In Conversation with an End-of-Life Specialist

pmsears-us

What if talking about death could change how you live? - In Conversation with End-of-Life Specialists brings honest, deeply human conversations with physicians, doulas, grief specialists, hospice nurses, attorneys, and chaplains — exploring Medical Aid in Dying (MAID), green burial, dementia care, digital legacy, and more. - These aren't morbid discussions. They're practical wisdom about what truly matters — for caregivers, professionals, and anyone who wants to live more intentionally. - Because the best time to talk about the end of life is while you're still living it.

Episodes

  1. May 26

    The Last Lesson: A Conversation with Dr. Ken Gorczyca

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

    49 min
  2. Apr 16

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

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

    56 min
  3. Mar 20

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

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

    54 min
  4. Feb 19

    Dealing the Cards on Death: How Lisa Pahl Is Getting Families to Have the Conversations That Matter

    What if talking about death could actually be fun?  Lisa Pahl, licensed clinical social worker, hospice veteran of 18 years, and CEO and co-founder of The Death Deck, believes that humor and the right questions can open doors that fear keeps shut. In this conversation, Lisa shares how a friendship forged through loss led her and co-founder Lori to create a suite of conversation tools — The Death Deck and The End of Life Deck. Lisa collaborated with Compassion & Choices to create the brand new Dementia Deck. All 3 decks are designed to help families have the conversations they keep putting off.  Whether it's what to do with your passwords, who's taking the dog, or how you'd want to show up for loved ones after you're gone, these cards meet people exactly where they are. Patricia and Lisa explore the surprising power of humor and silence in end-of-life work, what families argue about most at the bedside, why your partner might not be the best choice for your healthcare proxy, and the critical — often unknown — decisional moments that shape how we die with dementia. This episode is both practical and deeply human. You'll come away with a new appreciation for why starting the conversation now, before a crisis forces the issue, is one of the most loving things you can do for the people you'll someday leave behind. You'll hear about: The story behind The Death Deck and how grief sparked its creation, why dementia tops the list of what people fear most, what families don't know they can choose when a loved one has dementia, how to think carefully about your healthcare proxy, and what it means to truly honor someone's wishes when the pressure is on. Find the decks: thedeathdeck.com About the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, UVM-certified End-of-Life Doula and founder of Graceful Transitions in Vermont's Northeast Kingdom. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers. Join the Graceful Lifers community at Substack for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds.

    1 hr
  5. Jan 22

    When Loss Isn't Death: Jenny Filush-Glaze on Validating Every Kind of Grief

    Grief counselor Jenny Filush-Glaze joins us to discuss the losses that don't come with funerals but hurt just as deeply — from chronic illness to broken relationships. After her own alpha-gal syndrome diagnosis, Jenny brings both clinical expertise and lived experience to conversations about youth grief, permission to feel, and why "at least no one died" is one of the most damaging things we can say. With 15 years in hospice care and current work as a school-based therapist, Jenny shares insights on how children actually grieve versus how adults think they should, why we rank grief (and what that costs us), and how to create spaces where all feelings are valid. Her journey from treating ambiguous loss to living it offers rare perspective on navigating life-altering change. Whether you're supporting someone through loss or navigating your own grief, this conversation provides both validation and practical guidance for honoring every kind of loss. CONNECT WITH TRISH (aka Patricia M Sears): All links: ⁠linktr.ee/pmsears⁠Graceful Lifers: ⁠patriciamsears.substack.com⁠LinkedIn: ⁠The Threshold newsletter⁠CONNECT WITH JENNY: Books on Amazon: "⁠Grief and Alpha Gal: The Mind and Body Connection⁠" & "⁠Grief Talks 2⁠"Facebook: ⁠Alpha-Gal Grief GirlAbout the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, UVM-certified End-of-Life Doula and founder of Graceful Transitions in Vermont's Northeast Kingdom. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers. Join the Graceful Lifers community at Substack for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds.

    55 min
  6. 11/20/2025

    Why No One Talks About Dementia Caregiver Burnout

    In this National Hospice Month episode, the Second Season's first episode, host Patricia M Sears of Graceful Transitions speaks with Lori Rizzo, a certified end-of-life doula and dementia practitioner from Compassionate Crossings, about the urgent need to reduce stigma around dementia and transform how we support families navigating this journey.  With nearly 7 million Americans living with dementia and 12 million providing unpaid care—often quietly and exhausted—Lori shares practical guidance on early conversations, person-centered care approaches, and how communities can step up to support the "circle of care" surrounding someone with dementia.  From understanding the importance of getting tested early to learning how to visit a loved one with dementia, this conversation offers hope and actionable tools for families facing one of healthcare's most isolating challenges.  Whether you're planning ahead, supporting aging parents, or helping a loved one through this transition, this episode provides the compassionate framework to talk about dementia the way we talk about heart disease or diabetes—openly, without shame, and with dignity. Resources that Lori mentioned in our conversation and others she's sharing: Dementia Minds - ⁠https://dementiaminds.org/⁠ Support groups are for persons living with dementia or mild cognitive impairment (MCI).Training and tips for caregivers:  Positive Approach to Care (Teepa Snow) ⁠https://teepasnow.com/⁠ Caregiver training ⁠Free videos on Youtube https://www.youtube.com/channel/UCSXrEX7LkWOmfTaV6u1C7wQ'⁠Adria Thompson - ⁠https://www.belightcare.com/⁠ Speech Pathologist.Offers a ton of short videos and more! Follow on Facebook, Instagram, and YouTubeCaregiver Resources  Daughterhood offers a free, virtual dementia support group, “Circles,” that empowers family caregivers with emotional and practical support throughout the caregiving journey.⁠https://daughterhood.org/⁠GUIDE (Guiding an Improved Dementia Experience) Model - Medicare coverage for a comprehensive package of care coordination and care management for people with dementia, along with support for qualifying caregivers, including education and respite services. ⁠https://www.cms.gov/priorities/innovation/innovation-models/guide⁠Alzheimer's Association ⁠https://www.alz.org/⁠Alzheimer's Foundation of America ⁠https://alzfdn.org/⁠Conversation and Advance Care Directives  The Conversation Project - Starter guide for caregivers of people with dementia: ⁠https://theconversationproject.org/wp-content/uploads/2020/12/DementiaGuide.pdf⁠Compassion and Choices Dementia Values and Priorities Tool: ⁠https://compassionandchoices.org/dementia-values-tool/⁠ About the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, UVM-certified End-of-Life Doula and founder of Graceful Transitions in Vermont's Northeast Kingdom. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers. Join the Graceful Lifers community at Substack for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds.

    56 min
  7. 10/25/2025

    Angela Shook on How to Plan for Your Pet After You're Gone

    In June 2025, we were fortunate to talk with Angela Shook an End-of-Life and Companion Animal Doula. Angela Shook is an end-of-life doula, Hospice volunteer, and instructor for the Doula Programs at the University of Vermont, and offers multiple end-of-life educational workshops and grief support groups. She is a veterinary doula with Pet Well Mobile Vet, where she assists with euthanasia and the end-of-life care and support of companion animals. Angela has received the Animal Hospice Advocate Certificate from the International Association for Animal Hospice and Palliative Care (IAAHPC). She is a certified Pet Loss Grief Specialist through the Association of Pet Loss and Bereavement. How can you be more aware and prepared for your pet's death or your family & friends' pets' death? Have you wondered about that? What about after your death? How will your companion animal be cared for? There's an end-of-life care plan for that. Trusts? Directives? Care Circle? For many of us, our companion animals are family. And yet, too often, we're left making hard decisions in moments of stress or grief. Making a care plan for your pet while they are still well is a gift — to yourself, your family, and most of all, to the animal who trusts you completely. Having these plans in place brings comfort, reduces uncertainty, and allows you to be more fully present with them when the time comes. Companion Animal Advance Care DirectivesPet Trusts PrimerPlease find an hour to listen when you have a quiet moment. You don’t need to fill out anything right away, but I hope you’ll consider reading them and starting the conversation. These decisions can be emotional. But they can also be empowering. And the peace of mind that comes from knowing your furry family member’s future is lovingly accounted for? That’s something you truly can’t put a price on. Companion Animal Advance Care Directive Pet Trusts About the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, UVM-certified End-of-Life Doula and founder of Graceful Transitions in Vermont's Northeast Kingdom. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers. Join the Graceful Lifers community at Substack for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds.

    58 min
  8. 10/25/2025

    What Really Happens with Medical Aid in Dying

    Medical aid in dying (MAID) is legal in Vermont—but what does it actually look like? And where do you go if you don't want to die at home? Kasey March, a certified MAID Wayfinder and end-of-life doula with Doula Care for Dying, guides us through the realities of medical aid in dying in Vermont—from the process itself to finding a safe, appropriate location to take the prescribed medicine. This conversation addresses: What MAID actually is (and what it isn't)The role of a MAID doula or WayfinderWhy people travel to Vermont from out of state to access MAIDOptions for Vermont residents who don't want to die at homeCommon myths and misconceptions about medical aid in dyingHow families are supported throughout the processWhat questions to ask if you're considering MAIDThis is a robust, revealing conversation that expands understanding of this deeply personal end-of-life option. Whether you're considering MAID for yourself, supporting a loved one, or simply want to understand this aspect of end-of-life care, Kasey offers compassionate, clear insights. Death on your own terms—that's what MAID makes possible. About the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, UVM-certified End-of-Life Doula and founder of Graceful Transitions in Vermont's Northeast Kingdom. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers. Join the Graceful Lifers community at Substack for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds.

    1h 5m
  9. 10/25/2025

    Francesca Arnoldy on The Secret Ingredients of a Supported Death

    What if just starting the conversation—the one you've been avoiding—brought you relief instead of dread? Francesca Lynn Arnoldy, death literacy advocate and author of 'The Death Doula's Guide to Living Fully and Dying Prepared,' believes that transforming our relationship with death begins with a single step. In this conversation, we explore: What 'death literacy' actually means and why it mattersThe surprising pleasure of starting difficult conversationsWhat makes a 'good death' (hint: presence, choice, and love)How to support others during grief and lossPractical steps toward living fully while preparing to die wellFrancesca is the original program director for UVM's End-of-Life Doula Certificate Programs, a published researcher with the Vermont Conversation Lab, and her work has been featured in The New York Times, Fast Company, and AARP. 'Death literacy empowers us to navigate the end of life with clarity, confidence, and compassion—transforming fear into understanding and avoidance into meaningful preparation.' —Francesca Arnoldy Ready to take that first step? Find 'A Guide to Living Fully & Dying Prepared,' and other books by Francesca, here on my curated booklist at bookshop.org so you can support your local bookshop. About the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, UVM-certified End-of-Life Doula and founder of Graceful Transitions in Vermont's Northeast Kingdom. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers. Join the Graceful Lifers community at Substack for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds.

    1h 7m
  10. 10/25/2025

    The Hidden Costs of Dying Without a Will

    If you die without a will, your estate will go through probate—and your will will become public information. But that's not the scariest part. Without an advance directive, the court can keep you alive and 'comfortable' even if you don't want to be intubated or have limbs removed. Your family can override your unspoken wishes. Angela Ross, an attorney with 31 years of experience and current probate judge in Orleans County, Vermont, shares what most people don't know about estate planning—and what it costs families when they avoid it. In this essential conversation: Why your will becomes public (and how to avoid probate)The difference between revocable and irrevocable trustsMedicaid planning and Enhanced Life Estate DeedsEstate and gift tax thresholds ($12 million—you're probably fine)What questions to ask prospective estate lawyersWhy advance directives are MORE important than willsHow to ensure your end-of-life wishes are legally honoredThis isn't just legal information—it's protection for you and peace of mind for your family. You may want to listen more than once. About the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, UVM-certified End-of-Life Doula and founder of Graceful Transitions in Vermont's Northeast Kingdom. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers. Join the Graceful Lifers community at Substack for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds.

    1h 8m
  11. Funeral Poverty: How to Afford a Dignified Death

    10/20/2025

    Funeral Poverty: How to Afford a Dignified Death

    What if you could turn your body into a tree after you die? What if you couldn't afford a traditional funeral—what are your options? Lindsey Warren, green burial specialist, opens our eyes to end-of-life choices most of us don't know exist. Motivated by watching 'funeral poverty' devastate families after sudden deaths, Lindsey is passionate about helping people understand all their options for disposition planning. In this touching conversation with 'aha moments' throughout: What green burial actually is (and what it costs)How your body can nourish a tree or wildflower meadowWhy traditional funerals are so expensive—and alternativesOptions for families facing 'funeral poverty'How to make disposition choices that reflect YOUR valuesGreen burial availability in Vermont and beyondEnvironmental impact of traditional burial vs. natural burial'I don't think there's any one right way to go about end-of-life planning and disposition planning, but I think it's really important to look at all the options and make choices that reflect your values.' —Lindsey Warren You have more power and more choices than you realize. About the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, UVM-certified End-of-Life Doula and founder of Graceful Transitions in Vermont's Northeast Kingdom. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers. Join the Graceful Lifers community at Substack for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds.

    1h 4m

Ratings & Reviews

5
out of 5
3 Ratings

About

What if talking about death could change how you live? - In Conversation with End-of-Life Specialists brings honest, deeply human conversations with physicians, doulas, grief specialists, hospice nurses, attorneys, and chaplains — exploring Medical Aid in Dying (MAID), green burial, dementia care, digital legacy, and more. - These aren't morbid discussions. They're practical wisdom about what truly matters — for caregivers, professionals, and anyone who wants to live more intentionally. - Because the best time to talk about the end of life is while you're still living it.