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Barbara Karnes

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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What Does a Funeral Do?

I’ve been thinking about funerals. Doesn’t everyone? Maybe not. What does a funeral do? It honors the person that has died and brings support and comfort for the living. Funerals are about people coming together, a “send off” kind of gathering and sharing support for the beginning of our grieving journey.  We used to lay […]

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Do I Stay In Contact After the Death?

Dear Barbara, Working in hospice, I always had a terrible time with —  do I stay in contact with the family after the death? I think staying in contact with a family after the death is a personal practice and option. Most of the time there is another patient and family admitted to our full […]

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Medical Interventions on a Body That Can’t Be Fixed

I received a letter from a woman whose father recently died. She explained all the surgeries, medical interventions, TPN, gastrostomy,  multiple catheters, medicines, and hospitalizations that she, her father and their family dealt with over an 18 month period.  She lamented that no one in the medical arena, except one woman who used to be […]

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Entering Into “Precious Time”

Dr. Bob Lehmberg, husband of Jennifer O’Brien, author of The Hospice Doctor’s Widow, used the term “Precious Time” with his palliative care and hospice patients and families who were dealing with end of life situations. I LOVE that phrasing “Precious Time”.  What does it mean? Doctor Bob’s definition was “Precious Time is a type of […]

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The True Value of End of Life Support

There are just two ways to die: fast and gradual. Gradual death has a process to it. If it were happenstance and just happened, it would be a fast death. Gradual death occurs either because of old age or disease. With disease the process begins months before actual death and in old age the process […]

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Hospice Services Pulled for Dementia Patient

I got a letter about a hospice agency ending services for a woman whose only diagnosis was dementia . As sad as I am to hear those stories (and I get many) I am not surprised. These families have had the comprehensive services of hospice for months, even a year or so and then they […]

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Supporting Survivors of Suicide Loss

Dear Barbara, A friend of mine had a child commit suicide.  Do you have reference material that I might use to help my friend? Part of normal grief is all the questions we will never have answers to, the whys and what if’s? With death by suicide those questions are ten fold. With a child’s […]

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Caring For an Elder Who Needs to Eat

Dear Barbara, My father fell, was hospitalized and is now home. He just isn’t eating—popsicles but nothing else. The doctors have not offered any suggestions. What should I do? The elderly, after a fall or illness, often are not much interested in eating. If there are no other health issues, they gradually return to normal […]

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