Thursday - March 28th, 2024
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Barbara Karnes

 
“We’ve done the best we can and we can’t fix you…”
March 27th, 2024

Sometimes our patients and families don’t want to hear the words “hospice” or “end of life care.” I have been asked, “should we use words that are more sensitive?” I don’t think so; I don’t think we need to use other words to be more sensitive to end of life issues. This seems to be a problem today with physicians and healthcare workers. Don’t use the “d word.” Address treatments but don’t say “There is nothing more we can do.” Everybody dies. Our bodies are programmed to die. From the moment we are born we begin to die, yet... Continue Reading

March 27th, 2024
Tomorrow I Will Make my Wishes Known, but not Today
March 20th, 2024

We talk about a Durable Medical Power of Attorney and how important it is to make our end of life wishes known. If we don’t legally make our wishes known in writing and generally notarized, healthcare professionals will make those decisions for us.  Those decisions will be to try to start our heart when it stops beating. (The chances of this procedure being successful if there is a life threatening illness or we are age compromised are slim.) Medical providers will generally listen to the “loudest protester” as to what care is to be given. Generally that loud voice is shouting to do everything... Continue Reading

March 20th, 2024
Six Months After My Husband Died
March 13th, 2024

It has been almost six months since my husband of 62 years died. As an end of life educator I have taught about loss and grief, and even written a booklet about it. BUT what I didn’t really understand were the emotional thoughts and feelings of grief. I couldn’t and didn’t understand because I had not walked in those particular shoes yet. Now I have. I’ve shared thoughts with you during this grief journey. My thinking is if I am feeling a particular way, then others must also. SO, here is what I have experienced recently that would appear “wrong.” I think others must have felt this... Continue Reading

March 13th, 2024
How the Body Prepares to Die
March 6th, 2024

If you look at a person from a healthy perspective you see the need for food, sleep, and socialization. We eat to live. Sleep to revitalize. Interact with others for stimulation.  If the body is preparing to die, the reverse is the norm. We gradually stop eating. We begin sleeping more. We begin withdrawing from worldly interests. All of these patterns are part of the normal life progression. However, most people don’t think of the dying part as normal. They have been led to believe that something pathological is happening. Our body is programmed to die. We are born. We experience, and then... Continue Reading

March 6th, 2024
Can We Revive the Essence of Hospice?
February 28th, 2024

Dear Barbara,  What suggestions do you have in overcoming the changes we see in hospice and healthcare today? It doesn’t look like it did 20 years ago. How do we maintain balance while keeping patients centered?  Hospice originated outside of the medical model. It met needs the medical establishment did not. Gradually, ever so slowly, hospice agencies have been absorbed into that medical model and the original concept has morphed into a business. With any business, money becomes an important factor. With hospice outside of the medical model, in the hands of not-for-profits, it struggled... Continue Reading

February 28th, 2024
It’s Called “Beyond Burnout”
February 21st, 2024

Dear Barbara, We have heard the terms “compassion fatigue” and “caregiver burnout.” Today, after covid, it is being called “beyond burnout.” What are your thoughts about this? Doesn’t it feel like the world has sped up? Everything is so intense these days. That energy affects us all on many levels. Our minds and our feelings are constantly being touched with so much negative energy, world wide. When you add to the external happenings our own individual challenges and you have “beyond burnout.” What do you do about it? I’m not sure there is much we can... Continue Reading

February 21st, 2024
Another Aspect of Grief That I Didn’t Know Until Now
February 14th, 2024

Being in a relationship is about sharing and compromise. It is “let US do this, what do YOU think?” When a person is alone, not in a relationship, they can do what they want; there is no sharing or compromise. I hadn’t thought of that before because I didn’t have to. Now that I am only responsible for myself, I only have to figure out “what do I want?” The interesting thing for me is I’m not used to knowing or doing exactly what I want even though I thought I was. This is another aspect of grief I didn’t know until now that I am living it. Who am I if I am only one? What have I... Continue Reading

February 14th, 2024
Would You Rather Die At Home Or In The Hospital?
February 7th, 2024

Most people, if they had their choice, would want to be in their home with family and the dog or cat on the bed when they die. YET, most people die in a hospital or nursing facility without the dog or cat, and maybe even without family present. In the hospital, if a person doesn’t have a DNR (Do Not Resuscitate) order they will not be allowed to die naturally. The body will be attached to machines to keep it breathing, and when their heart stops, the medical staff will try to restart it, generally to no avail. Without a DNR order, death will not come gently and only hospital staff will be present. If... Continue Reading

February 7th, 2024
Grievers Probably Won’t Reach Out To You
January 31st, 2024

As I travel this grief path I am seeing that many people don’t know what to do or say to grievers. There can be awkwardness, even avoidance from people. I remember when a friend’s son died and Jack and I were on the way to the visitation, husband Jack asked me what he could say to our friends. He didn’t know what to say and he knew there was really nothing he could do for them. I suggested he say just that, “I don’t know what to say. I’m sorry.” There seem to be so many cliches that offer condolences. “I’m sorry for your loss,” “He is at peace now,” “He is with God,”... Continue Reading

January 31st, 2024
Professional Boundaries With Our Vulnerable Patients
January 24th, 2024

Why are professional boundaries so important? First let’s define “professional.” Being professional means being reliable, setting your own high standards, and showing that you care about every aspect of your job. It is about being industrious and organized and holding yourself accountable for your thoughts, words, and actions.  That definition can apply to any job. In this instance I am using the word professional in reference to employees of the healthcare system (doctors, nurses, social workers, home health agencies to name just a few) who are present to address healthcare issues. We enter... Continue Reading

January 24th, 2024