Saturday, September 25, 2010

Successful Hospice-Nursing Home Partnerships (Research)

A hospice volunteer in Detroit nursing homes for many years, I am familiar with the benefits and problems that can occur when hospices and nursing homes operate as partners. These partnerships can work very well when certain best practices are followed. What do successful partnerships between hospices and nursing homes look like?

This study by Brown Medical School uses case studies of six nursing homes and hospices working collaboratively. Interviews were held with care providers and chief executive and financial officers regarding seven domains critical to successful collaboration. These were the results:

1) Nursing home-hospice collaborators were philosophically and otherwise aligned; they had similar missions, understood their differing approaches to care, and administrators demonstrated an openness and support for the collaboration.

2) Hospices developed infrastructures to correspond to the uniqueness and complexity of the nursing home environment. For example, they hired nurses with nursing home backgrounds, created teams dedicated to nursing home care, and trained hospice staff in problem solving and conflict resolution.

3) Care collaboration processes focused on the importance of two-way communication by actively soliciting and sharing information with nursing home staff and responding to nursing home staff and administrators' concerns.

This successful partnership model demonstrates how well collaboration can work when hospices and nursing home leaders commit to operating strategically using communication, flexibility, and skills to match staffing to the nursing home environment. 

Frances Shani Parker, Author

Saturday, September 18, 2010

Suicide Prevention and Older Adults (Video 3:10)

Older adults kill themselves intentionally over 50% more than young people do in America. Each year more than 6,300 older adults take their own lives. Unfortunately, suicide among the elderly continues to lack the intense prevention and research focus that it should receive. 

Older white men have been particularly at-risk for suicide for the past half century. They are eight times more likely to kill themselves than are women of the same age group. They have almost twice the rate of all other groups of elderly men. This situation continues to escalate with the increase of millions of baby boomers (born 1946-1964) reaching senior status. The continued rise in elderly male suicides has the potential for creating a national crisis in geriatric mental health if more prevention strategies are not used.

In this video, Dr. Yeates Conwell, Director, Geriatric Psychiatry Program Director, Center for Study and Prevention of Suicide, University of Rochester Medical Center talks about the four Ds that contribute to suicide risk in older adults.


Frances Shani Parker, Author

Saturday, September 11, 2010

Nursing Assistant (CNA) Omar Cain With Loads of Inspiration (Video 6:38)

One of the extras that enriched my experiences as a hospice volunteer in Detroit nursing homes was the ongoing contact I had with staff members and residents.  I particularly appreciated my interactions with nursing assistants, also referred to as CNAs and nurse aides.  Because they worked closely with residents, I had many opportunities to talk with them. They seemed glad to have me there assisting my hospice patients while lightening their workload, especially at mealtimes. They shared their concerns about low pay, staff shortages, difficult work conditions, and not being appreciated.

Like employees on any job, CNAs were varied in their work performance. A famous American actress named Lena Horne  said, “It's not the load that breaks you down, it's the way you carry it.” Two people can experience exactly the same circumstances and respond in totally different ways. I found that many CNAs valued their jobs and relationships with residents, even during stressful situations. They made positive choices about how to carry their loads while working to improve conditions. Attitude was everything. This wasn’t always easy, especially on a daily basis or during the middle of a crisis. I have seen a CNA get slapped so hard by a dementia patient that she almost fell. But she maintained her composure and moved on while another CNA interceded. The passion they had for what they were doing helped them overcome adversity.

I don’t know Omar Cain, the CNA in the video that follows. But he demonstrates a spirit of caring commitment to residents he serves at Golden Living Center. A rapper and hero to many, he uplifts others with loads of inspiration. Omar models a message we can all embrace on how to carry our loads during daily encounters at work and in life.

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

Saturday, September 4, 2010

Oncology Nurses, Cancer, and Palliative Care (Research, Video 1:39)

In an earlier post, I mentioned the confusion many people have regarding what palliative care is. One problem is the close association they make between palliative care and hospice care. Those with misinformation include some who work in the healthcare field.
Oncology nurses provide and supervise care for cancer patients who are chronically or critically ill. The “Oncology Nursing Forum” presents results from a study at George Mason University. Researchers examined how some oncology nurses define palliative care, their views about who should and should not receive palliative care, and their beliefs about palliative care decision-making. These nurses’ beliefs include who should be involved in making palliative care decisions and how decisions should be managed. Interviewed were twelve nurses representing different aspects of oncology nursing.
Findings indicate that most of the oncology nurses interviewed focused on symptom management and made no distinction between hospice and palliative care. Palliative care was viewed as care only for patients near the end of life. Nurses perceived their own involvement in decision-making regarding palliative care as limited and indirect. These perceptions cause concern because they could limit palliative care that is appropriate for cancer patients who may not be eligible for hospice care.
While this study involved a small group of oncology nurses, it reinforces the need for more education and clinical experience so palliative care can be used to benefit more patients. Dr. Diane Meier, Director of the Center to Advance Palliative Care, defines palliative care in this video titled “What is Palliative Care?”

Frances Shani Parker, Author