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 […]

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 […]

Pets: dogs, cats, birds, horses, goats, hamsters, snakes, lizards, fish. I could go on and probably not cover all of the creatures that make it into our hearts and lives. For these we will grieve. Our grief will match the intensity of our connection to the animal. (I’m going to use the word animal but […]

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 […]

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 […]

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, […]

I’m writing a book about the experiences I’ve had in working with end of life. What keeps appearing throughout the chapters is “over a cup of coffee” or “sitting at the kitchen table.”  A lot of time spent talking, becoming acquainted, and listening to life and relationship stories. We talk about living and their life, […]

Taking care of someone as they approach the end of their life is hard, scary, frustrating, sad, and often guilt-ridden work. Caregivers carry the burden of care but are often invisible. We tend to give our attention to the patient by focusing on their wants, needs and changes. We come, often bringing gifts and food, […]

Dear Barbara, I need some advice. I am doing a patient evaluation and have been told not to use the word “hospice“ with the patient. The primary care person doesn’t want the patient to know the seriousness of their illness. I hear this way too often. I suppose the primary care person is trying to protect […]

I had someone ask me “Why do all people with dementia feel someone is out to get them?” My answer—not all people with dementia feel or react like someone is out to get them. There is no one size fits all when it comes to dementia. Just like all human beings are different, so is […]