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A Hospice Director recently asked me how to use my materials in her program. That request got me thinking that others might be interested in my reason and vision for writing the end of life booklets. …

A Hospice Director r…

A Hospice Director recently asked me how to use my materials in her program. That request got me thinking that others might be interested in my reason and vision for writing the end of life booklets. My first booklet, Gone From My Sight, was written to give the families I was caring for guidance for when I wasn’t there with them. A little later I wrote The Eleventh Hour as a companion booklet to Gone From My Sight guiding the families on what to do as death approached. Whereas Gone tells what is happening, Hour suggests what to do while it is happening. These two booklets should go into the …

I was cleaning out my computer and found this list. I don't know where it came from, but it is excellent so I am passing it on for others’ consideration. With husband Jack’s recent death, I know t…

I was cleaning out m…

I was cleaning out my computer and found this list. I don't know where it came from, but it is excellent so I am passing it on for others’ consideration. With husband Jack’s recent death, I know the Stress and confusion when these issues are not addressed. This is a guide all would be wise to complete now (and regularly update) before the information is needed. It is a gift to those left behind. Personal RecordsFull legal nameSocial Security numberLegal residenceDate and place of birthNames and addresses of spouse and children, and parents’ names (specifically mother’s m…

A friend of mine asked me how to get a hospice referral. I suggested she first talk with her mom’s physician to see if he would make a referral. Then search the internet for hospices in their area a…

A friend of mine ask…

A friend of mine asked me how to get a hospice referral. I suggested she first talk with her mom’s physician to see if he would make a referral. Then search the internet for hospices in their area and interview several. The doctor provided a referral and my friend made a call to a local hospice — on a Wednesday. An interview was set up by the hospice to come to the house the following Sunday.  Yesterday, Sunday, they had the interview. It was determined that hospice services were appropriate and the agency made an appointment for next Sunday to admit my friend’s mom and begin services. …

Fear moves on fleet feet, distorting all it touches; exaggerating, permeating, penetrating, overshadowing all. I think that sentence explains most of our reactions to approaching death. Our fear inter…

Fear moves on fleet …

Fear moves on fleet feet, distorting all it touches; exaggerating, permeating, penetrating, overshadowing all. I think that sentence explains most of our reactions to approaching death. Our fear interprets what we see. Fear that our special person is not being properly taken care of. Fear within ourselves that we have no control over what is unfolding. Fear that death will come no matter what we do or however much we don’t want it to come. It is through the eyes of fear that we react to the unknown of how life ends. Knowledge reduces fear. Even a little bit of knowledge helps ease and often …

Dear Barbara, our house is not big enough to have a hospital bed and all the medical things that my dad will need now that he's been referred to hospice care. We have to work, so no one will be home t…

Dear Barbara, our ho…

Dear Barbara, our house is not big enough to have a hospital bed and all the medical things that my dad will need now that he's been referred to hospice care. We have to work, so no one will be home to take care of him. Should we look for a hospice house? Hospice houses are care facilities generally managed by hospice agencies to provide end of life care for those whose life situation prevents them from being at home.  In the early hospice days, those “houses” were run by specific hospices and financed by fundraisers, charitable donations, and fundraising projects. Generally, a person was…

Many years ago, someone came up with the idea that once a year Americans would reach out to those they care about and say, “I love you.” This is done with cards, flowers, and poems. February 14th …

Many years ago, some…

Many years ago, someone came up with the idea that once a year Americans would reach out to those they care about and say, “I love you.” This is done with cards, flowers, and poems. February 14th is that day. Valentine’s Day. That is "I Love You" Day. Wouldn’t it be special if everyday was “I Love You Day?” Working with end of life all these years has shown me how special each day is. It has also shown me the value and the gift of living, doing, and saying that which we mean EACH day. But, since this is a special "I Love You" day, I will join the day with: I love hospice and end …

One night many years ago when I was a hospice RN, when most people couldn’t pronounce the word “hospice,” or understand what the services were about, I was sitting with a family. Mom was in the …

One night many years…

One night many years ago when I was a hospice RN, when most people couldn’t pronounce the word “hospice,” or understand what the services were about, I was sitting with a family. Mom was in the bedroom, probably a week or so from death. The family and I were in the living room. I was explaining why mom was doing the things she was doing. Why she was making “strange” sounds, why she was restless and agitated, why she wasn’t responding to them.  One of the daughters was taking notes. I was surprised. No one had done that before. What a great idea! To have these words of reassurance …

I so appreciate the many, many people that responded to last week’s I Am Now Reaching Out To You Fellow Grievers blog. I want to share with you some of the suggestions you have shared with me. Ideas…

I so appreciate the …

I so appreciate the many, many people that responded to last week’s I Am Now Reaching Out To You Fellow Grievers blog. I want to share with you some of the suggestions you have shared with me. Ideas for filling a huge space left empty by the death of someone who made us a “we.” Grief is a lot about the empty space they left behind. It is learning how to fill the space we had when we were a “we” that has become a space of emptiness now that we are an "I." I think the major revelation you all gave me with your suggestions is there are many kinds of “we,” not just a partner “we.�…

Widows and widowers who are living alone, I have a question to ask you. What do you do with your days? How do you fill your hours which turn into days now that you are a “me” instead of a “we?�…

Widows and widowers …

Widows and widowers who are living alone, I have a question to ask you. What do you do with your days? How do you fill your hours which turn into days now that you are a “me” instead of a “we?” I didn’t realize how much Jack filled my days and my routines until he wasn't here. Now, I’m having some challenges. Being the very busy, don’t-sit-still kind of person that I am, how do I fill my days? Household chores — done by 10 AM. Even after correspondence, paying bills, and writing blogs it's only noon or 1 o'clock at the latest. What to do now? Play solitaire, read, get all of my…

Dear Barbara, My mom is 83 and has moderate Alzheimer’s . Since May, I have noticed a big change in her behavior. She has really slowed down with everything. She sleeps a lot. I know she is depresse…

Dear Barbara, My mom…

Dear Barbara, My mom is 83 and has moderate Alzheimer’s . Since May, I have noticed a big change in her behavior. She has really slowed down with everything. She sleeps a lot. I know she is depressed and she is on medications, but I hate to see her sleeping like this. She is still asleep now and she went to bed last night at 8:30. Should I be making her get up earlier? I’m no expert on dementia related diseases. Teepa Snow and MaryAnn Oglesby are my go-to people for information and advice on "what I should do now." What I'm saying is that I, Barbara, am no dementia specialist. It is hard t…

Dear Barbara, My mother was transferred to an inpatient hospice. She was alert and talking to us when she arrived. Upon admission, the RN brought up the topic of medications to help her relax. I told …

Dear Barbara, My mot…

Dear Barbara, My mother was transferred to an inpatient hospice. She was alert and talking to us when she arrived. Upon admission, the RN brought up the topic of medications to help her relax. I told her my mom had been relaxed without any problems. The RN insisted she seemed uncomfortable and pushed for morphine. Within 30 minutes of getting the morphine, mom started having difficulty breathing. It seemed like the morphine over-relaxed her. We didn’t even ask about pain medication; the RN brought it up and suggested it. I regret not having the courage to tell her no! Tell me, did the morphi…

A life review helps us as our life is ending. It can put all the happenings of our life in perspective. How about an end of the year review? Let's take some time to remember and think through our stru…

A life review helps …

A life review helps us as our life is ending. It can put all the happenings of our life in perspective. How about an end of the year review? Let's take some time to remember and think through our struggles, our misadventures, and assess our strengths. From the knowledge and perspective found in our review of 2024, let's allow 2025 to be a fresh start, a new beginning to living the life we want to create. Something more… I write about the life review that is so common at end of life in my book, The Final Act of Living: Reflections of a Longtime Hospice Nurse.

For those of us who are grieving, the holidays can be challenging. Yearning memories, I-wish-I-had's, and loneliness can all be more strongly felt. Other people seem cheerful, happily planning holiday…

For those of us who …

For those of us who are grieving, the holidays can be challenging. Yearning memories, I-wish-I-had's, and loneliness can all be more strongly felt. Other people seem cheerful, happily planning holiday delights, and we, the grievers or caregivers, are reminded of what we don’t have, of what we’ve lost or are losing. What to do? Write your special person a letter. Put your feelings, your sadness and your thoughts on paper. Burn the letter and scatter the ashes to the wind. Let your grace in moving through these holidays be the gift of love you give to your person. Joy is where we make it. Jo…

Recently I have been hearing discussion of why families and significant others do not want hospice or EOL Doulas with them during the final moments of life. Families often do not want anyone with them…

Recently I have been…

Recently I have been hearing discussion of why families and significant others do not want hospice or EOL Doulas with them during the final moments of life. Families often do not want anyone with them as their special person is actively dying. That is alone, private time. Anyone else present is an intrusion, an invasion of privacy. My two cents: Yes, some may think it is a very private moment and do not want to share it with "strangers." HOWEVER, most people don’t understand how death happens. They don’t understand how people die. Movies tend to be today’s role model and that is not how …

Barbara, Can you write about "miracles" and how the hope/prayer for a miracle can make people miss what is in front of them? An internet search defines a miracle as: “a surprising and welcome event…

Barbara, Can you wr…

Barbara, Can you write about "miracles" and how the hope/prayer for a miracle can make people miss what is in front of them? An internet search defines a miracle as: “a surprising and welcome event that is not explicable by natural or scientific laws and is therefore considered to be the work of a divine agency.” I, Barbara, define “a miracle” as "an event attributed to a supernatural being (God or gods), a miracle worker, a saint, or a religious leader.” It is an event that seems to defy all logic. With that definition, you have to be a pretty high stakes gambler to bet your life (…

We go through labor to enter this world AND we go through labor to leave it. Most of us don’t know this. When we see our special person struggling, we, the watchers, think something pathological is …

We go through labor …

We go through labor to enter this world AND we go through labor to leave it. Most of us don’t know this. When we see our special person struggling, we, the watchers, think something pathological is happening or we think the professionals are not doing enough to provide proper care. In reality, nothing bad is happening. It is sad — but not bad. This is how we leave our body, how we leave this world. Dying is not pretty. It is often messy, loud, and very scary for us watchers. Because we only have tv and the movies as our guide on how people die, we are not prepared for its ugliness. Add our…

Those of you who know and follow me have heard or seen me use the phrase, “People don’t die like they do in the movies.” I think one of the biggest fears we bring to the bedside of someone who i…

Those of you who kno…

Those of you who know and follow me have heard or seen me use the phrase, “People don’t die like they do in the movies.” I think one of the biggest fears we bring to the bedside of someone who is in the dying process is expecting our special person to say something profound or at least "goodbye and I love you." We want them to close their eyes, turn their head a bit to the side and stop breathing. They are now dead, just like in the movies. Those images are what we expect, but are unfortunately not how death occurs. We used to have role models on what dying really looks like. People died…

Thanksgiving! A day of gratitude for a year of blessings. For many it is a challenge to find blessings in this chaotic world. For those living with a life-threatening illness, caring for someone faced…

Thanksgiving! A day …

Thanksgiving! A day of gratitude for a year of blessings. For many it is a challenge to find blessings in this chaotic world. For those living with a life-threatening illness, caring for someone faced with end of life issues, or experiencing their first year or even years of grief, it can be hard to find anything to be thankful for. That’s how I feel today. I’m tired. I’m concerned about the world. I’m sad some of my family won’t be with me this Thanksgiving holiday. I miss my husband Jack. He was my go-to person for helping me understand the world. He was my guidance when life seeme…