Friday, June 24, 2011

Hospice Racial-Ethnic Outreach: African American Brochures (Research, Video 1:47)

Hospice services are underutilized nationally among racial-ethnic communities. While several barriers to utilization have been studied, solutions always include the necessity of more outreach to racial-ethnic groups by hospice organizations.

The Leonard Davis School of Gerontology at the University of Southern California researched the outreach possibilities of comprising a brochure of hospice patient role model stories aimed at improving attitudes and knowledge of hospice among older African Americans. They used community-based organizations that included senior centers, community exercise programs, churches, and senior care management services in the greater Los Angeles area. Participants were seventy-one African Americans aged 65 and older.

Hospice brochures with role model stories showcased African Americans who had experienced successful hospice programs. They shared their initial attitudes, beliefs, influences affecting their enrollment in the hospice programs, and outcomes resulting from their participation. The conclusion of this pre-post pilot study revealed that "exposure to a hospice brochure containing theoretically driven, culturally parallel, role model stories was effective in improving knowledge of and attitudes toward hospice as well as intentions to enroll a family member or self in hospice care.”

The hospice philosophy promotes the entitlement of quality end-of-life care for everyone. Culturally sensitive brochures are among many examples of what hospices organizations committed to that philosophy can do to enhance community outreach. In this video, Treasure Coast Hospice of Florida shares testimony from role model Marian about her positive hospice experience while caring for her sister Valerie.

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.

Friday, June 17, 2011

Patients Rate Communication With Doctors (Research, Video: 52)

Does your doctor communicate well with you? Can you ask any question and feel heard, cared for, and unrushed? Are you involved in treatment decisions? Good communication includes compassion, respect, and attentive listening skills. To some degree, these skills can be taught, which is why medical students are given formal training in them. What are the mutual benefits? Doctors can benefit from fewer lawsuits and better reputations, which can enhance their careers. Patients benefit with happier healthcare experiences and better health, even in terms of life and death.

But what is too often the reality of patient-doctor communication from patients’ perspectives? A study reported in Cancer revealed these research results from questionnaires answered by 276 white, black, and Hispanic patients in various stages of lung cancer:

1)   For most topics, the majority of respondents reported that physicians communicated "not at all" or "a little bit."

2)   Low ratings were frequent for discussion of emotional symptoms, confidence interval, practical needs, spiritual concerns, proxy appointment, living will preparation, life support preferences, and hospice.

3)    Communication was inadequate for patients of different ages, stages, and races, although Hispanics were less likely than non-Hispanic whites and blacks to report inadequate communication.

Unfortunately, many of the topics reporting low rates of physician-patient communication impact patients’ health in very detrimental ways, including additional stress, impaired decision-making, and compromised outcomes. These results support research from Massachusetts General Hospital regarding the link between doctor –patient communication and outcomes. This video shares research results and insights for the future.

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.

Thursday, June 9, 2011

Hospice-Palliative Volunteer Ethics Boundaries (Research)

Does your hospice-palliative care organization have clear guidelines regarding boundaries for volunteers? If not, consider creating or modifying them to prevent future problems. Mount Allison University in Canada researched this ethics concern with two community-based hospice programs. When 79 hospice-palliative volunteers responded to a 27-item Boundary Issues Questionnaire, they indicated the boundary of each item. These are examples of one item in each of the three major categories:

Definite Boundary Issues
(things volunteers should never do).

1) Accept money from a patient or family.

Potential Boundary Issues
(things volunteers should stop and think twice about doing)

2) Accept a gift from a patient or family.

Questionable Boundary Issues
(things volunteers should be aware of doing)

3) Give your home phone number to a patient or family.

Would you agree with the three major labels? What are other items that volunteers might place under the three various categories? It would be interesting to know what volunteers perceive as their individual items of concerns and how they differ or agree on the boundaries relating to various items.

This research confirms the need for official boundary statements. This is information volunteers can benefit from through discussion and implementation with written policies. Keep in mind that having no clear boundary policies may lead to negative consequences later.

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 booksellers.

Thursday, June 2, 2011

Volunteer Program for Older Adults: RSVP (Retired and Senior Volunteer Program, Video 3:45)

Years ago, I shared a conference keynote speaking engagement with Arun Gandhi, Mahatma Gandhi’s grandson. Although we had not met before, we both spoke highly and at length about how our grandparents’ example had inspired us to embrace service.

Mahatma Gandhi was the spiritual leader of India during the Indian independence movement against foreign domination. He implemented a nonviolent philosophy of civil disobedience that inspired civil rights movements globally. Growing up in apartheid South Africa, Arun Gandhi had already learned from his grandfather the power of transforming the opponent through love and suffering.

My grandmother modeled service in her daily living. I observed her caring for others many times in ways such as giving food to strangers who knocked on her door. I recall comments some observers made about how she was being used, and she shouldn’t be giving her food away to strangers. But I saw her smiling as she looked out the window and watched recipients gobbling up her sandwiches and fruit. And she kept right on giving, never knowing that one day her granddaughter would praise her on something called the Internet. If she were alive today, she would be telling everybody at her church.

Thank goodness for all the older adults who continue to strive to make the world a better place by giving service to others. Fortunately, they don’t have to look far to find an organization like RSVP that can channel their enthusiasm into volunteer programs where their many skills can be matched appropriately with others’ needs. RSVP means Retired and Senior Volunteer Program. This federal program, which partners with local agencies across most states, is administered locally by both public and private organizations that serve the public in some way. Because of the wide range of services available, over 500,000 RSVP volunteers choose services they feel confident and comfortable in doing. Free training is included when necessary.

Of course, true service is always a win-win opportunity. Volunteers benefit with improved self-esteem, better health, more social interactions, and more learning experiences. They can also get reimbursed for some job-related costs. Research studies indicate that volunteering leads to a more positive mental attitude and to a longer life. This video explains the many services and rewards of volunteering with RSVP:

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.