90% of End-of-Life Care Is Knowledge — Barbara Karnes on What Families Actually Need episode artwork

EPISODE · Jun 22, 2026 · 53 MIN

90% of End-of-Life Care Is Knowledge — Barbara Karnes on What Families Actually Need

from In Conversation with an End-of-Life Specialist · host pmsears-us

Barbara Karnes, RN, started her hospice nursing work in the 1970s — before hospice was even a word most Americans knew. She didn't join a movement. She helped build it. And more than fifty years later, she is still writing, still teaching, and still asking the field harder questions.In this conversation, Barbara and Patricia talk about what it actually takes to walk with someone toward the end of life. Barbara's answer might surprise you. End-of-life work, she says, is far more about social, interactive people skills than it is about the medical. The medical model focuses on disease. End-of-life care focuses on the person who happens to have one.If there's one thing she'd want every family to understand — one sentence she'd leave behind — it's this: 90% of end-of-life care is about knowledge. It's about educating people in regard to what is actually happening. Because when families have that understanding and that resource, something shifts. They are less fearful. And the experience becomes something more sacred.Dying isn't pretty, Barbara says plainly. Neither is giving birth. There's labor on both ends of life's journey. Mom is working hard to get out of her body — and that's what it looks like. That's not something going wrong. That's the work.Barbara also shares the 3 a.m. phone call that led to Gone From My Sight, why she's still a social worker at heart, what surprised her most when she cared for her own husband, and what she wants people to feel in the room when she is the one dying.This is a conversation about what it means to really show up — for the people we love, and for ourselves.About the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, an End-of-Life Navigator and founder of Graceful Transitions in Vermont's Northeast Kingdom, serving globally. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers.Join the Graceful Lifers community at Substack for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds.You can find the hub of Graceful Transitions' work at Linktr.ee/pmsears

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Barbara Karnes, RN, started her hospice nursing work in the 1970s — before hospice was even a word most Americans knew. She didn't join a movement. She helped build it. And more than fifty years later, she is still writing, still teaching, and still asking the field harder questions. In this conversation, Barbara and Patricia talk about what it actually takes to walk with someone toward the end of life. Barbara's answer might surprise you. End-of-life work, she says, is far more about s...

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90% of End-of-Life Care Is Knowledge — Barbara Karnes on What Families Actually Need

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