Friday, December 31, 2010
Festive holidays have brought cherished opportunities for many older adults to enjoy some visitors they seldom see during most of the year. Whether at home or in institutions, loneliness can be both difficult and dangerous for their overall health. Too many of them endure the negative impact of loneliness daily.
“Missing” is one of sixteen original poems at the end of each chapter in Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes. A hospice volunteer, I wrote it after witnessing the sadness of lonely nursing home residents who were missing the missing. They coped with ongoing loneliness that could easily have been avoided with gifts of time. But some relatives and friends kept putting off visiting them until it was too late.
As this new year begins with resolutions for change, consider making every effort to visit those who are ill or alone. Don’t sentence them to another year of missing you.
hoping her years of caring
endured in grown-up minds,
rested in distant hearts,
conveyed how much she missed them.
living real-time movies
of restless nights, anxious days
with inhaled hopes of fellowship,
exhaled sighs of deep despair.
wishing nostalgic winds
flowed through cotton curtains,
brought relatives and friends
she cherished through the years.
grasping like a New Year's resolution,
like a second suspended in time
until her clock stopped ticking
for visitors who never came.
© Frances Shani Parker
Friday, December 24, 2010
Meeting the cultural needs and preferences (ethnic and religious beliefs, values, and practices) of hospice-palliative care patients is an important part of quality health care. People view the world through their cultures and values. To ignore this fact and impose one’s own culture and values on others caters to miscommunication and alienation. With respect and sensitivity, bridges can be built that help people connect at human levels, regardless of their differences. The availability of more language interpreters at healthcare institutions can facilitate this communication and bonding. Ongoing education on the culture and traditions of various populations, along with the understanding that varied beliefs exist within each group, must be increased throughout the healthcare system to improve service to diverse groups.
Many Asians prefer family caregiving of their aging, terminally ill relatives. In addition to being reluctant to place their elders in nursing homes for hospice care, they may also be reluctant to discuss specifics about illnesses with those in their care to keep them hopeful and without worry. Some Asian cultures consider direct eye contact, particularly with someone considered a superior to be inappropriate. Healthcare providers should gather more knowledge of Asian culture, including input from Asians, in order to promote benefits of hospice and palliative care.
In the following video, Nellie Kwan, a hospice clinical supervisor who works for Self-Help Hospice in San Francisco, describes cultural concerns regarding end-of-life care and Chinese Americans. According to her, most Chinese Americans do not understand hospice at all. This video is part of the Hospice Foundation of America “HFA Cares” series:
Frances Shani Parker, Author
Thursday, December 16, 2010
Happy Holidays From Frances Shani Parker
Years ago when I was a teacher, several co-workers decided to organize a staff choir. The announcement circulated quickly, and, to my great joy, anybody, even average shower singers like I was, could join. We met after school each week and slowly became acquainted with more layers of ourselves than my grandma’s lasagna. It was magical how music could so easily remove everyday distractions of the world.
Because music is so universal, I thought about this when I read research about healthcare workers of the Staff Christmas Choir of the Peter MacCallum Cancer Centre ("Peter Mac") in Australia. Peter Mac is a world leader in cancer treatment, research, and education. I wondered if their choir had teased one another like we had, joked about the challenges of harmonizing, and if they generally had a great time just singing. Most of all, I wondered if they were swept into the magnificence of inspiring and healing themselves and others through song.
Research indicates they definitely accomplished the latter. Seven performances were given at Centre locations which included inpatient wards, outpatient waiting areas, and a cafeteria. In order to evaluate performances, oncology inpatients, outpatients, and visitors were given anonymous, semi-structured questionnaires during and after performances. Of the 111 responses, including some from people with Jewish, Hindu, and atheist backgrounds, 93.7 % were favorable. Several people described “transformative thoughts and physical reactions, felt affirmed by the Christmas spirit or message, and/or appreciated the peaceful or enlivened and social atmosphere.” The importance of "enjoying the moment" was also a recognized benefit.
Healthcare workers in America also know the uplifting rewards of music for singers and listening audiences. The Sound of Mercy Choir, a group of co-workers in various departments at St. John’s Mercy HealthCare in St. Louis, Missouri, performs a “Spirit of the Season” concert in this video. Performing at various events, the group was formed as a Healing Environment Initiative. Enjoy the moment with holiday songs:
Frances Shani Parker, Author
Friday, December 10, 2010
As a hospice volunteer in Detroit nursing homes, I have had hospice patients stay as short as one day and as long as three years. With little quiet or privacy, almost all of them shared rooms with one to three non-hospice residents. My three-year patient was 94 years old. Having few visits from relatives and friends who lived out of town, her biggest fear was the possibility of being released from hospice care and the nursing home. I’ve also had rare happy patients who were released from hospice because their health improved.
One patient with dementia seemed to have a premonition that she would be leaving soon when she said to me one day, “I was wondering if you could help me find another apartment. I’ve been thinking about looking for a new place to stay, maybe a place closer to where I used to live. This apartment building is too noisy. Just close your eyes and listen to all the talking, buzzers, and everything. People come into my place without even knocking. They just walk right in and go through my closet and drawers. It’s not right. Three ladies even moved in with me when I wasn’t looking. Now, I can’t get them out.” I had never heard her say anything about leaving before. Two weeks later, she was released from hospice care and moved to a nursing home near her son’s house.
Are there characteristics of nursing homes and residents that are associated with long and short hospice stays? Using 13,479 residents enrolled in hospice care, researchers at Harvard Medical School looked for answers to this question. Research results indicated the following:
1) Nursing home characteristics were not statistically significant predictors of long stays.
2) The probability of a short stay increased with the facility's nurse staffing ratio and decreased with the share of residents covered by Medicaid.
3) Men (relative to women) and blacks (relative to whites) were less likely to have a long stay and more likely to have a short stay.
4) Those 70 years or younger (relative to those 81-90) and residents with Alzheimer's disease/dementia were more likely to have long stays and less likely to have short stays.
5) Fourteen percent of hospice users were discharged before death because they failed to meet Medicare hospice eligibility criteria. These residents on average had longer lengths of stays.
If you work with hospice patients in nursing homes, have you noticed these occurrences? Researchers concluded “high rates of discharge before death that may reflect a less predictable life trajectory of nursing home residents suggests that further evaluation of the hospice benefit for nursing home residents may be needed.”
Frances Shani Parker, Author
Friday, December 3, 2010
We can pretend that robots are only for sci-fi movies, but they are already being created to make life easier for older adults. Artificial intelligence of robots makes them especially good companions for older adults living alone or those in need of caregiving attention. What is artificial intelligence? This means the robot not only has the ability to navigate safely in its surroundings, but it also has the intelligence to do meaningful caregiving. Maybe that’s why they are called CareBots.
The GeckoSystems CareBot is a robotic eldercare system that allows family members to care for older adults from afar. According to Martin Spencer, President/CEO of GeckoSystems, CareBot is a new kind of companion that “always stays close to the care receiver, enabling family and friends to care for them from afar. It tells them jokes, retells family anecdotes, reminds them to take medication, reminds them that family is coming over soon (or not at all), recites Bible verses, plays favorite songs and/or other music.” Even the voice can be customized.
From a security point of view, a CareBot alerts family members when unexpected visitors or intruders are present. It notifies designated caregivers when a potentially harmful event has occurred such as a fall, fire in the home, or even if no one has been present for too long. It responds to calls for help and notifies those persons that the caregiver has designated.
Referred to as Emily, the CareBot in this video serves as a helpful companion to Doris by keeping track of her taking medicines, reminding her about TV shows, and performing other tasks that improve the quality of Doris’ life.
What do you think about having Emily or another CareBot living with you or helping an older adult in your family?
Frances Shani Parker, Author