Monday, October 24, 2016

Halloween Safety for Older Adults, Dementia (Video 3:04)

For many older adults, experiencing Halloween traditions can be a fearful and confusing time. Scary costumes, loud noises, strangers’ visits, and demands for candy may seem like innocent fun to trick or treaters. But some vulnerable older adults may feel uncomfortable with the ongoing disruptions, especially those who live alone. Adults with dementia may have even more difficulty trying to understand what is going on. In addition, caregivers who are eager to be a part of the festivities may underestimate the risks involved with opening their doors to strangers.

The following are a few Halloween safety tips to keep in mind:

1)   Have a responsible adult available to console vulnerable older adults, if needed, even if they are not participating in the festivities.

2)   Manage any Halloween activities, especially if the person needing help will participate in greeting guests or giving out treats at the door.

3)   Leave lights on even if the door will not be answered.

4)   Maintain a peaceful atmosphere as much as possible.

5)   Keep trick or treaters outside at all times.

6)   Post a sign stating when all treats are gone.

If you have other suggestions for making Halloween safe for older adults or anyone with dementia, please mention them in the comments. In this KSHB news video, Matt Latham from the Visiting Angels organization shares tips on improving older adult Halloween safety.

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, October 17, 2016

Down Syndrome: Older Adult Longevity, Health Risks (Alzheimer's Video 1:48)

Down syndrome is usually not associated with older adults. The life expectancy of those living with this condition was only age 25 in 1983. Fortunately, the National Down Syndrome Society has been advocating for people with Down syndrome since 1979. Life expectancy seems to be increasing so well, there have been several contenders for the title of oldest person alive with Down syndrome. In 2008, Kenny Cridge was officially named the world’s oldest living man with Down syndrome by Guinness World Records officials, who presented him with a certificate. Guinness no longer keeps records on Down syndrome because it is a disability. According to the UK March 2016 issue of Gazette Live news, Joe Sanderson (pictured above) at age 80 is the world's oldest living man with Down syndrome. Back when he was born, he wasn’t expected to live past 21. 

About 6,000 babies with Down syndrome are born annually in America. Older women have an increased risk of having a Down syndrome baby. Because there are three kinds of Down syndrome, people who have it may vary with unique characteristics in their appearance. This may include small stature, slanted eyes, low muscle tone, flat facial features, and a deep crease across the center of their palms. They all have an extra portion of chromosome 21 that alters their development.

People with Down syndrome are at higher risk for Alzheimer’s disease. Early signs such as changes in overall function, personality, and behavior may be more common than memory loss and forgetfulness. Other high medical risks are heart defects, respiratory and hearing problems, childhood leukemia, and thyroid conditions. Because treatment of these conditions has improved through the years, Down syndrome life expectancy has increased to age 60 today as survivors contribute to society in meaningful ways. 

This video explains the connection between Down syndrome and Alzheimer's disease.

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, October 10, 2016

Former Child Caregivers’ Adult Views (Research, Video 2:04)

Being caregivers for ill adults in the home is the reality of over a million school children in America. Many are from racial-ethnic minority communities, low to mid-income families, and single-parent households. As a former public school principal, it was not unusual for me to have students in elementary through high school grades with attendance problems due to caregiving responsibilities at homes when no one else was available to help. These children’s responsibilities included medicating, dressing, feeding, bathing, taking care of siblings, and more. The emotional stress of child caregivers can be even more harmful to them than the physical burdens. Unfortunately, as the economy struggles and the ranks of baby boomers expand, increasing numbers of children are being assigned caregiving responsibilities.

While caregiving roles of children under 18 who are living with parents who have health conditions or disabilities have been studied extensively abroad, little U.S. research has examined the caregiving activities and perceptions of children with similar parents. This U.S. research on child caregivers includes childhood perceptions of caregiving from adults sharing their childhood caregiving experiences years later. Through interviews with 20 adult former child caregivers of a parent with significant mobility disability, the following themes emerged:

1)  Most interviewees assisted their disabled parent with activities of daily living (ADLs) and instrumental ADLs.
2)  Some children provided more medical supports.
3)  Several parents, especially of older interviewees, did not seek their children's care.
4)  Interviewees reported both positive and negative childhood attitudes about caregiving.
5)  Roughly half recalled as children feeling proud, special, or otherwise positively toward caregiving activities,
6)  About one-third viewed caregiving as just part of their daily reality (i.e., simply needing to be done).
7)  Approximately half remembered also feeling resentful, primarily from time demands, insufficient appreciation, and being different from their peers.
8)  Interviewees reported gender and cultural factors affecting their caregiving roles and perceptions

These varied responses suggest that more understanding regarding caregiving roles of children and perceptions they have about their involvement are needed. This knowledge can lead to improving their experiences as well as those of the parent in need of caregiving. More people are recognizing this problem and, for some children, but not nearly enough, help is being provided. The Caregiving Youth Project sponsored by the American Association of Caregiving Youth provides in-school assistance and a caregiver camp for children who are caregivers.

This video focuses on children doing caregiving related to excessive supervision of other siblings and responsibility for household chores. These kinds of responsibilities can burden children in all kinds of living situations. Featured is research done by Michigan State University regarding effects that childhood caregiving can have on these children when they become parents themselves. Because they may not understand appropriate child development, they may be less sensitive with their own children and parent them in the ways they were raised.

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, September 26, 2016

Race and Class Biases Among Nurses and Doctors (Research, Video 2:34)

Have you ever become so accustomed to an odor, even a bad one, that you stopped noticing it at all? Sometimes race and class biases are like that. Unfortunately, men, women, and children can be harmed, even killed, as a result. Many people don’t realize how embedded racism and classism are in our society, particularly when they are not victimized regularly themselves. Overt acts are intended, meant to be hurtful. Covert acts are implied, often done unconsciously, but still do damage because the recipients of these actions are mistreated. 

The healthcare industry, like many others, consists of workers who make decisions about people’s lives on a daily basis. Consistently high numbers of disparities related specifically to race and class have existed over many years. Still, most healthcare workers continue to say they treat all patients equally. Ongoing disparities impact, not only patients, but also their families, communities, and ultimately our nation. In addition to generational suffering and repercussions on many levels, illnesses create long-term economic burdens and major losses of productivity. 

This post is based on race and class bias research in which implied preferences for a specific social group are shown that can have adverse consequences for patient care of other groups.  Clinical stories were used and analyzed to determine whether implicit race or class biases among registered nurses influenced their decisions in managing patients. Performed at the Johns Hopkins Hospital, the study involved nurses who were given 8 multi-stage clinical stories to read in which patients' race or social class were randomly altered. In addition, nurses were given implicit association tests about race and social class.

Results of this study involving 245 mostly white and female registered nurses were the following:
1)   Most nurses stated that they had no explicit race or class preferences.

2)   Only 36 nurses demonstrated no implicit race preference as measured by implicit association tests for race and social class.

3)   Only 16 nurses displayed no implicit class preference on the implicit association tests for social class and race.

This research, along with many other examples, concluded that the majority of registered nurses displayed implicit (unconscious) preferences toward white race and upper social class patients. However, unlike published data on physicians, implicit biases among registered nurses did not correlate with clinical decision-making.

In this video, Michelle van Ryn, Ph.D., a researcher at the Mayo Clinic, describes implicit bias in health care and future research underway to understand and further address this critical issue. Keep in mind that this is not only a healthcare issue, but also a moral one.

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.

Implicit and Overt Racism, Overt and Implicit Classism, Nurses and Doctors Racism-Classism, Dr. Michelle van Ryn, Bias in Healthcare Research

Monday, September 19, 2016

Hospital Wine for Terminally Ill (Video 1:40)

Quality of life for the terminally ill can be defined in innumerable ways. Depending on the person, it could mean something as extravagant as winning the largest lottery or something as simple as being hospitalized and having a glass of wine with dinner or visiting loved ones. The idea of being hospitalized and having a glass of wine is already being implemented by the palliative unit at a hospital that has a bar serving wine, whisky, and champagne.

Clermont-Ferrand Hospital, located in France where wine is a staple, provides additional quality end-of-life care for patients by serving medically supervised wine provided by local residents living in the area. After all, shouldn’t the pleasantries of living be available all the way through final days of our death journey? Patients are invited to drink wine at mealtimes. Caregivers are even encouraged to learn the basics of oenology, the science and study of wine and winemaking. A Roman playwright name Plautus said, “Let us celebrate the occasion with wine and sweet words.” Here’s to happy endings for all who are terminally ill! Cheers!

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.