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Saturday, July 27, 2013

Erectile Dysfunction Drugs Rejected By Older Mexican Men (Research, Video 3:25)


If you watch television regularly, you are probably aware of several commercials encouraging men with erectile dysfunction to use drug treatment to have better sex. Erectile dysfunction or impotence, which occurs commonly in older men, is a man’s inability to achieve and maintain an erection that is firm enough to have intercourse. There are various causes and treatments for erectile dysfunction that are explained in the video near the end of this post.

Many men embrace drugs and other medical aids to naturalize lifelong performance of intercourse as a marker of youthful sex in older aging. But few people hear about men who believe that having no or less sex can be a conscious strategy for respectable aging. Research reported on 250 Mexican men and published in Medical Anthropology Quarterly states that, despite the traditional association of intercourse with successful masculinity, many older, working-class Mexican men who have erectile difficulty reject “youthful” sexuality and drugs that facilitate it. They choose instead to embody a "mature" masculinity focused on home and family. The following social and structural factors influenced these men's decisions:
  1. Most participants were encouraged by their wives to act out respectable older masculinity. These men interpreted decreasing erectile function as natural and appropriate.
  2. Men were deterred from seeking medical erectile dysfunction treatment by drug cost. 
  3. Men were deterred by the structure of government-funded medical care.
According to the National Institutes of Health, between 15% and 25% of 65-year-old men experience erectile dysfunction on a long-term basis. This video titled Erectile Dysfunction (ED) - Causes, Symptoms, and Treatment Modalities further explains erectile dysfunction:




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, July 20, 2013

Volunteer Meets Nursing Home Patient With Dementia, Alzheimer's


Pointing her out to me, the nurse aide said, "That's Henrietta sitting by herself at the table." I followed her finger to a caramel-colored woman who sat humming. She had just finished eating and still hadn't wiped her mouth. A light coating of chicken grease looked like high-priced lip gloss when I walked closer to her.

Henrietta was going to be my new hospice patient, my first at this particular nursing home. Later, she would become my first patient whose health improved so much she was discharged from hospice care. For now, she knew nothing about me, including the fact that I was coming that day to serve as her hospice volunteer. I only knew she was seventy-nine and declining mentally with dementia. I pulled up a chair next to her and said, "Hi, Henrietta. I'm Frances Shani Parker.”

Looking me straight in the eyes like she'd known me all her life, she responded, "Girl, I know who you are, long as we've been friends. I've been waiting for you all day. I kept wondering when you were coming. I hoped you hadn't forgotten me, and here you are. What took you so long to get here?"

"Well, actually I got lost," I stammered, processing these new details concerning my whereabouts.

"Shucks, I get lost all the time. When you get lost, go to the lady at that desk over there. She'll tell you where you are. She'll tell you where you want to go. She knows everything. I'm surprised you didn't go to her before. We all do. How about some dinner? The chicken is something else, nice and tasty, just the way I like it. And I ought to know because I just had a wing that almost made me fly," she laughed.

"No, thanks. I'm not too hungry now. I'll eat when I go home. Some leftovers are waiting for me. I just came to visit you. I want to know if it will be okay with you if I come see you every week."

"Okay with me? Of course, it's okay. Look at all the years you've been coming to see me. If you stopped coming, I'd be wondering where you were just like I did today. So much is on the news, I'd be worried something happened to you. Keep on coming. I don't ever want you to stop."

"I'm looking forward to seeing you, Henrietta. We can talk together, and I can take you on wheelchair rides when I come. We'll get to know each other better. That is, better than we already know each other," I added, remembering our extensive "history."

"Sounds good to me. It's been working for us a long time. I think what you need to do now is eat something. You must be hungry after being lost all that time. Call the waitress over here and order some food. Don't worry about the money. Just put it on my tab. They know me at this restaurant. I eat here a lot."

So, this was Henrietta, an interesting oasis of serendipity. What would the future hold for us as patient and volunteer? I smiled to myself, buckled my mental seat belt, and prepared for another intriguing ride.

© Frances Shani Parker


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.com.

Sunday, July 14, 2013

Older Adult Lesbian, Gay, Bisexual, Transgender (LGBT) Health Disparities (Research, Video 2:44)


Lesbian, gay, bisexual, and transgender (LGBT) older adults, a population subjected often to adverse discrimination in society, experience unique health needs.  Research on LGB health disparities reports that these older adults are at high risk for the following:

1)   LGB older adults had higher risk of disability, poor mental health, smoking, and excessive drinking than did heterosexuals.

2)   Lesbians and bisexual women had higher risk of cardiovascular disease and obesity.

3)   Lesbians reported a higher rate of excessive drinking than did bisexual women.

4)    Gay and bisexual men had higher risk of poor physical health and living alone than did heterosexuals.

5)    Bisexual men reported a higher rate of diabetes and a lower rate of being tested for HIV than did gay men.

Far more research is needed in the areas of age and sexual orientation health disparities to address these populations appropriately. In addition, healthcare institutions must implement more staff development and dissemination of homophobia training and policy changes that positively impact older adult LGBT quality of life. 

This video titled “Reducing LGBT Health Disparities” features UC Davis Health System, the first academic health system in the nation to have physicians ask sexual orientation and gender identity questions as part of a patient's routine clinical assessment. 






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.

Sunday, July 7, 2013

Grief Responses of Older Adults With Dementia, Alzheimer’s (Research, Hospice Story)


Dementia can have a profound effect on how someone responds to the death of a loved one. Each person with dementia is unique with a response cloaked in a lack of memory layer different from someone without dementia.

Healthcare workers in long-term care often have residents whose primary loved ones have died. Family members and others also experience this as caregivers. The following common questions are of concern to many people regarding death of a loved one of someone with dementia:

1)   Should the person with dementia be told about the death? (In most cases they should be told, but preparations should be made for the kind of responses they may have after receiving that information.)
2)   How should the person be told?
3)   How will the person’s response impact the family?

Grief response researchers explored these questions in two focus groups. One group consisted of family members, and the other group consisted of an interdisciplinary group of long-term care healthcare workers. These are the three resident response patterns that became evident:

1)   Self-threat (concern about who will take care of them)
2)   Substitution (confusion over who actually died)
3)   Metaphone (substitution of loss of dead person with an object or unrelated item)

This true story from Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes explains how one of my hospice patients who had dementia dealt with her grief during a conversation we had:

“Is your mother alive?” Mamie asked me one day.

“No, she died a few years ago in her eighties,” I responded.

“You know, you can still be with her and talk to her if you want to.”

“Oh, I know we can still communicate.”

“No, I mean for real. You can be with her in person. Just get her clothes together and her shoes. Don’t forget her coat. They say it’s cold outside. Take them to the cemetery where she’s buried. Just set them on top of her grave and wait. She’ll rise out of her grave and put them on. Then you can take her home with you. In every way, she’ll be the same person you knew. Other people won’t be able to see her, but you will.”

“Hmm. I’ve never heard that before.”

“Most people haven’t. I know about it because I did it with my two grown sons. They were both murdered on the same day in a drive-by shooting. I didn’t know how I would get through the pain. Finally, I took their clothes to the cemetery and did what I just told you. Both of them came home with me. It was the best day of my life. I got my sons back.” Satisfied, she smiled.

Some people will dismiss this story as crazed comments of a woman with dementia. But, if you really listen, you’ll hear the magnificent empowerment in her words.


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.com.