June 29 2017
Written By
Barbara Karnes
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Whimpers and Tears in the Actively Dying

Whimpers and Tears in the Actively Dying


Melissa Cantu - July 10 2017

I see now where you have the books in other languages so disregard my question earlier. Thank You

Melissa Cantu - July 10 2017

I just wanted to ask if these books come in Spanish?

Barbara Karnes - July 08 2017

Hi Carol, your question do I see a “difference in the dying process and emotions, actions, of Christians and those professing no faith in Christ?” is one others have asked also. My answer is really, no, I don’t see a difference. People die the way they have lived. Their dying is reflected in their personality traits, their fears, their beliefs. We don’t suddenly go from being a challenging personality to being a submissive one. Our personality actually intensifies so from this example we become more challenging, not less as we approach death.

Sometimes as death approaches, or in the case of suicide in the days to moments before the action is taken, people explore their beliefs, previous and current and come to “terms” with what they have chosen to believe. Some pray when they have not prayed in a long time. Some do not. This relationship we have with our God (or not have) is such a personal one that these thoughts are generally not shared but kept deep, deep, within ourselves.

Nicole’s death is heart wrenching. There will never be answers for why she found life so difficult. What I have learned is that sometimes life is just too hard. It is just too hard to be alive. I hope you find a bit of comfort in the knowledge that she is at rest now from this challenging life that she had.

Barbara Karnes - July 08 2017

Hi Mary, I read your comment on this Blog Whimpers and Tears post about families being concerned about “gasping for air and short of breath”. Yes, it seems no matter how much teaching and prep work we do with families about the normal dying process and what all happens it never truly prepares them for the actual experience.

Ninety percent of our work in end of life is teaching. Repetition is part of that teaching. Repeat, repeat, repeat. “ Mom is doing a good job. Mom is doing what she is suppose to be doing. This is how a person dies. Nothing bad is happening, nothing pathological. This is how people die. See how she is breathing with her mouth open, those fish like movements. She is suppose to do that. The sounds—those are normal. Those are the sounds people make as they are dying.” All these things we say, over and over again as we guide a family through this final life experience of their special person.

Get the family involved in the moment. Get them individually to say goodbye. Talk about the positive as well as the negative. Encourage touching and holding. Get the family beyond their fears to what they are seeing and interpreting as “bad” into an interactive, giving love and encouragement space.

Mary, thanks for asking. Think I’ll take these comments and do another Blog with them.

Deborah Peters, RN - July 07 2017

Dear Barbara,
As a nurse for the past thirty four years, I have had the opportunity to fulfill many different nursing roles. The majority of my experience has been with Geriatrics. I have been a bedside nurse, as well as a DNS in SNFs and Hospice Director/Primary Nurse. As a very hands on Nurse Manager, I always made certain that my facility staff had direct access to your publications. I have probably used the “Gone From My Sight” booklet several hundreds of times. It was the perfect educational/supportive tool for the families and loved ones of my patients/residents. It was a very beneficial segway into those difficult discussions that needed to take place. Since I retired as of my last position of DNS, I can only hope that the new Director has continued to use it as well as having incorporated your other publications as needed. I just wanted to let you know how helpful and meaningful your work has been to me throughout my years in our profession. I very much enjoy following your email communications. Keep sharing your expertise and knowledge as you currently do. You are contributing a great deal to the Nursing Profession.
Deb Peters, RN

Mary Kautza - July 06 2017


Recently we had two hospice patient families express dissapointment that it appeared to them that their loved ones were “gasping for air and short of breath” while in the end stages of dying. Families were very upset, one of the individuals was even a RN! The patients were receiving medication for symptom control so it was not r/t a lack of medication. We do give all families your “little blue book” and explain the process, indicating that all family members should read the book as it will help them understand what will occur during the dying process. Do you have any further tips or hints we can use to help distressed families as their loved ones die?

Carol Alix - July 06 2017

In your experiences do you see a difference in the dying process and emotions, actions, of Christians and those professing no faith in Christ?
Do people in those end weeks/days tend to reach for God.

I ask because my daughter died by suicide (gunshot) 11-20-16. She was 47. Her 23 year marriage to a narcissistic man that does not believe and then a 5 year marriage to whom she thought was her soulmate -- (a narcissistic women) that likewise has no faith. The last 4 years were very hard on Nicole.

Nicole was saved at a young age and grew away from the church as an adult.

I fear she turned away from God in the end and wondered with all your experience if there was a pattern…..

Dee - June 30 2017

I agree with your description of how our dying ones might hear things. I have accompanied many dying persons over the past 50 years and am quite sure many – perhaps all- DO hear. Sometimes they will respond to my voice when they do not respond to others – I feel like I am really addressing them and when they respond it is often as if they are coming from a long, long way down. And, I believe they are. It is important just to reassure them that they are doing well. If it seems hard, acknowledge that it can be hard work, but rest is assured. Let them know great peace awaits them and, if you share a faith, acknowledge that. Otherwise, just try to honor them and be very humble in trying to discern their wishes.

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