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Barbara Karnes

Advance Directives Are Not Written In Stone

As I write this, I am thinking I may stir up some feelings. Please remember my goal is to give you something to think about. Filling out an Advance Directive when you are healthy is different than filling one out when you are elderly or living with a serious illness. When we are healthy we […]

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Why I Believe a Person Should Be Told They Can’t Be Fixed

I got a letter telling me that we, healthcare professionals and doctors, should not tell people they are going to die. The letter got me thinking about why I believe a person should be told, and also wondering if there are indeed people that don’t want to know.  Let’s start with people that don’t want to […]

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Helping A Family Decide Whether to End Life Support

Dear Barbara, How can I help my family decide whether to “pull the plug” on my ex-husband? He is on life support machines right now. Also can you give me some advice as to the Death Doula role for pulling the plug?  I don’t know the details of your ex-husband being on life support so […]

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We Euthanized our Cat Yesterday

Yesterday we put our seventeen year old cat to sleep. Euthanized is the proper term but “put to sleep” has a peaceful feeling and killed has an awful feeling. I work with dying situations all the time, 42 years to be exact. But this was personal, this was our Danger cat. (I know, a totally […]

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When It Comes to End of Life Care, It Takes a Village

When I started in hospice, in its beginnings in the late ‘70s, hospice met all end of life care needs. In fact, hospice was the only healthcare service meeting any end of life needs. However, most people had never heard of the concept. Fast forward 40+ years. Hospice is widely known for providing end of […]

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Is Increased Sleep a Sign of Approaching Death?

Dear Barbara, My father is 95. He has been in pretty good health but has started sleeping a lot in the day and is not eating very much. Is it possible that this may be a sign that the end is near? Your blog says sleeping more and eating less is a sign that relates […]

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The Sacred Moment of Death

The sacred moment of death – that is the goal for those of us who work with end of life. Guiding, supporting and teaching those present what is normal in dying and what is not. What is fixable and what is not. What is painful and what is not. What to do and what not […]

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How Do You Tell Someone Something They Don’t Want to Hear?

How do you tell someone something they don’t want to hear? Very carefully and with compassion in your words. In thinking about the answer to the above question I have two different answers. Those answers depend on who is delivering the information. Physicians: Nobody wants to hear they can’t be fixed, treatment is no longer […]

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