Barbara Karnes
“How do you answer a family member when they ask you how much longer their loved one has to live?” It’s a tough question, but here’s how hospice pioneer Barbara Karnes suggests handling it.
Barbara Karnes answers Rachelle S.’s question about end-of-life discussions with families.
Rachelle asked: How do you answer a family member when they ask you how much longer their loved one has to live?
Barbara’s answer:
That is a question most family members want to know – and one for which there is no concrete answer to give. There are so many dynamics to dying that we just can’t be specific. We can guesstimate months, weeks, days, or hours but really, even that isn’t for sure.
So what do you say?
It’s best to base your answer on the person’s current stage of dying. Tell the family what you see and give realistic advice on how best to interact with their loved one in the time they have left.
Here are a few examples:
“Nobody can say for sure, but based on what I see, he is not eating, he sleeps all the time, and he seems uninterested in what is going on around him. I would say we are talking months. That’s the closest I can get. Now is the time to be with him, visit, have conversations, enjoy him.”
Or
“Nobody can say for sure, but based on what I see, he is sleeping with his eyes partially open, he picks at his clothing, his breathing has changed, and has some random hand movements, his breathing changes I would say we are talking weeks. That’s the closest I can get. Now is the time to sit with him. You can expect that sometimes he will know you, other times not. Your presence expresses more than words right now.”
Or
“Nobody can say for sure, but based on what I see, his blood pressure has dropped, his skin is mottled (blotchy, blue-purplish marbling), and he is not responding. I would say he has days to hours. That is the closest I can get. This is the time you want to stay with him, talk to him, tell him you love him, even though he won’t respond to you.”
Or
“Watch how he is breathing like a fish. He will be gone soon. “Tell him you love him, and tell him goodbye.”
My booklet, Gone From My Sight, describes what happens in the months, weeks, days, and hours before death. In addition to your support and guidance, the booklet is a simple, reassuring, and teaching tool to guide families through this challenging time.
