How Do You Grieve a Violent Death?

How Do You Grieve a Violent Death?

June 23 2020
Sudden death by accident, suicide and certainly by violence intensifies those normal grief responses. Everything we feel with normal grief is as if we are being held under a magnifying glass, everything is more intense, hurts more. Part of grieving is questioning how this can happen. Why me? Why her? Why him?...

How Do You Talk About Approaching Death?

How Do You Talk About Approaching Death?

June 11 2020
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...

Bereavement Support is Important at Any Time, Now, it's Vital

Bereavement Support is Important at Any Time, Now, it's Vital

May 19 2020
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...

How To Help Families Care For Their Dying Loved One During Social D...

How To Help Families Care For Their Dying Loved One During Social Distancing

May 08 2020
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...

Front Line Workers, Do You Have Self Care Rituals?

Front Line Workers, Do You Have Self Care Rituals?

April 22 2020
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...

In This Time of Great Fear, DYING 101

In This Time of Great Fear, DYING 101

April 08 2020
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...

Be Aware of the Risk We Present to Those We Are Hired to Care For

Be Aware of the Risk We Present to Those We Are Hired to Care For

March 19 2020
Touch in with the families, “What’s happening? Do you need anything?” Use the same volunteer for each family to develop confidence and bonding. You are saving your staff while providing a sense of security  to your families...

Why Didn't They Tell Me?

Why Didn't They Tell Me?

January 07 2020
Your book explained so much. Mom's dying was almost exactly like you explained in your book. In hindsight, I am unsure why we, her family, were not advised, taught, or even given a clue about what was inevitable. We truly kept on fighting and advocating for her to get what we thought to be the best medical care she could get all the while thinking it would make some kind of difference in this outcome...

Would She Still Be Alive?

Would She Still Be Alive?

December 11 2019
It sounds like she was given morphine to ease her transition from this world to the next. Not knowing your grandmother's medical history I cannot say if the morphine was appropriate or not. What I can say is it did not kill her. She was dying...

Are Narcotics Necessary for the Dying?

Are Narcotics Necessary for the Dying?

October 17 2019
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...

Mom Needs Hospice? Here are your questions to choose the right one...

Mom Needs Hospice?  Here are your questions to choose the right one...

September 18 2019
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...

Why I Wrote My New Booklet: PAIN AT END OF LIFE

Why I Wrote My New Booklet:  PAIN AT END OF LIFE

July 24 2019
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”... 

Developing End of Life Expertise

Developing End of Life Expertise

July 07 2019
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...

Setting Up a Hospice Program

Setting Up a Hospice Program

May 28 2019

...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...

 

8 Things to Consider Regarding End of Life Pain Management

8 Things to Consider Regarding End of Life Pain Management

April 18 2019
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 Hear You, But I Don't Understand

I Hear You, But I Don't Understand

March 24 2019
...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....

My Personal Integrity Was Wounded Tonight

My Personal Integrity Was Wounded Tonight

February 26 2019
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...

7 Things to Consider Regarding End of Life Pain Management

7 Things to Consider Regarding End of Life Pain Management

October 30 2018
Dying is not painful. Disease causes pain. If pain has not been an issue during the disease process then just because a person is actively dying does not mean they are in pain. If pain has been an issue during the disease process that pain is present to the last breath...
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