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Dear Barbara, As a new hospice RN, I would like to thank you for your contribution to hospice. Your booklet Gone From My Sight was so touching to read and gives my patients' families so much comfort. …

Dear Barbara, As a n…

Dear Barbara, As a new hospice RN, I would like to thank you for your contribution to hospice. Your booklet Gone From My Sight was so touching to read and gives my patients' families so much comfort. I am sure you are a very busy woman, but if you have any advice for a new hospice RN, it would be greatly appreciated. After working in several areas of Nursing, I truly feel that hospice is my calling, and I want to do it right. Welcome to the world of hospice nursing and to finding your special place. So few people find that place anymore. For too many, a job is simply a paycheck. How lucky you …

Dear Barbara, I lost my mom to Cancer. I had taken 2 months off work to be at her home. I have lost my way since her dying. Lost my job, home, Family, friends. I am struggling as I write. Why is this …

Dear Barbara, I lost…

Dear Barbara, I lost my mom to cancer. I had taken 2 months off work to be at her home. I have lost my way since her dying. Lost my job, home, family, friends. I am struggling as I write. Why is this still the core of my downfall. I saw my alcoholic dad to his last breath too, 20 years before, and although at that time I walked out on a job I loved and people in my life to care for him, I was able to stand on my own two feet afterwards. Any writings for stunted Grief process would be appreciated. Grief can be very complicated- as complicated as our relationship with the person who died. In fac…

I have always been on the taking-care-of-people side of healthcare. Recently, my role switched and I found myself on the being-taken-care-of side. (Not to worry, I am fine now. My broken ankle is heal…

I have always been o…

I have always been on the taking-care-of-people side of healthcare. Recently, my role switched and I found myself on the being-taken-care-of side. (Not to worry, I am fine now. My broken ankle is healing.) I think the biggest challenge I had as a patient was not being seen as more than a physical problem needing to be fixed. What has left a lasting impression on me is that person-to-person human interaction is just as healing as the procedures performed, and that our medical emphasis is often not on the person and those interactions, but on the problem. Most healthcare providers do a job that …

I remember my mother sitting in a hospital gown on the end of an examining table, listening to her oncologist explain her lung cancer. She was smiling and nodding her head as if she understood what he…

I remember my mother…

I remember my mother sitting in a hospital gown on the end of an examining table, listening to her oncologist explain her lung cancer. She was smiling and nodding her head as if she understood what he was saying. I was standing off to the side, and I didn’t understand him — and I have a medical background. It wasn’t that I couldn’t hear him. It was as if he were speaking a foreign language—and he was. He was speaking medical language that most non-medical people (and some of us with medical backgrounds) don't understand or know how to translate into plain words. I am sorry to say my …

Dear Barbara, My 87 year old father has cancer and about six months to live. He will not tell his wife (my mother) or my sister who lives close by and helps them out. He has made me promise not to tel…

Dear Barbara, My 87 …

Dear Barbara, My 87 year old father has cancer and about six months to live. He will not tell his wife (my mother) or my sister who lives close by and helps them out. He has made me promise not to tell. I live far away. How can I help all of them? How can I convince him to share the closure of his life with those close by him. My mother is in denial of death--hers, his, ours. How can I help these people I care about? I see your dilemma: wanting to honor your father's wishes while also wanting your family to know about the gift of time they have been given. Let's start with your father since he…

The hours to minutes before death are some of the most important moments we will ever experience with another person. Yet most people are not prepared for what to do, what to say, or even what is okay…

The hours to minutes…

The hours to minutes before death are some of the most important moments we will ever experience with another person. Yet most people are not prepared for what to do, what to say, or even what is okay to do in those final hours. Everything hospice and end of life doulas do leads up to this moment. Their role is to guide, support, prepare, and educate families and caregivers so the experience can become something sacred: a sad but meaningful memory they will carry forever. People don’t die like they do in the movies, but most people don’t know that. Because they don’t know that, they also…

I was asked about a caregiver who was encouraging their special person to socialize with many visitors and to eat more. The hospice nurse’s teachings and suggestions about the dying process were eit…

I was asked about a …

I was asked about a caregiver who was encouraging their special person to socialize with many visitors and to eat more. The hospice nurse’s teachings and suggestions about the dying process were either not heard, not understood, or perhaps being ignored. Not understanding how people die, and knowing that food and activity keep our bodies functioning, this caregiver, like many others, continued to push both activity and food. This approach works when a person can get better. It does not work when someone has entered the dying process. At that point, death will come, no matter how much food is…

FOOD! We celebrate with it. We cry over it. We socialize around it. We express our anger, nervousness, sadness, and aloneness through food. We eat for a lot of reasons, but really we eat to live—to …

FOOD! We celebrate w…

FOOD! We celebrate with it. We cry over it. We socialize around it. We express our anger, nervousness, sadness, and aloneness through food. We eat for a lot of reasons, but really we eat to live—to keep our physical body healthy and strong. It is the nutrition food provides that keeps the body alive. If the body is preparing to die from disease or old age, it will gradually slow down, cut back on food, and eventually stop eating altogether. As death approaches (months before death from disease, years if from old age), the person unconsciously cuts back on eating. It is not deliberate. They a…

Grief is a lot of Emotions rolled into one package. Some days feel manageable. Other days, everything falls apart. If you have ever wondered why grief feels so overwhelming, this is why. Visualize a t…

Grief is a lot of em…

Grief is a lot of emotions rolled into one package. Some days feel manageable. Other days, everything falls apart. If you have ever wondered why grief feels so overwhelming, this is why. Visualize a table in front of an open window. There are stacks of paper on the table. Tidy, organized stacks. A slight breeze comes through the window and rustles the papers; now a strong wind comes through and scatters the papers everywhere.  The above image is what grieving is like. It is not steady or predictable. Just when you think you are managing, a strong wind comes—and everything scatters again. Ea…

I think a great disservice is done when physicians put an actual number on how long a person has to live. We cannot be that specific. We cannot know six months, one year, or any exact number. The clos…

I think a great diss…

I think a great disservice is done when physicians put an actual number on how long a person has to live. We cannot be that specific. We cannot know six months, one year, or any exact number. The closest we can come is to generally advise whether someone is in the ballpark of years, months, or weeks. When they are nearer to death, we may be able to say they have days or hours. Here is an example of the harm done by giving specific numbers. This is just one example — I could tell you many. A woman was told by her oncologist that if she did not have radiation for her lung cancer, she would be …

What do hospice volunteers do, and why are they such an important part of end-of-life care?  I've worked in hospice for quite a long time. I started out as a hospice volunteer in 1982. It was the ver…

What do hospice volu…

What do hospice volunteers do, and why are they such an important part of end-of-life care?  I've worked in hospice for quite a long time. I started out as a hospice volunteer in 1982. It was the very beginning of hospice care in the US. In those days, I volunteered much of my time -- I gave 20 hours a week as a supportive nurse to the one newly hired RN. Why did I want to be involved in hospice care? Why did I give so much of my time? I really don’t know. I just knew I was drawn to end of life work, that I felt I had something to offer, and that I really, really wanted to do this work. I�…

Why You Need an Advance Directive (Before You Think You Do) National Healthcare Decisions Day – April 16 Healthcare decisions are certainly important enough to have their own special day.The sad and…

Why You Need an Adva…

Why You Need an Advance Directive (Before You Think You Do) National Healthcare Decisions Day – April 16 Healthcare decisions are certainly important enough to have their own special day.The sad and unfortunate thing is that most of us don’t even think about them—or realize there are decisions to be made. Generally, we don’t make decisions about our Health (let alone how we want to face the end of our life) until we need to. And really, that is too late. When we don’t need to make decisions, we can think clearly—without strong emotions involved.But when something is seriously wrong…