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Sunday, March 31, 2013

Hospice Volunteer Research, Appreciation (Video 3:25)


Iowa City, Iowa Hospice Volunteer Appreciation Photo


Hospice volunteers play a vital role in the success of hospice organizations throughout the country.  During the month of April, these volunteers and many other volunteers will receive tokens of appreciation for their services. In recent years, several research projects have focused on hospice volunteers’ efforts by examining evidence of their work as end-of-life caregivers. The following hospice volunteer research results were conclusions of 54 studies:

What We Know About Hospice Volunteers

1)     We know the various roles hospice volunteers play, the stresses they experience, and the satisfying rewards they receive from their service.
2)     Less is known about how to successfully recruit, prepare, and retain them.
3)     A small body of information exists regarding the positive contributions volunteers make in the lives of families and in the longevity of patients.

What We Need To Know More About Hospice Volunteers

1)     While we know hospice volunteers play an important role in the lives of patients they serve, more research is needed on their important end-of-life contributions.
2)     Future research should focus more on ways to maximize contributions of hospice volunteers and provide them with needed support.

Thank you to volunteers everywhere for all you do to make the world a better place. “To the world you may be one person. But, to one person, you may be the world. “   Anonymous
        
This Reflections of a Hospice Volunteer video includes a poem highlighting my experiences as a hospice volunteer in Detroit, Michigan nursing homes:




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 and Barnes and Noble.

Sunday, March 24, 2013

Grandchildren Discuss Dementia, Alzheimer’s (Video 6:30)


So often, we hear views of adults regarding their parents with dementia. But what is dementia like through the eyes of grandchildren? Imagine their emotions when their loved ones forget their names and can’t remember the relationships they have. What about the hurt feelings these young people experience when agitated grandparents with dementia strike out at them verbally or physically, and they’ve done nothing they know of to cause this?

Dementia must be explained to children in age-appropriate ways that support them in their adjustments to dementia of grandparents and others. Listening to these young people’s concerns and encouraging them to express them are important. Family discussions can be helpful for everyone.

Parents should be aware of changes in grandchildren’s behaviors at home and school. These young people need reassurances that they are not the cause of grandparents’ mood swings, that they are still loved by grandparents who have an illness that sometimes interferes with the expression of that love. Children should be reminded of the many good times in the past that they shared with their grandparents.

In this video, young people express their feelings about how their grandparents’ dementia has impacted their lives.




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 and Barnes and Noble .

Sunday, March 17, 2013

Smoking Policy: Hospice–Palliative Care, Other Patients in Healthcare Facilities (Video 3:33)




Should hospice-palliative care or other patients be exempt from statewide smoking bans?  When I wrote a few years ago about the smoking problems I experienced as a hospice volunteer in nursing homes, I was told that was “a touchy subject.” All the nursing homes where I volunteered had “restricted” indoor smoking areas to accommodate patients and staff who wanted to smoke. I held my breath to avoid second-hand smoke every time I briefly entered a smoking room to get a chair when they were not available in the halls. Smoke, which was both seen in the air and smelled, floated into the halls every time the doors to smoking rooms opened. Whether they smoked or not, everybody’s nostrils were assaulted with sucker punches of first or second-hand smoke.

In the United States, tobacco use remains the single largest preventable cause of disease and premature death. It accounts for billions of dollars in healthcare expenditures and productivity losses. According to Wikipedia, smoking bans in the United States are entirely a product of state and local criminal and occupational safety and health laws. In 1995, California was the first state to enact a statewide smoking ban. More states have followed. Laws often have certain exemptions.

Because hospice-palliative care focuses on meeting patients’ psychological, physical and social needs, a smoke-free policy can be a serious concern. Many feel that terminally ill patients who smoke should be allowed to continue in order to have “quality of life,” particularly when their lives are already so limited. Several of my hospice patients who were only supposed to smoke in restricted areas had oxygen tanks stationed near their beds. Others say smoking has no place in a healthcare institution and that these institutions should all follow statewide legislation.
Should hospice-palliative care or other patients be exempt from statewide smoking bans? What do you think?

This video presents challenges of a smoke-free hospital in England where all hospitals have been designated as smoke-free sites. George Eliot Hospital also offers nicotine replacement therapy as an alternative for helping people, including visitors, quit smoking.



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 and Barnes and Noble .

Sunday, March 10, 2013

Veterans’ Post-Traumatic Stress Disorder (PTSD), Depression: Clergy, Spiritual Counselors (Research, Video 4:42)


My hospice patient Nat was like many men and women who have served our country during wars. He suffered with repressed fear and sadness resulting from his experiences. 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. These are words he spoke that I remember well:

(Excerpt from Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes)

“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. 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.”

Not much research is available about veterans like Nat regarding their search for support from clergy and spiritual counselors for their depression and PTSD. In this Veterans Administration research study, 761 veterans with probable major depression participated in telephone surveys. They were asked about their openness to seeking help and their actual contact with clergy and spiritual counselors during a six-month period. Almost half endorsed this support at some level. Ninety-one participants (12 %) reported actual clergy/spiritual counselor consultation. Others indicated support for primary care providers, psychiatrists and other mental health providers.

Knowing that veterans suffering with PTSD and depression are agreeable to receiving help from clergy and spiritual counselors as well as other providers is important. Including clergy and spiritual counselors, particularly those with specific PTSD training, on care teams for veterans can improve health of patients like Nat.

This video shares the PTSD journey of one marine veteran. Veterans Healing Initiative is a nonprofit dedicated to providing veterans of all eras access to treatment for substance abuse and PTSD. 







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.

Monday, March 4, 2013

Nursing Assistants’ (CNA’s) Grief When Patients Die (Research, Video 2:05)


As a hospice volunteer in nursing homes, I worked around certified nursing assistants (CNA's) who often provided front-line patient care. Many were dedicated to doing good jobs, even when conditions were stressful. When nursing homes were understaffed, nursing assistants were glad when I arrived to feed my patients. They usually had good relationships with residents, and their lives were impacted when patients died. 

Grief can be complicated, having both positive and negative consequences. For nursing assistants with strong connections with patients, the death of patients can include negative feelings such as depression, or it can include beneficial feelings such as growth in their ability to cope better. 

A study reported in Research in Gerontological Nursing that surveyed 380 nursing assistants confirmed that participants experienced both distress and growth. Those who reported greater distress from grief also reported higher levels of burnout. In addition, they reported lower levels of psychological and physical well-being. On the other hand, participants who experienced greater personal growth from their grief reported “significantly lower levels of burnout, higher levels of psychological and physical well-being, and higher levels of job satisfaction.”

Apparently, how nursing assistants respond to grief can be another indicator of their well-being at the job and a possible factor in how quality care is impacted. The following video highlights the intimate bond with patients that many nursing assistants develop that goes far beyond everyday healthcare tasks:




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.