We do this all the time. We enter tense situations where people are frightened and unsure, with people who have never seen us before. This is what we do: We create a bond of trust with strangers at a first visit. Being on call to a death visit is no different.

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...

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...

In our culture the holidays, Thanksgiving, Hanukkah, Kwanzaa, and Christmas, emphasize family and friend togetherness. The absence of a friend or family member becomes more evident. Our sense of loss is more “in our face” than other times of the year...

We really aren’t doing people any favors by not being honest with them. We aren't giving their families the opportunity to do and say what needs to be said and done. We are depriving people the opportunity to put their life in order, to say “goodbye and I love you”...

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...

The guilt, frustration, uncertainty, and helplessness of family caregivers is as much a problem to our healthcare system as the patient with dementia...

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...

 

Hospice has worked with nursing facilities for many years now. Our relationship  and interactions with patients and their families is now better understood and better defined. That said, some nursing facilities still feel threatened by the presence of hospice. Naturally when something goes wrong it is viewed...