Who Created Elephant in the Room


The husband and wife team of James Desiderati RN and Cindy Moyer LCSW CDP created Elephant in the Rööm™ based on their experiences in work and life.  As a hospice nurse for more than a decade, hundreds of patients and families have benefited from Jim’s clinical expertise, compassion and empathy, and his caring conversational style. Jim also understands what it is like to care for a loved one from a distance.  In a face-to-face visit during his Mom’s end-of-life journey, he encouraged her and his stepfather to consider (and accept) hospice care in her final months, which they did engage.  From 2,500 miles away, Jim was able to have peace of mind knowing that his Mom’s needs were being met and his stepfather’s caregiving load was relieved. 

Cindy is a licensed clinical social worker experienced in caring for home care and hospice patients and their families.  She is a former Director of Admissions and Social Services in a long-term care setting.  Her personal experiences as a family caregiver and advocate for beloved family members enable her to empathize and communicate compassionately.  When faced with difficult healthcare decisions, Cindy had the confidence to advocate for her loved ones’ wishes because they had conversations for many months before decisions were needed.  It wasn’t as easy when her Dad was dying. Cindy, her brother and their Mom had only minutes to make a decision about organ donation. Because they hadn’t had conversations about death and dying before her Dad was stricken suddenly, they had to quickly make a decision while sitting in a cardiology waiting room. 

Because they have “been there” and “done that,” Jim and Cindy started an advance care planning consulting service based in Pennsylvania (Caring Choices) to help individuals and families have these important conversations.  


“We created Elephant in the Room as a tool that individuals, families, and communities can use independently.  We know that these conversations are difficult, but can be so meaningful.  Through Caring Choices, we offer in-person consultations; but we recognize not everyone is comfortable talking with strangers.  So, we offer “Ellie” to start those conversations on your own!” ~ Cindy and Jim