Saturday, March 29, 2008

Hospice and Palliative Care: Veterans and Post-Traumatic Stress Disorder – PTSD (Video 7:41 mins.)

The following conversation is from my book Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes. I am talking with Nat, my hospice patient who is a veteran of the Viet Nam war. 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:

“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.”

Nat is like many men and women who have served our country during World War II and wars in Korea, Viet Nam, and Iraq. He suffers with repressed fear and sadness resulting from his war experiences. Hospice and palliative care for veterans, like the Hospice of the Western Reserve in Cleveland, Ohio, includes healing opportunities for patients to express feelings they have stored inside for years. Veterans and their families receive post-traumatic stress disorder education and support. Patients are often paired with volunteers who are also veterans. Being able to “let go” of the horrific burdens of PTSD is important at any time, but especially for closure during the final phases of life.

In this video titled “Welcome Home,” veterans share some of their agonizing service memories, including burial at sea.

Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback at many booksellers in America and other countries and in e-book form at Amazon and Barnes and Noble booksellers.

Thursday, March 20, 2008

Alzheimer’s Disease and Hospice Volunteering in Nursing Homes (Video 3:10 mins.)

The following includes an excerpt from my book "Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes.” This chapter titled “Mealtime Gathering” explores Alzheimer’s disease and patients’ mealtime interactions at an inner-city nursing home experiencing a staff shortage. I am seated at a table with several patients, most in varying stages of dementia. Alzheimer's disease is the most common form of dementia. Fictitious names are used.

“Some patients were confused about which utensils to use. They tried to eat soup with a fork if they were not guided to a spoon. For a few, the tray of food was more like a tray of colors that smelled like food. Sometimes with pureed food, they had no idea what they were eating, and neither did I. Fortunately, a menu came with each tray. At another nursing home, I had observed a nurse aide telling a blind patient everything on his plate when she sat his tray in front of him. He grinned with delight the whole time she went down the list of foods. That’s why I started telling my hospice patients what was on their plates. Even those who could see didn’t always know what was there.

I continued talking to Naomi, my hospice patient, and assisting her while monitoring others at the table. I noticed that Petra had not touched anything. Petra was not a very independent eater, but I knew she was physically capable of feeding herself.
“Petra, your food is just sitting there getting cold. You have a whole tray of delicious things to eat. You should eat some and see how good it is. You’re a good eater. Eat your food.”
“Food? What food? I don’t have none.”
“The food on this tray is all for you, Petra. This is your food tray right in front of you. Watch me point to each item. You have coffee, juice, milk, mashed potatoes, fish, broccoli, bread, and fruit. That’s your name spelled P-e-t-r-a.”
“That’s not my name. My name is Petra. That’s somebody else’s name. That’s not my name. I know my name.”
“Well, that is still your food on the tray. You should eat before it gets cold. Go ahead and eat. Give it a try.”
“Eat? Eat what?”
“Your food, Petra, your fish, potatoes, and everything else.”
“Fish? What fish? I don’t have none. Do you see a fish here? I don’t see a fish. I don’t have none.”

From previous experience, I knew that Petra and I could go on roaming forever around this same circle. Luckily, she was sitting next to me. I gave her a taste of the fish because I knew she liked it. Then I placed her fork in her hand and started her off eating. I did this in steps by steering her hand and giving her directions on putting food into her mouth, chewing, and swallowing. Patients with dementia needed tasks broken into simple steps. Usually, she ate for a while by herself, even with her hands, once somebody started her off. Without any help, she sat and looked at the food she said was not there. My other hand continued to assist Naomi.”

© Frances Shani Parker

This video explores stages of Alzheimer’s disease.

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

Tuesday, March 11, 2008

Wii Rehab in Nursing Homes: Physical Therapy Technology for Seniors (Audio: 3:32 mins.)

The popularity of Nintendo Wii games continues to grow in senior citizen communities. Some physical therapists have finally decided to ride that winning Wii horse, too. Wii is being used to help patients recovering from stroke or closed-head injuries. Patients can have energetic fun while going through the motions of actually playing a variety of sports that will help them heal.

At Stratford Village in Midland, MI, residents with wheelchairs and walkers can participate in various Wii challenges. The handheld “Wii-mote” is used to simulate body movements of actual sports. One 87 year old, who was working on her upper body strength, beat her own son after three rounds in a virtual boxing ring. When no human partners are around, residents can play Wii by competing against the computer.

Where is all this enthusiasm for Wii going? Nobody knows. The American Physical Therapy Association wants more research to prove just how effective Wii really is for rehab purposes. In the meantime, you can listen to an audio account of how therapists look to Wii games for rehab benefits. At last, couch potatoes can show how athletic they really are.

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

Saturday, March 1, 2008

Detroit Hospice Volunteer Interview (Podcast) with Frances Shani Parker: Patient Advocacy, Nursing Homes, Acceptance of Death

You can listen to this Detroit Today podcast interview hosted by Craig Fahle at WDET 101.9 FM Radio.

The following conversation is from Becoming Dead Right. It is an example of a hospice patient’s acceptance of death that I refer to in the Detroit radio interview above. The patient is having this discussion with me:

“How old did you tell me I was?”

“You’re ninety-nine, and you’ll be a hundred years old on your next birthday.”
“A hundred years old is too old. I don’t think I want to be that old.”

“There are three other ladies in this nursing home who are older than that. One is a hundred three. We talked to her last week during your wheelchair ride.”

“How much longer will it be before I make a hundred? I don’t know if I want to wait too much longer.”

“It’s only one more month. I remember you said you had spiritual talks with your minister. If you decide to wait, I’ll get you a big balloon that looks like a birthday cake.”

“I guess I could wait. Yes, I think I will wait. That way I can celebrate my hundredth birthday. When I do get to heaven, I can tell everybody I lived to be one hundred.” And that’s exactly what she did.

Praise for Frances Shani Parker's book Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes from Roger Woodruff, Director of Palliative Care, International Association for Hospice and Palliative Care, Austin Health, Melbourne, Australia

"A school principal turned hospice volunteer, Frances Shani Parker relates her experiences with dying people in nursing homes. The second part of the book is about what we as individuals and as a society must do to improve things for those who are dying. I particularly enjoyed the guided tour, conducted from a wheelchair, of Baby Boomer Haven."

Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback at many booksellers and in e-book form at Amazon and Barnes and Noble booksellers.
Hospice and Nursing Homes Blog