Death By Design


Brad Macy, RN

Season 4, Ep. 33
The Macy Catheter was invented by Brad Macy, a veteran hospice nurse and recipient of 2013’s National Hospice and Palliative Care Nurse of the Year Award. The inspiration for its invention came directly from a memorable patient interaction.Over the years, Brad has seen thousands of difficult symptom management cases while assisting patients and their families in the middle of the night. The most challenging cases were when the patient could not swallow medication and end-of-life symptoms were spiraling out of control.One night, Brad had a patient who was experiencing severe terminal agitation. The patient was suffering; he was shouting, he was climbing out of bed, and he was clearly very frightened. Brad got orders to administer a sedative that would help calm the patient. Since the patient was unable to swallow, the prescribed route of administration was per rectum. He administered the sedative in tablet form rectally as prescribed, and waited “that difficult wait” for the patient to calm while giving the patient’s son emotional support. An hour later, the patient was worse. The desire of both the patient and his family were that he be able to die peacefully and at home. Brad called the doctor again for a repeated dose of sedative. While preparing to administer the second dose, he realized that the previous dose was still undissolved in the patient’s rectum.Brad was left with a dilemma that is well-known by every experienced hospice nurse: how to help a patient who is experiencing severe symptoms and unable to swallow reach a state of comfort within the home setting.Motivated to reduce the severe agitation and suffering of his dying patient, Brad found a way to give the medication as a suspension that would absorb quickly in the patient’s dry rectum. He crushed the tablet, added water, and administered the medication suspension into the rectum with a urinary catheter. The patient calmed down quickly and was sound asleep within thirty minutes. The patient’s son was deeply grateful for an easy solution that controlled his father’s symptoms with minimal subsequent discomfort or disruption. The patient died peacefully at home a few days later.Given the successful outcome of this case, Brad decided to create an optimized device to facilitate this intervention. He subsequently co-founded Hospi with the goal of making a commercial device available that could provide comfort and relief for patients and their loved ones on a much larger scale than would be possible as a lone practitioner.Hospi developed the Macy Catheter to improve the patient and caregiver experience with serious or terminal illness. The Macy Catheter is designed to maintain patient comfort and dignity while leveraging the speed and established benefits of rectal administration. The Macy Catheter is of particular relevance during end of life, as it can help patients remain comfortable in their home. It can also reduce the need for more costly and complex administration routes like intravenous delivery, which is seldom used in the hospice setting. The patented device has received 510(k) clearance from the U.S. FDA.To learn more about Hospi Corporation,click here.

Dr. Christopher Kerr

Season 4, Ep. 32
Hospice physician. End-of-life researcher. Acclaimed author ofDeath Is But a Dream. Death Is But a Dream, based on Dr. Kerr’s extensive research with hospice patients and their families in Buffalo, NY, highlights and validates the powerful dreams and visions often experienced at end of life that bring comfort and meaning to the dying process.Dr. Kerr is the Chief Executive Officer and Chief Medical Officer of Hospice & Palliative Care Buffalo, a valued member of our Coalition and parent organization of Hospice Buffalo. Dr. Kerr wroteDeath Is But a Dream, an examination of ELEs, based on his experience with hospice patients and their families in Buffalo, NY.“Surviving Death” is a six-part series that explores the end of life through personal stories and research on near-death experiences. The fifth episode documents Dr. Kerr’s conversations with hospice patients of all ages who report seeing and interacting with deceased loved ones. These experiences can offer comfort for people as they near the end of life and, in turn, for their caregivers and loved ones.“We’ve done studies of hundreds of bereaved people and it’s very clear that what is good for the patient is good for the loved ones, and it absolutely soothes them in grief,” Dr. Kerr explains during an interview for the series.“Surviving Death” is now available to stream on Netflixhere. For more information on Hospice & Palliative Care Buffalo, clickhere. You can also learn more about the work of Dr. Kerr and his fellow researchers by clickinghere.

Jennifer O'Brien

Season 4, Ep. 29
Jennifer O’Brien helps people talk about caregiving and end of life. She encourages compassionate, real conversation through her book, The Hospice Doctor’s Widow: A Journal, where she shares her story of caregiving through collages and writings.After years of caring for people with serious illness as a physician, Jennifer’s husband, Bob Lehmberg, was diagnosed with a stage IV, metastatic cancer. But caregiving for the man who had made a 40-year career of caregiving as a physician was not easy. When Jennifer’s husband was diagnosed and later after he died, she turned to what had brought her comfort for years—art journaling. She documented and depicted the raw, honest, beautiful and exhausting reality of caregiving through collage, tableaus, notes and observations.She included much of the wisdom and perspective she learned from her husband in his years as a physician.When the book was just a stack of pages, she took it to a friend who had just been diagnosed with a rare, advanced bladder cancer.After reading the book and knowing his own prognosis, he said, “You need to give this to my wife. She needs to understand what is ahead and feel supported as my caregiver.”After seeing how much that stack of pages helped them in his final months, Jennifer knew that what she had created might help others.Having been a practice management consultant and educator to physicians for 30+ years, an executive administrator for two large medical practices, in administration at three major academic medical centers, the wife and now widow of a physician, Jennifer has a unique and thorough understanding of healthcare.Still, with all of this experience, caregiving for her dying husband was both the greatest honor and challenge of her life.Now Jennifer works to help caregivers feel supported while caring for others and taking care of themselves.

Rachel Kodanaz

Season 4, Ep. 25
“Nobody likes to sit down and listen to a talk about life’s challenges. But somehow, Rachel makes it all Okay. Her warmth and sensitivity, and especially her story, enables us to hear brutal honesty and embrace it, rather than fear it. Bravo, Rachel Kodanaz.”—Ora DeMorrow, Senior Financial Advisor, Vice President Merrill LynchNo one knows better how to embrace life’s challenges than Rachel herself. Overcoming her own adversity of being widowed at 31 years old with a 2-year-old daughter, she “wows” audiences with her down-to-earth, current and relevant presentations – helping attendees to reach their potential by embracing and learning from all of life’s complexities. Having worked in management for Fortune 100 companies, she is fully aware of the see-saw created when personal and professional challenges collide.Rachel has been speaking passionately to national audiences of all sizes for 20 years, addressing all aspects of change, growth, and acceptance that comes with embracing life’s challenges – those expected and unexpected. Through her books, Living with Loss, One Day at a Time and Grief in the Workplace, Rachel offers a wealth of knowledge, inspiration and practical advice for those who have lost a loved one or are supporting someone who has lost a loved one.​On October 1, 2019, Rachel released her third book, Finding Peace, One Piece at a Time. This book providesencouragement and tools for those seeking to down-size, right-size or sortthrough a loved one’spossessions. Whether they are in physical or electronic form, those possessions tell the story of the person’s life. Rachel’s book shares practical ways to thin, repurpose, and redistribute these possessions so they continue to share the story with future generations.Rachel is available for speaking appearances, educational programs, interviews and community outreach.