Book review of The Final Act of Living: Reflections of a Longtime Hospice Nurse by Barbara Karnes
A Gem of a Guide to a Good Death—5 Stars I LOVE this book.

Barbara Karnes, RN, reminds us that death is not a medial event but a normal, natural social event. It doesn’t have to be the ordeal most people dread. With accurate information and adequate support, dying can be a rich and rewarding family experience.

Karnes also wrote the invaluable pamphlet “Gone From My Sight,” which some hospices give to families of dying patients. This more recent book includes moving stories from the author’s own (as the subtitle says) longtime hospice experience as well as descriptions of the deaths of her own parents. She gives detailed information about how we die. For example, she explains the 3 areas—food, sleep, and social interaction—that let one know whether a person has weeks, days or hours to live.

Karnes cautions against the practice of hydrating a person near death, reminding us that dehydration is “Nature’s anesthetic.” She also recommends not using a suction machine, since it usually irritates the throat and triggers the body to produce more secretions. There are other, better ways to keep a person comfortable. I find her advice deeply reassuring.

Karnes sees dying as an opportunity to address any unfinished business, to live in the present, and to say goodbye. But she goes beyond outlining the tools and attitudes that can help a patient and caregivers experience a gentle, peaceful, natural death. She also explains what to do afterwards, for example washing the body and allowing people to view the body, both of which help the grieving process. Additionally, she discusses legal questions and stresses the importance of having an advanced health care directive.

I can’t imagine anyone I’d rather have as a hospice nurse than the knowledgeable, no-nonsense, compassionate Barbara Karnes. Her little book is a gem!

Nancy Manahan
Living Consciously, Dying Gracefully: A Journey with Cancer and Beyond
By Nancy Manahan and Becky Bohan