Saturday, October 30, 2010

Hospice Volunteers With No Patients (Video 1:34)

I have heard so many people say they admire what hospice volunteers do, but they couldn’t do that kind of work themselves. Maybe they don’t know that there are other ways they can provide admirable hospice service more appropriate to their personal comfort zones.

My class in training to become a hospice volunteer consisted of a dozen students from varied backgrounds. All of us were eager to learn what hospice entailed and what our future responsibilities might be. That class taught me the basics of what I would need in my role as a volunteer supporting patients and their families. I felt comfortable making a commitment to serving patients in inner-city Detroit nursing homes, instead of private homes. After I started volunteering, I thrived in that environment just as I had while working in inner-city schools.

But a few months later, I noticed a member of my former training class working at the front desk of the hospice organization. When we talked, she explained that she had been unhappy working directly with terminally ill patients. She especially didn’t like working in nursing homes, but service in private homes was also not attractive. When she mentioned her concerns to the hospice coordinator, she was given other service options. Those options included involvement with office work, community outreach, and fundraising. She chose office work and said she felt fulfilled and productive supporting hospice in this manner. She especially liked communicating with visitors.

Ultimately, we had both found our respective niches where we could make our best contributions as volunteers. I encourage anyone considering hospice volunteering to keep in mind that there are various ways to serve. Hospice organizations can give you a variety of options from which to choose. They could not function without the dedicated services of thousands of volunteers and the diverse talents they bring.

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, October 23, 2010

Comfort Feeding for Dementia Patients

A friend of mine was shocked and upset when he visited his mother recently. She has dementia and has only been in a nursing home a few weeks. Walking into her room, he found her being fed with a feeding tube. Although he is her primary caregiver, this decision had been made without his knowledge or approval.  His mother is in relatively good physical health for her age, and he felt this had been done because tubal feeding would be easier for the staff. He immediately set about changing her feeding back to hand feeding.

Although evidence suggests that feeding tubes do not improve survival or reduce risk of aspiration, they are used often on nursing home residents with dementia. Unfortunately, most residents have no documentation regarding their wishes on the use of artificial hydration and nutrition. One reason is that families may confuse the order of “do not feed” with meaning no artificial feeding. Nursing home staff members fear that they will be in trouble if residents lose weight and a feeding tube hasn’t been used.

The “Journal of the American Geriatrics Society” addresses these concerns. One solution is having residents’ wishes regarding goals of care clearly stating an individualized feeding plan that supports the residents’ comfort and wishes. The phrase “comfort feeding only” through careful hand feeding presents an alternative to imposed orders to end artificial hydration and nutrition.

Frances Shani Parker, Author

Friday, October 22, 2010

Frances Shani Parker and Susan Baida Interview: BlogTalkRadio “Empowering Family Caregivers”

Recently, I was interviewed on “Empowering Family Caregivers,” a BlogTalkRadio show run by Susan Baida and John Mills, co-founders of This show focuses on issues of care providers, long-term care and advanced aging. It features expert speakers on aging, long-term care, dementia and other illnesses and issues typically associated with aging in America. The website provides comprehensive information, tools and resources to help those seeking and providing long-term care.

Susan Baida and I covered several topics during our 30-minute interview. They included the following:
2) Negative Impact of Children Serving as Major Caregivers
3) Nursing Homes and Certified Nursing Assistants (CNAs)
4) Eldercare Blogging
5) Hospice and Palliative Care
6) Pain Management
7) Dementia
8)  Holiday Caregiving Suggestions
9) Nursing Home Culture Change
10) Racial-Ethnic End-of-Life Healthcare Disparities
11) Death Preparation
12) Baby Boomer Haven Nursing Home
13) Homegoing Death Ritual

You can listen to the Empowering Family Caregiversinterview.

Frances Shani Parker, Author

Sunday, October 17, 2010

Hospice Racial-Ethnic Outreach for Cultural Diversity (Research)

It is no secret that hospice services are underutilized nationally among racial-ethnic minorities. While several barriers to utilization have been studied, solutions always include the necessity of more outreach to racial-ethnic groups by hospice organizations. For example, a study on the willingness of older Korean-American adults to use hospice services highlights the importance of prior knowledge in shaping attitudes toward hospice care. Researchers stress the need for  “community education and outreach programs for racial and ethnic minorities, with specific emphasis on dissemination of information and greater awareness of hospice services.” Sharing successful racial-ethnic outreach practices can be a great strategy for hospices in promoting cultural diversity.
These are a few examples of outreach practices implemented by two hospice organizations:
1)  Starting a committee to identify, educate, and serve populations not being served
2)  Offering free health screenings at local minority churches
3)   Changing photos on brochures to reflect diverse populations
1)  Making cultural diversity an important part of staff development and recruitment
2)  Having language interpretation services provided over the phone and available 24/7
3)   Participating in Latino health initiatives, festivals, and African American events
Many hospice organizations have cultural diversity best practices to share that can benefit other organizations in their quests for cultural diversity. Quality end-of-life care is an entitlement for everyone. That is the hospice philosophy. What is your hospice organization doing to promote racial-ethnic outreach? 

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.

Friday, October 8, 2010

New Orleans Jazz Funeral: Homegoing Celebration With Second Line Dancing (7:39)

In New Orleans, my hometown, a jazz funeral is considered a homegoing celebration because the deceased is going home, crossing over to the other side. Emotions often run high as mourners are moved by the music and spiritual energy building up as the service progresses. Although there is sadness because the loved one is no longer physically available, there is joy in knowing that the deceased has gone to a better place where there will be no more sorrow and where they will be reunited one day with loved ones who went home before them.

Mourners come prepared to render a dynamic farewell. Death is an event that requires rejoicing. After services at the church or funeral home, a grand marshal leads a brass band and an assembled group of mourners, along with the hearse, in a procession to the cemetery to “drop the body.” The band plays solemn music at this time.  Stepping unhurriedly with the beat, participants walk a route down city streets. When they reach the cemetery, they “cut the body loose” as the hearse slowly enters for final services where the body is laid to rest.

After the procession of mourners leaves the cemetery, a rousing celebration begins with the band playing an upbeat song like “When the Saints Go Marching In.” The funeral procession continues, growing in size with many community members collectively called “second liners,” who join in the joy with curious bystanders. A spirited dance called the “second line” is prominent among the celebrants. Many participants bob umbrellas, some brightly decorated, and wave handkerchiefs in the air to the hot-sauce beat of the music. Surely, the deceased must be ecstatic with the large turnout of well-wishers expressing such jubilance in the send-off.

This video features part of the homegoing celebration of Juanita Brooks, who was a prominent jazz and gospel singer. Wanda Rouzan, a popular performing artist known as the Sweetheart of New Orleans, serves as grand marshal. The focus is on the musical transition from slow and somber to spirited as the funeral procession progresses with second liners.

You can learn more about New Orleans at my New Orleans Memories website.

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 booksellers such as Amazon.

Saturday, October 2, 2010

“Defining Moments” Poem: Hospice Volunteering and Life

Each chapter of my book Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes ends with an original poem relating to the chapter. “Defining Moments” was written after I realized that a series of events having nothing to do with anyone close to me dying had led to my becoming a hospice volunteer. Previous to these events, I was not attracted to being actively involved in the healthcare profession as a caregiver and advocate for seniors. Nobody is more surprised than yours truly that I am an eldercare consultant, author and blogger now.

Several readers have told me that “Defining Moments” resonates with them. As a writer, I appreciate knowing when something I have written has connected with other people. But I was especially surprised one day when a reader who had actually memorized the poem approached me while reciting it. This was followed by a heartfelt explanation of a defining moment in his life. Perhaps this poem will remind you of a defining moment in your own life.

Defining Moments

They come without warning,

grab us in chokeholds of change,

fling us into outer space

where past meets future.

In this realm resonating

with first-time knowledge,

we awaken wide-eyed,

infused with wisdom

to turn around, stand still

or move forward with clarity.

No matter how they smack,

stroke, lift, drop, push, kiss

or kick us to get our attention,

when they finish their mission,

we are permanently scarred.

©Frances Shani Parker

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