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Monday, May 22, 2017

Aging Veterans' Post-Traumatic Stress Disorder (PTSD), (Story, Recovery Video 3:22 )

My hospice patient Nat was like many aging men and women who have served our country during various wars. A Viet Nam veteran, he suffered with repressed fear and sadness resulting from his war experiences. We had many conversations about his life during my weekly visits with him. His story is typical of many veterans who suffer with post-traumatic stress disorder (PTSD). (Excerpt from BecomingDead Right: A Hospice Volunteer in Urban Nursing Homes)

“Did you see my flag on the side of the bed?” Nat asked me one day.

I looked again at his small American flag taped to the bed railing and responded, “Yes, I noticed it the first day I came. It’s always there on your bed. I can tell you like it.”

“I fought in a war years ago. Gave the best I could give. I’ve seen and done things you couldn’t imagine. Some of them were horrible, I mean really horrible. Don’t ask me to tell you what they were, because I can’t talk about it. They say time heals all wounds, but it’s a lie. I left Viet Nam, but Viet Nam never left me. I carry it with me everywhere I go.

All these years later, I still have nightmares like you wouldn’t believe. The doctor says it’s post-traumatic stress disorder or PTSD. I wake up shaking, gasping for breath with tears in my eyes. In my dreams, I’m always running hard trying to escape. Sometimes my enemies are close enough for me to touch. I almost stop breathing to keep them from hearing me. I’m constantly thinking I’m not going to make it. Some nights they kill me before I wake up. My dreams are so raw, so real they turn my soul inside out.

In real life, I came back alive. A lot of people who served, some of them my friends, didn’t come back. That’s why I keep that flag there all the time. It’s out of respect for those who came back in body bags; it’s for those still struggling with physical and mental injuries. It’s the least I can do for them.”

What help is available for veterans with PTSD? In this video a Marine Corp veteran named Warren details the horror of his life living with PTSD and how he recovered by facing his demons. He received help from the U.S. Department of Veteran Affairs. Warren encourages all veterans to get the help they deserve after fighting for this country. 


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 15, 2017

Win-Win Hospice Volunteering

By Frances Shani Parker

1) Remember why you serve.

There’s a reason you feel compelled to enhance lives of the terminally ill. Cherish that inspiration. Move forward committed to an amazing and rewarding healthcare adventure.

2) Believe it’s all win-win.


Providing end-of-life service is a privilege, not a calling to be a savior. You and those you support come together in relationships of mutual improvement. Honor your win-win journey.

3) Be present.

By all means, show up. But be present with patients after you arrive. Evaluate appearances, behaviors, surroundings, and interactions with others. Listen with your heart. Even silence speaks. Really try to understand life from their perspectives. Focus on advocacy for improving their quality of living.

4) Try other doors.

Patients will have challenges such as dementia that may not respond to your usual front-door communication. Try other doors and even windows. Obstacles are enrichment opportunities in your partnerships with patients. Touch, music, pictures, stories, and fantasies are a few entry points. Let patients help you navigate your way into their world.

5) Know your piece in the puzzle.

Adherence to rules of protocol and professional ethics should be routine. Be aware of boundaries such as confidentiality regarding yourself, your patients, and their loved ones. Follow guidelines of your hospice organization, and seek help when needed.

6) Untie your knots.

There may be times of doubt, confusion, sadness, and guilt. These are normal knots of the caregiving process. Untie them by seeking support for your total well-being. Maintain proper rest, nutrition, exercise, and balance in your own life. Do your best. Don’t be surprised when you discover reasons to kiss yourself.

7) Spread the word.

Be knowledgeable about hospice and palliative care. Share information so others can benefit from these specialized areas of healthcare. Encourage involvement in hospice and palliative care career and service activities.

8) Pick up a turtle.

If you see a turtle sitting on a fence post, you know somebody helped to put it there. Be on the lookout for turtles aiming for fence posts. Be a role model for other volunteers. Participate in organizations, conferences, workshops, and discussion groups where you can share best practices while learning new ideas.

9) Write death sentences.

Death will come no matter how often you avoid it or wrestle it to the ground. Have your advance directives, finances, and property in legal order. Urge others to do the same. Don’t burden loved ones later with important decisions you can record now. As you unfasten yourself from this life, be satisfied knowing your death sentences will be carried out according to your wishes.

10) Expect rainbow smiles.

Rainbow smiles hug you so tightly you can feel ribs of joy press against your essence. Hospice volunteering provides ongoing experiences for you to positively impact lives. When you do, rainbow smiles will come.

© Frances Shani Parker, author of Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes

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, May 8, 2017

Grandparents, Grandchildren Cancer Support (Research, Video 1:48)


Holding hugs and holding hearts are what grandparents and grandchildren do best. During sickness and health, they can play crucial roles in one another’s lives. A grandchild with cancer greatly impacts a grandparent’s quality of life. In a research study including grandparents of children with and without cancer, grandparents were assessed regarding sleep, medications, and hospitalizations.

The following results were reported:

1) Grandparents of children with cancer reported significantly worse quality of life. They also reported more problems with anxiety, depression, and pain.

2) Grandparents of children with cancer reported taking longer to fall asleep and taking more medications in the last 4 weeks.

3) Hospitalizations across groups were comparable. But grandmothers living in urban locations, and retired/unemployed grandparents experienced reduced quality of life.


Cancer of a grandchild affects a grandparent in significant ways. Given that four or more individuals may be affected per child, and that a grandparent’s well-being can influence the whole family, interventions targeting at-risk grandparents are needed.

Sometimes, the grandparent is the person with cancer who needs support. While many family members and friends may rally around the grandparent, loving attention of a grandchild can also be very helpful. This video shows how Cheryl Gerald's granddaughter stepped up to do her part in helping her grandmother, especially while she went through chemotherapy for breast cancer.


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 1, 2017

Doctors’ Religions, Spirituality, Influence on Patients (Research, Video 2:31)


So much medical focus is placed on doctors, it’s easy to forget that they are people just like everybody else. They come into the world and evolve while embracing various ideas and philosophies that mold them into the people they are at any given time. Religion and spirituality can play important roles in their becoming doctors and in their everyday decisions. Do most doctors believe in God? Do most doctors within a particular specialty tend to believe in agnosticism and have no certainty God exists or not? Are most doctors atheists who don't believe in God? Do doctors pray with patients or try to influence them toward their religions? These are questions with answers that may be of interest to you.

This research study examines the influence of religion and spirituality on doctors’ decisions to pursue medicine, daily medical practice, and their interactions with patients. Emailed anonymous surveys were completed by 2,097 responding doctors whose practicing years ranged from ≤1 to ≥ 30 years. Medical fields represented included primary care, medical specialties, surgical specialties, and psychiatry.

The following results were reported:

1) The majority of doctors believe in God (65.2 %), and 51.2 % reported themselves as religious, 24.8 % spiritual, 12.4 % agnostic, and 11.6 % atheist.

2) Most doctors consider themselves religious or spiritual, but the rates of agnosticism and atheism are higher than the general population.

3) Psychiatrists were more likely to report agnosticism and were the least religious group.

4) Frequent prayer was reported by 44.7 % of doctors, but only 20.7 % reported having prayed with patients.


Although the influence of religion on doctors’ lives and medical practices did not influence the majority of them to incorporate prayer with patients, there are times when doctors and other healthcare workers may try to sway patients’ beliefs to be more in line with their own religious and spiritual beliefs. This video presents a scenario including a patient's charge of religious discrimination by a doctor.




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 24, 2017

Gerontology Students Living in Older Adult Communities (Research, Video 5:33)

The UN predicts that by 2050 more than 20% of the world population will be over age 60. In recent years, inclusion of gerontology students living with older adults has become more common in the United States and internationally. Using elements of service-learning, community participation, and residential immersion, gerontology students are receiving broader field experience in gerontology education.

This research, which involved a gerontology student living in older adult housing for 3.5 years, is among the longest and most intensive gerontological field experience ever reported.  Based on more than 2,000 hours of observations and conversational interviews with 14 elderly residents, this study reflects the importance of shared history, support for one another, negotiation of environmental tensions, and demand for attention on the part of residents. This unique combination of physical and social proximity in an intergenerational alliance enables life enhancement for older adults and learning opportunities for students.

The research reported above recommends that student live-in roles with older adults become more formal. This video features an innovative retirement home in the Netherlands that has opened its doors to college students who live on site and help residents in return for free lodgings while they carry out their studies.



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 10, 2017

Cancer: Telling Family and Friends (Research, Video 3:11)

You’ve received the phone call about a positive biopsy. Yes, it’s cancer. Now what? At some point after the diagnosis, a decision must be made about how family and friends will be told this information. This may be difficult, particularly for those who don’t want to burden others with their problems or who are used to handling their problems independently. But sharing this information is supported by research as contributing to quality of life.

In a study including 45 cancer patients, researchers investigated the association between cancer patients' ability to share information about their illness with selected others and their quality of life. This was the conclusion:

Encouraging patients to share information about their experience of cancer may help to improve their quality of life. Attachment security (emotional bonding with others) seems to promote social sharing.

In this video, Tamarin Severin, who was diagnosed with cancer in both breasts, shares the plan she created to inform her husband, son, mother, and later her friends. She put a lot of thought into how to do this and was very pleased with the results.


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 3, 2017

Older Adults Raising Intellectually Disabled Children (Research, Video 1:33)

The numbers of older adults raising intellectually disabled children through adulthood continues to increase and will be very significant over the next 30 years. What they undergo in their parenting roles is often not fully known or understood by most people, particularly regarding their unpleasant experiences. Through unstructured in-depth interviews, research regarding older adult parenting of intellectually disabled children revealed several themes.

Bitterness is one of the four emergent themes extracted in this study, which has these five theme clusters:

1) Inappropriate behavior toward the child in society

2) Society's failure to support the child with intellectual disability

3) Sorrows experienced by parents

4) The child's problems

5) Barriers in the care of the child with intellectual disability

6) Limitations due to aging


These results suggest that older adult parents of children with intellectual disabilities experience many sorrows and unpleasant feelings. However, further investigation reveals that they mostly consider the social factors as the cause of problems and not the presence of the child. Results also indicate that older parents cannot look after the child in their old age as they did in earlier years. This gives them another level of concern. More research s needed on how these older adults can be supported better by society while maintaining their own quality of life.

This video features CJE Senior Life's Linkages program, which identifies and addresses the issues, needs and challenges of older adults and families with adult children with disabilities. Monthly support groups offer parents the opportunity to discuss their mutual concerns. Located in the Chicago, IL area, they provide a wide range of services.


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, March 20, 2017

Euthanasia, Physician-Assisted Suicide Update (Research, Video 2:07)

Euthanasia and physician-assisted suicide continue to become legalized in various countries. Whether individuals agree or disagree with these practices, it is important that healthcare communities stay informed about them and how they are perceived by the public.

In this euthanasia and physician-assisted suicide research, polling data and published surveys of the public and physicians, official state and country databases, interview studies with physicians, and death certificate studies were reviewed for the period 1947 to 2016 with these results:

1) Euthanasia or physician-assisted suicide can be legally practiced in the Netherlands, Belgium, Luxembourg, Colombia, and Canada (Quebec since 2014, nationally as of June 2016).

2) Physician-assisted suicide, excluding euthanasia, is legal in 5 US states (Oregon, Washington, Montana, Vermont, and California) and Switzerland.

3) Public support for euthanasia and physician-assisted suicide in the United States has plateaued since the 1990s (range, 47%-69%).

4) In Western Europe, increasing and strong public support for euthanasia and physician-assisted suicide has been reported. In Central and Eastern Europe, support is decreasing.

5) In the United States, fewer than 20% of physicians report having received requests for euthanasia or physician-assisted suicide, and 5% or fewer have complied.

6) In Oregon and Washington state, fewer than 1% of licensed physicians write prescriptions for physician-assisted suicide per year.

7) In the Netherlands and Belgium, about half or more of physicians reported ever having received a request; 60% of Dutch physicians have ever granted such requests.

8) Between 0.3% to 4.6% of all deaths are reported as euthanasia or physician-assisted suicide in jurisdictions where they are legal. The frequency of these deaths increased after legalization.

9) More than 70% of cases involved patients with cancer.

10) Typical patients are older, white, and well-educated.

11) Pain is mostly not reported as the primary motivation.

12) In no jurisdiction was there evidence that vulnerable patients have been receiving euthanasia or physician-assisted suicide at rates higher than those in the general population.

13) Most patients receiving physician-assisted suicide in Oregon, Washington, and Belgium reported being enrolled in hospice or palliative care.


From these findings, we can conclude that euthanasia and physician-assisted suicide primarily involve patients with cancer and that the existing data on these practices do not indicate they are widely abused. The following video presents a more visual and detailed review of these findings:



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, March 13, 2017

Funeral Therapy Dog Comforts Mourners (Research, Video 2:20)


Meet Lulu, a therapy dog making positive contributions in the lives of humans. Animals’ ability to positively impact people in terms of anxiety has been demonstrated innumerable times with animal assisted therapy in the treatment of PTSD patients. In one study of the effect of dogs with patients, psychologists noted an 82% reduction in symptoms. It seems only fitting that animals should continue their successful caregiving during commemorations of death with mourners during funerals.

A death ritual is an opportunity where a dog like Lulu can provide her therapy services. A gorgeous golden doodle, she’s a trained and certified therapy dog at the Westchester County funeral homes. Like healthcare dogs in service in many locations such as hospitals and nursing homes, Lulu goes to funerals and provides comfort to loved ones of the deceased. While some people don’t know what to say or do at funerals, Lulu, who is introduced to families at their request, seems to know just what they need. She takes her job seriously. Funeral director Matthew Fiorillo, Lulu’s owner, says the dog has an uncanny knack for knowing who might want to be near her for comfort. Lulu with all of her eagerness to serve has a way of replacing the anxiety some mourners feel with a calmness that makes life and death seem easier.




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, March 6, 2017

Unwilling, End-of-Life, Family Caregivers (Research, Video 2:29)


Let’s be honest about end-of-life caregivers. While their contributions can be significant, they don’t always choose to have that role. Some caregivers enjoy nurturing loved ones and find the experience challenging and  rewarding. But few people talk about family caregivers who feel depressed, guilty, trapped in a hole with no way out except the death of persons in their care. 

Maybe unwilling caregivers were the only siblings living near the loved ones, the only relatives or friends with resources to provide care, or the only persons willing to step up when others refused. Whatever their reasons, they became caregivers reluctantly, never fully embracing the responsibility, and made the most of their situations. If they had a choice, would they do it again? Some say they would not.

In a study about family caregivers and unwillingness to serve again, questions were asked about the following:

1)   Whether someone close to them died within past 5 years (25%)
2)   Relationship to the deceased
3)   Provision, intensity, and duration of care
4)   Supportive/palliative care services used
5)   Willingness to care again 

Former caregivers (9%) indicated they would be unwilling to provide care again regardless of time since the death, duration of care, education, and income.

It is interesting to note that older people and those who had not used palliative care services were more likely to be unwilling to care again. Barriers preventing access for disadvantaged groups need to be overcome. Clearly, caregiving a loved one at the end of life can have negative ramifications that need to be addressed. In this video from the National Hospice and Palliative Care Organization, Anita Brikman explains caregiver stress and how to cope with it.


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, February 27, 2017

Age Progression Stereotypes of Young Adults (Research, Video 3:38)



Are you locked in the age cage with negative views on aging that you have nurtured since childhood? Do you find yourself making cynical, stereotypical jokes about older adults' undesirable behavior and appearance? Negative self-stereotyping unconsciously influences behaviors. Older adults can help eliminate ageism by committing to unlocking and leaving their own age cages and modeling positive acceptance to younger generations.

Technology can speed up the visual aging process now with age progression simulators that eliminate the long wait to see results of certain aspects of aging. Consider how many young adults today view aging and their responses while being participants in a research study in old-age progression. These college students were randomly assigned to one of three groups: self-aged simulation (viewing their own aging), stranger-aged simulation (viewing strangers aging), or a control group. Which group do you think had the most negative responses regarding aging? If you said the self-aged group that evaluated their own aging progress, you are right.

Individuals in the self-aged simulation group reported greater aging anxiety and greater aging. They also perceived older adults as less competent and expressed more pity and less envy for older adults. Compared to the stranger-aged group, participants who observed their own age progression were more likely to deny the authenticity of their transformed image.

These results confirm the stereotypes many young people have already accepted about older adults, even negatively stereotyping their own aging in virtual experiences. In this video, young people explain their views regarding their own age progression simulations predicting how they would look in 40 years:



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, February 20, 2017

Long-Distance Conversations Through Robots (Dementia, Alzheimer's Research, Video 1:26)


The Telenoid R1 is a human-like remote controlled robot created by Hiroshi Ishiguro, a Japanese roboticist. What makes this robot so unique is an audio and transmitter movement through which people can relay messages over long distances. In other words, a loved one in another location can speak to the user of the robot in a conversation. Made of silicone rubber, the robot is designed to be an ambiguous figure in terms of gender and age.

This is what happens when the user communicates with someone who is not present. Cameras and microphones capture the voice and movements of an operator which are projected through the Telenoid R1 to the user. The mouth is able to open and close to imitate talking. A webcam or other video capturing device can record a person's movements and voice and send them to the Telenoid R1 using a connection with Wifi. A few pre-programmed, controllable behaviors are greetings, expressing happiness, and motioning for a hug. Random actions include such behaviors as breathing and blinking, which give the robot the appearance of being alive.

Telenoid R1 was researched at a group home for the elderly with dementia. Researchers compared Telenoid-mediated and face-to-face conditions with three residents with Alzheimer's disease. The results indicate that two of the three residents with moderate Alzheimer’s disease showed a positive reaction to Telenoid. Both residents became less nervous while communicating with Telenoid from the time they were first introduced to it. They also started to use more body gestures in the face-to-face condition and more physical interactions in the Telenoid-mediated condition.

This video, which was recorded at a conference, gives a brief demonstration of how Telenoid R1 communication operates. In addition to usage at work and in education, researchers hope Telenoid R1 can be used successfully with older adults in care homes to communicate with family members who are not able to visit them personally.


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, February 6, 2017

Unconscious (Implicit) Healthcare Bias: Causes, Solutions (Research, Video 4:33)


Quality of healthcare always depends on the context in which it is given. Context includes all resources available, including attitudes (overt or implicit) of healthcare providers. Healthcare bias toward people of color is experienced widely in America. Sometimes the bias is overt, even intentional. Other times, it is done implicitly, unconsciously, but still doing harm. 

People of color face disparities in access to healthcare, the quality of care received, and health outcomes. Bias in attitudes and behavior of healthcare providers has been identified as a factor that contributes to health disparities. These disparities have been confirmed by considerable research, the Centers for Disease Control, the American Medical Association, and other reputable sources. 

An investigation of the extent to which implicit racial/ethnic bias exists among healthcare professionals was done. Including reviews of 15 studies using mostly American participants, this research examined the relationships between healthcare professionals' implicit attitudes about racial/ethnic groups and healthcare outcomes. These were the results:

1)   Low to moderate levels of implicit racial/ethnic bias were found among healthcare professionals in all but 1 study.

2)   Levels of implicit bias against Black, Hispanic/Latino/Latina, and dark-skinned people were relatively similar across these groups.

3)   Although some associations between implicit bias and healthcare outcomes were not significant, results also showed that implicit bias was significantly related to patient-provider interactions, treatment decisions, treatment adherence, and patient health outcomes.

4)   Implicit attitudes were more often significantly related to patient-provider interactions and health outcomes than treatment processes.

Conclusion of Research:
“Most healthcare providers appear to have implicit bias in terms of positive attitudes toward Whites and negative attitudes toward people of color.” 

Clearly, more interventions targeting implicit attitudes among healthcare professionals are needed. This video titled “How Can Providers Reduce Unconscious Bias?” addresses this issue. David R. Williams, Professor of Public Health at the Harvard T. H. Chan School of Public Health, has been researching health inequities in the United States for two decades. In this video, he sits down with Don Berwick, MD, President Emeritus and Senior Fellow at IHI, to describe three promising strategies to reduce implicit bias.



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