As a hospice nurse and an end-of-life doula, Kristin “Apple” Applegate-King, is passionate about having conversations that transform the way people view death and the dying process.
NWADEBs board member Amy Lindholm sat down with Apple at Sanborn’s café in Sellwood to engage in one of these conversations and to discover how she is living out her calling in the Portland community.
You’ve said your journey to become a hospice nurse began with two formative death experiences as a young person. Tell us about that.
Yes, when I was 11-years-old, my 85-year-old grandfather fell and became paralyzed from the neck down. In his final days, I was the family member who wanted to sit with him when he was on hospice. I was also the last person he took food from. My grandfather stopped eating and he told me he was ready to die. At first my 11-year-old self was shocked by this and may have said something like, “But you can’t do that. That’s illegal!” But then I came to understand how important his wishes and decisions were in how he was able to face death.
Several years later, I had a very different experience with my grandmother, who was also on hospice but not ready to die and went out ‘kicking and screaming.’ At the time, I was a potter and working part time at a retail store. When I visited her she communicated that she’d like me to stay with her and I knew it was important for me to do so, even though it might not the best situation with my employer. I set up a cot and stayed with her for three days.
Looking back, what do you make of these very different death experiences?
I am aware how different each person’s death is and how important it can be to understand a dying person’s wishes, concerns and experiences. I bring that into my work as a doula and a hospice nurse.
What was your career path like?
Nursing was actually a second career for me and arose out of a practical situation in my family. My first career was as a potter. After getting married and having a son, there was a time when my husband had medical issues and could not work. That’s when I started nursing school. At the same time, I began volunteering in hospice as a respite volunteer.
After nursing school, you started out in oncology. How did that come about?
Yes, the advice I got in nursing school was that it was important to have experience in another area of nursing. As it turned out I landed a bone marrow transplant job. It fit it in well with my skills because many don’t survive that process so I ended up doing quite a bit of anticipatory grief work.
What were some other jobs in nursing you had that you feel prepared you for hospice nursing?
I worked as a nurse navigator with breast cancer patients. Later, I worked with head and neck patients, many of whom were veterans. I felt that my time with them helped me to become an expert in a complicated and narrow field that doesn’t always get as much attention as other cancers.
Tell us a little bit about your work as an End-of Life Doula. I attended a training 2-3 years ago and knew I wanted to do this in addition to being a nurse because it gave me the opportunity to work in vigil with people without constraints of Medicare. When I work a doula, I don’t act as a nurse but I do use nursing knowledge. .
What are some important things you’ve learned from your patients about the grief journey?
I’m learning more and more that birth is like death. Every birth and death is different. A term I use a lot with people is “This is unchartered territory.” You need to remember that each person’s experience includes that sense of not knowing what to expect and figuring that out.
Who are you in the unchartered territory?
I see myself as a navigator or guide.
How do you help people address end-of-life issues and fears ?
I’m a Quaker. So it’s often not what I say but what I don’t say. People in our society are quick to say something or fix something. I am comfortable with silence. I don’t view my role as a fixer. It’s my job to help them people make safe passage and their own decisions. I do a lot of active listening and ask many open-ended questions.
Do you see your work as a kind of calling?
I often feel that way as I look back on the story of my grandfather and grandmother, I had no idea at the time but see now this was what I was meant to be doing. I can’t imagine doing anything else.
What still surprises you about the way grief is treated in our society?
People are still so uncomfortable with it. I just lost my Dad a year ago. I couldn’t read through all the bereavement cards because so many said things like ”He’s in a better place now.” People are well intended but just can’t seem or don’t want to ask, ”How are you feeling?” or “What do you think you might need now?” A lot of people also base their reactions on what they have experienced instead of trying to figure out what you are experiencing.
What refreshes and sustains you in your work?
I love reading, nature and am into animals, especially chickens.
Chickens, yes! I see you use the term “Urban chicken whisperer” to describe yourself. What is that?
I had a special chicken named Marigold. She lived to be 8 years old. She was like a therapy chicken. She loved to be picked up. And when I had a hard day working in oncology, I could come home and hold Marigold. It helped me transition back into regular life.
How we transition in and out of grief work is so important.
Yes, I have learned it’s extremely important how to transition in and out of spaces. I always try to take a moment before I enter into home so I can let go of distractions and be completely present. At the end of a shift, I may do a few minutes of breathing and meditation.
What is one of the takeaways you’ve had about the conversations you walk on with dying patients?
Often as a culture we don’t tend to talk about death. But I find that we do start having these conversations in a safe and non-judgmental place, it becomes empowering for people and less scary. If your fears are addressed, you have a better understanding about things that might happened and you end up heading into the whole situation with clarity and with not as much fear.
Thank you Apple!
Apple works as a hospice nurse at Providence Hospice. Her business is Applegate Overcrossings. She provides end-of-life doula services and consultation. She also organizes gatherings to discuss end of life issues. She can be reached the old fashioned way by phone (503) 444-1898 or email applegateovercrossings@gmail.com
