First, what is meant by “dying person”? In the months before death most people really don’t believe they are dying. “Other people die, not me. There will be a cure, a mistake, or a miracle”.  They also begin withdrawing, showing less interest in the outside world and become more introspective. That introspection is not always peaceful or even positive. Thoughts and behavior will relate to how much fear is present. We are all going to be afraid as we approach death.

Our job as an end of life specialist is to address the elephant in the room, to be direct and honest in the gentlest way possible. We are not doing our job, and doing a great disservice to the family, if we don’t talk about Mom’s approaching death, educate, and at least try to prepare the family...

Hospice Bereavement support, as well as any bereavement support program (church, Community Support, Senior Activity Program) is important during the best of times. Now it is vital.  Here are my recommendations; what I would do if I had a bereavement program today during this pandemic...

We bring our fears, our childhood experiences with death, our culture, our belief systems, and our stereotypes to the bedside of the dying and the dead. Generally, none of that is actually how people die...

Hospices seem to be struggling with how to provide services now that being in homes and facilities is not an option. When we cannot rely on routines, when there is no normal anymore, we have to begin thinking of new ways to provide service. We have to start thinking outside the box. We have to create new ways of providing care, new ways of getting education to our families...

During this time of crisis work it is hard to remember to take care of yourself. There doesn’t seem time for that but if you don’t at least try to put “your own oxygen mask on” you will not get the essentials you need to continue. You are carrying fear for yourself (whether realized or not), excess adrenaline just to meet the shift needs (which brings a sense of exhaustion when the shift is over), and non stop 8, 10, 12 work hours, so sleep for you is vital. Don’t neglect the basics, food, sleep, and a release of each day...

People don’t die like they do in the movies—alive one minute, saying something profound and dead the next. There is a way that the body dies. A way it is programed to die. It’s just that most of us don’t think about it, don’t know and generally don’t want to think or know about it. This is part of the death denying society that we live in...

I see families devastated by not being able to be with their loved one as they are dying. I am writing this for any person who is faced with a loved one dying alone in the hospital. My hope is that some understanding hence comfort can be found among these words. This guidance can also be used by healthcare workers when they face the difficult job of telling families they can’t be present. These ideas can’t fix this horrific situation but they can bring a bit of understanding and “something to do” to an otherwise bleak message.

There are many of the same circumstances with today’s coronavirus as we faced with  HIV/AIDS in the early years— lack of medical knowledge, lack of guidance, and fear. I think the same directives hold now as they did then...

I'm sorry to say when a family member is dying it can bring us together and be our finest hour as a family or it can bring out the worse in us and create resentments that last a very long time. From what you are describing this may not be your family's finest hour...

We really aren’t doing people any favors by not being honest with them. We aren't giving their families the opportunity to do and say what needs to be said and done. We are depriving people the opportunity to put their life in order, to say “goodbye and I love you”...

Dementia is like a road map with many, many roads that eventually lead into a city. Each road is different, each road is of varying lengths and offers various views but all enter into the city at the same place. That place for my dementia analogy is when a person stops eating...

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 that by setting the standard high, and...

I know it is scary to think of using hospice. It says death will happen soon, but there is such guidance and support to help that at least ask for an information visit. A hospice referral is a win-win. You win if hospice says it is too soon and ...

The guilt, frustration, uncertainty, and helplessness of family caregivers is as much a problem to our healthcare system as the patient with dementia...

You have to walk the walk before you can talk the talk. Learn from your patient/family interactions. At the same time read everything you can get your hands on...

Dementia isn’t a terminal illness in that it doesn’t have a limited prognosis. It is like dying from old age, it takes longer. Alzheimer’s, or any form of dementia, is difficult to gage as to approaching death. The personality changes and withdraws often over a period of years and sleeping habits are...

...You really don't need a doctor or nurse at the bedside when someone is dying. You need someone who understands the natural way people die and can educate and guide those present through the experience. So, first, you are going to select employees that don't view death as a medical emergency, as a medical failure, and particularly don't view death as bad. Sad for everyone, yes, but not bad...