Episode 059: A Conversation on End of Life Care with Janice Chobanuk, BscN MN DBA

Join Sarah Noll Wilson and guest Janice Chobanuk as they discuss Janice’s experiences during her career in healthcare, and what makes her so passionate about providing palliative care for those nearing death.

About Our Guest

Specialized in oncology and palliative care. Have a combination of clinical and administrative background. I have been working in the healthcare field for over 30 years. Have an undergraduate and masters in nursing and Doctrate in Business Administration.

Website

Episode Transcript

Sarah Noll Wilson
Hello, and welcome to this week’s episode of Conversations on Conversations where each week we explore a topic to help us have more powerful conversations with ourselves and others. I am your host, Sarah Noll Wilson. And this week, we’re going to be exploring the oft not talked about topic of end of life care. And so joining me today, I’m so very excited. Joining me today is Janice Chobanuk. And let me just tell you a little bit about Janice’s background, and also how she and I connected because it’s a really fun story. (chuckles) And so I’ve been eager to have her on this conversation. But she has been in the healthcare field for over 30 years. In fact, she is working right now. So she may have to bounce off on the, you know, our conversation real quickly, if any emergencies come up. But she has an undergraduate and a Master’s in Nursing and a Doctorate in Business Administration, but she specializes in oncology and palliative care. And so one of the things that was really intriguing to me it was when I had the privilege of meeting, Janice was hearing about the work that she’s doing up in Canada related to end of life treatment. I don’t know what the right language is, this is something you can help guide me in. But the end of life experience and what does that look like? You know, we previously on the show had someone who has a death doula to come talk about that experience. And what does it look like to support people, but this is certainly one of the topics that I feel like, is very common for people to not want to talk about, or there’s ethical conversations, right, related to end of life opportunities or ways that we can best – I don’t want to even say support ourselves, but to be in a position to make choices that not everyone can. So welcome to the show, Janice, what else would you like folks to know about you before we talk about how we met?

Janice Chobanuk
Oh, hey, I’m a scuba diver. And I love sharks! That’s pretty cool. And an avid yoga chick. So yeah, yeah, love to be upside down.

Sarah Noll Wilson
(laughs) You’re my first guest to say, “And I love sharks.” What is it –

Janice Chobanuk
I do!

Sarah Noll Wilson
What is it about sharks?

Janice Chobanuk
What is it about them? When you swim by a shark you know, you’re insignificant. (laughs) And the beauty of a shark underwater, they are so majestic. When they swim by you, you just like oh my goodness, what a beautiful, beautiful creature. They’re so powerful. But you don’t want to get too close. But boy, they rule. I mean, I get excited when I see a shark. I like – every, every time it’s my birthday, and I love to go scuba diving overseas, and that’s the first thing I do is say, are you gonna guarantee me a shark? And whatever they do, those divemasters, somehow they’re like, hey, hey there’s a shark! And it’s like, Woohoo! And everybody else is like, using up their air and taking off and I’m just hanging out. You know, the last time I went diving, I went, we ran into three sharks, and they were all sleeping, I’m like, (clapping) “Wake up, I’m here!” And everyone’s like, calm down. (laughs)

Sarah Noll Wilson
If this doesn’t describe you – just I just I adore you. And I’m so excited. I’m so excited to just be in your presence, and your company and to be in conversation with you. So here’s, here’s our cute meet story. I was doing a keynote up in Kananaskis, Canada for the Results BEx conference. And in the middle of you know, the beginning of my keynote, I often will invite the audience, like just ask questions throughout, let’s not wait to the end, I can handle it. You know, I usually make some joke about, uh, you know, 10 years of improv and have a healthy case of ADHD. And 99.999% of the time, no one will take me up on it until we get way into the session, and they feel a little bit more comfortable. Janice is off in the corner. And as soon as – she was like, “I have a question.” And I think I said something like, I’m in awe of you. And I’m a little terrified of you. (laughter)

Janice Chobanuk
You said you were scared.

Sarah Noll Wilson
(laughs) And at that moment, people were like, what, what is happening? What’s going on? And so that –

Janice Chobanuk
There was a lot of laughter.

Sarah Noll Wilson
Yeah. And so that, that was how we met was you were you know, now that I know more about you, I’m like that, that moment totally makes sense that you’re like, Yeah, I have a question. Let’s get into this. And, and so then we had the opportunity to talk afterwards. And that’s when I learned more about the work you do, and are so passionate about and wanted to make sure that we had you on the show for us to explore. So thank you, Janice for saying yes.

Janice Chobanuk
Well, it’s interesting, because typically when someone says well, what do you do? What’s your background? And I start talking about that I work in a hospice where people die, and I deal with families that are very, very emotionally taxed, and I’m dealing with a really sensitive topic in a very vulnerable time. Everybody goes silent and they don’t want to talk to me anymore. But you you stayed talking to me and you wanted to hear more so I was like, somebody wants to hear about the specialty of palliative, I’ll share what I have. I love it. So yeah, so this is really a privilege, it’s quite exciting for me because it’s um, that’s the one thing we have in common we may be, you know, a different ethnic backgrounds, different cultural backgrounds, whatever it may be. But the one thing that we have in common is that one day we will all die and go through a lot of different kinds of experiences, and most people have no experience in dying. And so I have the privilege to work here. And work with many people that go through this, and they are so flipping honest. They share so much with me that, and it is a privilege to walk with them through this process. And I’ve learned a lot. And it is so thrilling to be here. And that people let you into their private like life, because it is a very personal experience. It’s just like delivering a baby. It’s like one of those private times. And they need someone to help sometimes, and they’re willing to trust you, and at end of life, they’re willing to trust me and my team and my team is just phenomenal. It’s just some people just can’t thank you enough, it just makes a world of difference.

Sarah Noll Wilson
It would, I imagined that I mean it you know, just because of the nature of the work and knowing that in you know, most cases, there is going to be some loss and there will be a death. And there will be the grief left behind of the people who loved them that I would imagine it attracts a very specific type of person. Talk to me a little bit, Janice, about your journey? You know, did you know you always wanted to be in this space? Or what what were some of the moments that shaped you in pulling you towards this type of work? Because again, I can – just like you said, I mean, even just the conversation of it. People don’t know what to do with it and much less talk about it. Imagine working in it day in and day out. So what was your journey to this place?

Janice Chobanuk
Oh, because I’ve been in nursing a long time. I started out in acute care. And we’d have some really complex patients, I was on general surgery. And people were close to dying. And there were all these weird rules like I’d have someone who’s, you know, believed in their afterlife, and they want to bring their moccasins with them. And we had policies that they weren’t with, they weren’t allowed to, or they wanted to wear their parka when they died. And I’d get in trouble because I break the rules all the time. And I would put the parka on, and then my boss would come and give me heck. (laughs) And I’m like, somehow I don’t fit in the box, I gotta figure out how to fit in the box. And of course, time changed in palliative that was just developing. And I sort of latched on to that going, there’s got to be a place where I can bring in colored quilts and do these things. And I can bring in the cat and the dog and it doesn’t matter. It’s part of the family. And so maybe not in acute care because we’re you know, really focusing on curative. And then I got into some home care where we provided palliative care in the home. And then started looking at other kinds of opportunities, and so got into hospice care. And then I was really fortunate, I got to work in an area where there was 82 towns, and I had to set up a program and introduce palliative care into 82 different towns. And so I had to use different nursing skills to be able to develop not only a program but implemented, evaluated, educate physicians, educate nurses, home care staff, etc. And get a program up and going where you could measure your outcomes and ensure that families were happy, and you could work with the police department, you could work with the ambulance department and such. And again, it just filled my cup. It was so exciting. And the staff, because you you get the right staff, right. And they’re they’re all they’re all happy. They love what they do. They’re passionate. And you know, although you work in a very emotionally trying area, and it can be emotionally fatigued, the staff were just full of energy and full of happiness and so cheerful. Sure, they experienced loss and sadness, but they’re just so delightful to work and you just see people blossom going, “I love working in palliative care.” And even like when I do performance appraisals with staff, they’re just like, I just love what I do. I just love it so much. And my my physicians that currently I work with, they are passionate about palliative care.

So there’s a lot of excitement at end of life even though it is sad, because it’s such a subspecialty and all I can say is people are super duper honest. They are so honest, they got nothing to lose. So when they share stuff with you in such a vulnerable moment, they, I mean, they’ll tell you, they’re like, I hate your hair color. (laugh) You’re like, I love it. I love the honesty, right? But there you also appreciate things that we sometimes take for granted. Like they’ll go out in the courtyard and you know the flowers are in full bloom and they they noticed smell right away, the sun is shining on their face. And they’re just like, oh my goodness, Janice this is so beautiful. This is just so amazing. They just sort of stop and they’re really present in the moment and take time to appreciate everything until their last breath. And you’re like, wow, they are living life to their fullest. And you know, a lot of them, they aren’t discontent, they’re just like, you know, it’s the end of my life. And, you know, I had a really great life. The family is grieving and their family’s having a difficult time. And so a lot of your energy is working towards, working, supporting the family. And also, I mean, this subspecialty of palliative involves a lot of people as they go into system failure.

Sarah Noll Wilson
Sure.

Janice Chobanuk
They get clusters of symptoms. And so you need a little bit of a special body and knowledge of knowing which kind of drugs and non pharmacological products to help people get comfortable. And we do some really fun things like we’ve got Starlight therapy going. And we use the special lights and lots of Reiki and massage and, you know, the cool stuff, aromatherapy, plus, like the medical management kinds of stuff, too. So yeah, lots of lots of cool things. And hospice has got a whole different approach to like, there’s all kinds of what we call wraparound services to give people a real, let’s see, super quality at the end of life. Like, you know, I had one lady and you know, like, it’s the end of your life. Like, what’s the most important thing to you? What would you like to do? She’s like, I’ve never worn cowboy boots,

Sarah Noll Wilson
(laughs)

Janice Chobanuk
Like, totally, totally catches you off guard. I had another lady she wanted to ride a Harley, right? Like, you just you just never know, you’re expecting something else, right? Something maybe some more spiritual.

Sarah Noll Wilson
Sure.

Janice Chobanuk
Like something deep. See my last daughter, or you know, but nope. Put on some cowboy boots. And it’s like, okay, we can do that. That’s an easy one. So people, you know, people are amazing and fun to work with. And when they share these things at end of life, you’re always surprised, it’s never dull, there’s always something. But there’s also difficult times because sometimes the symptoms are really complicated. And there’s lots of ethical dilemmas. But again, you know, that’s the skills that you have to, to help work through those processes in complex situations, and you pull your whole team together and work with the families closely, and try and work through it the best you can.

Sarah Noll Wilson
Yeah. When you know, when you think about all the experiences you’ve had, and all the moments you’ve witnessed, and you know, and the conversations you’ve had, what, you know, if you had a wand to have people have different kinds of conversations around death, dying end of life, what would you what would you want for people? I know that, in my own experience, in a place where parents are aging, so right, becoming much more aware of that. And I can see them becoming more aware of their aging, and their mortality in a different way. Like, we were just at a family event, and mom was like, we are the old people. Like we’re, we’re the next shelf, right? Like, we’re the old ones. And, you know, and, and so, you know, I’ve witnessed, I’ve witnessed the avoidance. And and that’s part of what drew me to, to having you on the show. And also when we had the other person is I’m trying to push myself even of like, how do I have different conversations about this? How, how do I get to a place of acceptance, because this is the inevitability, right? It’s the one thing that’s true, we don’t know what happens on the other side of it. We don’t know what our life is going to be leading up to that moment. But that is the one thing that is true. So with your, with your experience, what do you wish? Or what would you hope for, for people to think about in how they think about approach death and dying?

Janice Chobanuk
Well, it’s probably twofold. Like the first thing is that that people do have the comfort and start talking about it, because you talked about early, you watch a show when someone dies. And how did your kids react? How did your brother, your sister react? Or how would you feel if you were in that moment, right? Somebody was in a car accident and you lost that person, suddenly, you didn’t have time to sort of prepare yourself like a slow death, right? Or someone you thought that you were very prepared for was dying, like I’ve got an elderly father-in-law who’s 95. And you think think think he’s gonna go, you think think think he’s gonna go and then all of a sudden, up and about, he’s doing well. And it’s it, you know, it’s, it’s like a roller coaster and he just keeps on going and he’s doing okay, and then he does poorly, and you just keep going and he goes another year. So you never know, in those situations. So from from a wish list, it’s just having people to start talking about it and being comfortable. You know, I made a joke about when I say what I do and people go dead silent and and it’s really uncomfortable for them. Just me telling them what my job is makes them uncomfortable, or they’re like, oh, that must be awful. And I’m like, why would you think it would be awful? Tell me more about what what your thoughts are about death and dying, and then they get really uncomfortable. So that would be probably my my one wish, right.

And there’s many ways of having those conversations with your families, your loved ones, because sooner or later, you’re supposed to write a will. And sooner or later, you know, you’re supposed to write something about what your personal directive is, what you want to happen, when you can’t, if you can’t make decisions yourself at end of life. Or you have to make decisions on behalf of someone else. And when you start talking to them, people have very different beliefs from one another. And if you don’t have those open conversations, you may not be honoring what they want, or they’re, what they want is not realistic, right? Like they want to go up to the top of a mountain and they’re like, they’re already in multi-system failure. It’s just not possible. There’s no running water.

Sarah Noll Wilson
Yeah.

Janice Chobanuk
Those kinds of things. The second thing is that a lot of people, as they get closer and closer to death, they often have lots of – it may be spiritual or existential questions, because they may, you know, be an atheist or just trying to figure out what the purpose is of their whole existence. And that’s a pretty heavy question at end of life, and you’re, you know, you’re just doing your first shift, and you’re like, holy moly, getting hit with that kind of a question. So just having people have the opportunity to be able to find purpose and feel like they’ve had a meaningful life. So that magic wand would be, if I have that superpower, to help people to sort through those existential question. And I know a lot of our spiritual care workers are really good at helping people to explore that and get deeper, but a lot of people they can manage the pain, they can manage all the other symptoms, sometimes the delirium, but that meaning behind life, when they’re, you know, sitting there quietly, in their last moments. And a lot of times, it comes back to family, and friendships and love and you know, all those things that we sometimes even take for granted. And then sometimes it’s just small things like nature and such. But you’ll see commonly, at end of life, people start talking about that. And just having that skill to be comfortable to go through those existential questions, I think is so so valuable. And you know, then when they close their eyes, they just look so peaceful. They’re just happy and contented. But that’s not the case all the time. Because sometimes deaths aren’t always that nice.

Sarah Noll Wilson
Yeah, yeah. It’s yeah, those are, I mean, those are heavy questions, even when you’re thinking about them in a healthy state. Right?

Janice Chobanuk
Yeah. Yeah.

Sarah Noll Wilson
Those are big questions of what, what is, what is the meaning of all this? What is, what is my purpose? What? Why do I exist? And sometimes I think it can be seductive for us to not slow down to answer those, right? You just get busy, and you’re moving through life, and you’re doing the next thing in front of you, instead of pausing and saying, is this what I want? You know, one of the things I’m curious about is, you know, what are what are some of those, like, in addition to the spiritual questioning, or exploration? What are what are some of the other, I don’t want to say topics, but what are some of the other things that come up, you know, when you’re working with people who are, you know, very aware that they’re facing the end of their life? You know, I think that when I think about my experience with loved ones, in particular, it was either, you know, situations where people went really fast, and, you know, didn’t have that, and or the illness sort of took over quickly, even if it was not a quick death. Right. So they were sick for a very long time. But what are you know, I’m just, I’m just curious to know, like, what, what are some of those reflections that people like, often have when they’re at that point of, okay, like, I’m in a position where I’m actually aware that this is the end, right? Like, medically, we know that there’s nothing more we know that this is happening.

Janice Chobanuk
So people do a lot of what’s called legacy work, or ethical wills, and what they do. And, you know, it’s too bad they didn’t start earlier, but it’s like they’re writing their book, their autobiography, but they want to leave things for, say, a grieving wife. And they write this beautiful, heartfelt song or story, or just memories of all the things that they’ve done that were really magical and special, and they put their heart and soul into it. And then we support them through that writing process, and story after story, and then they share it with their their wife. And then years later, like the wife takes that out, and they’re like, they can hear their voice in it almost, right, or share it with their grandchildren or their children. And it’s all those magic moments that you kind of forget when that when your loved ones gone. And so that work, that journey, they’re at the end of their life and they walk through that process of all those things. And some people are so gifted, we get in our facility, there’s some really incredible people, you know, from psychologists to farmers to truck drivers and the stories they have. And at this time because they’re dealing again, you know, like that existential question word, is they start thinking about all the great things that they’ve done or important things or the the stories they want to share with their kids or lessons in life so that their kids know what to do. And they capture it in writing, and from the families, that exercise when they take that back and when they read it, you could just see all the tears flowing from their eyes, but tears of happiness almost going, Oh, I forgot about that. And they laugh, or it just touches their heart, but that legacy work and ethical will writing, they take back and it keeps that memory alive.

You know, when when I sometimes instead of, you know, saying my condolences, I say, “Remember to celebrate their life.” And those kinds of little tools gives people you know, I didn’t think about that, that was so fun, because instead of thinking just about the sad things going, I’m going to miss them a lot, or I’m going to miss her a lot. But these things are so, they were so great memories. And that was a gift to me and having it in writing in their handwriting is a special gift. So that’s, I think, really, really important work. And in that work when I said, you know, my magic wand, I’d wish people could, you know, reach or the answers to those existential questions. That actually is one of those superpowers in my toolkit that does work and works in palliative care. It’s not just my toolkit, it’s many, many people they do that legacy work, and to start early. And really, really fun. Um, you’ve had people that are, you know, really musically gifted, and they’re like, I’m gonna write my wife a song. And it’s like, they’re the very end of life. I’m not meaning to make you cry. I’m like, –

Sarah Noll Wilson
No, keep talking. And I’ll just share what’s coming for me.

Janice Chobanuk
They’re at the very end of the life. And they’re like, I just got this inspiration. And they write this love song to their wife, and like on their last breath, and you’re like, Oh, my Lordy, Lord. And it’s just like, they share it with my team. And it’s just beautiful. Like, we’ve even had flippin weddings here. We’ve had weddings, too.

Sarah Noll Wilson
I love that.

Janice Chobanuk
Like, it’s so it’s just so amazing. But yeah, so some of that work is really, really important. We have a music therapist too. And she can bring out some special special things and people that they just open up, it’s not just, you know, they’re singing along and, you know, shaking their head, clapping their hands, it just gets to a deeper point in their heart and soul, and they open up and they’re just like, that’s exactly what I needed right now. Things were just not going very well. And you know, I was experiencing a lot of pain and nausea. But that music, it just brought back memories of when, you know, when I first met my wife, or when I had my first baby and or, you know, those kinds of things.

Sarah Noll Wilson
Yeah.

Janice Chobanuk
We do get really hard situations where we get really young, like, you know, like an 18-year-old or a 17-year-old. And you know, you’ve got the mom and the grandparents here. And it’s out of order, right? It’s messed up.

Sarah Noll Wilson
Yeah.

Janice Chobanuk
It should be the older people dying. And that that can tug on people’s hearts, because they sometimes you you know, you need to take time to say that’s not your life, it’s somebody else’s life. So make sure you’ve got your professional boundaries. But that can be really hard on the staff as well. And, you know, visitors coming in when they see such a young person because they’re always like, Oh, you work in hospice, it’s all old people is like, absolutely not. We have a lot of young people, right. Because, you know, it’s just part of life. Death.

Sarah Noll Wilson
It’s, uh, no, I think part of you know, part of my emotions coming up was as I was hearing you talk. I was first introduced to the idea of ethical wills at an event I used to run that was like a presentation, kind of like a TEDx. But it was called PechaKucha somebody talked about ethical wills. And it was the first time I’d ever heard of that, that term, but, you know, some of the emotions, there’s layers of the emotions, right? You know, thinking about how we don’t often slow down enough to share those things while we’re present and with with people. And you know, I think what, like, for me what, part of what was causing my emotion was, how many people I wish in my life I had that, right, like people who have passed on and I’m like, I wish I had her voice. Or I wish I could still, like hear their perspective. And, you know, and that’s something I think, for me, as I you know, hit certain milestones, right, like, you know, starting to hit middle age and you know, and you having siblings who are right, like hitting 50. And suddenly it’s like, oh, wait a second. You know, we’re in the second half of our life, definitely opens up a different perspective, at least it has for me of just how do we how do we be more present? How do we share those things? How do we pass on those legacies? How do we, when we’re in the moment with people make sure that they know how much we appreciate them, and even if that’s vulnerable, and hard and emotional, right to to do that, and so I’ve definitely been finding myself. trying to push myself more of like, let’s not wait, like, let’s not wait till the end, let’s not, and we might not get that we might not get that privilege. So I appreciate you, you sharing and if there’s other things that maybe if you can just really quickly just talk about what an ethical will is for audience because they might not be familiar with that term. I think the the descriptions of the other things you’ve been speaking to, like, Oh, that makes sense. But how would you define an ethical will to somebody who’s unfamiliar?

Janice Chobanuk
It’s writing out the things that are really important to a person, and what they want their loved ones to learn about them. And to think about them when they’re gone. And share the things they feel are so important that when they’re gone, they won’t be able to share with you. And it can be anything from their heritage to their life experiences, to things that they are, you know, you better go to school and get a university education. (laughter) So sometimes it’s not just about them, it’s about that what they expect of other people. And it’s it, it’s their voice. And it’s, it’s, it’s very in depth about what they feel and think. And it ends up helping the people that are grieving who loved them, and are close the most, I think. I mean, I think the whole process, going through it, people are just like, they’re overjoyed with when they start talking and listening and hearing what someone wants to share in an ethical well, and everyone’s ethical will is a little bit different and unique. And they take different approaches, depending on on the individual. But in the end, the people that are close to them, they feel like they got something very, very important, very, very special. And it changes both of them, that changes all of them forever, going through the process. So you know, sometimes it’s not the end product, the will, the ethical will itself, it was spending that time sharing that time to get this memory. And then when they leave, and then their loved one has passed and died. They now have that and they they cherish that time. And when they’re having you know what people will often say when they’ve done an ethical will, and come back and talk about it, is like, I just having a really bad day. And I just was wishing my husband was right here with me. They pull up that ethical will and they read it and they’re like, and it just it made them cry. But it just made them stronger. It is pretty powerful.

Sarah Noll Wilson
Yeah. It’s, I mean, this, you know, all of this stuff is why it’s so important for us to normalize, right? How do we show up in these moments? How do we talk about it more? How do we – you know, I think something that I’ve observed in, there’s my dog wanting to say hello (laughter) – but what I’ve observed sometimes is, you know, maybe we go into denial about the reality of where someone is, and there’s a, no we’re not, I mean, this isn’t the end, instead of just how do we embrace that journey. And also, on some level, just embrace the temporariness – is that a word? (laughs) The temporary quality –

Janice Chobanuk
Kinda not but that’s ok. (laughter)

Sarah Noll Wilson
It’s not, but we’re gonna make it. Like the fact that our lives are temporary. Right. And, you know, one of the things that I was curious to get your thoughts on, because one of the things we had talked about, back up in Kananaskis, is the fact that and you’ll you’ll have to catch me up on like the history, but Canada has moved to having some End of Life Options, right, if I understand that correctly. And that, you know, that is something that I think is feels like a taboo topic. Feels. I mean, certainly there’s ethical, like I get the ethical dilemmas. And as it’s something actually that, you know, my husband and I, we, you know, we talk about and, you know, just from the standpoint of like, when I think about things like assisted suicide or whatever, you know, like that’s sort of how – you know, back in the 90s it was Dr. Kevorkian and it was such a scary thing. And I think that when you’ve experienced, when you’ve experienced loved ones suffer so much, suffer so greatly. And that there was an awareness that there was, there was no place that this was gonna get better. You start to question and go, man, is this about quantity of life or is this about quality of life? And there is something for me personally, my personal opinion, really beautiful about having that option to to control your journey a bit, right? Obviously not in a situation of somebody struggling from like, a mental health perspective. But you know, I’ve seen situations where, and just just reframing it for myself, even. So I’m curious just to hear about, you know, what is it that has shifted in Canada? What, how have the conversation shifted? What have you observed, as those options have become more available. And I say that, but there’s still like a rigorous process of approval, and right, all of that, but just like, just educate us on on what’s going on up there.

Janice Chobanuk
Okay, and I always put up a solid line between, and I’m going to use the word MAID, and palliative care, because palliative care is comfort and symptom management. But there is a procedure that people can apply for, to end their life peacefully. And that is done very ethically. And it’s an option for people. And exactly as you said, it’s really great to have that option. It isn’t palliative care, but in many palliative settings if people choose that, and I mean, people do that with their pets all the time.

Sarah Noll Wilson
Yeah.

Janice Chobanuk
And they have that opportunity. And what it has done, in a very positive way, is given people a lot more control. A lot of people like may just, you know, they may contemplate it, they have it set up. And they may say, you know what, I’m just sticking with palliative care. And if I need it, I know that it’s available. And then others have said, you know, what, today’s the day, today’s the day. I’ve seen everyone. I have all my existential questions are answered, I feel good. And I just you know, what it’s it’s time to go. I mean, I’ve seen opposite where people have just willed themselves too without any procedure. But I think it’s just given people other options and given them a good sense of control. I mean, I know there’s a lot of different spiritualities. And it’s not, doesn’t align with everyone’s belief. And but we have a diverse world, with many different people with many different beliefs. And that’s an option that works for some of them. But it is a procedure that is not part of palliative care, but it’s a procedure that we can we always will make available in palliative care. It doesn’t take away that you’ve got a family that is grieving, they’ve just lost someone, someone you know, was ultimately going to go into multi-system failure, the end is the end is the same, but it gives them some some sort of control. And they can choose the time, the date and all of that and be greatly supported. So you know, in my again, I’m going to own this one a personal opinion, it gives us a really great option. However, I’m always clear that that isn’t part of palliative care, palliative cares about quality of life, good symptom management, etc. But there is a procedure available for them so that they can maintain that control and choose the time and date they want to go. And it’s done in a beautiful manner. And everyone’s treated exactly the same. And they have a really high quality of life at end of life. And when they decease, you know, the treatment is completely the same, like the processes are all the same.

Sarah Noll Wilson
Sure, yeah.

Janice Chobanuk
But it’s nice to have that option. And I’m glad that Canada is open. I know when in my old or younger days, and we used to always study what was going on in Holland in places where they didn’t have palliative care. And they only had they called it euthanasia back then, as an option. It was horrible. Like just that’s the only option. And there were all kinds of, you know, the procedure wasn’t, you know, always fine tuned and all that kind of stuff. So the world has changed completely. And so it’s nice to see that we have a great palliative care, and I’d like to see more of it and it should be more available to people when they need it in a timely manner. But there is that option and gives people that sense of control of their life and I think that’s really a good thing.

Sarah Noll Wilson
Yeah, it’s I mean, you know, you mentioned how we have that option with pets. And we, last, a year ago February, we had to put down our first dog and I’m just you know like this. I’m embracing and just leaning into and I will not apologize for tears. So this is me catching myself, because they’re normal and healthy and natural, but like, we were home, he was in my lap. My husband and I were together. And I, after it was over, I remember being like, this is how I want to go out. Like if I obviously there are things that happen, there’s accidents that happen, who knows what our future is. But there was something really beautiful about, he was suffering, it was very clear he was suffering. Like it was, there was no alternative, right, it was only going to be suffering more. And like there was something so beautiful and peaceful, as hard as it was, there was something so peaceful, about being there for his last breath, and knowing he was just absolutely surrounded by love and in his safe spot. And all I kept thinking was like, man, if this, if there there is an option, right, if I get to a point where I go, I feel complete, or, and I don’t say that flippantly, right, like but or, or there’s a situation where you go, that the future is not like the future is going to become really bad because of, of, of diagnoses or medical. Like there is something I think, really beautiful. And I think coming from a culture that I was born into and raised into where we just don’t talk about it that much. We don’t talk about death. And just normalizing like, what what does that look like, so that somebody has options. So that we can be with each other, so we can really celebrate with each other. And have that be, what do I want to say, like an acceptance of that’s part of our journey, right? There’s something so powerful about being present with somebody or somebody not wanting people to be present with. I know that this is something that my colleague, Teresa and I we talked about is some people don’t want to pass with people around them right. They want their own space, or they want whatever. And I just –

Janice Chobanuk
That happens.

Sarah Noll Wilson
Does it?

Janice Chobanuk
Yeah, because some people will stay there 24/7. And as soon as they go and leave the room to use the washroom, and their loved one says, Oh, I can finally die, they’re out of the room, and they just go to sleep. And you’re like, I think they did that intentionally, they she would not leave that room is like, you know, so I do think that happens. But you know, with your example, with the beauty of the pet, I’ve seen that with people that have just used palliative care. And and not any treatment, it was just a beautiful, that’s a good death, a beautiful death, right. And we’ve seen ones that aren’t so beautiful, but also within palliative care we have, I always call them this super drugs, that we can help people using stuff like palliative sedation, get into a really deep sleep and get them really comfortable if their symptoms are difficult to manage. And so our team is really, really good at that. So there are other options in palliative care. But it’s good to have a lot of tools in your toolkit for end of life. And going back to your comment, you know, wishing for people to talk about it be more open about it. Most people because they haven’t died, they don’t have an experience. And it’s uncomfortable talking about something you don’t know anything about, right? You’re only guessing. And so you get, when you start talking to people that have seen a number of deaths and are more comfortable with it, then people start getting a little bit more comfortable to say, well, what does it look like when they you know, when their breathing starts to slow down? Or what’s that sound when like that ugly sound when it’s so gurgly and you’ll say oh, it’s just a little bit of fluid. They’re not in pain. But a lot of people have never seen it or experienced it. So when they see it in their loved one, they think Oh, terrible is happening. And it you know, sometimes it’s not that bad at all, but you just need to explain it, right? Because they have never seen it before.

Sarah Noll Wilson
Yeah, I would imagine that you, you know, you’re probably really tuned into the signs of dying. You know, that’s something I feel like when I’ve maybe heard other people talk or have just yet our again, having my own loved ones and having somebody from like, say hospice or palliative care, like, you know, we don’t know, because we’ve never been through it. And they’re like, no, these are the signs, right? And here’s what we know of where the body is, or here’s what to expect, and even to normalize that of like here’s what might happen once they have passed, because otherwise you’re I mean, most most people will not have experienced that.

Janice Chobanuk
But you know, people the human body is amazing. Like I just like sometimes, you know, you think you know it all and then you’re surprised. Like I can remember this lady and she hadn’t eaten for weeks and weeks and weeks, you know, like almost like a coma state. Like she opened up her eyes occasionally. And, you know, we’re just counting maybe, four more days, five more days, and her granddaughter arrived on a weekend. She sat up and ate an ice cream come. And I’m like, that’s impossible, impossible. But people, like the human mind and what what wills people. And that’s again, going back to that existential stuff, I don’t get it. But people are always impressing me, always impress me, there’s always these things and you’re like, wow, being human is just such a pleasure, you know, we’re so lucky, we don’t know it. So we should, you know, live each day fully. Because this experience, when it ends, it’s gone. Like the human experience, the smell, the taste, like the things, the feel sensation, feel soft blankets, like all those things. And when you’re dealing with end of life, those little things like giving them a warm blanket, or a soft blanket, changing their pillow, or giving them some ginger ale, or whatever it may be. A sip of beer at the end of life, it’s so meaningful to them. And you’re like, that’s just a simple pleasure. But when you you know, a little bit more present, slow down things, those little things are important that somebody you know, it’s that human connection, right?

Sarah Noll Wilson
Yeah.

Janice Chobanuk
Especially for us, because we see people in our hospice environment in the last three months of life. So we have no relationship, and you want to build that relationship really quickly. And they trust you so quickly. And they’re so open and honest. And I’m like how can this happen, we can have this great relationship in such a short time. But because they’re so honest, and of course, you know, we want to help and prepare them for what’s going to happen, you just become really entwined. And so it actually is a very, very rewarding career. So I am blessed, and honored to have this opportunity to spend with people that are at end of life, and they invite me into their life. And I’m like, wow, how can this be so good, like, people trust me that much. So it is really a privilege and an honor. So I’m glad. I’m like, I have a good life. And when people say I don’t want to talk about your job, I’m like, why not? It’s really great!

Sarah Noll Wilson
You are such – Janice, you’re such a gift. And I could keep asking you lots of questions. And I also want to be really thoughtful of the time that we’ve, you know, we’ve taken with you. I just really appreciate your perspective. And I think it’s such a valuable one. And, and there’s just so many lessons to take from from this conversation. And unfortunately, I think sometimes does take losing somebody to be like, gosh, we need to spend more time, we need to say I love you more, we need to slow down more. And then what happens is, then eventually we get on autopilot, which I think is some part of the human mechanism of survival. (laughs) So we aren’t in an existential crisis all the time. But it’s such a you know, it’s a good reminder, and, and just really fascinating to hear about the work you’re doing. So thank you so much for coming on the show and talking with us. There’s no doubt, no doubt, lots of people will be probably curious about more after they hear this. But in the spirit of of us winding down our conversation, there’s a question we always ask everyone, and I’m curious to hear yours. Your answer to this. And that is, you know, knowing that our conversations can transform us, what is the conversation you’ve had with yourself or maybe with someone else that was transformative for you?

Janice Chobanuk
Probably would be is, I was with a gentleman who was atheists. And he just, he’s like, I wish I was spiritual. I wish I could grab on to something, I need something. I don’t get it, like what’s going to happen, you know? And so we sat down and I said, well, how about if we just bring some one of those spiritual leaders in, it could be a chaplain, I don’t know what faith but let’s just explore it right? And, um, and that moment, transformed him completely. He’s like, he was so sick, and he’s dying, right? He’s actively dying, and so unsettled. And you know, he was having spiritual distress, and just didn’t know where to channel his energy. I mean, we had his symptoms, all his palliative, physical symptoms will manage, but his soul, we hadn’t fed his soul and he didn’t know what to do. And he, you know, he was a confirmed atheist, but he just needed to latch on to something. And by working through some spiritual distress, he was able to settle himself. I mean, he hadn’t changed his belief system, but he just found he was able to focus and just be more resolved and just, you know, he’s just more settled. He’s like, now he has something to hang his hat off, hat on, and he had wished he was spiritual, but he wasn’t. And he couldn’t change. But he found a different outlet and was very, very happy. And it was just through it was probably three different conversations, but it asked, it answered some of his questions about you know, what the meaning of life is, you know, what, what, what is this all about in this world, and now that he’s taking his last breath, and he was very content. And so that, like witnessing that and being, you know, privileged to that vulnerable moment because not everybody’s gonna fess up. Right. And yeah, they’ve just met someone, and to allow me to bring in someone really spiritual to someone who’s atheists, but to see that transformation blew me out of the water going, you know what, like, you got to try things, you got to try things different, you got to think outside of the box, and that’s okay. I mean, this is palliative care. And we needed to bring them comfort, and nothing else was working. But this worked. And I witnessed it, and it helped him so much. And so I’m like, okay, just never give up. And always think, it may not be what you define as spirituality. But something there’s always something that somebody can latch on to so for me that was quite transformational just because I witnessed it from someone who was in total total distress to someone who said, I’m okay, now. I’m, I’m okay, thank you very much. Thank you, that I really, really helped.

Sarah Noll Wilson
I, what I love about that story, too, is sometimes and boy, this is a conversation for another day. So I’m gonna just like, point at the door, but we’re not gonna go through it. (laughter) You know, is when we say when when you hear phrases like spirituality, I think it can be easy to think of organized religion. And that’s not always the same thing.

Janice Chobanuk
No, it could be standing on a mountain.

Sarah Noll Wilson
Right. Right. And so –

Janice Chobanuk
Watching the moon.

Sarah Noll Wilson
Yeah, I you know, so that’s, that’s what I also like, I think is so beautiful too, is just this exploration of, you know, spirituality can look very different for different people. And it doesn’t always have to be a belief in an entity or right, like, organized religion in the way that we know it. But, but just that sense of meaning.

Janice Chobanuk
I saw this this, she’s a researcher, and she, she was really into the spirituality and the soul when the soul leaves the body. And she was capturing it on camera. So it was really interesting. She’s a researcher, and capturing, I don’t know how the image imaging how she did it, but that’s what she studied and focused in. And there’s a lot of research in that area. And she was using special techniques to capture the soul leaving the body and I’m like, this is really weird –

Sarah Noll Wilson
(laughter) Open the window.

Janice Chobanuk
There’s a science behind it, right? Going, okay. So it’s like, yeah, there’s a lot out there we don’t understand. And it just makes it a really interesting world.

Sarah Noll Wilson
Yeah, for sure. I just like, for me, curiosity is such a big thing. I’m like, I don’t I don’t know what happens on the other side. But I’m gonna be real open and curious to experience whatever it is like, there’s nothing, there’s nothing I can do to answer it now. So just like, you know, live the life I’m meant to live and show up in that moment and discover right, whatever’s on the other side of it. Janice, thank you so much for coming on the show. Thank you for just being you. Thank you for your energy. Thank you for your passion. And thank you for the clear love that you bring to the people at a time when they need it most. So thank you.

Janice Chobanuk
And maybe I can get you to go shark diving. You never know.

Sarah Noll Wilson
I mean, I, I’ve never scuba dived, but –

Janice Chobanuk
It’s fun.

Sarah Noll Wilson
But I am not opposed to it. I just have never done it. And I feel like –

Janice Chobanuk
Think of a hammerhead, they are pretty cool. Like, really. That’s the weirdest thing, a hammerhead.

Sarah Noll Wilson
Just put me in a cage. I’ll go in a cage.

Janice Chobanuk
That’s for a great white. They can do that. Come on, that’s like a pet.

Sarah Noll Wilson
I, you know, I will not say no, I just need to learn how to scuba dive if I’m gonna join you sometime. But I’m, I love. I love that that is something you love. (laughs) I think it’s so so fantastic. And I love that we’ve come full circle in our conversation and that we are ending it where we started. It’s beautiful storytelling, Janice. Thank you so much for saying yes. And being on the show.

Janice Chobanuk
Okay, thank you very much.

Sarah Noll Wilson
Our guests this week has been Janice Chobanuk, talking about the very comfortable, uncomfortable conversation of death and dying. And there’s just this, I just have a lot of feels going on about this conversation. But, boy, if I had the choice, I would love to have someone like her walking alongside me and my family when, when and if, when that day comes. So I just want to thank her for everything that she does and gives. And I realized that I didn’t ask her how people can reach out to her. So we will put her email, she did give us permission to put her email in the show notes. So if you have questions or if you want to reach out, she loves talking about this. She also you know, loves talking about sharks. So if you’re interested in that as well, you can do that. So we’ll put that in the show notes. And we want to hear from you. We love when we receive emails of whether it’s questions or whether it’s people sharing about what resonated for them. So you can always do that by sending me an email at podcast @ Sarah Noll Wilson.com. Or you can find me on social media where my DMs are always open. And if you’d like to support the show, you can do that in two ways. The first is to please be sure to rate, review and subscribe to the show on your preferred podcast platform. This helps us get increased exposure and to be able to bring on great guests like Janice and have these conversations. And the second way is you can become a patron you can go to patreon.com/conversations on conversations where your financial contribution will support the amazing team that makes this possible and you’ll also get some pretty great swag.

So a huge thank you to our team that makes this podcast possible. To our producer Nick Wilson, to our sound editor Drew Noll, our transcriptionist Becky Reinert, our marketing consultant Kaitlyn Summitt-Nelson, and the rest of the SNoWCo. crew and just a big final wholehearted thank you to Janice Chobanuk and just being the amazing human she is. This has been Conversations on Conversations. Thank you so much for listening. And remember, when we can change the conversations we have with ourselves and others, we can change the world. So please be sure to rest, rehydrate and I’ll see you again next week.