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...

At 8:17pm she took one more breath and then at 8:18 there was one more which I describe as hot caramel pouring onto vanilla ice cream. It was the most perfect breath, the most peaceful entering into another portal. I felt like I had had a complete birth experience...

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...

What I have discovered is that a family member dying can bring a family together. It can be their finest moment of closeness and comfort. But for other families it brings out the worst in relationship...

We can be as much at a loss when our pet is dying as we are when a person is dying but there doesn’t seem to be the support and guidance available for when a beloved pet is dying hence this new booklet...

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...

Hospice can not take the experience and sadness of a loved one dying away. Our goal is to help the family create a sacred experience, to help their loved one have as gentle a death as possible, and when we have done our job well the family will have that sacred memory...

The hours before actual death is very scary, a "I don't know what to do" time, for anyone present. Someone who knows the normal natural way a person dies can be like a conductor as they guide those present through the experience. You being there with your knowledge of end of life can have a significant role in turning an often frightening time into a sacred one. So, yes, I think you should stay if people unexpectedly arrive. Explain that if it is alright you would like to stay and

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...

Be the best hospice you can possibly be, provide the highest quality of care with the most compassionate, caring staff your area has to offer. Build a reputation within the community not of how many patients you serve but what kind of compassionate, “we go the extra thousand percent for our patient”, care you provide. Build a reputation within the community...

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.