Own Your End: Navigating the “Staircase of Decline” with Palliative Care Expert Kristy
EnhDme Feature ❖ Leaders in Care
Why are we waiting until a crisis to have these conversations? Palliative care expert Kristy, founder of Own Your End, shares her powerful framework for navigating senior decline with clarity and confidence.
Hi, I’m Kevin from EnhDme. Our mission is to share the stories of the caregivers and medical professionals who define the heart of senior care. Today, I’m talking with Kristy, a veteran Palliative Care Nurse Practitioner and the founder of Own Your End.
With over 20 years of experience, Kristy helps families move from “crisis mode” to “ownership.” In this interview, we dive into the difference between palliative care and hospice, the signs of caregiver burnout, and her powerful framework for understanding senior health decline.
The Spark: From Japan to “Own Your End”
Kevin: Kristy, you’ve been doing this for two decades. What was the specific moment that sparked your business, Own Your End?
I was visiting my daughter in Japan, finally feeling relaxed for the first time in a long while. I realized I was good at my job, but as a medical community, we can do better. Why are we waiting to have these conversations until people are in crisis? Crisis is the worst time to make life-and-death decisions. I wanted people to decide what the end of their life looks like. My daughter said, “You should call it Own Your End,” and I felt truly called to move forward.
Debunking the Myths: Palliative vs. Hospice
Kevin: Many families get confused by the terminology. How do you explain Palliative Care without the jargon?
It’s a huge myth that Palliative is the same as Hospice. Palliative care allows for concurrent medical treatment at any stage of illness, while Hospice focuses solely on comfort in the final stages. Palliative care is for every stage of an illness. Hospice is for the end stages, focusing on comfort once “curative” treatments are stopped. Both focus on quality of life, but Palliative starts much earlier.
Understanding the “Staircase Pattern” of Decline
Kevin: You’ve watched families navigate decline for 20 years. What patterns do you wish you could prepare every family for?
I call it the Staircase Pattern. We start at the top. When an elderly person has an “event” — a fall, a UTI, a hospital stay — the medical team “fixes” the event, but the person doesn’t return to the top step. They land on the next step down. They are a little weaker, or their thinking is a bit off. Eventually, those steps happen closer together until they turn into a slide. Recognizing this helps families stop expecting a return to 100% and start planning for the reality of the next step.
“Recognizing the Staircase Pattern helps families stop expecting a return to 100% and start planning for the reality of the next step.”
Defining “Quality of Life”
Kevin: “Quality of Life” is a phrase we hear often. What does it actually mean in your practice?
I don’t define it; the person does. For one person, it’s staying out of the hospital. For another, it’s having enough breath to talk to grandkids or taking fewer medications. I help them explore their values — dignity, comfort, family — and those values become the guide for every medical decision we make.
The Power of Planning
Kevin: What is the one conversation families avoid but desperately need to have?
I have a list, but these two are non-negotiable:
- Do you want CPR or a natural death? Over age 65, CPR rarely restores health; it just brings you back to a state of suffering.
- Designate a Healthcare Proxy. If you don’t pick someone, the state will. In Florida, for example, if you have six kids who don’t agree, it becomes a nightmare. Put it in writing.
Caregiver Burnout: Leaving Perfection at the Door
Kevin: Caregiving is an immense emotional burden. How do you support those who are hitting a wall?
I see so much overwhelm and uncertainty. My advice is to leave perfectionism and guilt at the door. Ask yourself: “Did I do my best?” Usually, the answer is yes. Let that be enough. To fight burnout, I recommend the “5-minute rule”: 5 minutes to journal your worries, listing 3–5 things you are grateful for, and 3–5 small accomplishments.
Looking Ahead to 2026
Kevin: If you could give caregivers one piece of guidance for this year, what would it be?
I know your “to-do” list is already exhausting. But if you work through these decisions before the crisis happens, you will face the future with confidence instead of anxiety. You can “Own Your End” by being intentional, just like we are with weddings or births.
“Preparation is an act of love. Clarity is the best antidote to caregiver burnout.”
Connect with Kristy & Own Your End
Kristy is launching a 90-minute guided session called “Clarity and Confidence: Before the Sun Sets” — designed to help you orient to the stage of decline your loved one is in and start making values-based decisions.
- Take the Quiz: Find out what stage of decline you are navigating
- Instagram: @ownyourend.co
- Facebook: @ownyourend
- TikTok: @ownyourownend
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