Something to Think About

 90% of end of life care is education. People don’t die like they do in the movies, yet movies are our current role models. This leads to unrealistic expectations...

Not everyone who is dying has pain. Disease causes pain. If pain is not present, a narcotic is not appropriate (except a tiny bit can ease labored breathing is present...

I'm going to start by being blunt: hospice, end of life workers, hospitals, and nursing facilities make their money only as long as the people they serve are alive.. They...

Taking care of someone at the end of life is different from taking care of someone who is going to get better—-but most people don’t know that either. Unless we...

From what you have told me I believe your mother's death was no one's fault, certainly not yours. Her body, after all the years of illness, couldn't continue and she...

...Rapid breathing like your dad was doing is exactly where a small bit of morphine (5 ml is small) helps slow down those 40/50 breaths a minute to a more...

Trying to "calm" a person who is choking or panicking doesn't actually work whether death is close or not. The question we have to ask is how close to death...

 Know that all of these signs of approaching death, whether indicating months or weeks, are just guideposts. Some people will show all of them...

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...

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...

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...

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...

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...

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...

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...

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...

The use of Morphine is one of the most misunderstood practices I encounter with families and end of life issues. Our society is so drug conscious we tend to equate...

Being active helps us poop therefore the less active we are, and people approaching the end of their life through disease or old age gradually have less and less energy...