Boston Globe article affirming the importance of end-of-life dialogues with our healthcare professionals

Recently I read an article in the Boston Globe entitled Doctors want to talk about end-of-life care, but often don’t know how, survey finds. Below is a link to the article in case you are interested. This article reaffirms the ongoing need to continue to educate, and talk with, our healthcare professionals about tough situations like end-of-life care and our desires and wishes.

Blessings, Melody

Regrets? Hopefully not.

One of my dearest, long-time friends and former college roommates shared the following article with me over the holidays. It deals with end-of-life regrets. Hopefully the start of a New Year is a great time to reflect on these regrets and more importantly, how not to have them in our own lives.

Happy New Year and Happy Fullness of Living in 2014 and beyond,


Nurse reveals the top 5 regrets people make on their deathbed

By Sina Anvari | November 11, 2013

Nurse reveals the top 5 regrets people make on their deathbed

For many years I worked in palliative care. My patients were those who had gone home to die. Some incredibly special times were shared. I was with them for the last three to twelve weeks of their lives. People grow a lot when they are faced with their own mortality.

I learnt never to underestimate someone’s capacity for growth. Some changes were phenomenal. Each experienced a variety of emotions, as expected, denial, fear, anger, remorse, more denial and eventually acceptance. Every single patient found their peace before they departed though, every one of them.

When questioned about any regrets they had or anything they would do differently, common themes surfaced again and again. Here are the most common five:

1. I wish I’d had the courage to live a life true to myself, not the life others expected of me.
This was the most common regret of all. When people realize that their life is almost over and look back clearly on it, it is easy to see how many dreams have gone unfulfilled. Most people had not honored even a half of their dreams and had to die knowing that it was due to choices they had made, or not made.

It is very important to try and honor at least some of your dreams along the way. From the moment that you lose your health, it is too late. Health brings a freedom very few realize, until they no longer have it.

2. I wish I didn’t work so hard.
This came from every male patient that I nursed. They missed their children’s youth and their partner’s companionship. Women also spoke of this regret. But as most were from an older generation, many of the female patients had not been breadwinners. All of the men I nursed deeply regretted spending so much of their lives on the treadmill of a work existence.

By simplifying your lifestyle and making conscious choices along the way, it is possible to not need the income that you think you do. And by creating more space in your life, you become happier and more open to new opportunities, ones more suited to your new lifestyle.

3. I wish I’d had the courage to express my feelings.
Many people suppressed their feelings in order to keep peace with others. As a result, they settled for a mediocre existence and never became who they were truly capable of becoming. Many developed illnesses relating to the bitterness and resentment they carried as a result.

We cannot control the reactions of others. However, although people may initially react when you change the way you are by speaking honestly, in the end it raises the relationship to a whole new and healthier level. Either that or it releases the unhealthy relationship from your life. Either way; you win.

4. I wish I had stayed in touch with my friends.
Often they would not truly realize the full benefits of old friends until their dying weeks and it was not always possible to track them down. Many had become so caught up in their own lives that they had let golden friendships slip by over the years. There were many deep regrets about not giving friendships the time and effort that they deserved. Everyone misses their friends when they are dying.

It is common for anyone in a busy lifestyle to let friendships slip. But when you are faced with your approaching death, the physical details of life fall away. People do want to get their financial affairs in order if possible. But it is not money or status that holds the true importance for them. They want to get things in order more for the benefit of those they love. Usually though, they are too ill and weary to ever manage this task. It is all comes down to love and relationships in the end. That is all that remains in the final weeks, love and relationships.

5. I wish that I had let myself be happier.
This is a surprisingly common one. Many did not realize until the end that happiness is a choice. They had stayed stuck in old patterns and habits. The so-called ‘comfort’ of familiarity overflowed into their emotions, as well as their physical lives. Fear of change had them pretending to others, and to their selves, that they were content. When deep within, they longed to laugh properly and have silliness in their life again. When you are on your deathbed, what others think of you is a long way from your mind. How wonderful to be able to let go and smile again, long before you are dying.

Life is a choice. It is YOUR life. Choose consciously, choose wisely, choose honestly. Choose happiness

Nancy’s Resiliency

As mentioned before, I am a proud Hospice Austin volunteer. As such, I receive periodic words of inspiration from one of the many wonderful Hospice Austin staff members. Below is a recent one that I wanted to share, with permission. Enjoy – Melody

Resilience: Adaptability

When we are no longer able to change the situation,
We are challenged to change ourselves.
~Victor Frankl~

It is not the strongest of the species that survives,
Nor the most intelligent that survives.
It is the one that is most adaptable to change.
~Charles Darwin~

The biggest challenge was the frog. A few months after we married, my husband, Bill, and I embarked on an open-ended trip around the world beginning in Mexico and Central America. Prior to leaving we whittled our possessions down to whatever would fit in my mother’s attic or our two back packs. Once we left the United States we traveled by bus, train, bicycle, rickshaw, ox-cart, and even on the top of a few buses when there was no room inside. We stayed in the most basic hotels and we ate in the street markets. For a girl who grew up in the suburbs of Austin, I thought I was doing pretty well at adapting to our ever changing circumstances, locations, and accommodations. Until the frog, that is.

Several months into our travels, somewhere near the border of Mexico and Belize, we checked into a simple, two-story, cinder-block hotel in a dusty little town. Our room, although spare to the extreme, met our standard of clean floor, clean sheets, and clean bathroom. The ceiling fan worked and the windows opened, ensuring a cooling breeze. The sheets, whisper thin from use, were freshly washed. The bed, while small and hard, was nevertheless inviting after a long day of travel on a crowded, un-air-conditioned bus. And we had a private bathroom, often a luxury in international travel. With all my heart I was looking forward to a hot shower, a bite of supper, and a good night’s sleep. Grabbing my towel, I headed to the bathroom while my husband fell back onto the bed and closed his eyes.

The bright green line of mildew meandering from the shower head down the white tile to the floor should have been my first clue that things might not go according to plan. I turned on the faucet expecting a refreshing spray of water. Instead, the shower head sputtered, then gurgled, and finally released a slow, labored stream of cold water that followed the green line down the wall and across floor before lazily winding its way down the drain. No matter which way or how far I turned the spigot, the result was the same. No! I thought. This can’t be! I’m sweaty and grimy and tired. Is a hot shower too much to ask?!?
And that’s when I saw him; a large, warty frog sitting in the corner of the shower eyeing me defiantly. I stared back, equally defiant, feeling a tide of frustration wash over me. Suddenly the choice before me became crystal clear: I could either (a.) allow the frog to push me over the edge and throw the wall-eyed fit I was capable of, or (b.) take a deep breath and roll with it. Realizing that I simply did not have the energy needed for a respectable tantrum I went with “b.”

Hey Bill, I said, peaking around the corner at my snoozing spouse, guess what? He opened one eye. There’s no hot water OR water pressure, and there’s a frog in here.
Now he had both eyes opened.
I haven’t figured out how I’m going to take a shower in the first place, but I’m absolutely positive that it’s not going to involve this frog. For all our safety, would you mind re-locating him for me?
Bill yawned, pulled himself upright, and ambled to the bathroom. Leaning down he scooped up our visitor, Come here little buddy, he said, let’s find you another safe, cool place outside.

While he was gone I found an empty water bottle and, filling and emptying it over my tired self repeatedly, managed to get thoroughly washed and rinsed. And you know what? It was almost as refreshing as a long, hot shower…all right, it wasn’t even close. But it was oddly satisfying, nonetheless. Instead of falling apart because life didn’t go as planned, I found a way to adapt to a less-than-ideal situation, discovering an unexpected store of inner resources. And no one got hurt.

The ability to adapt to changing or unexpected circumstances is crucial, not only for our happiness and well-being, but sometimes even for our survival. The organizations and individuals who adapt to change quickly; who decide to deal with what is rather than hanging onto what should be, are the ones who thrive in the midst of chaos; who find their way through seemingly impossible situations; who discover new and sometimes better ways of doing things.

To Practice: Because of built-in survival mechanisms our brains are naturally wired to notice negative experiences more readily than positive ones. But in reality, we experience positive events with much greater frequency. One way to build greater resilience is to notice and appreciate the positive things that happen to you, even in the midst of the crummy ones. For the next week, write down three good things that happen to you each day.

Nancy Chester McCranie

Rev. Nancy Chester McCranie, M.Div.
Director of Volunteer and Bereavement Services
Hospice Austin
4107 Spicewood Springs Rd, Suite 100
Austin, TX 78759
P: (512) 342-4716

An inspiring note from Nancy …

The amazing Rev. Nancy McCraine from Hospice Austin sent the following, and it meant a lot to me. Perhaps it will to you as well. Here’s to more stillness in each of our lives … Melody

Doorways to the Soul:
Cultivating Stillness

If our outer world is a reflection of our inner world,
don’t you want to take time to weed and care for your inner garden?
~Renee Trudeau, Nurturing the Soul of Your Family~

I am deeply thankful for those moments in the early morning when I try to be quiet, to sit in the presence of the gentle and compassionate and unruffled One to try to share in or be given some of that divine serenity. If I do not spend a reasonable amount of time in meditation early in the morning, then I feel a physical discomfort — it is worse than having forgotten to brush my teeth! I would be completely rudderless and lost if I did not have these times with God.
~Desmond Tutu~

Peace. It does not mean to be in a place where there is no noise, trouble, or hard work. It means to be in the midst of those things and be calm in your heart.

Our family raises organic blueberries and in the early summer we have a “pick your own” berry business on our Bastrop County farm. From sun up to sun down for several weekends in June all kinds of wonderful people come to pick these delicious dark blue orbs. It is great fun to listen to families talking and laughing as they fill their buckets and to see children, their fingers and faces stained blue, experience the joy of the harvest. By the end of each day, however, we are usually spent: over-heated, sun scorched, dusty and tired. On one such evening, several years ago, I had just returned to the comfort of our air conditioned home when I heard my husband finish a phone conversation something like this… That sounds great! We’ll see y’all in a couple of hours. You’re more than welcome to stay the night!

Who was that? I said, in what I’m sure was a less-than-gracious tone.

Some people are riding their bikes from Austin and want to camp out on our place, he replied.

You’ve got to be kidding!?! I said, imagining myself entertaining four sweat stained strangers for dinner when all I wanted was a shower and sleep.

Reading my mind, he assured me that there was nothing I had to do. They just want to pop their tents, he said, and hang out on the farm, maybe pick a few berries in the morning.
Noticing that I was still scowling in his direction he asked me what was the matter. I said something about being hot and cranky and that I probably just needed to go wash my face. And with that, I excused myself to go and pout in our bedroom. As I was sitting there (arms crossed, mouth pinched) I asked myself what exactly WAS the matter. Peace and quiet! I thought, is that too much to ask?!? And then I heard a voice from within whisper, Nancy, all the peace and quiet you ever need is here in this moment. Peace and quiet doesn’t depend on what’s going on around you; it’s what’s happening inside you. If it’s stillness you seek, seek no longer. Simply go within and be still.

It was a realization that changed everything for me. I became more aware that I could intentionally cultivate stillness every day so that, no matter what I was doing or where I was doing it, I could quietly slip into a place of inner serenity and peace. Spending at least 10 minutes of meditation or prayer first thing in the morning and last thing at night is, for me, like placing a soft cushion around my day: the edges aren’t quite as sharp; my emotions aren’t quite as unruly; there is available to me greater equanimity, compassion, and humor to face whatever comes.

What are other ways to cultivate stillness? Keep in mind that there is no right or wrong way. For many, exercise is one way to stillness. As our bodies move through space our thoughts can begin to settle. Gardening is another way; listening to or making music; cooking; writing; building something. Whatever it is, keep it simple, make it meaningful for you, and keep a sense of humor about it. And give it time.

If you’re ready to experience lasting change in your life and tap into inner peace on a daily basis, develop and stick with a daily spiritual practice. A spiritual mentor once said to me, ‘Want to experience a little bit of peace? Meditate once a week. Want to experience a lot of peace? Meditate every day.’
~Renee Trudeau~

Rev. Nancy Chester McCranie, M.Div.
Director of Volunteer and Bereavement Services
Hospice Austin
4107 Spicewood Springs Rd, Suite 100
Austin, TX 78759
P: (512) 342-4716

World days

Today in my church, University United Methodist Church in Austin, Texas we celebrated World Communion Sunday.  Along those same lines, this coming Sunday, October 8, 2011, is World Hospice and Palliative Care Day

Seldom a week goes by that I don’t hear accolades about the role of hospice in end-of-life times.  For our family, hospice was and always will be a Godsend.  Perhaps the same is true for you.

Let us remember and celebrate all the tremendous hospice care professionals across our world as we look to World Hospice and Palliative Care Day.  In this organization’s web link, there is a tab to ‘tell your story’ which I hope you will consider given the power of stories to change peoples’ lives and give comfort to all by knowing we are not alone.


A referral for ‘Letting Go’

This past week on NPR’s Fresh Air with Terry Gross, I heard an outstanding interview on end-of-life issues with Dr. Atul Gawande.  Dr. Gawande also authored a recent piece in The New Yorker entitled “Letting Go“.

Check out these works.  They are wonderful, and will go a long way in advancing the much-needed death and dying conversation for all of us.

Happy reading, Melody

Health Care Reform – An Accurate Perspective on End-of-Life Care

Given all of the mis-information and escalated rhetoric about health care reform, especially as it relates to end-of-life healthcare issues, the National Hospice and Palliative Care Organization has provided us with an accurate and timely web-site link to stay abreast of this important issue currently being debated in Washington, DC and across the country.

Advance Directives On-Line

One of the most important components of what the late Rev. Charles Meyer refers to as The Good Death is to get our medical and legal affairs in order long before end-of-life is near.  Such a pro-active plan allows us to have our collective faculties around us when making decisions like what kind of medical care we prefer, who we want making decisions for us if we are incapable, where we want to die, etc.  Making such decisions is vitally important, yet seldom at the forefront of our minds.

In order to help us with this endeavor, the National Hospice and Palliative Care Organization’s Caring Connections, a leading provider of advance care planning information, and Google Health™ have joined together in a goal of increasing the access to and availability of advance care planning information and resources on line.  As J. Donald Shumacher, President and CEO of NHPCO, stated: “How can medical professionals honor your health care wishes and preferences if they don’t know what they are?  Advance directives are useless unless they are available during emergency health care situations.  Google Health will make these documents accessible on line and will eliminate a huge barrier of access during times of need.” 

Through this partnership, users of Google Health can access and download a free, state-specific advance directive and then store the scanned documents securely on line.  For more information on accessing this important resource, go to and create a count for yourself.  Then download and print the advance directive form for your particular state at

Best wishes on your planning.  Melody

Hospice Horizons International – A Look at Myanmar …

Wendy Bixby is the fabulous Volunteer Coordinator at Hospice Austin’s Christopher House.  She recently spent a month travelling in Myanmar, formerly known as Burma.  Myanmar is just west of China and is about the same size as our home state of Texas.  During her visit, Wendy was fortunate to visit six hospitals and one of two existing hospices.  She wrote about her visit to the hospice, called U Hla Tun Hospice (Cancer) Foundation, in a recent Volunteer Voice newsletter article for Hospice Austin, and I thought you might be interested.

Enjoy your vicarious expedition into the world of hospice care of Myanmar courtesy of Wendy.   

Hospice in Myanmar
“Our Duty is to Care – Care is to Share”

“Our Duty is to Care – Care is to Share” is the motto of U Hla Tun founder of U Hla Tun Hospice (Cancer) Foundation. Mr. Tun established this foundation in memory of his daughter Ruby who died of Leukemia in 1997. During Ruby’s illness Mr. Tun found a book on hospices and liked the concept. So what would have been Ruby’s inheritance became the seed money for the trust fund that this foundation is supported by as well as by donations from the community.  (

Most noticeable is the gentle nature and hospitality of the Myanmar people. I visited over a dozen cities, saw more than 100 pagodas and stayed at hotels, monasteries and local people’s homes. At every stop we were greeted with lovely smiles, a cold drink and a delicious snack. I was never hungry and very alert taking in all the similarities and differences between our culture and theirs whether the object was physical, emotional or spiritual. The people that I met have mastered making people feel welcome and comfortable and will go out of their way to get what you want if they think it will make you happy. You may find 3-4 generations living together in a small home. The culture is very social and we instantly became part of the family.

Burma (now called Myanmar) is located almost exactly on the other side of the globe from the U.S.  It is just west of China and is about the same size as Texas. This tropical land is rich in resources like fertile agricultural land, teak wood and priceless gems and metals. The richness of people’s hearts, patient, warmth and generosity, were of the most interest and inspiration to me. Ninety percent of the population is Buddhist and the inevitability of suffering and dying is easily accepted.

I visited six hospitals and one of two hospices. I went into the U Hla Tun hospice a 50 bed inpatient center in Mandalay established in 2003. Presently, all the patients have a diagnosis of cancer and the admission criteria are as follows:
I) A hospital discharge certificate, II) Status – terminally ill, poorest of the poor with no homes no dependents, III) Free from any infectious diseases and, IV) any race or religion or creed.  There are no costs or charges to the patient and the patient’s length of stay is unlimited, with some patients being there for 3 years. Burial costs and emotional support to the bereaved family is also included.  They use only paid staff, there are no volunteers.

We were told that the patients will often follow a schedule similar to that of the monastery, i.e. early morning prayer and chanting, breakfast, chores, meditation twice a day and they will also have guest monks come and lecture. I noticed photos of some musical and dance entertainment as well. People from the community will often offer meals to all patients and staff in addition to monetary donations.

When I walked in I was first struck by the openness and the large windows, then by the concrete, and then I saw the common grounds where patients could garden and landscape as they pleased. All my training on patient privacy was circling my mind as they took us to visit the patients and told us about their illnesses. They have no privacy laws it seems in Myanmar and at all the 6 hospitals that I visited it was the same. They would tell us, “It’s ok to take photos of the patients.”

We were taken to the chapel and our group sat and sincerely chanted a loving kindness prayer led by four Buddhist monks. It was here at the Mandalay Hospice that I really believed that my chanting made a difference. Whether it did physically I have no idea, but the people were touched by our intention and even more so seeing the “foreigners” offer this kindness.

Dame Dr. Cecily Saunders, founder of modern hospices has really shared this concept of loving care all over the world. From Myanmar to Texas I return glad that we have a volunteer program and very proud of the incredible volunteers we work with. I was overwhelmed with love when I returned to my work and I can’t really explain why. I do know that I love working with each one of you on our Hospice Austin team.