#171： The Dying Experience -- Myths and Answers
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Summary
Barbara Karns has spent her life trying to educate people about the dying process, the dying experience, and what we can do to prepare to die. She is a hospice nurse, a writer and speaker, and she goes around the world, around the country, and around the globe, talking and sharing about what dying is like, and how we can prepare for it.
Transcript
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brett mckay here and welcome to another edition of the art of manliness podcast so death
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dying it's not a topic we like to talk about in modern day life particularly in america where
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everything is awesome and everyone will be eternally forever young but as a result of our
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hesitation about talking about death and sort of coordinating off to the hospitals or the nursing
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homes there's a lot of misconceptions about death and the dying process and a lot of myths and
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consequently a lot of fear about it you know from my own experience i can count on one hand the number
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of people close to me who have died and i never actually saw them go through the dying process i
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saw them at the funeral when they've they're gussied up in the casket but this is all going to
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affect us at one point in our lives either we're going to die because we get a terminal uh diagnosis
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cancer or something like that's untreatable or we have a parent who's going to be dying of an old age
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or we're going to die one day eventually sometime so it's be good to know what exactly is going to
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happen to us physically emotionally mentally as we get closer and closer to death well my guest today
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has spent her life trying to educate people about the dying process the dying experience her name is
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barbara karns she's a hospice nurse as well as a writer and speaker and she goes around the world
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around the country in america talking and sharing with people what the dying experience is like to
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prepare them for this experience and how they can make the process more meaningful and less scary
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so today on the podcast we're going to discuss dying what's it like the physicality of it
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the psychology of it the the emotional aspect of it the social aspect of it and what we can do to
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prepare to die today i know it sounds kind of like a downer podcast but i think you'll be surprisingly
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be uplifted at the end of it because you'll have some knowledge that you can actually use
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for an experience that we are all going to encounter at some point in our life whether you're
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rich poor uh doesn't matter death affects us all so without further ado barbara karns and the dying
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experience barbara karns welcome to the show thank you uh so can you tell us a little about your
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history how did you become a hospice nurse well um i graduated from nursing school in 62
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and thought wow i've made a huge mistake i should have been a social worker but in the 70s elizabeth
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kubler ross came forward dr elizabeth kubler ross with how poorly we americans were treating
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people who were dying in the hospitals and at the same time in england dame cicely saunders was creating
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a uh a plan of care for people who were dying and she called it hospice well the idea was that
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she would hospice would throw out all the rules that the medical establishment was using to take
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care of people who were dying and that they would treat them differently you know um they could have
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the dog on the bed and and it wasn't about the medicines it was about quality of life and i thought
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this is what i want to do and so i got back involved in nursing and uh became a hospice nurse
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and i was a bedside hospice nurse for oh five six years and then got into administration and eventually
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uh was the director of two different hospices in kansas city i liked the holistic approach
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to um to care that we're more than a physical body we're emotional mental and spiritual beings
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and um the hospice approach dealt with all aspects of the person as well as working with the family
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where our medical model is really just focused on the physical uh physical body and on the person
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that's sick so we'll talk a little more in detail about what intel what exactly hospice care is and
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what's involved with it um before we get there you talk about how there was a need for hospice care
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because in america at least and probably in other western countries as well we started treating death as
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a physical disease almost and we've become really uncomfortable with it we isolate it we send people
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who are dying to the hospital and we just kind of forget it why are modern americans so uncomfortable
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with death and was there a time in our history when death was more integrated into our daily lives
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very definitely there was a time because grandma used to live at home you know we were multi-generational
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all in one home um all in one home and when grandma got sick she didn't go to the hospital she went to
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the upstairs bedroom and there she died and when she died we didn't call a funeral home we washed her
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body and we put her in the parlor and family and friends and neighbors came to our home and paid their
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respects well today um grandma lives in a senior citizen high rise and when she gets sick she goes
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to the hospital and from the hospital she goes to a nursing facility and there she dies and because
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we're not multi-generational all in one home we're scattered all over the world family comes in the last
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week or so before grandma dies and then we see her in the coffin and in a funeral home and we have have
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made dying as you said a medical event when in reality it's it's not medical dying is social it's a communal
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event but we've we've taken it out of the home we've taken it out of the normal naturalness of it
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and we've made it um something to be frightened of we've made it a pathology where in reality life is a
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terminal illness you know we're all dying from the moment we're born um but we americans have
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have become very afraid because all we have is television and the movies that show us what death is like
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we're not experiencing it firsthand with those that we care about we'll talk about some of those myths
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about death uh and dying in a bit but like what do we lose in the process i mean what have we lost in
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the process of isolating our our loved ones who are dying you know into a hospital somewhere i mean i'm
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sure the the individual who is dying loses something and i'm sure those who survive or also lose something
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as well what is that exactly well we we're losing the normalness of it um and replace that normalcy with
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fear um with the unknown and of course we're always afraid of that which we don't know or haven't
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experienced before for the person that's dying there is a from a disease or old age there's a process
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but most of us don't understand that there's a process to dying from disease or old age most of us
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think a person's alive one minute and dead the next and so we start trying to take care of people who
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can't be fixed as if they can be fixed and um then you add your fear of i don't want to talk about
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this because i don't know what to say or i don't know what to do and we have an isolation that goes
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um around the person that has the illness and is approaching death as well as an isolation
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um with the family because not only do people not know what to say to the family um you know they
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they are all by themselves they don't we don't talk about dying we don't talk about death it's
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almost like if i talk about it then i probably will die so i better not bring it up right um so let's
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talk about this one of the things i i found so enlightening about your book is you get into details
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like the nitty-gritty details of what dying is actually like because you know i've i've probably seen
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i'm gonna i'm gonna like off the top of my like i can count on my number of fingers the number uh on
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my single hand how many dead people i've seen right and they they'd actually died um i've had
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grandparents and that happened when i was a little kid so i have never actually seen someone go through
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the dying process and so reading your book talking about what goes on was really helpful i mean it took
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some of the mystery away from it uh so before we actually talk about what death is actually like or
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dying is actually like what are some of the biggest misconceptions or myths that people have about
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the process of dying well number one i think that um look at look at your movies how someone is saying
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something very profound they're um giving this message and then you know they close their eyes and
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their mouth and they're dead and people in the hours to minutes before death they're not saying
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something profound they're generally non-responsive um and if they are talking they're probably not
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making any sense because they're otherworldly so one of the misconceptions is that we literally think
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we're alert and alive and talking and then one minute later we're dead and that that's not how it
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works even um with what i call fast death is where you're in an accident or you have a heart attack
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even then you're you're not saying something profound and then we also expect people to have their eyes
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wide open and people don't have their eyes wide open when they die they have their eyelids open kind
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of a half mask but not wide wide open in a blank stare um and then in the movies you you see someone
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take their their finger and their um thumb and they close the person's eyelids well if you do that
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their eyelids don't stay shut they open right back up but people don't know that i'm sure it freaks
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them out when they come back yeah it's like you know i have to scrape everyone off the ceiling when
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that happens because that the movies it doesn't happen like that are on television and that's our only
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role models anymore because we're not at the bedside when someone who's dying uh and when we are
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there we're there we're there because we're emotionally involved and when you're emotionally
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involved you don't see what's really happening because if everything that you perceive comes
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through your culture your role models your stereotypes your fear your belief system your experiences
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and all of that distorts what's really happening okay so you've hit on some of the things
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what dying is really like uh you're not keeping your eyes open there's usually not profound words
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spoken at the very end but let's talk about what dying really is like i'm sure most people who are
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listening unless they're doctors or they're working hospice as well they probably never seen someone
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die or go through the process of dying so what are the signs that someone is beginning what you call
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i think this is interesting you call dying sort of liking it to a birth labor um what are the signs
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that someone's getting close to dying and why do you liken death to pregnancy labor okay i'm gonna i'm
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gonna back up a little bit for labor okay and say that there are just two ways to die and we in the
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medical profession make it really complicated and it's so easy you either die fast which is uh getting
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hit by a truck or a heart attack or suicide or you die gradually and gradual death is either through
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a disease or old age and gradual death has a process it doesn't just happen if it just happened it would
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be fast death so that process of a gradual death or dying gradually begins two to three to four months
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before death actually occurs and three things start happening one is a person's eating habits change
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food is what holds us on this planet food is our anchor to this world and if the body's preparing to die
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it doesn't want the grounding or that energy or the hold that food gives us and so the person all by
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themselves will cut back and stop eating over this period of months and that's the hardest thing for
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people to understand and it's not that the person doesn't want to eat it's literally they can't eat
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they want to because they see what it does to us but their body is rejecting the food so gradually they
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stop eating they gradually start sleeping more and over a period of months they will sleep more and more
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and more until they're asleep more than they're awake and then the third thing is they start withdrawing
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from the world around them they're not interested in their favorite football team they're not interested
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in socializing and eventually on this continuum of months right up to death they're not they've gone within
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and they're not um they're totally withdrawn and they're not interacting with other people and they're not
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interested in what's going on on this continuum there comes a point one to three weeks before death arrives
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where a person begins what i call labor we go through labor to get into this world we go through labor to
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leave it and the labor to leave this world is harder on us the watchers than it is on the person that's dying
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because they're so withdrawn and removed from their body that they're not experiencing anything in this in the
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what we consider a normal way so when labor begins that's one to three weeks before death occurs
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a person is sleeping almost all the time they're sleeping with their eyes partially open kind of at half
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mass they're picking at the air or their bed clothes they're restless and agitated um there they may be
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puffing and and you just see their kind of their lips coming together and blowing a little bit or they'll do
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what i call start and stop breathing where you look at me and you think oh my gosh he just died he's not
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breathing and then he starts breathing again start and stop breathing what you're going to remember
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when labor begins is that nothing in the physical body works right it's all shutting down so you can
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have a fever and fever goes with dying you're not going to do a bunch of lab work to see why a person has a
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fever if they're in the dying process you're going to get them some Tylenol and cool claws um you're just
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the body is shutting down then um part of their body can be hot another part can be cold you're just
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going to remember nothing works right then there are changes that occur in the hours to minutes well
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let's do days days to hours and that key change is called modeling and it's a bluish purple to the
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hands and the feet and the legs and it's the body shutting down it's not the circulation isn't normal
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anymore and then days to hours uh or hours to minutes excuse me hours to minutes a person is generally
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non-responsive that means their eyes are partially open um they can be talking but they're not making
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any sense but they don't respond to this world and you call their name they don't respond touch them
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they don't respond and then um they start breathing like a little fish breathes just picture of a fish
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and how it breathes in the water how its mouth open and closes well that's how they're breathing
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in the hours to minutes before a person dies i think it's important to know that a person can hear you
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in the moments before death and so you talk to that person even though they're not responding
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even though it appears they don't hear you you talk to them tell them what's in your heart
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say your goodbyes um this is an opportunity um to love them as they go from this change
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from this world to the next and then their breathing gets slower and slower and slower
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till they're taking maybe five or six breaths a minute and then they stop breathing
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and then they're gone and after they stop breathing they may take one or two or three long long spaced
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out breaths where you think they're not going to take one and they do and that's kind of scary
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um but that's that's how we die and even a fast death will do the the hours to minutes um
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that that i've just talked about and if you know what to expect then you know that mom's doing a good
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job you know that she's doing what she's supposed to be doing that nothing bad is happening it's very
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very sad when someone we care about dies but it doesn't have to be bad there is a normal way that
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people die and it's not bad and it's not scary if you know what to expect right that was really
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fascinating and actually i did not know that like i did not know that's how it went down um but also
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what surprised me too i didn't know this and i actually i had a we're talking to a friend while
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i was reading your book her father passed away from cancer and she went through the in details and
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like it literally it followed everything that you said and one thing she's mentioned too and you wrote
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about in your book is that you know talking about how your body is in is failing uh there's issues
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of incontinence and you know you're going to be going to the bathroom in the bed you have no control
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over it and it's like really messy and my friend's like she was changing sheets quite a bit for her
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father and i did not know that that happened yep i and i should have mentioned that in the weeks
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before death and for sure in the days to hours before death a person's going to be peeing and pooping
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the bed because they're releasing everything in their body it's just letting go you know they're not
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in control of their body anymore and there's also a point of confusion and we get really upset when
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when they start in the weeks before death they start talking and they're not making any sense
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and they're talking about hearing people and things that we don't see and we get real confused scared
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um and so what i what that confusion is is think about they're sleeping more than they're awake
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and so their world is not this world anymore they're talking about their dream world and so what's
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what they're what they're talking about is making sense to them but not to us and if they're not
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a danger to themselves falling out of bed or hurting themselves you don't have to give a lot of
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medications you know listen to them you know they're telling you what their world is like um and this is
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perfectly normal if someone gets very very agitated and and you think they're going to hurt
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themselves um then of course you're going to get some held all or out of van or something to calm them
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down but generally that confusion and you know people will say oh they're hallucinating and they're
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delirious they're telling you what their world is like um we don't have to be afraid of that
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um another thing that you mentioned i think it confuses some people it happens in some people
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who are dying i've heard it uh two family friends who had died this happened to them but like the day
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before they actually died they had like the sudden burst of energy oh yes i call it the calm before the
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storm and it's it doesn't always happen but it happens enough that we hear these stories where
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you know dad's been in bed for a month and he's been sleeping all the time and not eating at all
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and he wakes up and he says i want a steak dinner and i want a baked potato with my steak
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and call the kids and get them all over and we're going to the dining room table and he does and he
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visits and he eats his food and what we think is the miracle has happened he's going to be better
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all of our prayers have answered you know this is fantastic and 48 hours later he's dead and you think
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what happened here now this is purely me it is not medical this is just what what barbara karnes
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came up with um is i think that nothing operates in a void and as our physical energy starts with
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drawing from our body that since there's no void a spiritual energy starts filling in that space
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to help us get from this world to the next and some of that energy lops over into the
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physical and we have this wonderful little gift of interaction but we're so startled by it and so
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caught up in our own expectations that we off that we miss the gift you know we're in the forest and
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we don't see the trees and it isn't till the visitation that we then start saying what in the
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world happened i think it's just a little gift that some of us get interesting um so you write you said
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this uh several times in your book that people die like they live what do you mean by that well there
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are dynamics to dying and um one of them is we die the way we've lived dying is just really one
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one more experience in life you know it's it's one more challenge that all of us are going to
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experience and we are going to deal with that challenge in the same way that we've dealt with
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any other challenge in our life so if i have run away from my challenges in living then i'll be in
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denial about my approaching death if i've been organized and very much of a doer then i'll have
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my dnr in place and i may even write my own obituary dying doesn't change our personality it intensifies
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it so if i'm ornery and cantankerous in living then i'm going to be an absolute monster in dying
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because it's not going to change who i am we don't suddenly go from being ornery to being a saint
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it just intensifies our personality and so you know we use the word dying all the time and if you
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think about it that's a misnomer because life is a terminal illness from the moment of ball up that
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we're born we begin to die cells in our body die every day it's all a part of living and so
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really the time that i talk about the dying process it's really our final act of living
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it's a living process i thought that was there was no deathbed conversions
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rarely yeah no all right so get it get it go get it get it right now right yeah you better do it
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while while you're very alert and very grounded because as you're as you're dying there isn't
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going to be time to say oh i've changed my mind so i think because we're so unfamiliar with death
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and we like as a society uh we don't know how to act around people who are dying right and you
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a friend gets that uh diagnosis of cancer and they only have six months um and you just don't know
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what to do like what like you do do you talk about it like you would avoid talking about it because you
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don't want them to like feel uncomfortable so how should we approach individuals that we know who are
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dying how do we how do we approach them and talk to them and interact with them i think it depends upon
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the closeness of your relationship with them you know if they're a neighbor and you only see them
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when uh they're out walking and you wave and say hi you're not going to suddenly show up on their
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doorstep and say i hear that you've got a life-threatening illness talk to me but if it is a close
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friend that has been given a diagnosis of a life-threatening illness of course you're going
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to want to support and be there with them i think that you look to first to the the depth of your
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relationship with the person that's going to determine the depth of the conversation that you'll
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have with them the other thing is um you want to see what they're comfortable with i i had a i just
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wrote an article uh for the blog about a person who has a life-threatening illness and she said um
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i i i am so tired of people asking me how i am and what i'm doing and telling me that i look good
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she said i know i don't look good um i don't want what can i say to people um who who talk to me and i
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don't want to talk to them and i said you can say to them you know i'm fine the journey's been
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rough one and i don't want to talk about it you know be honest be open um so my key there is to be
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yourself and if you have a relationship that's close enough with a person that you talk about
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stuff then talk about this because you may be the only one that has approached this person um to say
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let's talk about it so what about if you are the person right you go to the doctor and the doctor
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says look you're you're dying you need to get your affairs in order how do you i'm sure there's there
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might be people who are listening to this right now that that might be them and it might happen to
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want some of us at some point we don't know um how do you how do you respond psychologically
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that i mean how do you come to terms with your pending death very interesting because i'm not
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sure we do um number one is in the months before death when we've been told by a physician that we
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can't be fixed i don't think we believe it i don't think we can comprehend our own death you know
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i don't think we can see that in the months before death it's like there'll be a cure though doctors
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are wrong there'll be a miracle um we can't really see ourselves as being dead even though we can talk
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about it but in our core we don't really believe it um then as this progression as we get closer to
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dying um and we get to weeks before death then that knowledge that intellectual knowledge that we
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haven't really grasped um becomes real and we know indeed we are dying we may not share it with anyone
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but in in our very core we'll go yeah they were right i'm gonna die and what we also have at that time
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is we're so disconnected from this world you know we've spent these months withdrawing sleeping more
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eating less and so we're going within but we're not our our mind is more
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within and it's not thinking like we normally think if that makes any sense at all it's really hard to
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describe it but we in when labor begins the one to three weeks before death we really
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don't care we just don't care we just don't care because we're just so withdrawn that um our emotions
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are different and so that fear that we all are going to have every single one of us are going to be
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afraid as we approach death because it's the unknown we haven't done it before we're always afraid when
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we do something new and so that fear can be manifested in restlessness it can be in agitation
00:33:09.280
um when i see someone really really in labor and agitated i put that on fear can be lack of oxygen but
00:33:22.060
more than likely it's fear and i'm going to do relaxation techniques um they aren't at a point
00:33:30.660
where i can sit down and have a conversation with them but i can still talk to them because they can
00:33:36.680
hear me and i will try and help them relax and be more at ease so i mean it seems like uh when we talk
00:33:45.720
about hospice care now i mean is that what hospice care is all about i think when people hear
00:33:49.380
hospice the the typical image they have is like well it's sort of like uh they come to your home
00:33:54.280
or you go to a special nice little place where they just help you you know care for the dying but
00:33:59.360
what exactly is involved in hospice care and not just hot good hospice care i think you talk about
00:34:06.080
that in your book you make a distinction between hospice care and good hospice care right it's real
00:34:10.800
hospice is changing a lot and so it's it's getting more and more difficult to find a good and i put that
00:34:20.300
in quotes hospice um you you want for hospice you want some you want a hospice that has the same nurse
00:34:32.440
coming every time because you want to trust and develop a bond with that nurse because that nurse
00:34:41.340
is going to guide you through this experience and i think the key role for hospice is education
00:34:51.700
is to educate the family and those significant people that are going to be involved with that
00:34:59.500
dying time that process that they understand it so that they can put their fears aside it is hard work
00:35:09.740
it's 24 7 taking care of someone dying at home it isn't easy but it is a gift it is an opportunity
00:35:20.280
to have a closeness um that it's even hard to have words to describe how great you will feel
00:35:30.480
after you've done it but it's scary to think about yeah i'm bringing mom home and she's going to die
00:35:37.860
here in bed and how am i going to take care of her well hospice will bring in um nurse's aides who
00:35:47.100
will give her a bath and change the bed they will they have chaplains to give you spiritual guidance if
00:35:54.660
you want it um they have social workers who can help you connect with community services and just give
00:36:02.800
you the the emotional and and support uh through this experience they have volunteers that will come in
00:36:12.940
and and and help stay with you so stay with mom so you can go to the grocery store you know just to
00:36:21.280
um have a little respite time um all of this is what hospice can give the the really sad thing that i'm seeing
00:36:33.740
today is that hospice referrals come when a person looks like they're dying because we think hospice
00:36:45.180
takes care of people who are dying well when a person looks like they're dying is when labor begins
00:36:52.400
before that time in the months before death they look frail they look sick but they don't look like
00:36:59.440
they're dying well so we wait till they till labor begins and then hospice comes in they can't really
00:37:07.560
do anything for the patient other than teach mouth care and positioning because the person who's dying
00:37:15.660
is so removed from their physical body that you know you're just going to do physical care for them
00:37:22.920
and the family is in crisis because no one has said to the family mom's dying now we're talking a matter of
00:37:31.500
days or a week or so so they're in crisis if you get hospice when the dying process begins months before
00:37:42.460
death then the hospice people can work with the patient and help them live the best they can within the
00:37:52.480
confines that their body and disease has put them in and they have time to educate and support the
00:38:00.860
family i the key to hospice that they don't always have time to do is to teach to teach the dying process to
00:38:15.640
teach how to care for the person they're the support but it's all about education so i'm curious for our
00:38:24.800
listeners who are listening they might have parents who are you know in their 80s and 90s and maybe
00:38:28.940
they're healthy and going active they're strong right now but how do they know at which point they should
00:38:33.620
bring in hospice because their their parent is dying of old age okay old age is is a different ball game
00:38:44.220
in that old age okay in that old age a person will have the same signs of approaching death the not eating the
00:38:53.280
sleeping more the withdrawing but those signs occur over years instead of over months where gradual death
00:39:04.060
from disease occurs over months so there's a bigger timeline when you get to the point where
00:39:13.720
labor begins where the person who's just old is um sleeping all the time is not eating is totally
00:39:25.660
withdrawn that's the time you're gonna think okay now let's call hospice and see let's talk to the
00:39:33.660
physician and see if the physician will refer us to hospice because you have to have a physician
00:39:42.520
referral to be on the hospice program okay and if it's disease like it's just when do you know
00:39:48.520
as soon as you get the the diagnosis or should you wait a little bit when should you decide to bring in
00:39:53.200
hospice if the doctor has sat down with you and has said look there's nothing we can do um we don't
00:40:01.720
recommend any chemotherapy or radiation um we can't fix you um then i think that that's a very very
00:40:13.080
appropriate time of course you've got it i i need to know what the disease is sure um but for a lot of
00:40:22.880
of cancers um remind me to talk about dementia but like copd is unpredictable so that's harder to know
00:40:33.840
when to bring on hospice congestive heart failure if you're if you decided you're not taking all the
00:40:41.180
meds that that they have then that would be the time to call hospice and the cancers if you're not
00:40:48.420
having uh chemotherapy that depending upon what kind of cancer may be the time so you have to go
00:40:57.280
through your doctor um and that that's a whole nother issue too because doctors are often hesitant
00:41:05.620
to to recommend hospice they'd rather do the treatments they want to fix yeah that's what
00:41:13.080
they're taught to do and they're um my philosophy is just because you can do something medically
00:41:22.320
doesn't mean that it's appropriate to do it right because you might be able to extend someone's life
00:41:28.320
by a month or two but in the process it could probably do more damage or just make you really
00:41:33.760
uncomfortable or make everyone's life uncomfortable right right your your quality of life for living that
00:41:40.020
extra month or two um is it worth it if if you had known would you have traded the pain and the
00:41:48.640
sickness um and the debilitation uh for another month some people would say yes i would i don't care
00:41:57.040
others would say no you know i really would have rather been able to um interact with my family
00:42:05.700
more to not be so sick and debilitated to have taken this gift and that's what a gradual death is a gift
00:42:14.840
it's a gift of time a lot of us throw that gift away um and when we've been told we can't be fixed we
00:42:22.740
basically stop living but it's a gift an opportunity to do and say that which we want to do and say
00:42:31.860
um so that's another thing hospice tries to help people see that they've been given a gift and how
00:42:39.740
can we help you utilize this gift in the very best way so you talk about this you hit on this a little
00:42:47.160
bit in your book um and it actually is very timely uh it's the issue of advanced directives and living
00:42:52.780
wills and it's very curious to talk to someone who's seen people what it's like to be in the last
00:42:57.920
stages of life you have a terminal condition and you know there's putting feeding tubes in you and
00:43:02.200
hydration tubes you know my wife and i are trying to figure out okay what are we going to do like i'm
00:43:05.960
unconscious but i'm terminal there's nothing the doctors can do do i want a feeding tube i want
00:43:11.140
hydration so i'm curious i mean from your experience of decades of working with people and watching people
00:43:18.120
who have gone through the dying process right and have been sustained maybe beyond you know the natural
00:43:25.640
course of life because they've had treatment or hydration or feeding tubes is it is it worth it
00:43:32.640
or should we just let nature take its course is my like i don't i have no idea like because i've never
00:43:39.320
seen that process i have no idea what decisions i should make i think it depends upon the person's
00:43:45.920
personality um you know my my father-in-law my my stepfather said i want absolutely everything done i want
00:43:55.540
everything you know and if i'm on a ventilator you know i want to be brain dead for three days before
00:44:02.680
you disconnect the ventilator you know some people want to do absolutely everything but there are other
00:44:11.000
people that'll say you know look if you can't fix me then i i want to be able to to leave with
00:44:21.160
dignity and um i want to be able to live um as as best i can as long as i can but living is is the
00:44:33.020
operative word here i want some quality i don't want to just breathe and we have the medical capabilities
00:44:39.940
to keep a physical body breathing um for a long time after actual life and the interaction and
00:44:52.440
enjoyment of life is gone so you have to ask yourself what do i want and then if you decide you know
00:45:01.840
i don't want to just be hooked up to a machine and that's all just my body breathing then the natural
00:45:12.940
way we die is not eating and that includes not drinking and so you wouldn't want a feeding tube
00:45:23.320
um or ivs for fluid because you would be going against the natural way that a body dies and you would
00:45:35.360
just be prolonging now again you have to look at um the disease you know uh and how fixable it is
00:45:46.580
if i can have an active life by having a feeding tube and i'm not in the dying process but whatever
00:45:59.240
my disease is that i can't put food in my stomach but i can still walk around and i can interact then
00:46:09.460
yeah i'm going to have the feeding tube but if the doctors can't fix me and i'm in the dying
00:46:16.580
process then no i'm not going to have a feeding tube because that's just going to prolong
00:46:22.980
um my leaving this world and and my dying you're with me yeah i'm with you and and let me say about
00:46:34.440
fluids because this is so important um and that is the normal way that we die is being dehydrated
00:46:45.740
when we die when we're dehydrated the electrolytes in our bloodstream get out of whack and our calcium
00:46:55.440
goes up and we close our eyes we go to sleep and we don't wake up that's how we die and that's part
00:47:05.860
of the reason we stop eating and we stop drinking um so that we get to that place where we close our eyes
00:47:12.960
and we go to sleep and we don't wake up we interfere with that normal process and that easy gentle way
00:47:21.300
to die when we start doing ivy floods so it's not uncomfortable that's the thing i was worried
00:47:26.420
about like man is this going to be uncomfortable if they it's not okay it is dehydration dehydration if
00:47:33.300
i'm healthy and well yeah that's uncomfortable but if i am in labor in the labor of dying
00:47:42.780
one to three weeks before death dehydration is not uncomfortable always always always offer food
00:47:53.400
and water you always offer it right up to the last breath offer never deny offer but don't force
00:48:05.100
don't force so barbara i'm curious this has been a really just fascinating conversation um you know
00:48:11.620
i'm 33 and i don't i don't have any signs of a terminal illness um i hope living you know another 60
00:48:19.000
60 odd years hopefully but is there a way for me and other young people who are listening to this
00:48:25.200
like to start preparing for death right now or is it something you just have to deal with once it comes
00:48:29.900
right great great question the first thing that everyone should do is have um a durable medical
00:48:39.840
power of attorney assigned to someone you should have your your advanced directives
00:48:47.840
filled out so that if there is an accident um you can die be allowed to die the way you want to be
00:49:00.020
want to if you don't have an advanced directive then you're going to die the way the medical profession
00:49:07.080
wants you to but if you have opinions you don't want to be on a respirator for seven years um then
00:49:16.920
you've got to have an advanced directive and a durable medical power of attorney that's a must and then
00:49:26.200
the second thing you do to prepare for your death is you live your life the very best you can you
00:49:36.920
recognize how precious being alive is and enjoy the moment enjoy living and we get so caught up in our
00:49:48.540
durable wheel of routine that we forget to really the old cliche smell the roses you know um i think that's
00:50:00.080
the best preparation for for dying that there is is to live and enjoy the life that you have
00:50:08.300
well barbara on that note we're going to end this thank you so much for this enlightening conversation
00:50:12.720
where can people learn more about your work you can go to my website which is www.gonefrommysite.com
00:50:24.680
you can read my books you can ask me questions you know go to the website if you have questions
00:50:31.960
go to the blog section and ask me questions and i'll i'll write about it and if you give me an email
00:50:38.880
address i'll give you a personal response um and answer your question personally as well
00:50:44.500
barbara karns thank you so much for your time it's been a pleasure
00:50:47.580
oh thanks brad my guest today was barbara karns she's a hospice nurse as well as the author of
00:50:52.740
several works on the dying process she mentioned gone from my site it's a really great little book
00:50:57.100
you can find that on amazon.com you can find more information about her work at barbara karns.com
00:51:02.860
really go check it out even if you don't think you're dying or you know someone who's going to
00:51:06.860
be dying anytime soon really read this stuff because it really will enlighten you about the
00:51:11.200
dying process it was a completely eye-opening experience for me to learn this information and
00:51:15.560
i'm actually feeling not completely comfortable with that but i'm not feeling as uncomfortable about it
00:51:23.480
well that wraps up another edition of the art of manliness podcast for more manly tips and advice
00:51:30.680
make sure to check out the art of manliness website at art of manliness.com and if you enjoy this podcast
00:51:34.900
and you've gotten something out of it i would really appreciate it if you give us a review on
00:51:38.160
itunes or stitcher help us get the word out about the show and as always i appreciate your continued
00:51:42.900
support until next time this is brett mckay telling you to stay manly