How do You Know When?

One of the most frequent questions any hospice worker gets asked is: “How near to death do you think [my loved one] is?”

This is, of course, a very difficult question to answer. Symptoms will vary greatly from person to person as they decline. So there is just no way of knowing for sure. Period.

But people with great experience in the hospice and palliative care arena can give some general descriptions of things to look for as as a patient approaches their final time..

Many professionals in the field feel that one of the best sources of information on nearness to death his a booklet written by Barbara Karnes, a registered nurse working in hospice care. She was asked this question so many times that she wrote a booklet. It has been continuously in print since 1985, having sold over 12 million copies.

The little blue book Barbara wrote is entitled  entitled Gone from My Sight.

Hospice agencies often distribute this booklet to families of patients nearing the end of life. That’s what the Good Samaritan Hospice at which I volunteer does. But you can order a copy on line from Amazon as well. It is inexpensive and well worth the money to get an expert answer to the question “How do you know when?”

By the way, the title of the book refers to this poem:

I am standing upon the seashore.
A ship at my side spreads her white sails to the morning breeze,
and starts for the blue ocean.
She is an object of beauty and strength,
and I stand and watch her until she hangs like a speck of white cloud
just where the sea and sky come down to mingle with each other.
Then someone at my side says: “There! She’s gone!”
Gone where? Gone from my sight – that is all.
She is just as large in mast and hull and spar as she was when she left my side,
and just as able to bear her load of living freight
to the place of her destination.
Her diminished size is in me, and not in her.

And just at the moment
when someone at my side says: “There! She’s gone!”
there are other eyes that are watching for her coming;
and other voices ready to take up the glad shout:
“There she comes!”

The poem was written by Rev. Luther F. Beecher–cousin of Harriet Beescher Stowe–at the turn on the twentieth century.

About Richard Haverlack

Richard Haverlack has been writing the memoirs of hospice patients for more than eight years. He has recently written a book, A Memoir of Memoirs - Writing Stories Told at Life's End, which is about the poignant and enlightening experiences he's had in doing this work. Richard is a volunteer for the Good Samaritan Hospice near Pittsburgh, Pennsylvania. He also is active in the Osher Lifelong Learning Institution at the University of Pittsburgh where he studies as well as teaches.

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