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Sunday, November 5, 2017

Alzheimer’s Dementia Doll Therapy (Research, Video 3:05)

Dementia affects more than 47.5 million people worldwide, and the number is expected to increase as the population ages. Doll therapy has often been used as a management strategy for people with advanced dementia to decrease stress while adding responsibility, caring and structure to their lives. However, for too long, there was no protocol or official record of scientific experimentation of doll therapy success. A review of 12 studies reports that dementia doll therapy usually improves cognitive, behavioral and emotional symptoms along with overall well-being. Doll therapy is recommended because it helps many people with dementia relate better to their external environments.

Doll therapy continues to be a source of interesting discussion. These are two considerations people sometimes have before presenting a doll to someone with dementia. Will the doll be viewed as an added responsibility the person doesn’t want to assume? Will the person resist playing with a doll known not to be a real baby? The adult daughter in the video below shares her mother's reactions to the doll she gave her.

“This is my Mom. She’s 84 years old and was diagnosed with Alzheimer’s about three years ago. She will be moving into a home this weekend and has been depressed and crying for days. I learned that doll therapy is now being widely used with seniors. I fell in love with this particular doll’s smile and realistic appearance and ordered her right away, hoping she’d give Mom something to make her feel less alone during her transition.”

Did the doll gift work? Draw your own conclusions. 


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, October 30, 2017

Aging in Place Planning (Research, Video 1:50)

Many older adults view aging in place as the gold star of living well during declining years. It means having the health, social, and physical support you need to live safely and independently in your home or community. Aging in place is an advanced life event that supports independence and well-being. But planning ahead for aging in place has to be done with the same commitment as planning for any important life event. A lack of planning can greatly impede the realization of this life event for many older adults.

What do older adults perceive as their roles in planning for aging in place? Focus groups with 68 older adults over age 65 and living in the communities (rural, urban, and suburban) answered open-ended questions about their perceptions of future health events, needs, and planning. Three investigators analyzed and identified these five emerging advanced life events that impacted their ability to remain at home:

1) Hospitalizations
2) Falls
3) Dementia
4) Spousal Loss
5) Home upkeep issues


Many subjects reported a lack of planning for aging in place and perceived that life events such as those listed above simply would not happen to them. Other reasons for not planning ahead included these:

1) Uncertainty in future
2) Being too healthy/too sick
3) Offspring influences
4) Denial/procrastination
5) Pride
6) Feeling overwhelmed
7) Financial concerns


Although many older adults had not communicated their needs to their offspring, they still expressed reliance on offspring for taking care of their future advanced life events. If life events such as aging in place are to happen in increasing numbers, the reasons for older adults not planning ahead must be addressed vigorously to prepare them for future home needs and a voice in their care along with their offspring and/or other advocates.

Aging in place takes planning. Preparing for future needs is the key. The following video offers helpful resources to improve living while aging at home. Keep in mind that, while aging in place is what many older adults say they want, aging at home until the end of their lives is no guarantee of a high quality of life. Each situation has unique needs to be considered that may include other living options such as retirement communities.



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 23, 2017

Old-Young Aging Expectations (Research, Video 4:08)

Are people less or more angry as they age? What about their degrees of sadness? Is it harder for others to hurt their feelings? Many older adults think they have become much more resilient and calmer in dealing with their feelings. Others say they are less tolerant and more annoyed and resentful than they were when they were younger. What do you expect to be the likely answer to these questions on anger and sadness based on research?

A study investigating age differences in anger and sadness was done with 82 younger and 80 older adults. Participants relived personal angry and sad memories and expressed aloud their feelings. Various emotional responses such as verbal expressions, facial behaviors, and physiological arousal were also noted. While age differences in sadness were less pronounced, older adults really did react with less anger than did their younger counterparts. Is that what you expected?

Expectations regarding aging, including physical aging, are often self-fulfilling among older adults and stereotypically incorrect among younger adults. This video illustrates the importance of both older and younger adults having positive aging expectations.


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, October 16, 2017

Laughter Therapy in Nursing Homes (Research, Dementia Video 5:42)



Look at his face. Think about his lack of agitation, the light of wellness he reflects beyond his actual physical expression. You are looking inside. This could be someone you know with dementia, someone who has been engaged in a special way that opened an inner door of enlightenment. This could be someone experiencing joy in a nursing home. Maybe that wonderful stimulation came from laughter therapy, a series of techniques designed to produce laughter, reduce anxiety, and improve well-being.

In nursing homes where many residents ache with loneliness and feelings of depression, laughter can be a happy solution. This was demonstrated in a laughter therapy research study that included 32 nursing home residents in the control group and 33 nursing home residents from another nursing home. For two days per week (21 sessions in total), residents of the experimental group received laughter therapy. Total quality of life scores of residents in the experimental group significantly increased in comparison to the pretest. Nursing homes are encouraged to integrate laughter therapy into healthcare and as a routine nursing intervention.

Residents with dementia can benefit greatly from laughter therapy. This video features the Smile Study with Dr. Lee-Fay Low. He reminds us that behind the dementia is a real person.




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 9, 2017

Prayer Requests from Patients and Healthcare Practitioners (Nurse Research, Video 2:36)

Nurses and other healthcare practitioners sometimes are asked by patients to pray for or with them. Although spiritual care is believed by many to be a part of the healing process, patients’ prayer requests can still be perceived in different ways. For this reason, exploring the comfort levels of nurses receiving patient-initiated prayer requests was studied.

This study involved 134 nurses in America completing an online survey which was later analysed. Their responses revealed the following patterns of ease and dis-ease in response to patients’ requests for prayer.

1)  The pattern of ease for prayer with patients distinguished three themes: being open to the voice of calm or silence, experiencing physical or spiritual peace, calling the chaplain.

For these nurses, prayers are natural components of nursing care. The majority of responses to all scenarios demonstrated an overwhelming ease in response and capacity to pray with patients on request.

2)  The pattern of dis-ease for prayers with patients distinguished two themes: having cautious hesitancy and praying to whose God.

These nurses experienced dis-ease with patients’ prayer requests, no matter what the situations were.

Healthcare practitioners should be prepared for how they would respond to patients’ requests for prayer.

In the following video presented by the Christian Broadcasting Network, a Christian nurse in the UK was suspended for initiating an offer to pray with a patient.



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, September 25, 2017

Lesbian, Gay, Bisexual, Transgender (LGBT) Healthcare (Research, Video 4:13)

Most people will agree that their sex and sexuality are core components of their human experiences. Lesbian, gay, bisexual, and transgender (LGBT) people are no different in this regard. Unfortunately, they continue to be discriminated against in society based on these important components that reflect who they are as people. This discrimination exists in the healthcare system and negatively impacts the kinds of treatment they receive.

Scholarly research on the sex and sexuality of terminally ill lgbt people receiving palliative and hospice care, especially those from minority populations, is very limited. LGBT sexual expressions may change with advancing age and illness in ways that differ from more traditional concepts. While the U.S. Supreme Court decision regarding marriage equality has further advanced LGBT cultural views in society, much more research is needed to advance understanding of this population’s unique healthcare challenges.

All healthcare clinicians should focus on treating lgbt clients with patient-centered care that respects who they are and enhances their quality of life.
Produced by the American Academy of Hospice and Palliative Care Medicinethis video features the palliative care insights of Dr. Bruce Scott. He shares ways for healthcare professionals to improve their relationships with lgbt clients and positively impact 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 online and offline booksellers.
Hospice and Nursing Homes Blog

Monday, September 18, 2017

Homeless and Old (Research, Video 3:25)

Older homeless adults have high rates of geriatric conditions which may increase their risk for acute care and nursing home placement. In research interviews of 350 homeless adults 50 and older in Oakland, CA, the following results revealed their living environment over a 6-month period:

1) Participants stayed in 4 primary environments: unsheltered locations, multiple locations including shelters and hotels, intermittently with family/friends, and, in a recently homeless group, rental housing.

2) Overall, 38.9% of participants reported difficulty performing 1 or more activities of daily living, 33.7% reported falls in the previous 6 months, 25.8% had cognitive impairment, 45.1% had vision impairment, and 48.0% screened positive for urinary incontinence. The prevalence of geriatric conditions did not differ significantly across living environments.

The prevalence of these conditions was higher than that seen in housed adults 20 years older. Clearly, services addressing geriatric conditions are needed for older homeless adults living across varied environments

My Detroit Pk-8th grade school where I was principal had the highest student homeless population in Michigan. I have visited a well-run homeless shelter before. Unfortunately, the large homeless shelter where I visited regularly that housed several of my students had unacceptable conditions on many levels. Those conditions, along with having to follow certain rules, are major reasons why many homeless adults refuse to stay in shelters. Substance abuse was high. My primary focus was on getting the children out to school and meeting their needs there. On the day the shelter was permanently closed due to poor food and other conditions, there were several emergency units transporting victims of food poisoning to the hospital.

The following video gives a disturbing review of conditions in some homeless shelters in New York City. Possible solutions are also discussed.




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 11, 2017

Cancer Patients’ Last Year of Life (Research, Video 2:33)

Can general predictions be made about cancer patients and their healthcare experiences during their last year of life? The last year presents many challenges and is a critical period in terms of providing quality care for optimal patient satisfaction. In a study of 5,102 Medicare beneficiaries with cancer diagnosed within one year before death , various measures of healthcare experiences were reported.

1)    Patients with higher general or mental health status were significantly more likely to indicate excellent experience with nearly all measures examined.
2)    Sex, race/ethnicity, and education also were found to be significant predictors for certain ratings.
3)    Greater time before death predicted an increased likelihood of higher ratings for health plan and specialist physician.
4)     Clinical characteristics were found to have few significant associations with experience of care.
5)    Individuals in fee-for-service Medicare plans (vs. Medicare Advantage) had a greater likelihood of excellent experience with health plans, getting care quickly, and getting needed care.

Patients within a year before death from cancer experience critical issues related to health plans, physicians, and medical care associated with socio-demographic, insurance, and clinical characteristics. These conclusions are important in providing guidance for the development of programs to improve the experience of care among individuals with cancer.

Research shows dying patients tend to live longer at home than in a hospital after families have received training and support. In this video, Jennifer Glass' husband, Harlan, took her picture every day for a year, starting on the day she was diagnosed with lung cancer until she died the following year. 



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, September 4, 2017

Grandparents, Great-Grandparents Parenting Again (Research, 2:41 Video)


The number of grandparents raising children continues to increase in America. There are more than 13 million children living in homes with their grandparents. Without grandparents' loving support, many children’s lives would be in great jeopardy. But these grandparents’ own health and quality of life are often put at risk for declining after they make that child-rearing commitment. These are some of the statistics about grandparents raising grandchildren. I have listed a few below:

1)  There are 2.7 million grandparents raising grandchildren.
2)  Two events have contributed to large spikes in this statistic: the recession that occurred between 2007-2009 and the epidemic of crack use in the late 1980′s.
3)  Custodial grandchildren have higher levels of behavioral and emotional problems than children in the average US population.
4)  Families that have a grandparent raising a grandchild help to save taxpayers over $6 billion each year because they keep those children out of the foster care system.
5)  With 1 out of every 5 households in poverty, it is essential for grandparents to be given the information they need to access resources in their community to get resources they need. When this can happen, many grandchildren are given an extra chance to succeed. AARP offers several supportive resources.

While it is common now to read about the millions of grandparents raising grandchildren, very little is mentioned about great-grandparents in similar circumstances. Imagine parenting again after 65 years of marriage. When I think about great-grandparents accepting a responsibility of this magnitude with challenges legally, financially, physically, and mentally, I think about the Cooks. Their story is one of my favorite videos. They have reached that amazing stage where they can look back on their wonderful accomplishment with great pride in knowing they saved their great grandson's life “like a seatbelt.”




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.
Hospice and Nursing Homes Blog

Monday, August 28, 2017

Anesthesia Fear (Research, Video 1:30)


Afraid of anesthesia? You definitely belong to a large group of the population. Your sex and age can also impact your feelings about this procedure. Research on surgical anesthesia involving 400 patients with 80% experiencing preoperative fear reveals the following top three causes of anesthesia fear:

1) Fear of postoperative pain (Will you be in pain after the operation?)

2) Fear of intraoperative awareness (Will you be awake when you shouldn’t be during the operation?)

3) Fear of being sleepy postoperatively (Will you be sleepy when the operation is over?)


Other fears related to surgical anesthesia include drains, needles, saying personal information, and not waking up at all after surgery. What roles do sex and age play? Females are more likely to experience fear before surgery, and patients over 40 years old are at higher risk of being afraid.


Are anesthesia fears unwarranted? No, there are always risks associated with any anesthetic procedure. However, serious complications such as paralysis and death are rare. Because so many people fear anesthesia before surgery, now would be a good time to relieve some of that anxiety with this video featuring Dr. Richard L. Kahn of Hospital for Special Surgery (HSS) who addresses the safety of surgical anesthesia and possibilities regarding what to expect:



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, August 21, 2017

Hospice Dementia Live Discharge Impacts Caregiver Grief (Research, Video 2:23)

Live discharges from hospice include patients deciding to resume curative care, improved patient conditions beyond hospice guidelines, or hospices inappropriately using live discharge to avoid costly hospitalizations. In terms of patients discharged who have dementia, another layer of concerns can be added for caregivers. Caregiving a hospice patient who has dementia includes a series of transitions in their roles. When the patient no longer meets eligibility criteria, it can be very difficult for caregivers who have been anticipating an end to understand the discharge in the context of their grief process.  

Research on hospice discharge of patients with dementia explains the unique grief experience of these caregivers. They struggled to understand the patient’s terminal prognosis as temporary. In addition, caregivers were left to resume caregiving responsibilities or assume a new caregiving role after experiencing a loss of hospice services. Hospice social workers are particularly needed to offer emotional and other concrete support to caregivers who experience a live discharge of patients who have dementia.

This video indicates the symptoms and behaviors commonly seen during the final stage of dementia progression.



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, August 14, 2017

Keeping Older Adult Volunteers (Research, Video 2:15)


The presence of older adult volunteers in many nonprofit organizations is increasing steadily along with their numbers in the general population. But how can they be persuaded to keep returning? When it comes to keeping older adult volunteers, being mindful of what motivates them and their needs are significant. A critical clue lies in the reasons they find their service satisfying. That’s what will tell you when and how to hold them.

A research sample of 172 older adult volunteers reported that, in addition to enjoyment of the volunteer tasks, the degree of satisfaction with management is an important predictor of older volunteers’ intention of remaining in service. These answers have important implications on how organizations manage volunteerism and the relationship between paid staff and volunteers.

Numerous volunteer programs exist that provide varieties of tasks that need to be done. One popular program in America that is designed specifically for older adults is Senior Corps RSVP (Retired and Senior Volunteer program). It is one of the largest volunteer platforms for individuals at least 55 years of age. Their motto is “lead with experience” because experience is what these volunteers have and what our community needs.

Sharing with volunteers the many research-based benefits that they can receive is another means of encouragement. As this video highlights, those benefits include improvements in health, longevity, brain function, depression, and a sense of purpose.



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.