I worked on-call triage from Sunday night into Monday morning - a job I don't do often because I really like a good night's sleep.  I was filling in for a nurse who had her baby a couple weeks early, but I believe her with a newborn and myself with the telephone got the same amount of sleep: almost none.

Some of the calls that came in really surprised me.  I was roused from a light doze at 12:00am to inform me that the caller's father was going to need a refill of his medication in the morning.  I can't figure out why that call couldn't have waited until normal business hours.  Another call in the middle of the night was to inform me that a patient was constipated.  I can't imagine the patient wanted an enema in the middle of the night and we certainly don't send nurses out in the middle of the night to do them.  Other calls came in that were urgent and needed my attention.

As much as hospice nurses want and need to be there for our patients in times of crisis, we don't want to be woken up in the middle of the night for non-urgent matters.  Remember, we are better nurses when we are well rested and healthy.  I think it's important for hospice staff to educate patients and caregivers about what constitutes an after-hours emergency and what issues can wait until the next day.  I am creating some guidelines that will be posted on this site very soon to help patients and caregivers, but in the meantime I'll leave you with this advice:

If the hospice patient is in pain or suffering in any other way, has any emergency that you would normally call 911 for, or if you have urgent caregiving questions that can't wait until morning call the hospice nurse for advice.  If you need medication refills, are dealing with constipation, or if you have general questions about caregiving, wait until daylight hours to call the hospice nurse.

Common End-of-Life Symptoms:  This list can help you recognize and manage some of the most common end-of-life symptoms.

I've made it perfectly clear to my loved ones that I want a celebration when I die, not a stuffy, sad funeral.  I imagine something very close to my wedding - festive, great food, music, drinks, and a good time had by all.  My husband is all for it; my parents cringe and extol the importance of somber grief.  Oh, if my parents only knew how the Ghanians do it!

The New York Times reported on the growing number - both is size and frequency - of Ghanian funeral celebrations in New York City.  These celebrations, whether done in Ghana or in New York City, are all-night parties with DJs, photographers, videographers, and open bars.  Looking for a good time on Friday night?  Find a funeral!  You don't even have to know the deceased to join in on the fun.

Let's discuss:  are the Ghanians on to something here?  Are we too somber here in America?  What kind of funeral would you want?

I say, bring on the party!

5 Reasons to Plan Your Own Funeral (hint: you can decide for yourself how raucous the event should be!)

How to Plan a Funeral

All forms of dementia, including Alzheimer's disease, are life-limiting illnesses that will eventually lead to death.  While individuals are living longer with dementia, the end does come eventually.  A lot of people wonder what death from dementia looks like and what they can expect as their loved one or friend progresses through the illness.

Of course, each individual with dementia is unique and will follow their own unique course, but there are some fairly consistent changes seen as individuals with dementia near death.  This article can explain what to expect if your loved one is dying from dementia.

What is it Like to Die from Dementia?

There's a few conversations most of us dread having with our kids.  Death is one of them, and it's the only one we are faced with as early as toddlerhood - maybe the first time they squash an ant under foot or watch the flowers die in autumn.  It's important, then, that we feel comfortable having an honest and compassionate conversation with our kids about the seasons of life.

I've shared some tips for having the conversation with kids.  I think you'll find them useful as you prepare to have the talk yourself.  Readers can also share their own tips for having sincere discussions about death with children.

Explaining Death to Children