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Ring Theory

A familiar sentiment of loved ones who journey with someone who is nearing the end of life is the fear of saying the wrong thing.  In our insulated worlds, we are so good at keeping tragic things out,...

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Readiness and Dying

To parents the concept of readiness is very familiar. The idea implies that there are certain milestones a child will not achieve until they are ready. I have heard the term associated with first...

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A Pill for Will

We have pills for just about anything. We have pills to make our blood pressure come down, pills to make our hormones go up, pills to bring our sugar down and pills to make our mood go up. We take...

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The Five Things that Matter Most

It happens more frequently than you might realize; a patient with a terminal illness, with every reason to have already passed on, seems to linger.  The family is often gathered, and has spent several...

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Family Dynamics

Have you ever noticed how a crisis can bring out the best or the worst in families? We see this in natural disasters, financial crisis, and physical traumas. Usually the stories we hear are the...

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Just one more bite

Food is a word that carries baggage. Think of all the associations when you hear the word food; hunger, diet, money, stress, planning, tradition, illness, etc.  From the moment we take our first...

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The Dreaded "Death Rattle"

Have you ever noticed how a disruptive repetitive sound has the ability to not only distract us but completely alter our mood?  A peaceful ride in the car gets ruined by the vibrating clacking of a...

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What Dying Teaches us about Regrets

Astute learners will tell you that often life’s best lessons are learned outside of the classroom.  While this is usually based on learning that comes from our own successes and failures, watching how...

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Giving Up

When we live in a performance driven, achievement rewarded, and success valued society, it only makes sense that endurance would be applauded.  Those are the stories we like to retell; the odds were...

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A dose of dignity

The loss of control over so many aspects of our lives can be daunting as we age.  What seemed unlimited, like time and energy, begins to ebb away, and our bodies don’t always preform like we want....

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The Power of Respect

When I was in college I had the opportunity to work with Mother Teresa at the Home for the Dying and Destitute in Calcutta, India.  The mission of the sisters was simple; love the least of these....

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Morphine Fears

It is the most dangerous misinformation about hospice that exists. I run into it so often that clearly somewhere it must have become woven into our cultural ideas about how people die when hospice is...

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Always a Choice

If you’ve ever been admitted to the hospital you might realize what a well-oiled machine it is, and must be to function well. Depending on what diagnosis is at play, whether that is illness or...

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Please Die, Don't Die

It is gut wrenching to watch someone die. I use the term purposefully; as in internal anguish or the visceral twisting that people feel on the inside.  Even when the person passing is completely at...

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The Conundrum of Energy and Fatigue

A good rule of thumb for end of life issues should be ‘forget what you think you know about normal.’  This is where much of the confusion and misguided expectations comes from in hospice.  People try...

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A Handful of Medication

If you’ve ever helped as a caregiver to someone in the twilight years of their life, or perhaps you yourself are at this stage, you may have noticed when it was medication time that there were a lot of...

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The Trouble with Pain

When I made the decision in college to turn from my pursuit of becoming a psychologist to that of a physician, it was based on my perception that medicine was a field of black and white answers and not...

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To Reorient or Validate? Caregivers and Dementia

I would guess most of us have encountered dementia. With approximately 14% of those over 70, and estimates that 40% of those over the age of 90 have the disease, the expectations are that if not yet,...

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Oregon's Death With Dignity Act

If you’ve been listening to the news you will have undoubtedly heard rumblings about something called the “Death with Dignity Act” and a 29 year old woman named Brittany Maynard with terminal cancer...

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Talking to kids about death

It’s difficult for adults to talk to one another about death.  The topic makes us uncomfortable.  Despite this fact, most of us will muster up the courage and have these hard conversations when the...

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Optimism and Pessimism

As a parent, one of the incredible mysteries has been to watch each of my children come into this world with a predetermined personality.  Our parenting style seems to have little effect on these...

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The Greatest Gift? Granting Permission

Certain things are just universal.  All humans need nutrition. All humans need hydration. All humans need air. There really is no argument to these basic needs for existence. Once our physical needs...

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Preparing for the Extremes

When we turn on the news or listen to the radio to hear what the meteorologist is predicting the weather will be, we don’t usually call this ‘the day’s weather prognosis’. We use the term forecast, and...

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The Art of Dying Well

In the success driven society that we live in, I’m surprised there is so little out there about a successful dying experience.  There are hundreds of books about how to be a successful parent, a...

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Death Avoidance

We have a serious problem on our hands.  It’s been around for decades, but it seems to be getting worse.  Our problem? Death avoidance.   As a society, we keep getting farther away from the reality...

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