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Barbara Karnes

Establishing a Bond – The Admission Visit

We who work in end of life situations take care of the patient and the caregiver/ family. As end of life approaches, our attention and interactions revolve around the family/ caregiver as much as the patient. Our work involves creating trust with all involved as quickly as possible. End of life work is time sensitive. We […]

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Do I Need a POLST and an Advance Directive?

There seems to be some confusion about advance directives and POLST forms (Physician Orders for Life Saving Treatment). Both are very important if you want to have input in your end of life decisions. So — here is what you need to know. Advance directives are legal documents that provide instructions for medical care. They only […]

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Caregivers Need Knowledgeable Guidance

“You often can’t see the forest for the trees” is one of the many things I learned being a caregiver. Now, months after my husband’s death, I have been thinking, “Barbara, you know the signs of approaching death. Signs of months, weeks, days, and hours. How did you not see them with your own husband?” […]

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All The Ways We Have For Saying Our Final Goodbyes

We used to have grandma’s body “laid out” in the parlor and family and friends came to our home with support and food. Grandma died in the home and we said goodbye to her in our home. Gradually, we moved from home gatherings to funeral homes and churches. An internet search says funeral homes began […]

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Using Palliative Sedation At End of Life

Dear Barbara, Will you discuss palliative sedation? Palliative sedation is a term used by hospice, palliative care, and medical professionals to describe giving large doses of sleep-inducing medications to induce unconsciousness. It is a pain management technique used when all other pain management options have been unsuccessful. It is not routinely used. I would even say […]

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It’s Okay Not To Eat! Food At End of Life

FOOD! We eat to live. It sustains living. Everyone and everything needs some form of food, of nourishment, to maintain life. Animals (and that includes humans), plants, insects, all need some form of food to live. It seems that with humans, we add to the nourishment aspect of eating a social component as well as […]

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How Do You Train Your Hospice Volunteers?

I was thinking about hospice volunteer training. What makes a good training program? I am hearing stories about the lack of professional staff training for new hires, which led me to wonder about volunteer training.  So—here are my thoughts for a hospice volunteer training program: At the first meeting of the training, have a discussion […]

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Keep No Secrets From Those at End of Life

I hear “don’t tell mom” way too frequently. Mom has a life threatening illness or may even be showing signs of approaching death and her family says to me as I walk in the door, “don’t tell mom.”  They  want to protect her. They don’t want to worry her or scare her. SO everyone is […]

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“I’m Fine,” The Universal Response From Grievers

In response to “how are you,” “I’m fine” seems to be a universal reply from people suffering. This suffering can be the result of pain, grief, illness, family upheaval, or any other major distress a person is experiencing. Well, my mother would have told you everything and more than you’d ever want to know in response […]

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