The Comfort Kit

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My mom had been found doubled over and non-responsive, and when they put the oxygen monitor on her finger, her oxygen saturation was in the 70s. Which, if you're in the medical field, a sustained oxygen saturation in the 70s, it's not compatible with life. In fact, it's not very long until someone is brain dead. This is Rachel Waters. In July of 2023, she got a phone call from the Memory Care Unit at an assisted living facility where her 74-year-old mother Marsha lived. Marsha had advanced Alzheimer's and cancer that had stopped responding to treatment, and had been on hospice care for the past seven months.

Rachel says, "When staff from the facility found Marsha, non-responsive, they'd gotten in touch with a hospice nurse." And when he got there in examined her, he declared that she was actively dying. My mom did have a DNR. Had do not resuscitate order. So, she did not want any resuscitation. And so, in the absence of resuscitation, he determined that she was eminently dying and had hours two days to live.

“And so, the staff called me and they got him on the line too, because he was there, and they said, "You need to get down here immediately, because your mom may not be alive for you even to make it from New York."”

Rachel lives in Queens, the care facility was in Georgia, not far from her hometown. Rachel had been traveling to Georgia once a month to be with her mother, and had known it was possible she might receive a call like this. When someone is on hospice care, it usually means they have six months or less to live, and they receive care that focuses on comfort instead of treatment. Rachel and her partner David quickly looked up flights. Unfortunately, there was a really catastrophic storm with massive flooding that had grounded all flights leaving New York.

We had three flights in a row canceled, so we had to take an amtrak the next morning to DC, and then fly to Augusta, and the whole time I'm texting the nurse like as she still alive as she still there. Even though she was not responsive, she was still hanging on, and by the time I got there, it had been more than a day,

non-responsive, no food, no fluids. She'd been put on oxygen, that brought her oxygen saturation up, but she never regained consciousness,

and basically looked paralyzed when we arrived. She couldn't move, and it was clear she was in the active dying process.

“So we set up a bed in her room and waited, did she seem comfortable?”

No, she did not. She had to large bed sorrows that appeared, and the only responsiveness she had was when staff came to turn her face, which is distorting agony, looked like a Greek theater mask, and it was clear to my husband, not that she was in an immense amount of pain when she was turned, and sometimes she would try and make an utterance, but her eyes were unfocused and glassy. They were starting to dry out because she had had no fluids. It was really clear that whatever

dying process she was going through was not comfortable. Rachel asked the care facility staff if they could give her mother something for the pain, most of the people who worked there were AIDS, not doctors or nurses, it was in a medical facility. So Rachel asked if they had what's called a comfort kit, something that's often given to caregivers when someone enters hospice care. It can include medications like morphine and the Razopam

that help manage pain, anxiety, and other end of life symptoms, like shortness of breath.

that hospice get one prescribed ASAP. The care facility consulted hospice nurses. They worked with.

“And they were like, "Well, we don't think she needs it," and they were like, "She's comfortable."”

And I was like, "She has bone cancer and bed sores," and she's clearly in pain. She's not comfortable, and she is entitled to comfort care under law. According to Georgia State Law, hospice services must ensure that patients and their families receive palliative care for persons with advanced and progressive diseases, when offered. In a manner that respects and protects their dignity,

and ensures all patients' rights to receive care that neither physically or emotionally abuses the patient,

nor neglects the patient's needs. Rachel says the hospice staff didn't explain

why they believed her mother was comfortable and didn't need the comfort kit. Which was the source of conflict, right? Because we and my friend Allison, who was also a hospice nurse, was coming in and examining her. And she was like, "I don't know why they're declining to prescribe this. This is very unusual. This is not the standard of care." The care facility wrote in their logs, "The bay consulted a family doctor," who said she

"will not start morphing at this point." And the logs noted that a hospice nurse "doesn't see any reason to start resident on morphing." And it seemed like when Rachel talked about morphing made this nurse really uncomfortable. Rachel's partner David remembers feeling confused about the nurse's reaction. She's in a life, and hospice's whole entire purpose is to ease people's pain as they pass. I mean, I must have had a emotional time. You wrote

watching Marsha clearly in pain and dying, and then trying to speak with these nurses,

“or speak with the workers at the facility. I mean, what were those conversations like?”

I can imagine it was probably not heated, but you know, you were trying to advocate for someone who's on pain. Yeah, I mean, we were advocating Rachel's very direct, but she wasn't being agitated or anything. It was a very calm, like, direct, like, "Oh, this is what she needs." And it was just kind of frustrating because they were not listening to her. And there wasn't any heated argument. It just seemed like this person had already made up their mind

about what Rachel's mom needed. Rachel remembered that there was a comfort kit with morphing at Marsha's house, which was about a 30-minute drive away. Marsha had stayed in her own home

for the first few months of hospice care, and Rachel had been given a comfort kit then,

along with instructions. The nurse who came to the house for weekly visits at the time explained,

“you know, this is what these medications are for, especially if she begins to experience pain”

or respiratory distress during the dying process. Here's the emergency hotline number. This is what you call, if you start to see these symptoms, and we can walk you through the given administration of these medications, but you'll essentially be expected to administer them at home, especially in the event. If you're a loved one can, administer themselves. And it's generally assumed that you're loved one can't if they're actively dying. When Marsha was moved to the

memory care facility, Rachel says she was told it was fine to hold on to the comfort kit. David drove to Marsha's house to retrieve it. And so I just picked it up and put it in the car. Because we knew the care facility is not having anything on hand, and in the evening it was almost like skeletal personnel. You know, there's a perception this and like maybe some more delays, no medical, real medical professionals. I knew there was a nurse on call, but in the evening when

we were there by ourselves, we knew, you know, we're kind of on our own. And so we just wanted to be prepared. That night, Rachel and David set up an air mattress on the floor of Marsha's room. Very early the next morning around 4 a.m., a noise will come up. And that was my mom fighting for air. And I knew from a booklet that actually my hospice nurse friend, Allison, had given me about what to expect at the end, the explanation of

Aginal Breathing. And this mandibular breathing, where they sort of just thrust their and smash their teeth together in an effort to kind of galper swallow air, that is a kind of impending death. It usually happens anywhere from three or four hours to 20 minutes before death.

gasping for breath. It's like watching a fish out of water, trying to breathe.

And we knew that the comfort kit literally says on the bottle, the morphing bottle says, for shortness of breath. Rachel remembers wanting to check one last time to see if the care facility would order a prescription, which would enable the workers at the facility to administer the medications, right? We didn't want the responsibility for that because it is an utterly nerve-wracking thing already to watch your parent die much less be responsible for their comfort

care. So at that point, seeing my mom in this desperate agony, hungering for air, I ran all the way to the front desk and said, "Please, please tell me that

comfort kit prescription has come through with morphine because my mom needs it now."

They went and checked and said, "Nothing had come through." And at that point, my husband's like, "I can get it from the car and we can call the hospital hotline and see what we can do." And so that's exactly what happened, as he went and he got the kit from the car. And I called the emergency hotline and I explained her symptoms to the woman who was on the line and one of the things I asked, I said, "Even though she's in memory care,

“is it legal for me to give her medication here?" And she said, "Well, yes, of course, that's why”

we prescribed the comfort kit." The family, like, that's what this is for. David says while Rachel was on the phone with the hospice hotline, some of the aids came into marshes room. David Rembers Rachel told them that the hospice hotline had told her it was okay to give her mother some morphine from the comfort kit. She was trying to make sure she was doing things right, make sure everything everyone knew, what was going on. But they said, "Oh, I don't want

any of that." And just like walked out. Essentially, it's as if we, I don't know, like pull out a gun or something. This is the way they reacted. It was just seen like a complete overreaction to something that's in a comfort kit. Like they were suggesting it was something illegal or something. Yeah. Essentially, they were reacting as if we were, you know, committing a crime and they didn't want any part of it. Rachel asked the nurse on the hospice hotline, "How much morphine should

give her mother to ease her pain?" And Rachel says the nurse recommended one milliliter.

“I was so nervous. I was like, "You need to double check and make sure I'm trying”

up the exact amount because my biggest fear was the idea of making something worse for my mom." But it's given sublingually under the tongue just a couple of drops of, um, of liquid morphine. And unfortunately, probably because she was so advanced, it really made no difference whatsoever. She continued to gas for air and smash her teeth together until she died about 36 minutes later. After she died, you know, hospice came and they declared her and they did all the expected

things. They came and changed her clothes. They cleaned her. They dressed her and the funeral home was delayed and coming to pick her up. You know, she died very early in the morning. The funeral home couldn't get there to, like, 11, 10, 11 a.m. and so the funeral home said, you know, you guys can just go home and rest. She probably had any sleep. Rachel and David started driving to Marsha's house. In the car, Rachel got a phone call

from someone at the funeral home who said that there was a problem. They couldn't pick up Marsha's body because it'd been taken to Atlanta to the crime lab at the Georgia Bureau of Investigation. I'm Phoebe Judge. This is criminal. We'll be right back to listen without ads. Join criminal plus. Thanks to Squarespace for their support. Making a website can be intimidating,

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varies. See mintmobile.com. Tell me a little bit more about your mother. Well, she like. My mom was amazing. My mom was an brilliant engineer. She was in satellite communications, civilian personnel for the U.S. Army. So she did all of their set-coms. But she was also a great artist. She was a painter. She drew something she and I shared in common. We both were very

much into art. She did a lot of wildlife art for autobahn, for ducks unlimited, and never mind art.

She was an English teacher for a year before she went to work for foreign issues. Also super literary. She got a huge love of literature and poetry. And it was something that really deeply connected us. Rachel Waters says growing up in the small town of Harlem, Georgia, she always felt

“like kind of an outsider. I was a weird kid growing up. I didn't know it at the time. But I was”

later diagnosed with autism. So I was quirky. And my mom was always my steadfast defender. Whether it was from school bullies or, you know, my father or I had kind of a difficult childhood. You know, he didn't understand me as much. So my mom and I were extremely tight. And that carried through kind of all my life, you know, before I moved away to New York, we were together every day, whether it was running errands, running to the grocery store, or hanging out in some

capacity. And even when I moved to New York, we talked on the phone every day or texted. About five years after moving, once she was in her late 20s, Rachel did a 23-in-me genetic screening test. Her partner David is an Alzheimer's researcher at NYU, and Rachel wanted to know if she had a kind of gene that put her at risk for developing the disease later in life. They would find that if you had the APW4 variant, which is sort of colloquially known as the Alzheimer's

gene. And I had a copy of it. And my mom hadn't done the test at the time, but as soon as I came up positive for a copy of the gene, I was really haunted by recollections of family stories of my maternal great-grandmother having seen Isle dementia, as they called it in the early 1900s. And so I urged my mom to get a test, and sure enough, she also came up positive for the gene. And it was within literally a couple of months that I started noticing just some weird blips

here and there, it was just pronoun reversal. So all he's where she's, all she's, where he's but it stayed like that for years. And when I say there was no other sign of decline, this was the woman who did everyone in the family's taxes, including mine, and didn't make a mistake. So there was no real meaningful signal for cognitive decline, but it was a quirk that I sort of made a note of to kind of pay attention to. But when the pandemic came in 2020 and lockdown happened,

I realized that something really serious was happening when her text messages to me became increasingly garbled, really screwing up her spelling and grammar in ways that were really unusual for my mom. And I knew then that she was probably on that downward slope into Alzheimer's, and we rushed

which was when I'd less senior in January of 2020. She had lost a lot of weight. Her entire

“spine will call them head collapsed from osteoporosis. And I rushed her into a gerontologist”

and kind of immediately jumped into action to sort of stabilizer bones and hopefully get her on some medication that would slow the march of Alzheimer's. Rachel says that together with Marsha's doctor, they decided she could remain at home for the time being. And so we managed it initially by just kind of setting up her home in a way that would help her feel familiar and safe and coming down there really frequently. So I was

down there every six weeks. And I would spend about a week at a time just kind of evaluate

where her function was, how she was doing. And at first, it's kind of a slow burn, but then when

she was diagnosed with multiple myeloma, which also impacts people cognitively in 2022, she fell off a cliff quickly. And that was when, you know, we really had to rush into action to get in home care. Marsha began a immunotherapy for the multiple myeloma, a rare kind of cancer. But after a few months, the oncologist told Rachel, it wasn't working. Rachel remembers the oncologist said Marsha probably had about six months to live

and suggested thinking about hospice care. The modern-day hospice movement was led by an English physician and social worker named Cecilie Saunders in the 60s. She talked about the concept of total pain, which included not just physical pain, but also emotional, spiritual, and psychological suffering. She believed all of it should be addressed when caring for dying patients. Her ideas inspired the first modern hospice

in the U.S., which was founded in 1974. The hospice movement kept growing throughout the next few decades, in part due to the AIDS epidemic. One man who runs a hospice in California has said, "Many health care workers were afraid to take care of these people, but this was core to the hospice philosophy of care, to deliver on compassion, dignity, respect."

Today, around 2 million Americans receive hospice care every year, and many of their caregivers

receive a comfort kit, like the one Rachel had. When Rachel got the call from the funeral home that her mother's body had been taken to the Georgia Bureau of Investigation,

“she remembers feeling shocked. I mean, did anyone explain to you why?”

Oh, I didn't need an explanation why. I knew the only reason the person's body would be taken to the crime lab is if someone had alleged that there had been a murder. And so my husband was like barely able to continue driving the car because, you know, I have this on speakerphone, and he can't believe what he's hearing either, because typically also you're told what to expect if someone dies in hospice that typically do not have an autopsy because it is an expected death.

So, it's not standard procedure by any means. And so, I called the first attorney I could find

Robert Hamler in the area, and he, after relaying my story, he said, "Yeah, you know, you're almost certainly correct. They probably are looking at you potentially as a murder suspect or a felony murder. So, I start Googling, you know, what these potential charges are, what they carry. But also, you know, telling him the story, he and I both felt really reassured because every record showed the reason I was down there was because she was actively dying, she had a prescription

for more pain, she had active Alzheimer's and cancer, and had been dying for days. She was declared

“dying long before I arrived, and he, you know, said, I think your odds have ever been charged for anything”

like this, you know, just like your bow is good as getting hit by a meteor. So, you know, as long as, you know, you're really thoughtful and, you know, you know, that you have all these records, it should be resolved." Later that same day, police officers came to Marsha's house, looking for Rachel. Two plain closed investigator showed up at the door, asked for my phone, asked to speak to me, and I said, you know, you can speak to my attorney,

and you can get a search warrant for my phone. They came back with the search warrant about three hours later, and it had my name and the words homicide on it, which confirmed my fear, but the search warrant also included the comfort kit or the prescription for more pain. So,

understand that this is like a normal course of work for hospice.

“Did you ask your lawyer, you know, hey, is this something that happens from time to time?”

You know, trying to hurt of it in his life? It was one reason he and none of the other lawyers because God knows I talked to a ton of other lawyers to say, you know, what can I expect? Like, how long did these investigations take? Have you ever heard of a case like this? You know, should I have anything to be concerned about, but they did not know of anybody who had been under investigation after their very sick loved one died in hospice?

Rachel spent hours looking for similar stories with no luck. One of the closest things she found was the story of a Philadelphia nurse named Barbara Mancini, who'd been charged with assisted suicide after giving her father a vile of morphine. Her father had been 93 and in hospice care. According to local police, the hospice nurse said Barbara told her she "gave him the morphine it is request so that he could end his own suffering."

Barbara said she hadn't said that, and that she'd just been trying to help a Mancini's pain. She was arrested and prosecuted on the felony charge of assisted suicide, but a judge dismissed the case. The judge said there wasn't enough evidence that Barbara had intended to help her father die, and that the prosecution was relying on speculation and guess. Rachel was worried she could face even bigger charges. Her lawyer thought it was possible

she could get charged with something called felony murder. You don't have to kill somebody or even intend to kill somebody, but if they die during the commission of a felony, you can be charged with murder and subject to the death penalty or life in prison just as if you had murdered the mancini. Rachel says she tried for months to get the memory care facility to hand over

marshes medical records. Finally, in February of 2024, seven months after her mother died, she received

them. When I read through the record, I saw that on July 11th, the day I had gotten into conflict with the nurse about morphine not being prescribed. She charted that I had requested youth in Asia, put it in quotes. We'll be right back. Support for criminal comes from Natorium. Once you have consistency, chances are you'll find results.

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you can try Nat Suite next for free. If your revenues are at least in the seven figures, go to net Suite AI.com/criminal. Built-frivery industry, ready for every boardroom, Nat Suite.AI/criminal. Rachel Waters says she was shocked when she read that the nurse that her mother's care facility

I started to panic again, called my attorney, and it was like, what is going on? He's like,

this is, you know, someone's here, say, I'd still like stay calm because this is just tiling unlikely for anything to come of us. And for a while, nothing happened. But in February of 2025, the day before Rachel's 42nd birthday, an anonymous Instagram account left a comment

“on one of her posts. Quote, why have you been indicted for murder in your mother's death?”

Shame on you. And then posted underneath that was a copy paste of a very official looking indictment number with Judge Barry Fleming. What do I know? Was the Judge in Columbia County's

name there? And two counts of murder, felony murder, and malice murder, and my name.

I was terrified. My husband was like, this has got to be some kind of scam, somebody's trying to blackmail you. I had a feeling it was not. Sorry took a screenshot. I sent it to the attorney. I had consulted with. And I said, Robert, is this real? Am I about to be arrested? He replied, yes. Robert recommended that she hire another lawyer named Brian Steele, who had worked on a couple of high-profile cases. Brian said to me that it was one of the most

“horrifying things he'd ever heard, and so he felt compelled to take it. And I think any attorney I”

spoke to was really shocked by this. They never even heard of it, never even conceived of anyone

being charged with murder under these circumstances. Rachel says Brian Steele started planning right away. And he said, you know, one of the first things we're going to do is we're going to make arrangements for you to turn yourself in so you can make bond. Turning herself in meant going back to Georgia to be arrested. Because Rachel was facing murder charges, it was possible that she would not be granted bond and would have to wait in jail for trial. She'd been planning a party for her 40

second birthday the next day. As when asked me, it was like, I'm going to go through this party. I said, yes, because I need to let people know what's happening to me and let them know what to

“expect. And so when people came over the next day, it was like 45 people came for the party.”

I gathered folks around and told them what was happening. Rachel says most of her friends were in shock. Some of them started crying. Many of them volunteered to come down to Georgia to testify as character witnesses at her bond hearing. Early in the morning on the following Wednesday, Rachel turned herself in at the Columbia County jail. I was put in medium security. You know, shoured sprayed with disinfectant and oil

possessions taken away, put in a cell with your soulmate. Her bond hearing was later that day. Over 30 people showed up to be character witnesses for Rachel. Friends flew down from New York and her ex-husband from an earlier marriage was there. Her partner David remembers that the courthouse was so packed. There weren't seats for everyone. Eventually, the district attorney asked for a break and spoke with the judge. After that, Rachel was granted bond.

The judge granted $200,000 bond and my husband was able to pull together to pay that bond you know, fee. It's like 15%. And to secure my release at 6.30 that evening. Rachel was able to return to New York and she and Brian steal the gun preparing for trial. It wasn't long before they received the prosecution's evidence. When we got that evidence, we realized it was scant. There was almost nothing there except for two witness testimonies,

only one of which implicated me negatively in any way. It was from the hospice nurse at the facility who said that Rachel, quote, wants Marsha to die and she did not want Marsha living any longer. There was my Google searches for murder charges after my mom died and there was the autopsy report and it listed morphine toxicity along with a ton of other things as caused a death like liver and a crisis and kidney failure. And it has the morphine concentration

which stood out to us because we'd been looking at morphine concentrations in overdoses and we

like various search warrant visitor logs but we noticed that her medical records didn't appear to be

there. We didn't see any of the records showing that I had been called down that she was declared actively dying and there didn't appear to be much context that they had for my mom's death. And upon seeing this I like my husband I call my attorney and we're like are we sure that's is it? This is all they have like they don't have medical records. They don't have any of this because

“we have them and he was like yeah I think this is this is pretty much it and we realized then”

my God like if these things weren't available to the medical examiner we can provide boat loads of context if we were able to get our evidence over to him and to the DA. We have a mountain of evidence with like thousands upon thousands of pages and documents and photos and text messages far more from my phone than what law enforcement seemed to have pulled from my phone. And so we got on the line with Brian and was like like with the medical examiner and the DA

would they be receptive to seeing all our evidence of front you know and Brian was like yeah it's worth a shot because you know there's no guarantee that it's going to change anything but yeah let's give them medical examiner in the DA an opportunity to look at your evidence and we sent the medical

examiner everything first he reviewed it and then in August I got a call from Brian that he was

revising the cause of death for it to no longer be listed as a homicide after reviewing everything. The medical examiner changed the cause of death to undetermined. Rachel and Brian also sent their evidence to the district attorney and she spoke to the medical examiner and it was less than an hour before she announced that she was going to drop request that all charges be dropped. We reached out to the care facility and hospice service for

“comment but didn't hear back. What has life like Ben Views since the charges were dropped?”

Oh man it's it's been brutal. I I had a career I loved I had a life savings and a retirement and that is all gone. I have not been able to find work. I've applied for jobs in my field and I have not heard back. Rachel says even though the charges were dropped they could pop up on some background checks

and the first thing that comes up when you google her name are headlines about the case.

Over the past year she spent a lot of her time talking with hospice workers and attorneys and has drafted a proposed law that would create more structure and protection around the use of comfort kits. There are no explicit laws at least not in the state of Georgia and almost certainly

“not in other states so that we have not dealt as deeply as we have in a Georgia law that explicitly”

protects caregivers who are given these medications these control substances and told to administer them to their loved ones as they're dying and there's sometimes an assumption especially in light of the opioid crisis that you know if you have your hands on these medications and you're not a doctor or nurse that there might be something nefarious behind it and because there's no explicit documentation of that or explicit protocol surrounding that it kind of leaves it wide open where if someone

alleges wrongdoing or foul play then family caregivers are in a really tough position when they're loved one inevitably dies. Rachel says she started hearing from other caregivers some of them saying that they've been under investigation after their loved ones died in hospice too. There's an ongoing investigation in Michigan into a woman who allegedly gave her sister a hospice patient an overdose of morphine. Just a few months ago on what would have been my mom's birthday

March 18th I went back down to Georgia and so I had a small ceremony with my husband and friends. Rachel invited people over to her childhood home and put out lots of marshes art. Marcia had requested some of her ashes be scattered on the property and Rachel buried some at the edge of the pond behind the house right next to a bridge that her grandfather had built.

accuse me of killing my mom. We'll have a link in the show notes.

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“That's why over thousands of businesses have made the switch. So why not you? Try Odo for free”

at Odo.com. That's OdoO.com.