Pages

Monday, May 23, 2016

Transgender Veterans’ Healthcare Disparities, Veterans' Benefits (Research, Video 6:37)

Healthcare disparities are inequalities that exist when members of certain populations do not benefit from the same health status as other groups. The Veterans Health Administration is the largest healthcare system in the United States, an ideal place to do research on how equal medical and mental health services are between transgender veterans matched with non-transgendered veterans. Transgender veterans’ healthcare research is particularly important because no large controlled studies like this one existed before.

This study included 5,135 clinically diagnosed matched transgender veterans and non-transgender veterans. The purpose was to determine whether medical and/or mental health disparities existed with the transgender veterans. 

Results indicated that statistically significant transgender disparities were present in all 10 mental health conditions examined, including depression, suicidality, serious mental illnesses, and post-traumatic stress disorder. Transgender veterans were also more likely to have been homeless, to have been incarcerated, and to have reported sexual trauma while on active duty. Significant disparities in the prevalence of medical diagnoses for transgender veterans were also detected, with HIV disease representing the largest disparity between groups.
On a global level transgender veterans were also found to have disparities in psychiatric and medical diagnoses compared to matched non-transgender veterans. The Transgender AmericanVeterans Association (TAVA)is an organization that acts proactively with other concerned gay, lesbian, bisexual and transgender (GLBT) organizations to ensure that transgender veterans will receive appropriate care for their medical conditions. Unfortunately that equality does not exist. In terms of policy, healthcare screening, and service delivery in Veterans Health Administration and other healthcare systems, it is critical that corrective policies are implemented and monitored to eliminate these inequalities in treatment of transgender veterans.
This following informative video produced by Erica Elizabeth Ravenwood, a former veteran, was created to give transgender veterans and the public a better understanding of the Veteran Administration benefits and procedures as they relate to transgender veterans starting the transition process which does not include reassignment surgery, follow-up care, and review of their rights.


Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.
Hospice and Nursing Homes Blog

Monday, May 16, 2016

Empathy: Do Your Healthcare Providers Express Any? (Research, Video 4:23)

You expect that your medical needs should be addressed by your healthcare providers. But what about your emotional needs for understanding and support as a whole person? Shouldn’t your providers also be able and willing to express feelings about what you are going through? If they don’t, why don’t they? And what can be done to improve their responses? Empathy research studies have repeatedly found that healthcare providers miss 70-90% of opportunities to express empathy. These are high percentages. 

In this research study on healthcare provider empathy, there were 29 empathic opportunities within 21 visits. Provider responses were categorized as ignore, dismiss, elicit information, problem-solve, or empathize. Empathic statements occurred in only 13 of 29 opportunities (45%). When problem-solving was the initial response, empathic statements rarely occurred in subsequent dialogue. Among the 16 instances with no empathic statements, providers engaged in problem-solving in 8 (50%). Like many studies in the past, providers missed most opportunities to respond empathically to patients’ emotions, even when problem solving was done.

Healthcare providers need to be able to better recognize situations where they can offer empathy in addition to problem-solving. Patient care is more than just physical healing. Good healthcare provider care includes building a connection that encompasses a patient’s mind, body, and soul. It includes standing in someone else’s shoes, feeling what that person feels and responding. This video is a reminder of the various emotional needs both patients and healthcare providers may have.




Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.

Sunday, May 1, 2016

Want to Have a Baby in Your 60s? (Research, Video 2:58)


Are you age 50 or over and thinking about getting pregnant or fathering a child? If so, you are among an increasing number of older adults considering and making that choice. Are you planning to start a new family or extend a current one? According to AARP on births by older mothers in 2013, an average of 13 children were born every week to mothers 50 and older. The Centers for Disease Control and Prevention report that births by women ages 50 to 54 rose by more than 165 percent from the year 2000 (255 births) to 2013 (677 births). Most women used donor eggs fertilized by sperm and implanted in a womb. This process is known as in vitro fertilization (IVF).

Not that it should affect your decision, but how do you think your family and friends would react if you had a baby this late? Would they be happy and supportive that you have chosen this new direction in your life?  Or would they think you are too old to be effective parenting a child at this stage in your life when you should be taking it easy and certainly not taking on unnecessary medical risks for both you and your child. Complications such as hypertension, diabetes, organ damage, genetic defects, etc. are real, but good health and care can go a long way toward successful results.  After all, people are living longer and taking better care of themselves.

Some people think the government should have pregnancy limits on age in case older parents die before children are able to take care of themselves. Do you think it's fair for taxpayers to pay for raising your child? While everyone may not approve of your reasons or even the technology of the procedure itself, the decision ultimately belongs to you.

This CNN news video features a 60 year-old mother who may be the oldest in America to deliver twins. She and her husband have been married for 38 years and also have adult children and a younger child.



Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.

Monday, April 25, 2016

Attention-Deficit/Hyperactivity Disorder (ADHD) in Older Adults (Research, Video 3:17)


A former school principal, I have known many students diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD). They often displayed behaviors such as inability concentrating on and completing tasks, mood swings, operating impulsively, and having low tolerance levels when interacting with others. I actually witnessed a father who was so frustrated with his seventh-grade son’s destructive and belligerent behavior that he asked him, “Son, why don’t you just run away?” This father also refused to put his diagnosed son on medication.

Many young people with ADHD age into adulthood never knowing why they act the way they do. They become older adults before they are even diagnosed. Imagine the anger and grief of discovering late in life that the sadness and madness you endured all those years went nameless, undiagnosed, and untreated. An increasing number of those who went many years undiagnosed with ADHD are now over 50 years old.

Unfortunately, ADHD research on older adults is limited. However, there is reason to believe that symptoms decrease with age and that medication can be helpful for them. Side effects of medicine may cause more problems after age 65. Different psychological therapies are also helpful alone or with medication for patients who are motivated. Most important is good support based on knowledge and understanding of how ADHD has affected health, quality of life, and function throughout their lives.

What’s it like being diagnosed with ADHD later  in life? In this video, Dr. Barkley explains the difficulties and the need for acceptance. 




Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.
Hospice and Nursing Homes Blog

Monday, April 18, 2016

Dolphin Palliative Care Providers (Research, Video 1:24)


Dolphins represent many animals that instinctively convey their profound capacity for caregiving by supporting other distressed, injured, or dying animals. This research on caregiving dolphins and distress calls includes the first documented underwater account of multiple wild bottlenose dolphins caregiving a distressed dolphin. The suffering animal appeared to elicit help through calls of anguish to other members of a group of Atlantic dolphins.

When this incident was recorded in underwater video and acoustic recordings later analyzed, it was revealed that a distressed dolphin frequently produced what are most likely distress calls often paired with the emission of long bubble streams. The frequency of her whistle production was positively correlated with the frequency of the supporting behaviors received from other dolphins.

What did supportive dolphins do? Caregiving behaviors of the other dolphins included raft formations, lifts, and stimulating pushes that were predominantly directed toward the upper third of the distressed dolphin’s body. These activities appeared to be directed towards bringing the distressed dolphin toward the surface so that she could breathe. This account highlights the possible role of distress calls in such scenarios.

Dolphins are well known for displaying empathy and emergency assistance for other species in need. In this video, two incidents are featured in which dolphins come to the aid of a dog and a human in danger of death.




Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.
Hospice and Nursing Homes Blog

Monday, April 11, 2016

Elderspeak Views of Certified Nursing Assistants’ (CNAs), Research


What is elderspeak? Essentially it’s baby talk that most adults would not think of using in conversations with other adults. As a hospice volunteer in nursing homes, I noticed elderspeak being used often. For example, “Hi, Mr. Smith. I hope you’re enjoying your day? Did you have a good dinner?” might become a singsong version of this: “Hey, Handsome. Are you behaving today? Did you eat all your dinner veggies like a good boy? You did? That’s my baby!” Imagine what the average adult would think about being addressed in this manner. But some nursing home staff members, caregivers, and others think nothing of speaking to residents in this way.

This research on elderspeak focused on the perspectives of certified nursing assistants (CNAs) who frequently spend time with older residents. The goal was to learn more about the intent and conditions under which elderspeak is used. Participants who were interviewed included 26 CNAs who worked in long-term care facilities. It should be noted that half of the CNAs reported that elderspeak is more appropriate with individuals with dementia and that others believed elderspeak was always inappropriate.

These were the findings regarding the intended purposes of CNAs using elderspeak:

1)   Make residents feel more comfortable.
2)   Make caregivers seem friendlier.
3)   Help residents better comprehend verbal communication.
4)   Increase the likelihood that residents cooperate during caregiving tasks.

Based on these findings, more staff education is needed that incorporates previous research results. For example, elderspeak research reported in Behavior Therapy states that resistiveness to care has been linked to communication by staff using elderspeak. This study examined videotapes of nursing home residents with dementia interacting with staff.

Use of elderspeak implies that the resident is not competent enough to be spoken to on an adult level. Even when residents get used to being spoken to in elderspeak and seem not to mind, research studies indicate that their self-esteem may be lowered. In addition, using elderspeak perpetuates negative stereotypes about the elderly.


On a personal note, I was raised in the Jim Crow South and was taught that children should never call adults by their first names. For many African Americans, including adults addressing other adults, this was not only a practice of respect, but mandatory in society under certain racial conditions. After I received my driver’s license at sixteen, I felt proud when I was told I could start picking up my grandmother from her job as a cook at a segregated white school.

Imagine my distress when I arrived at the school and saw young children calling my grey-haired grandmother “Lou.” She allowed it because she needed the job, but words cannot describe the humiliation in her eyes when she saw me and realized I had witnessed how she was treated there. That night, my mother told me I couldn’t pick up my grandmother from work again. For many older African Americans, being called by their first names without their permission by younger adults is connected to painful memories of historical injustices.

Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.
Hospice and Nursing Homes Blog