w/ Alison C. Kepple, MSW, LSW, ACHP-SW. No Place to Die: A Good Death as a Human Right

Send us Fan MailA lot of people assume that when the time comes, end-of-life care will simply be there: a safe place, the right meds, and someone to guide the family through. The reality can be far harsher. We’re joined by Alison “Ali” Kepple, MSW, LSW, ACHP-SW, a certified hospice and palliative care social worker, end-of-life doula, and psychopomp, to name what too many patients and families only learn in a crisis: coverage is complicated, and the biggest gaps often show up at the exact moment you can least afford them.We break down the difference between hospice care and palliative care, why the Medicare hospice benefit covers some things but not others, and how out-of-pocket room and board fees can reach hundreds of dollars per day in hospice houses or skilled nursing facilities. We also talk about what happens when someone is “ready for hospice” but cannot go home due to caregiving needs, housing insecurity, or lack of funds and why some patients end up pushed into unsafe or exhausting workarounds.From the social work side, Ali shares what she’s seeing across New Jersey through her capstone research: moral distress, pressure to discharge, and systemic incentives like hospital morbidity and mortality metrics that can shape where people die. We end by reframing the entire conversation around human rights: death care is health care, and everyone deserves the chance at a good death with comfort, dignity, and support.Subscribe, share this with someone who needs it, and leave a review to help more people find these conversations. What do you think should change first so access to end-of-life care isn’t decided by money?Resources:International Federation of Social Workers. (2025, April, 14). Health. IFSW.org. https://www.ifsw.org/health/Singh, S., Furman, C. D., Flint, L. A. & Teno, J. (2026). Rehab and death: Improving end-of- life care for Medicare skilled nursing facility beneficiaries. Journal of the American Geriatrics Society, 74(1), 26-32      https://doi.org/10.1111/jgs.70067United Nations, (1966). International covenant of economic, social and cultural rights. https://www.ohchr.org/en/instruments-mechanisms/instruments/international-covenant-economic-social-and-cultural-rights  United Nations. (2025, March 7). Ensure healthy lives and promote wellbeing for all at all ages. UN.org. https://sdgs.un.org/goals/goal3World Health Organization. (2020). Palliative Care. WHO.int. https://www.who.int/news-room/fact-sheets/detail/palliative-careSpecial thanks:Alison Kepple, for sharing her expertise, grace, and compassion.Ellen for her fabulous branding and photos. If you need a photographer or graphic designer, [email protected] for the music into/outro. Looking for a custom sound? Reach out to  [email protected] My cousin Gab for sharing your expertise. The best resource and expert to help pull this together. For any podcast assistance, contact [email protected] Monmouth University: School of Social Work; Department of Communication (WXCM 88.9FM); and the Department of Psychology for all your support. Go Hawks!My capstone committee, and my fabulous professors and mentors, for pushing me past my comfort zone“Team B” for your unending support.And, to my children~ just because. <3 humanUpNJ