As an experienced hospice nurse with years of experience, I have come across numerous resources that aim to guide families and caregivers through dying. One such resource that stands out is “Gone from my sight: The Dying Experience” by Barbara Karnes, RN. This booklet, often called the “Little Blue Book,” has been a staple for hospice providers for over three decades, and for good reason.

Understanding the dying process

Death is a natural part of life, but it can be scary and confusing for those who witness it. Many people do not know what happens to the body and the mind as someone dies. That is why Barbara Karnes wrote “Gone from My Sight: The Dying Experience.” She is a nurse who has helped many people die peacefully. She knows how to explain the dying process in a simple and honest way. In her booklet, she tells us what signs and symptoms to look for as our loved one gets closer to death. She also tells us how to comfort and support them during this time. She helps us understand that dying is not a sudden event but a gradual transition that can take days or weeks. By reading her booklet, we can learn to accept and respect the dying process as a natural and normal part of life.

Clear and compassionate language

Some people use big words or vague expressions when they talk about death. They may think this makes it easier or less painful to discuss. But this can make it harder for us to understand what is happening. Barbara Karnes does not do that. She uses simple and clear words to explain what happens when someone dies. She does not hide or sugarcoat the truth but does not scare or shock us. She speaks with kindness and respect, like talking to a friend. She helps us relate to what our loved ones are going through and what we can do to help them. She makes us feel less alone and more informed by using clear and compassionate language.

Comfort and reassurance

Losing someone we love is extremely hard and sad. We may feel scared, angry, or guilty. We may wonder if we are doing enough for them or saying the right things. We may not know what to expect or how to cope. Barbara Karnes understands these feelings. She has seen many people die, and many people grieve. She wrote “Gone from My Sight: The Dying Experience” to help us feel better. She tells us that what we feel is normal and that we are not alone. She tells us that what our loved ones are going through is natural and that we can help them by being there for them. She tells us that death is not something to be afraid of but to be respected and honored. She comforts us by being our guide and friend during this grim time.

Benefit for families and caregivers

When someone we love is dying, we may feel helpless and hopeless. We may not know what to do or say or how to cope with our feelings. We may wish we had someone to guide us and support us during this challenging time. “Gone from My Sight: The Dying Experience” is a helpful booklet. It teaches us what to expect and how to prepare for the death of our loved ones. It shows us how to recognize the signs and stages of dying and how to respond to them. It helps us understand what our loved ones are feeling and thinking and how to communicate with them. It also helps us take care of ourselves and our families and how to deal with grief and loss. By reading this booklet, we can feel more confident and calmer and provide our loved ones with the best care and comfort.

Conclusion

“Gone from my sight: The Dying Experience” by Barbara Karnes, RN, is a remarkable booklet that offers a clear and compassionate guide to the dying process. It helps families and caregivers understand what to expect and how to cope when their loved one is approaching death. It provides comfort and reassurance, as well as practical and emotional support. It is a valuable resource for anyone who wants to learn more about death and dying and how to make the most of the precious time they have with their loved one. I highly recommend this booklet to anyone who is facing the loss of a loved one or who wants to prepare for their death. You can purchase this booklet from Amazon using this link. It will change the way you think about death and dying and help you live and die with dignity and grace.

Resources

Providing Comfort During the Last Days of Life with Barbara Karnes RN (YouTube Video)

Preparing the patient, family, and caregivers for a “Good Death.”

Velocity of Changes in Condition as an Indicator of Approaching Death (often helpful to answer how soon? or when?)

The Dying Process and the End of Life

The Last Hours of Life

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Gone from My Sight: The Dying Experience

The Eleventh Hour: A Caring Guideline for the Hours to Minutes Before Death

By Your Side, A Guide for Caring for the Dying at Home

Some key highlights from the book, Gone from my sight: The Dying Experience by well-known and expert Barbara Karnes, RN:

One to Three Months Before Death

• Withdrawal from the world and people
• Decreased food intake
• Increase in sleep
• Going inside self
• Less communication

One to Two Weeks Before Death

MENTAL CHANGES

• Disorientation
• Agitation
• Restlessness
• Picking at clothes
• Confusion
• Talking with the unseen

PHYSICAL CHANGES

• Decreased blood pressure
• Pulse increase or decrease
• Skin color changes: pale, bluish
• Increased perspiration (clammy)
• Respiration irregularities
• Congestion
• Sleeping but responding
• Complaints of the body being tired and feeling heavy
• Not eating, taking little fluid
• Body temperature: hot, cold
• Decreased urine production — urine becomes tea-colored
• Urine and/or bowel incontinence (writer note — it is common for there to be a release of urine more than anticipated and often stool if even a smear of feces hours to a day or two before death; I view this as the body preparing itself and cleansing itself for death).

Days or Hours to Death

• Intensification of one to two weeks’ signs
• A surge of energy (“Rally”)
• Decrease in blood pressure
• Eyes glassy, tearing, half-open
• Irregular breathing: stop, start (Cheyenne Stokes or Agonal)
• Death Rattle breathing
• Restlessness or no activity
• Purplish, blotchy knees, feet, hands (mottling)
• Pulse week and hard to find
• Decreased urine output
• May wet or stool the bed

Minutes to Death

• “Fish out of water” breathing (Gasping breathing)
• Cannot be awakened