What is the aim of a life review? As a caregiver my aim is not to direct a life review but to be a presence, a listener, and a friend. If life review becomes a subject the patient wants to pursue (whatever words may be used...

Hospice can not take the experience and sadness of a loved one dying away. Our goal is to help the family create a sacred experience, to help their loved one have as gentle a death as possible, and when we have done our job well the family will have that sacred memory...

The hours before actual death is very scary, a "I don't know what to do" time, for anyone present. Someone who knows the normal natural way a person dies can be like a conductor as they guide those present through the experience. You being there with your knowledge of end of life can have a significant role in turning an often frightening time into a sacred one. So, yes, I think you should stay if people unexpectedly arrive. Explain that if it is alright you would like to stay and

If the signs are there, get the referral and let a hospice professional determine if Hospice is appropriate. Three things I look for to tell me if it is time for Hospice are: 1. the patient’s condition is deteriorating in spite of the treatment that is being given. 2. You look at the person and say to yourself...

It is certainly not within our role to act if a person, in the pain of the moment, wants help in ending their life. In the “pain of the moment” are the operative words here. I cannot tell you the number of times I have heard that plea in the throngs of pain, and the relief when that pain is relieved and life continues...

Be the best hospice you can possibly be, provide the highest quality of care with the most compassionate, caring staff your area has to offer. Build a reputation within the community not of how many patients you serve but what kind of compassionate, “we go the extra thousand percent for our patient”, care you provide. Build a reputation within the community...

When living with a life threatening illness we are eating for two---our physical body and our disease. In most cases the disease eats before we do. If we don’t eat, the disease still does. Nutrition will not keep a person alive indefinitely. It does not stop the disease progression. If we have a terminal illness...

For healthcare professionals it is often a balancing act to care for patients and then deal with the sense of futility that is triggered when they are doing their job...

There are other signs of approaching death that indicate a person with a disease (at any age) has weeks to live...

I can say that dementia doesn’t play by the rules for end of life. Withdrawing and sleeping can be present for years and does not signify approaching death. Not eating and not swallowing are your key signs. If we don’t eat, we can’t continue to live. Always offer food (be careful of choking), but don’t force food.

My message throughout all this time has been to educate, educate, educate. Educate anyone who will listen about how people die. To help people understand how death comes, what it looks like, (a part of life we will all experience one day) is my focus, to neutralize the fear we all bring to approaching death. With my desire to teach as many people as possible I have created a new end of life educational film, This Is How People Die.

...Fortunately, I suppose, my mother is now bed-bound and we were able to
get Hospice to help out, so she now fits the bill for a 'model patient'... but it
still seems one nurse can wreck her entire day with a bad attitude at
changing time or bath time. And family (which is me) must try to piece back together a mindset that keeps her contented and unafraid. this is a sad time of life. And I do have the Nursing Home Blues, quite regularly...

As we get older, life presents us with different challenges. We adapt to them in the same way we have lived our life and dealt with all the challenges in our life up to this point---only our reactions become intensified. If we were withdrawn and not very social in our earlier living then as we get older we become more withdrawn, even less social. Think about...

From the moment of a diagnosis of a life threatening illness we begin grieving. We grieve not just the eventual losses that come with serious illness but the approaching death itself...

There have been many changes in hospice care since it began. Some for the better, some not so much. What I am suggesting as representing a “good” hospice is becoming harder to find. My hope is...

When we die we work to leave our body. That work begins months before death from disease actually occurs but we only really see the work happening when death is days to hours away. I call this time labor because we the watchers don’t understand what is happening. We think it looks painful, abnormal, that something bad is happening...

...not telling a person they can’t be fixed is taking away their opportunity to do and say that which is important to them. It is taking away their ability to make decisions based on knowledge of how their life will proceed. It also confuses them in that internally they sense they are not going to get better yet everyone is acting as if they are...

What do I mean by being "gentle" with yourself? I mean forgive yourself for
all the things you feel guilty about. Remember we always do the best we
can with the information we have at the time...