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Friday, August 24, 2007

Hurricane Katrina: Nursing Home Evacuation Lessons Learned

It’s been two years since Hurricane Katrina and broken levees caused catastrophic flooding in Louisiana. Most nursing homes did not evacuate residents. Those too ill to sustain the tragedy died as hours of waiting to be rescued turned into days and nights of horror. Nursing home administrative directors plan for future emergency disasters by learning from these experiences.

This 2007 research study, which included Louisiana nursing homes in parishes affected by Hurricanes Katrina and Rita, reports these results in the “Journal of the American Medical Directors Association.” The design included twenty in-depth telephone interviews followed by a focus group conducted in New Orleans, my hometown.

Nine of 20 nursing homes evacuated before the hurricanes, and 11 sheltered in place. Six additional nursing homes evacuated following the storms. The most common perceived consequences related to the evacuation process were resident morbidity or mortality (6 of 15), transportation issues (5 of 15), and staffing deficiencies (3 of 15). Common findings among the nursing homes that sheltered in place included supply shortages (8 of 11), facility damage (5 of 11), and staffing issues (4 of 11).

These were the conclusions, which centered around four general themes:

1) Directors felt abandoned by the state and federal emergency response apparatus during and after the hurricanes. They continue to feel that nursing homes are not a priority.

2) There is substantial physical and technical difficulty in evacuating frail nursing home residents.

3) Staff retention remains a critical problem, regardless of the evacuation decision.

4) There are key "lessons learned" that can be incorporated into future disaster planning.

You can listen to information at NPR.org.
regarding the negligent homicide trial
of owners of St. Rita Nursing Home where 35 elderly residents drowned.

Frances Shani Parker
Hospice and Nursing Homes Blog

Sunday, August 19, 2007

Alzheimer's Disease: African American and Hispanic Survey Results

“The older I get, the less I remember.

She’s getting old and forgetful.

His mind goes blank since he turned seventy.

Do you hear comments like this a lot from senior citizens? I do. Many people equate old age with loss of memory. But a recent scientific survey concluded that almost 70% of African Americans and Hispanic families who have relatives with Alzheimer's disease dismiss their symptoms as part of aging, compared with about half of non-Hispanic whites.

This research information resulted from a survey released by the Alzheimer’s Foundation of America. The telephone survey included 655 adults. Another conclusion of the survey is that African Americans and Hispanics were less likely than non-Hispanic whites to place relatives with Alzheimer's disease in nursing homes or assisted living facilities and more likely to rely on support groups. I know these choices are often based on cultural reasons. No doubt, hospice placement also would have ranked low if it had been surveyed.

These survey results indicate the need for more information outreach about Alzheimer’s disease, particularly among communities of color. The results partially explain why African Americans and Hispanics are often diagnosed late. More corrective measures should take place to prevent further racial-ethnic health disparities regarding Alzheimer’s disease.

Frances Shani Parker, Author
"Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes”
Hospice and Nursing Homes Blog

Sunday, August 12, 2007

Hospice CNA/Nursing Assistant Story: “Little White Box” Video (5:13mins.)

Sometimes a nursing home patient needs someone to solve a special problem. The urgency becomes especially important when the patient is in hospice care, and death is imminent. “Little White Box” is a video story from “The Life and Times of Roger Dean Kiser.” A hospice volunteer, I was reminded of a hospice story in my own life when I read this story. In my story, I helped to locate a missing key for a beautiful music box owned by a patient who had never heard the box play before.

In “Little White Box,” Mrs. Mathers, a dying patient, keeps saying, “Before I die, my little white box, please.” But no one knows exactly what she means. To her rescue comes a caring and determined CNA/nursing assistant who successfully solves the mystery. With Celine Dion’s breathtaking singing in the background, this story will grab the handle of your heart and make you smile. Click here and enjoy "Little White Box."

Frances Shani Parker, Author
"Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes”
Hospice and Nursing Homes Blog

Sunday, August 5, 2007

Hospice Spirit Sightings (Video: 3:47 mins.)

Sightings of spirits are not unusual for hospice patients. I have had several patients tell me about spirits coming to see them. Patients also spoke about visiting the spirit world, often referring to the place they visited as heaven. Discussions about these visits created opportunities for patients to express emotions openly about death, while reflecting on life. They enjoyed describing their visitors and their trips. Their detailed conversations explained to me, not only whom they saw, but also the scenery and what the spirits were wearing. Pets were included in these descriptions.

(Below is an excerpt from my book Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes. )

“What did you do today?” I asked Rose after feeding her.

“Me? I’ve been spending time with my people. I enjoyed myself a lot.”

“Hey, that’s great. Did your relatives drive in from Chicago?”

“No, I went to heaven. It’s the nicest place, all clean and bright with beautiful scenery everywhere. I saw my family and plenty of my friends. They all wore long white gowns.”

“Wow! I guess that’s a place you’ll want to visit again.”

“Oh, I’ll definitely be going back. I’m planning to go stay there when I die. I’ll see if I can help you get in, too.”

“Thanks. I would really appreciate that.”

Some say these spirit sightings are chemical reactions in the brain or simply imaginary. Many say they are angels, while others say they are ghosts. What do you think about this mysterious phenomenon of spirit sightings?




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