Something to Think About

a blog on end of life

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About the BK Team
What Families Need to Know in the Final Hours Before Death by Hospice Pioneer, Barbara Karnes, RN

Most people don't know what to do or can do in the final hours before death. Here are gentle ways families and caregivers can create a meaningful goodbye and bring...

Why Caregivers Need Written Guidance at the End of Life article by Barbara Karnes, RN

Caregivers are often alone when caring for someone who is dying. Written guidance can provide reassurance and support when it is needed most.

Who Cares for the Caregiver in End-of-Life Work?

Those of us who work in end-of-life care walk beside people and families during one of the most intimate times of life. Because of the emotional nature of this work,...

Why Does Dying Look So Disturbing? By Barbara Karnes, RN  Sounds, restlessness, and physical changes can be unsettling to witness, but they usually don't mean there is suffering. Understanding what is normal can ease fear for those keeping vigil.

Sounds, restlessness, and physical changes can be unsettling to witness, but they usually don't mean there is suffering. Understanding what is normal can ease fear for those keeping vigil.

What I Wanted Families to Know About Dying at 3 a.m.

Years ago, a 3 a.m. hospice call changed the way I thought about caring for families at the bedside.It led me to write down what I wanted families to know...

I Was 17 and Told to Sit With a Dying Patient — Alone

When I was 17, I was told to sit with a dying patient — alone. I didn’t know then how profoundly that moment would shape my life’s work...

Why “Not Now” Is Still a Decision

Many of us avoid thinking about death, assuming it won’t affect us or our loved ones—until it does. This article explores advance directives, DNRs, and why understanding these choices matters...

Guilt and Grief: What We Carry and How to Set It Down

Guilt is part of love’s shadow — the echo of what we wish we’d done differently. Healing begins when we release that burden and let how we live now be...

We Die As We’ve Lived: The Personality of Dying

After being present at so many deaths, I’ve come to believe that we die the way we’ve lived. Our personality doesn’t change because we’re dying. Dying is the last part...

Purple square with a green circle around the words, When Dying Looks Different Than You Expected

Most of us imagine dying will be quiet and peaceful, but real dying often looks different. Nothing bad is happening — the body is doing the natural work of letting...

What I Learned About Dying While Caring for My Husband

It is hard to comprehend that our special person will die no matter what we do. No matter how many treatments, how much medicine, or how much food we give,...

Saying Goodbye at the Bedside

So often I have walked into a room when family is standing at the side of the room, watching. Watching their special person dying...

What If I’m  Angry at  My Dying Parent?

First, there is no perfect relationship. Life is a learn-by-trial adventure. It’s hard work, not always smiles and happiness.

When Treatment Stops Working: What Hospice Really Offers

What do you say to someone to get them to accept hospice? Well, one thing to say after explaining the services hospice offers is to ask what they think will...

Introducing the Approaching Death Support Kit: Gentle, Trusted Guidance for Families and End of Life Doulas

If I could sit beside you at the bedside, this is what I would place in your hands. Whether you’re a family member, a friend, a caregiver, or an end-of-life...

When Death Comes Suddenly: What to Expect and How to Offer Comfort

How do we interact with someone dying a sudden death? The same way we would react with someone dying a gradual death.

Writing Our Final Chapter More Meaningfully article by Barbara Karnes, RN

The experience of dying a gradual death is an important, integral part of life. It is an opportunity to write our final chapter, to define the ending of our story...

The Parallels Between  Birth and Death:  Understanding Life's  Bookends, article by Barbara Karnes, RN

Just as we have to go through an intensive process to enter this world, so do we go through labor to leave it.

Do Families Want Hospice Present During The Death?

We need to explain the way most people die — especially the not so pretty parts. This includes the sounds, movements, pees, poops, frowns, grimaces, and the struggles that accompany...

This is how we leave our body, how we leave this world…

When we see our special person struggling, we, the watchers, think something pathological is happening or we think the professionals are not doing enough to provide proper care...

When people don’t die like they do in the movies, we think something bad is happening…

We used to have role models on what dying really looks like. People died at home, in their own bed. Family and friends gathered — held a vigil, so to speak. When...

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