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...

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...

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...

I suggest writing a letter to the person that died and saying from your heart what you need to say that you didn't say before. I recommend that you write your baby girl a letter. Pour your heart out to her and offer to her your wanting to let go of all the negative feelings you have been carrying all these years. Tell her, from the bottom of your heart...

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...

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...

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...

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.

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...

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...