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Barbara Karnes

Acknowledging My Grief and Gratitude

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 […]

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Hospice is No Longer the Outsider

When I first became aware of the hospice concept it was the 1970’s. It was an abstract idea that most people couldn’t pronounce, let alone did they know what it wanted to accomplish. Dr. Elizabeth Kuebler Ross and Dame Cicely Saunders both began saying the “D word” and ever so slowly, minds began to awaken […]

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Humanity in Caring for the Alzheimer’s Patient

Dear Barbara, I have a question for you: When one of our residents dies, how should we handle telling other residents? This is what happened this past week: Resident A and B were very close. They always held hands, liked to sit together and watch the bird cage. They were very good friends. They were […]

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What I Would Look For in an End of Life Doula Training Course

Dear Barbara, I’m interested in learning more about a career as an end of life doula. I understand there are courses, programs, and even certification. Do you know of one that you would recommend?  I have done webinars and podcasts with several end of life doula groups but am not comfortable in recommending a specific […]

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Slipping Into the Shoes of a Hospice Patient

Dear Barbara, How does a person feel as a hospice patient?  Everyone is waiting on them, they are unable to do things for themselves. They have to wear diapers and probably don’t want to be a problem for caregivers. Often, their well-meaning loved ones stay for long visits when they want to rest. I don’t […]

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When Families Resist Calling In Hospice

Dear Barbara, as a hospice admission representative, what do I say to families who say they are “not ready” for hospice — even when they clearly are? There is an old saying “you can lead a horse to water but you can’t make him drink.” I think that applies here. Our job is to explain […]

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Family Guidance In The Final Hours and After…

Someone asked me about deathbed rituals. They wanted to know what to say and do when someone is in the moments before death and what to do before the funeral home arrives. Here are my suggestions: In the hours to minutes before death, gather family and significant others. Encourage each person to spend some time […]

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Rushing Your Hospice Nurses Benefits No One

Dear Barbara, I am a hospice nurse advocate and working on an education piece for hospice leadership. What is the average length of time you feel is appropriate for a comprehensive/quality nursing visit that includes education and psychosocial support? This is such an important question, particularly today after all of the changes that have taken […]

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Supporting a Hospice Patient During Their Life Review

Dear Barbara, I have a patient talking to me about all the mistakes he’s made in his life. Regrets for doing things that he isn’t proud of. He was noticing that very few people had visited him. What should I say? As end of life approaches, people start looking at their life; what they’ve accomplished, […]

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