up and I said, you’re wrong, dad. I’m smart and I’m going to do big things.

David: I just got the chills when you said that.

Gabby: It makes me tear up every time because if only he knew then what I would’ve accomplished now. He died when I was in my late twenties, and so I didn’t get a chance to show him what I was capable. But I was proud of myself in a way that I never had before, and I knew then that I wasn’t going to let anyone tell me I wasn’t worth something.

So I became a nurse, a hospice nurse specifically, which they don’t teach in nursing school. So I had to learn and I learned from some amazing people, doctors and social workers and chaplains and caregivers, and everybody who’s wrapped around the hospice team. And I learned how to be present for people who are dying, how to show up, what it means to hold space, all the things that us in this field say often.

And also I learned the fragility of life, and I had to face some of my own demons and bad choices thinking about all the time I wasted, you know, disconnect with family and friends, things that I could have done differently, and experiencing that feeling of wishing I hadn’t wasted so much time.

And so once I started working as a hospice nurse I learned about the different patients and the different cultures and their different faith and their different backgrounds and their family relationships — and all of that made me want to do more and do better. And so I’ve just continued to educate myself, both scholastically as well as with the people that I get to sit with and do this work in such a way that maybe I might have something to do with helping to improve the way people are cared for when they die, but also when they grieve.

David: Yeah, because you aren’t just helping people who are in decline. You’re helping people help people who are in decline, which is, you’ve taken it to another level.

Gabby: I educate people to be caregivers. One of the things I first learned when I was at nursing school is that it takes a village. I had to learn how to not walk in and think I sort of had some sort of Midas touch to make everything better. I realized quickly, actually, was that I needed to do was hand everyone the tools so they can do it. I learned that this isn’t about me, and my role is not to make magic happen. My role is to give as much tools and education to people so they can do this work.

David: So obviously you’ve been talking a lot about end of life and people who have talked to me about The Bucket, they’ve all heard me say that The Bucket is not about end of life. That’s not what we’re about. So. The question, someone might be thinking is why are you guys talking? What’s this got to do with The Bucket? And when we first connected a couple years ago after The Bucket launched we’ve always been looking for ways that we can collaborate and how we can work together given that we’re at different ends in some ways. You did write an essay for The Bucket called The End of the Exhale about Covid, which I encourage everybody to read. But your focus is on the end of life. And our focus is beforehand — things you can do so that when you reach the end of life you don’t have any death-bed regrets or as we call them, DBRs.

And that’s when we realized, when we were talking about this, where we do overlap because you see a lot of deathbed regrets in your line of work and at a time in a person’s life where it’s often too late to do anything about it. Is that fair?

Gabby: That’s very fair. You know, when I’m sitting at the bedside, what I hear from people is never, I’m so glad I worked so much. What they say is I wish I had more conversations with the people I love. I wish I tried all the things I dreamed about. I wish I had traveled the places I talked about. I wish I had done this or said this. And so what I witnessed at the end of life is people regretting not living their life.

So I think that what I do and what you do is very well connected because if people did more of what you put out into this world, perhaps they would have less regret at the time that they die.

David: We’ve always been using mortality as a leverage point. This idea about thinking ahead and thinking about your own mortality, how many years you have left on this planet. It could be that kick in the ass that gets you to make a change to avoid that DBR instead of just putting your head in the sand and doing nothing. And I love finding evidence that this is true. And so when you told me about one of your classes “The Best Three Months” I thought that this could offer some of those proof points. Why don’t you talk about what “The Best Three Months” is about and why people take it.

Gabby: So it’s evolved over the years. When I was going through my doula program, one of the things that we received at the graduation of that was this template for The Best Three Months class. I didn’t make up the name, it’s their name, and what I did was I took the template and I turned it into something my own over the last few years. It started out as sort of a class to plan your last three months or how if you only had three months left to live, what would that look like?

Well, what I did was I did that same idea. I’ve changed it significantly. But now what it is is a class that’s seven weeks long, and I have people who take this class of all walks of life. I’ve had, almost every class has a terminal patient, a person caring for a terminal patient, someone who is getting older and just wants to plan for their life. Some people who want to help others do this work — so it’s all over the board. The class that I am holding now, what it has evolved to, is that for seven weeks each week I talk about a, a time of life. Like how you want to be cared for, what you want, what you need, what’s most important to you.

And we go through this each week and I give these assignments that do two things. One, they give them something to add to their plan of care, their end of life plan of care. I always have them start out with a folder. In this folder each week you’re going to add something to it. So I’ll give the first one out.

I won’t tell you the others. The very first assignment that I have them do is to go out for a walk and gather some supplies and sit with it. And by supplies I mean rocks, leaves, feathers. You know, anything that nature Mother Nature has gifted us, right? That’s on the ground. You don’t pick anything, you don’t steal from the neighbors.

You just get these beautiful things that Mother Nature has gifted. And while you’re on this walk, you think about your life. Where are you right now? Where do you want to be? What could you change? If you could, what do you want to do? What matters most to you? And then you sit with these items and you make a mandala.

As you’re making this mandala, you start with the outside going in because your piece in the center, that’s your intention. That’s what you set for your life. It’s not like a New Year’s resolution. It truly is about an intention of making changes in your life. So if you only had three months left to live, you would do it in such a way that you left without regret if possible, right?

So each week I give them an assignment. Part of it is to fill their folder of all the things that they want. You know, maybe one of them is also a musical playlist. What do you want to hear when you’re done? But also, I want to know what you thought about when you were creating this playlist. For me, music is the diary of my life.

I go back to, you know, my life. My mom used to work for Joan Baez, and my dad followed the Grateful Dead around. My music started at a very early age. Music was huge in my family, and huge in my life. When I made my admittedly 12 hour playlist, it took me back in time. It took me to my favorite memories, to my firsts of all kinds of things, to things that made me feel good.

It reminded me of who I was, who I wanted to be back then, and the differences between that and where I am now. And so that’s, the whole class is based on that. I get you to think about your life currently, and I get you to think about how you’d like it to be. What does that look like for you? But also to think about things that you want to let go of.

There’s two rituals that I do that helps people let go some stuff so they don’t carry it with them. And at the end of the class, you will have a folder that you can hand to the people that you love that says, this is how I want to be cared for when I die.

David: So it, at first blush, it seems like, okay, this is a very practical class. You know, if you want to do your advanced directive or healthcare proxy or get the, uh, get your affairs in order kind of thing. But really what it seems to have evolved into is much more of a philosophy. By thinking about having three months to live it could change how the rest you live the rest of your life.

Gabby: Absolutely.

David: You were nice enough to connect me with a few people who have taken this class and I found that this was definitely the case. For example, Linda, one of your students told me that after taking your class, she made a promise to herself that she would no longer quote unquote miss stuff.

And then after her father died, she came back home. Her husband met her at the airport and she just said to him, we’re moving back to the Midwest. And that’s where her family was from. And she wasn’t going to miss stuff. And when I asked her if your class was a factor of that decision, she said that “it opened my eyes and my heart to choices that I didn’t even think I could have.”

Gabby: Wow. Thank you for sharing that with me.

David: Isn’t that great? That’s what I was talking earlier about, that evidence, those proof points about thinking about the last three months can change now. Others who talked to me about your class had similar revelations. Is this the kind of result that you had anticipated when you first came up with the idea or was this an unexpected outcome?

Gabby: It was an unexpected outcome because after each class. After each seven weeks, since they have all left and I’ve started a new one. I changed it up a bit because I realized something different in each time that I wanted to add to this. Where it is now is, is what we’re talking about. It’s this beautiful place of getting people to find a way to savor their life a little more intensely. Maybe have some childlike enthusiasm about what lays ahead. Knowing that you can make changes, you can go in different directions. You are never too old to do something new, and I think people get stuck, right? It, it’s about being stuck in life and, and this class sort of elevates their, their dreams and wishes in such a way that can make them reality.

This class has become really beautiful at the end of the seven weeks. No one wants it to end and I just, most beautiful messages from them.

David: That’s great. Another person I talked to was Leah and she told me about this moment when she realized that the class wasn’t just about the last three months, and she told me, “I remember recognizing very quickly that she’s meaning you, she, that she’s talking about being present like right now, and she kind of guides us through this practice of recognizing what your regrets might be in the future in order to help you fix or heal them right now.”

Gabby: Wow. Oh, that’s all of this just makes me so happy to hear.

So one of the assignments is kind of about facing the difficult things. The things that you have held onto that really serves no purpose, but you’ve gotten so used to it that you’ve just sort of walked along the rest of your life with it right by your side. And what I did was I gave them permission to put it aside and say, “you’re not welcome here anymore.” And what does that feel like?

It’s so deep and heavy, it’s the heaviest assignment in the class, and they have a hard time with it, admittedly, but they also come out of it saying, why did I hold onto that so long? And the truth of the matter, David, is that this is me. All of these things that I’m teaching in the class are all the things that I had to learn for myself.

I’ve spent my whole life holding onto regret, being a victim, you know, I wasn’t treated well when I was younger. This happened to me and that’s why I’m this way. And then one day I realized, and it was after doing the work that I do, that it’s my choice to stay. It’s my choice to continue on this same path.

I didn’t want to do it anymore. And once I made changes, once I let go of that stuff, that icky, just heavy, uncomfortable stuff, things changed in my life and I really wanted to create an environment that I can help others go through that same thing before it’s too late.

David: What stops people? What stopped you? It’s always like somebody who’s done it says, it’s the best thing I’ve ever done, but it’s hard. And so what do you hear when people say it’s hard and how can you get them over that hump?

Gabby: Well, we get comfortable. It’s like being in a bad relationship. You know, I did that as well. I was in a very long 14 year relationship with someone who didn’t treat me as well as I know I deserve. And I wanted out, but I didn’t know how to do it. I didn’t see myself, and this is a little embarrassing, but it’s my truth. I didn’t see myself as worthy of better. So did he treat me poorly? Yes, but I allowed it. What I had to realize was that I’m the maker of my own magic. I am the one that makes the changes.

People get comfortable. They get comfortable in their job, they get comfortable in their relationships, they get comfortable in their life, always dreaming. You know, the 11-11 shows up on your phone and they make a wish, right? Oh, I wish my life was different. I wish for this. And then they go back into their life and wait for the next time the phone shows up and it says 11-11. I think to myself, what if we didn’t use the phone as our igniter, right? What if we just said, I’m done. I’m going to live my life differently. I did that. I made so many changes in my life and it wasn’t easy, and I didn’t suddenly make lots of money. I mean, it wasn’t like any of that.

I had to work really hard, but now I’m in a place where I am exactly where I’m supposed to be. I am happy with who I am and what I bring into this life. I made enough significant changes so that if I was to die in three months, I would be, yeah, I lived a good life. And I also think about my legacy. What will be my story? What will my grandchildren say about me? I want them to say, my nana did this. You know, my mom did this, and that matters to me. I want to live a life fully because I know it’s the only chance I’m going to get at it, and I don’t want to waste a second of it. I’m done with wasting time on stuff that doesn’t have any significance or true place in my life.

David: That’s so inspiring, Gabby, it’s hard to segue out of that. If we could go back for a second to what Leah said about, she realized, wait a second — this isn’t just about the last three months. Is there an “aha” moment that you see from people when taking the class of what Leah went through and is there any particular time that it happens?

Gabby: Yeah, it’s about halfway through with that one assignment that I told you about where they have to kind of face something. But before I give the assignment, I share a story of my past that was very difficult. I’m very transparent, which I am anyway. I mean, you’ve read my stuff. I’m very transparent.

In this class, I share something that was really, really hard for me and I said, this was my life and this was difficult. And not only did I need to let it go, but I needed to send some forgiveness to those who caused the harm. Not in hopes that they would suddenly magically make things better or condone them for what they did, but to say, this is your weight to carry, not mine.

So what I did was I give them an assignment that has them face a very difficult time, something we all have, something that you wish you could have done differently. Something that was horribly done to you. Something so deep and dark that you’ve tucked it so far out and you have to get a pitch fork to get it out.

And it’s super hard and people cry and they write to me and say, this was the hardest assignment I’ve ever done. And then after. And it’s all in writing. They aren’t allowed to type it or, you know, put it on in the computer. They have to write it with a pen or a pencil. They so they don’t have backspace and delete to, to change it.

They have to really go with their emotions and then we set it on fire and we burn it to ash and say goodbye to it. And there is such a sense of release and all of a sudden there’s this awareness of, what have I been holding that in for so long for? Why did I do that? And, and that’s probably my favorite part of the class because from there on, they’re in with both feet.

They’re like, what else you got? Bring it Gabby. What else you got? We want to do this.

David: That’s great. Another thing I heard from people who took your class is, and this was a little bit of a surprise, that it’s not just for old people, quote unquote. In fact, she said, “it brings us all to a much deeper place. I would love my kids to take it and they’re in their forties. I mean, it really might help them make some major changes in decisions.” Have you noticed any difference in what a younger person gets out of the class versus an older person?

Gabby: So you’d be surprised the younger ones I’ve had as young as 20 and as old as 98. I have watched people come in who are — it’s the terminal patients that teach the others so much that the terminal people who take the class, because they really do have a very short amount of time. What I found with the younger ones is that they have so much hidden wisdom.

You know, they’re sponges, right? They soak all this up and they don’t have years and years worth of negative stuff to cloud their vision. They still have vision. And I think that the “aha” moments are as powerful for the 20-year- olds as the 97-year-olds. And then I watch what happens with each other because you know, like in my two classes ago, we had a person who was dying. And her sister and her caregiver were both there at the class. They wanted to learn some, some skills to help her plan their end of life. And they, they took it all together. Well, she died on the day of the last class, and they came to the class to show up. They came to let us know.

I watched the faces on everyone in the room, and I could see that in that short amount of time of seven weeks, relationships had formed, a compassion for one another had formed, and they all felt this realization that life was ending. And we sat for a moment and did this moment of peace and I watched all their faces as we honored this person who had died and it was equal. It wasn’t about age or money or anything that they’d done in their life. It wasn’t about that. It was simply about being human and being present and right this moment. And that’s what this class does. It brings complete strangers together, each going through something different, reminding at the end of the day that we’re all human.

David: Oh, that’s powerful. That’s very powerful. And do you think that at that moment, obviously they’re thinking about their relative, but is there introspection in terms of their own life and, and uh, what they’re doing with it?

Gabby: Yes. Always. I think many people want to do more. Um, they want to help their community. I find a lot of people want to actually give back. There are people who do want to change their lives. They want to, you know, change their jobs, change their relationships, but mostly I think that all of them want to be proud of themselves and maybe evolve as, as human beings and, and maybe stop holding themselves back.

There’s a significant change. I watch them shift just about the second to last class where they start sharing more and talking more and more, far more open with how they’re feeling. You kind of see these layers peel during each week. I had one person who, and I think she was probably 65-ish. She didn’t talk the entire class.

She would not speak out. She didn’t share anything. And that’s allowed, you don’t have to. But on the very last class, she took about 20 minutes to share everything this class had done for her. And we all just sat like this, just leaned forward and listened. Because what we realized was that everyone going through it was going through exactly what she experienced.

And they were like, yes, yes. And they were high fiving and clapping and saying, yes. That’s how I feel too. So, you know, we do this differently. We process things differently, but the end result was, was pretty equal across the board.

David: That’s cool. Now, those stories, that evidence that I was talking about, I gave you a couple from the, the people I talked to, but are there others, other examples that you’ve been given by people who have taken the class about how it changed the way they were living?

Gabby: I think it’s not so much about how they were living, but how they saw themselves in their own life and the difference they wanted to make. I bring up my grandchildren a lot because I really want to be a role model for them. I want them to strive to do good and beautiful work. And I think a lot of people in my classes go to that place as well.

About their children and maybe their grandchildren and the legacy they want to live. So I think it’s more about how they see themselves and, and their contribution and giving themselves more credit and seeing their worth and knowing that they are valuable in so many ways. I think a lot of people look in the mirror and they see years worth of perhaps how they were treated or talked to. That’s their guide and motivator in this class. I often see that shift.

David: That’s really cool because I admit, I’ve been thinking of this as an action that somebody gets this awareness and they change let’s just say their job or they change something. And that is how they eliminate a deathbed regret.

But what you’re talking about is deeper in the sense that — I shouldn’t say it’s deeper, but it’s different in the sense that their life changed by thinking differently and that that can lead to the same result of eliminating a deathbed regret because of that coming to peace with it.

Gabby: Absolutely. I think that you could be in a job, for instance, right, and think, gosh, I want to change my job. I’m a secretary and I want to be a manager. I mean, you know, whatever you are, you want to work here, I want to do this. I think change has to come from inside and you have to peel the layers of, of the things that have maybe scarred or blocked your way.

And so change can’t just happen because you make a choice change. You know, you can want to take a new job, but what would it take to do that? And that’s one of the things that I do in the class is I see your current life right now. Now what is your vision for your future life? If you could change it, what does that look like? But here’s what I want to ask you.

What steps would it take to get there? If you could dream, we could talk about our end of life plan, right? Where do you want to die, for instance, which is one of the questions. My answer is always this. I want to be by the ocean. I want to see the ocean. I want to smell it. I want to hear it. Well, I’m in a, a tiny little apartment out on a busy street.

What would it take for me to get from my tiny little apartment to the beach? You can’t just wish things into happening. You have to do the steps. So what would it take? So it has to come from within. You have to make a commitment that you want to stop living your life the way you are now to be able to strive for bigger and better.

And that doesn’t mean financially necessarily, or a better relationship. It means a better version of yourself. And if you can do that, pretty much anything is possible. Yeah. But it starts from within.

David: That is great. Well, I’ve done a lot of the question asking which is fine, but is there anything I didn’t ask you about this whole idea of preventing DBRs, this idea of changing your life that you wanted to ask me or that you wanted to add?

Gabby: Well, you know, I could talk about this forever. I think that because of the work I do, you know, I see last breaths all the time, so many last breaths, so many ends of a life, so many goodbyes, so many tears. And all of that has really resonated deeply with me. And I think what I see, we call it a deathbed regret. But what it really comes down to is not so much I wish I traveled more, I wish I did this. You know what it’s about conversations. I wish I talked to my partner more. I wish I listened better. I wish I had heard what they said. You know, I wish we didn’t fight so much. There’s a lot of emotional baggage that people carry, which is more on the weight of the regret list than places they wanted to travel to. Of course we all want to travel. I want to do more traveling. And I have set that in motion. But I think that what I see and what I want to help people work through is maybe being, like I said just a minute ago, about being a better version of yourself and what does that look like?

And it’s about owning your stuff like saying, you know what? I screwed up. I’m sorry. And getting past that. It’s about saying your truths and being comfortable with that. I think to, to avoid death-bed regrets. You have to make peace with your life the way it is. And if that’s what you’ve done and this is good enough, then good for you. But if it’s not, then that’s when you need to really kind of do some self-evaluation and think about what you could do differently and what that looks like. And hopefully you have a whole lot more than three months left to live. But having it that soon, right. Putting that, that, that timeframe on it. Three months is not very long. I see a lot of people with less than three months left to live. And the thing they would do differently is live their life with a little bit more playfulness, honest, trust, and stop caring so much weight of the past they have no control over.

David: Well, that’s a, a wonderful way to come to a close. I just want to thank you so much for having this conversation and I encourage people to also read the article in The Bucket, which goes into more depth with some of the people I talked to that took your class. So definitely read that. And Gabby, if people want to find out more about the Hospice Heart and your books and classes, where can they find that?

Gabby: Everything is on my website, which is the hospiceheart.net. It has classes, it has blogs, it has other podcasts that I’ve done. It also has links to my books. And it also has the link to the Facebook community, which is a beautiful community.

David: It is an amazing community. It is the amount of work that you put into that in terms of there’s always something new. And it’s not just putting it out there to see the response that it gets. And I know this is important to you, but you are making a huge difference to so many people, because it isn’t just putting out stuff and one or two likes. This is so much interaction and so much conversation to what you were talking about before.

So I encourage everybody to go visit the Hospice Heart on Facebook.

Gabby: Thank you for saying that.

David: Well, thank you so much for talking with me today. I’m really excited that we’ve found a way to connect our causes in a way that can help people now and later. And I strongly encourage people to learn more about what you do and how you do it.

So thank you so much.

Gabby: Thank you, David