🧠 Book Review: How Do I Know You? Dementia at the End of Life by Barbara Karnes, RN (Kindle Edition)
A compassionate, clear-eyed guide for families and caregivers navigating the final stages of dementia—written by one of the most respected voices in end-of-life education.
📘 Overview
Originally published in 2016, How Do I Know You? is a 26-page booklet by Barbara Karnes, RN, a renowned hospice nurse and educator. This guide is part of her acclaimed series of end-of-life resources, including Gone From My Sight and The Eleventh Hour. In this edition, Karnes focuses specifically on the unique challenges of caring for someone with dementia as they approach death.
Unlike other illnesses, dementia doesn’t follow predictable patterns. Karnes gently explains how the dying process looks different for those with cognitive decline, offering practical advice, emotional support, and spiritual reassurance.
🧠 Key Themes & Insights
- 🧩 Dementia’s “different rules”: The dying process in dementia often lacks the clear signs seen in other terminal conditions
- 🕊️ Letting go of expectations: Families are encouraged to release the need for recognition or traditional closure
- 🍽️ Eating and not eating dilemma: Karnes addresses one of the most distressing issues—when a loved one stops eating—and reframes it as a natural part of the dying process
- 💬 Communication and presence: Even when verbal recognition fades, presence and touch remain powerful tools of connection
Karnes writes in a gentle, direct tone, making complex emotional and medical realities easier to understand.
💬 Reader Reception
- ⭐ Amazon rating: 4.8/5 from hundreds of reviews
- 📖 Widely used in hospice and palliative care programs
- 🧾 Families praise it as “reassuring,” “beautifully written,” and “a lifeline during a confusing time”
“This booklet outlines the issues and progress that a person with dementia will probably follow. It is written in a manner that is simple and direct, yet gentle.” — Amazon product description
⚠️ Considerations
- 📄 Short format: Designed as a pamphlet, not a full-length book
- 📚 Focused scope: Specific to dementia at end-of-life—not broader dementia care
- 🧾 Emotionally intense: May be difficult reading for those early in the caregiving journey
🏁 Final Verdict
How Do I Know You? is a deeply empathetic and practical guide for anyone caring for a loved one with dementia in their final days. Barbara Karnes offers not just information, but comfort—helping families understand what’s happening, what to expect, and how to be present with grace and love.
