Barbara Karnes

When doctors and healthcare professionals place a number on how long someone has to live, they are doing that person a disservice.   We have the right to be told about our disease, its progression, and the options of care and their expected outcomes. We need to know what the probability of our being cured is vs. the disease just controlled. If controlled, what does that mean? What kind of quality (physical and mental activity) will we have? We also have the right to be told if we can’t be fixed, if our disease has progressed to the point it is not fixable. This knowledge gives us the opportunity... Continue Reading

I was thinking about birth and death at three o’clock this morning. I know most people are asleep at that hour—hopefully.      I was thinking how similar they are and that they create a circle. A circle of life. We go through labor to get into this world. It can be easy and gentle or it can be a hard, wild ride. So it is with our labor to leave this world. Some of us go easier than others. For some it is gentle, for others it is very, very hard. After we get to this world we take deep breaths and settle in to get adjusted. As we leave, our breathing gets slower and slower. We are relinquishing... Continue Reading

“I’m so angry! I’m angry that he is sick. I am angry that I’m angry that he is sick.”  “I feel guilty that I’m angry. I’d better not tell anyone how angry I feel. They’ll see what a ‘bad’ person I am. I won’t tell anyone——I’m so depressed.” Anger held inward becomes depression. The above are thoughts from a caregiver’s inner being. Thoughts probably never shared, just kept inside. AND driving its owner deeper into depression. The role of caregiver for someone we care about, or even someone we don’t care about, has many challenges. The challenge... Continue Reading

We tend to forget that life is a terminal illness. We are born, we experience, and then we die. All of living is on the road to death. How is that for a downer?   The thing is dying is a part of living. Like living, it has stages – a road to travel. The road from birth to death passes through infancy, childhood, adolescence, young adulthood, middle age, old age, and ends at death. This is the normal dying pattern. However, not everyone “plays by the rules” so death can occur anywhere along the life road. Disease can occur anywhere along the life road also.   Then there is fast death.... Continue Reading

Dear Barbara, I have two questions please, if you would help. 1. My Mother’s eyes turned color a few hours before she died. Do you know anything about this? 2. When my Mother was struggling (fighting) at the end the pulse oximeter displayed no numbers, the hospice nurse said, ‘She’s gone.’ However, my Mother still ‘breathed’ these abrupt, jolted exhales for about 30 minutes and then these stopped. I want to know, please, did she die when the nurse said ‘She’s gone.’ or when the last breath was exhaled? To answer the first question, about your mom’s... Continue Reading

Dear Barbara, Is the process of dying different for the elderly? Is it different for children? There is no difference for a young person dying from disease, a medium aged or an older person. People dying from disease, whether old or young or in-between, go through the same process.  An older person with no disease actually goes through the same dying process as someone with a disease, only it takes the healthy, older person longer–years instead of months, months instead of weeks.  When it comes down to days, hours, and minutes, we all die in the same time frame, no matter age. There are... Continue Reading

My dementia knowledge revolves around the end of life process. I know it is a symptom of various diseases rather than a disease itself. I know that as we get old our mind naturally has bits of dementia— memory loss being a major “old age” symptom.  I know that dementia doesn’t play by the rules of approaching death. The guidelines relating to food, sleep and sociability don’t fit with dementia. I know that I am seeing and interacting with more situations that involve dementia than I have in my many years of healthcare. I know that almost everyone I know has someone living with various... Continue Reading

Dear Barbara, I have two friends who recently died from strokes. They were both in their 90’s. They were heavily sedated and died within days. I know narcotics can slow breathing to the point where a person stops breathing and dies. Could hospices be using narcotics to euthanize their patients? I can’t respond directly to the situations of the two people referenced above. I would need a lot more medical history. BUT I can address the use of narcotics and euthanasia in general.  As I responded to this letter I thought how often I hear “Hospice killed my mom” or “Did hospice kill my mom”?... Continue Reading

I’ve frequently said that “other people die, not me or anyone close to me.” It’s a statement that seems to fit most people’s attitude toward death. “I’m not going to talk about death. I’m not going to make any plans, like an Advanced Directive. I’ll address those issues later” is basically how we approach end of life issues.  And then one day we are faced with our potential ending. Shock, oh shock! Not me! I thought it was only other people. We can talk about our not being able to be fixed but deep inside we really don’t believe it.  We think, “the diagnosis was a mistake,”... Continue Reading

First let’s clarify the word dying. Aside from the fact that we are all dying a bit with every breath we take, that life is a terminal illness, there comes a time when the body’s breathing, functioning ends. The above is the time I am referring to when I say dying is not a medical event. It is the days to hours before death actually arrives.  The months before death and the weeks of labor before death is when the body is approaching death but not actually dying. I know: semantics, but some people are wondering. In the months and weeks before death, medical intervention and medical tools are... Continue Reading