Saturday, August 30, 2008

2008 Post-Katrina Elderly Deaths and New Orleans Healthcare Services (Video 4:30 mins.)

The third anniversary of Hurricane Katrina’s impact on New Orleans, my hometown, arrives with continuing concerns about the elderly and healthcare services in the city.

The journal “Disaster Medicine and Public Health Preparedness” reports the following statistics regarding elderly deaths and Hurricane Katrina:

1. Most Louisiana deaths resulting from Hurricane Katrina were in New Orleans. According to researchers, of the nearly 1,000 who died, almost half were age 75 or older. Keep in mind that even more deaths were indirectly related to the storm.

2. Most elderly persons drowned on the day of the flooding, and more than a third died at home. Many old people refused to abandon their homes, due to potential looting, fear of the unknown, and the possibility that hurricane warnings were a false alarm.

Three years after Hurricane Katrina, the people of New Orleans are still waiting for adequate healthcare services. Even though flooding only occurred in the basement of the famous Charity Hospital, the second-largest hospital in the nation and a primary trauma center, the hospital still remains closed in 2008.

The basement had been cleaned up and ready to reopen in October of 2005, but that never happened. Unresolved issues over plans to build a newer hospital continue to delay progress. To build a new hospital would take years and millions of dollars. Charity Hospital stands empty, while many people must rely heavily on free health clinics or wait in long lines to be seen at smaller remaining hospitals, while their health deteriorates.

This video examines the healthcare crisis in New Orleans.

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

Thursday, August 28, 2008

Impact of Hospice-Palliative Care Service on Volunteers (Sarah House Video 4:45 mins.)

People sometimes make untrue assumptions about hospice-palliative care volunteers. A common one is that we are all depressed saints. They probably say this because death in our society has so much sadness surrounding it. The truth is that most of us don’t find hospice volunteering depressing at all. I know it has made me a better person.

Recent research made me consider more specific ways that volunteering impacts lives of direct-patient care volunteers. Results were gathered through in-depth interviews. These are some of the findings:

1) Over half of the participants became volunteers because of previous death experiences with friends or family.

2) Most volunteers said they had been changed, that their outlook on life had changed, and that they learned the importance of living one day at a time.

3) Volunteers found ways to prevent compassion fatigue or burnout.

4) Volunteers said they would encourage others to volunteer.

5) Many volunteers offered suggestions for changing their programs.

Only 23 volunteers were interviewed for this study. I would have preferred that there were more. However, I think these five general findings can still be applied to a broad section of volunteers. Differences in demographics, culture, personalities, etc. would be more evident during discussions of specifics, particularly regarding numbers 3 and 5. Discussion among volunteers and their managers about these kinds of issues and more provide the open communication that enriches the workplace culture.

You can read more here about this study reported in the “American Journal of Hospice Palliative Care.”

This video features Sarah House, a "social model" hospice dedicated to end-of-life care for homeless and low-income residents, including those with AIDS who may or may not be near death. Sarah House is located in Santa Barbara, California.

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

Monday, August 18, 2008

Nursing Home Culture Change: Working with State Regulators (Pioneer Network Video 2:36 mins.)

Many people don’t plan to live their last days in nursing homes. However, with over 37 million Americans over the age of 65, a large segment of them will live and die in nursing homes. Culture change, which focuses on living life with dignity, can include the following:

1) Flexible Schedules

Everybody doesn’t have to eat, sleep, and bathe at the same times.

2) Intergenerational Activities

Relationships between children and the elderly are encouraged. The unique, beneficial exchanges that take place in this context are lacking too often in today’s society.

3) Interactions with Animals

Appropriate animals provide companionship and improved health.

4) Independent and Social Activities

Nursing home residents feel respected when their input is welcome regarding activities they can do independently. They also appreciate social activities that keep them connected with others.

There are several models of culture change for nursing homes. They all respect and incorporate input from residents and staff members in such areas as decision-making and scheduling. The Household Model is a product of the Pioneer Movement. Small groups of residents form households resembling "homes" where they have opportunities to develop quality relationships in a calm environment.

In this Pioneer Network video, Steve Shields describes how his organization approached working with state regulators to remodel an existing nursing home into the Household Model.

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

Sunday, August 10, 2008

Service-Learning, Schools, and Nursing Homes: Intergenerational Partnerships (Video 3:30 mins.)

This excerpt is from my book Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes, which includes a chapter titled “School-Nursing Home Partnership:"

“The most effective learning usually does not come from classroom lectures or always translate on standardized tests. I witnessed academic and affective growth by students as a direct result of their interactions with the elderly. Growth occurred when the two groups became involved in meaningful projects such as letter writing, storytelling, biography writing, arts and crafts, and performing arts. This excellent educational approach to teaching and learning that connects classroom learning with meeting community needs is called service-learning. Research shows that students derive many benefits in areas of academic achievement, enthusiasm for learning, caring for others, and greater civic and political engagement through involvement in service learning."

When I was a teacher, I took students on service-learning field trips to nursing homes. Students practiced educational skills, showcased their talents, and provided entertainment and companionship to residents. Residents also benefited from these exchanges. Our trips came about after extensive preparation between the intergenerational partners and included ongoing reflection and evaluation.

I encouraged schoolwide service learning with all staff and students. We became a national model for research-based, schoolwide service-learning. You can read research our fourth graders did in partnership with nursing home residents on ageism stereotypes here:

What is service-learning in practice? This Better TV video defines service-learning and explains how it is used by schools and community groups to improve communities and promote positive development in young people.

Note: Winner of the National Service-Learning Partnership Trailblazer Award, Frances Shani Parker, a national consultant and former school principal, has been instrumental in implementing service-learning in school districts across the country. Her book includes a chapter on intergenerational partnerships between schools and nursing homes.

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

Sunday, August 3, 2008

Hospice and Nursing Home Poem: Hospice Volunteer Reflections

Over 400,000 hospice volunteers across America enhance life in patients’ days. This poem is from my book "Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes,” which includes an original poem after each chapter:

Reflections of a Hospice Volunteer

I leave my car and walk into a world with many fates.
The people live reality where three words dominate:
“Nostalgia” brings memories that make them question why.
“Delusions” create fantasies that often come alive.
“Anticipation” beckons the beginning of each day.
A visit, party, special news⎯what is on the way?

Sedonia tells me stories of how life used to be.
Many things seem different now. She’s almost ninety-three.
Moochie shields unseen friends he pledges to protect.
I wonder if he sees and hears the friends he manifests.

Dexter smiles and says with pride while waiting for his son,
“All my children visit me, and each is Number One.”
Pearl yells, “I want some cake, and bring it just for me!”
She thinks that I’m employed here. She sees me every week.

An empty bed reminds me that someone else has gone.
Next week, I’ll see someone new. Life’s cycle will go on.
Juan trails me through each room while planning his escape.
“I have somewhere to go,” he pleads. I stop him at the gate.

I leave this special world today with wisdom strong and rare,
Respecting every circumstance that brought each person there.
Our futures are unknown to us like roads with endless curves.
I drive away feeling good, happy that I served.

© Frances Shani Parker

You can hear me reciting this poem on YouTube.

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