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...

Pain management is different in the last seven days because the body is not functioning in its normal way. Circulation, breathing, oxygen exchange are not happening properly so medications are not being absorbed and carried throughout the body in a normal way. Nothing in the body works “right” so medications won’t work “right” either...

It is how we feel at the end of the day about ourselves and our life that comes first. Our personal well being takes priority over any amount of work that we do for others. If we don’t feel good about the work we are doing then no matter how...

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 ...

In our personal situations we may never have an answer to the question did he know or had the process started months earlier. What I suspect is that at some time before we die we know that the moment has come...

In todays culture with the opioid crisis rampant, fear of narcotic use is everywhere. That fear hinders our ability to provide appropriate comfort management and is leading to misconceptions about how hospice takes care of their patients. I hear way too often that “Hospice killed my mother by overdosing her with morphine”... 

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...

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...

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...

 

I am sharing this letter and my response because this family is not the only family that has carried memories, sometimes for years, of situations that occurred as their loved one was being cared for. As health care professionals it is a huge part of our job to educate, to explain what we are doing and why we are doing it...

Often dying looks painful to the people watching. Dying is a struggle to get out of the body. There are sounds that ordinarily would indicate discomfort but, when a person is actively dying, are part of the struggle. Just as the little chick works to get out of its shell, a person works to get out of their body. It takes effort to release from our body. That includes rattling and gasping sounds, twitching, random hand and leg movements, picking the air, facial grimaces...

...I remember being with my mother in my hospice Medical Director’s office. He was explaining to my mother his medical findings as they related to her illness. I, being a hospice Director and in the medical field, didn’t understand what he was talking about. My mother sat on the end of the examining table nodding her head up and down indicting that she understood. She didn’t....

This is the story that came to mind when I decided to write a blog for National Social Work month. Social work, to me, is about saying the right words at the right moment, words that have a profound effect on a person’s life from that point forward. Being the listener with just a touch of direction...

When hospice began it was outside of the medical model. It provided end of life care based on quality, not quantity, of life. It recognized when physical healing couldn't be accomplished there was emotional, mental, and spiritual healing to address...

Why make your mother’s remaining time be unhappy and with more discontent than is already there due to age and illness? Being old is hard work. Our thinking processes aren't as sharp, our memory is diminishing...

So many factors affect the length of our labor to leave this world that it is imprudent to put a specific time frame on approaching death. The closest we can credibly come to predicting when death is going to arrive is to guesstimate the time in months or weeks with no numbers attached...