Dreams About the Deceased: Dream Themes and Bereavement (Hospice Caregiver Research)

Have you had dreams about someone close to you who has died? Did the  dreams affect your mourning process? Researchers of dreams and mourning asked these same questions and more to 278 bereaved persons who had been hospice caregivers. The study focused on the relationship between dreams and the mourning process. Fifty eight percent of those who responded said they dreamt about deceased loved ones. Most dreams were pleasant, both pleasant and disturbing, and a few completely disturbing. Which kinds of dream have you had?

Prevalent dream themes included these:

1)   Pleasant past memories or experiences

2)   The deceased free of illness

3)   Memories of the deceased's illness or time of death

4)   The deceased in the afterlife appearing comfortable and at peace

5)   The deceased communicating a message

How did your dreams about the deceased affect your mourning process? Sixty percent of research participants felt their dreams increased their acceptance of the loved one’s death and improved their comfort, spirituality, sadness, and general quality of life.

This research is important because it shows the high prevalence and therapeutic relevance of meaningful dreams among the bereaved. While many counselors may be uncomfortable addressing dreams during psychotherapy with patients, they should consider the relevance of dreams among those who are bereaved. Counselors should consider increasing their own awareness, knowledge, and skills on this topic.

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 booksellers such as Amazon and Barnes and Noble .

Hospice and Nursing Homes Blog

Cancer, Suicide, and Holocaust Survivors (Research, Video 2:17)

Question: Do you think a higher number of older adult Holocaust survivors who have cancer would commit suicide more than their counterparts who have cancer and are not Holocaust survivors? After all, many older adults were children when they witnessed and experienced the atrocities related to this part of history.

It’s easy to assume that Holocaust survivors with cancer would have more suicides. But a study of these older adult cancer patients indicates otherwise. The incidence of suicides were not significantly different between the Holocaust exposed and nonexposed groups. Past exposure to maximum adversity did not increase the suicide risk among persons with cancer.

These Holocaust cancer-suicide research results were surprising to me in a good way. Erika is my Jewish friend who was a child during the Holocaust. Her firsthand stories give history a name and face that validate the plight of those murdered during that horrific period. She attributes her current existence to a sympathetic family that hid her in their home from Nazi soldiers. Like many survivors who are older adults now, Erika continues to cope with the trauma of her childhood experiences. 

This video titled Holocaust Survivor Testimony: Menachem Frenkel showcases another Jewish child who survived the Holocaust due to the extraordinary goodwill of others who risked their own lives. Rescue attempts were made by three organizations -- the OSE (Children's Aid Society), Amitie Chretienne, and the Jewish Underground in Lyons -- to remove some 100 Jewish children from a concentration camp. Menachem and his sister were among those rescued one night. They escaped being among the 1.5 million Holocaust victims under the age of twelve. 

Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at booksellers such as Amazon and Barnes and Noble .

Hospice and Nursing Homes Blog

Death Rattle Distress, Drug Treatment Research

The gurgling death rattle sounds of dying patients attracts a lot of attention. Onlookers who witness it often agonize over the noisy breathing of loved ones during their final phase of life. Many have expressed an interest in the death rattle to me. This is how Wikipedia defines it:

“A death rattle is the sound produced by someone who is near death when saliva accumulates in the throat. Those who are dying may lose their ability to swallow, resulting in such an accumulation. Usually, two or three days earlier the symptoms of death can be observed as saliva accumulates in the throat, making it very difficult to take even a spoonful of water. Related symptoms can include shortness of breath and rapid chest movement.”

By the time dying people begin the death rattle experience, their consciousness is low. Although it may appear that they are actively choking, there seems to be a general assumption that these patients are not in any pain.

Drug Treatment Research Concerns:

Patients experiencing the death rattle are often treated with drugs. Some say the drugs are given to the patients more to relieve loved ones witnessing the experience which they may perceive as very distressful for themselves and patients. Unfortunately, some of the drugs involved have negative side effects. Lately, research questions the purpose of using drugs at all for death rattles and encourages more reassuring education for loved ones about the experience so they won’t be so worried.

Visit here to read more about this death rattle research.

Visit here to read 17 comments from my previous blog post on the death rattle.

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 booksellers such as Amazon and Barnes and Noble .

Hospice and Nursing Homes Blog

End-of-Life Racial Disparities in Nursing Homes: Hospice, Hospitalization, Advance Directives (Research, Video 4:22)

Healthcare disparities refer to inequalities that exist in the quality of healthcare among groups such as racial and ethnic populations. Causes for the inequalities may be access to good health care, community obstacles, and personal behaviors.  In America, racial-ethnic disparities have continued to persist, even when income, health insurance, and access to care are the same among various racial-ethnic groups. This post focuses on research on end-of-life racial disparities in nursing home residents who are deceased.

Nursing homes certified for Medicare or Medicaid reimbursement were included in this study. Assessed were advance directive measures, hospice use, and hospitalization with these results:

1)   Across different types of advance directives, black, Hispanic, and Asian nursing home residents were significantly less likely to have these documented in their files.

2)   Compared with white residents, Asian residents were also significantly less likely to receive hospice services during their last year of life, whereas Hispanic residents were more likely to receive services.

3)   Finally, all racial-ethnic groups were more likely to experience hospitalization within 90 days before death, regardless of whether they had documentation of a do-not-hospitalize order.

These results indicate a great need for more education of healthcare workers and community members as well as more monitoring and accountability to eliminate disparities.

An explanation of healthcare disparities in a broader context including gender disparities is presented in this video featuring Dr. Martha Gulati, cardiologist at the Ohio State University Wexner Medical Center. Dr. Gulati explains her work to eliminate healthcare disparities.

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 booksellers such as Amazon and Barnes and Noble.

Hospice and Nursing Homes Blog

Prison Inmate Hospice Volunteers: Can They Change? (Video 2:55)

Thousands in need of end-of-life caregiving die in prison every year. Some people ask, “So what? Did these prisoners treat their victims with dignity? Why be concerned about their death journeys?” One response is that society should be held to a higher standard of treating prisoners better than they treated victims. At several prisons, inmate hospice volunteers serve as caregivers for terminally ill inmates. There are those who say this is the ultimate test for inmates to prove whether they have changed or not.

Serving Life, a film that premiered on the Oprah Winfrey Network (OWN), documents a hospice program inside the Louisiana State Penitentiary, a maximum-security prison at Angola. Award-winning actor Forest Whitaker narrates and produces this film. Hospice volunteer inmates viewed as hardened criminals care for dying fellow inmates at this prison where inmates have average sentences of more than 90 years. Can these inmates find redemption through caregiving involvement with hospice care?

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 booksellers such as Amazon and Barnes and Noble .

Hospice and Nursing Homes Blog

More Healthcare Humor Needed (Nurse-Patient Research)

This cartoon is an example of a humorous exchange between a patient and a healthcare worker. Whether the patient was pretending to be serious or really was serious, the idea of breakfast with a cocktail and dessert is just funny for many people. While funny stories are not uncommon in the healthcare field, healthcare workers would probably have many more humorous stories to tell if they initiated more humor themselves. 

Research on healthcare humor reports that humorous exchanges with patients are important and should be encouraged. With four patient focus groups participating in interviews, Lancaster University UK researchers explored patients’ perspectives on humor. Conclusions indicated that there is a gap between what patients want in healthcare humor and what they receive. Why is this? Initiating humor involves a risk factor that many healthcare workers may be reluctant to take.

Here are three healthcare jokes for starters:

Patient: "Nurse, I just swallowed my pillow!" 


Nurse: "How do you feel?" 


Patient: "A little down in the mouth"


Nurse in Kentucky to Patient: “How did you like your breakfast this morning?’

Patient: “I really enjoyed it, except for the Kentucky jelly. I‘m not used to the taste.”

Nurse: That’s interesting. Let me see it.

Patient: The man showed her a foil packet labeled “KY Jelly.”

A man walks into a doctor's office. He has a cucumber up his nose, a carrot in his left ear, and a banana in his right ear.
"What's the matter with me?" he asks the doctor. The doctor replies, "You're not eating properly."

Do you know any jokes or stories about healthcare workers and patients that you can share? (Surely, you can do better! lol)

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 booksellers such as Amazon and Barnes and Noble .

Hospice and Nursing Homes Blog

Older Adult Obesity: Marriage, Gender, Diabetes (Research, Video 2:28)

Question: If marriage promotes health and increases longevity, are fewer married older adults obese?

Not according to this research on older adult marriage, gender, and obesity. Using the Health and Retirement Study (HRS) including men and women aged 51-70, marriage is associated with weight gain. Leaving a marriage is associated with weight loss.

What other theories about older adult obesity should be considered?

1)    Shared risk factors, such as social obligations regarding meals, increases weight for married couples, but does not last for marriage duration.

2)    Marital transitions, not marital status, determine differences in body fat. Short-term effects are seen for divorce, but not for the persistent weight gains associated with marriage or the persistent weight loss following widowhood.

Question: Based on marriage and gender, who are the heaviest older adults?

3)    Prominent gender differences in late middle age reveal the heaviest group is unmarried women and the lightest is unmarried men.

4)    Pressures of the marriage market in combination with gendered preferences regarding partner body fat may account for differences found in this data.

Obesity is related to many health problems that reduce the quality of life for older adults. Type 2 diabetes, the most common form, is more prevalent as people grow older and gain more weight.

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 booksellers such as Amazon and Barnes and Noble .

Hospice and Nursing Homes Blog