Saturday, August 31, 2013

Older Adults Alone in Crisis: Personal Alarms, Home Care Aides (Palliative Care Research)

Recently, I became aware of three crisis incidents impacting older adult women living alone in apartment buildings, two in my city.

The first woman fell and stayed on the floor for three days with no assistance. Because she had removed the personal alarm device she was supposed to wear at all times, she had no way of contacting anyone. Fortunately, she was discovered on the third day. The doctor said she would have died in another day if she had not been reached then.

The second woman was being called on the phone regularly by family members, but for several days there were problems with her phone. Family members assumed she was probably doing well as usual. On the fourth day, still with no phone response, a family member asked the apartment manager to check on her. She had already died from a heart attack.

The tragic story of the third woman was on the news. A leaking roof lead to her discovery. She had been dead in her apartment for FIVE YEARS before anyone found her badly decomposed body. Rent and other bills had been paid through her bank. Her apartment was on the top floor where few people ever ventured.

These women’s devastating experiences are beyond heartbreaking. With so much discussion about the availability of family caregivers, it’s almost easy to forget the large numbers of older adults who are ill and living home alone, many in multiple dwellings. This population has the disadvantage of experiencing higher levels of distress and is less likely to die at home than those living with family caregivers. Their needs for safe independent living and peace of mind are very important.

In this research study on 26 palliative care patients of Silver Chain Hospice Care, participants were randomly assigned to either having a personal alarm or additional care-aide hours in their home. Through interviews with patients, this information was revealed:

1)   The care-aide model of care resulted in benefits such as easing the burden of everyday living, supporting well-being and a sense of dignity, and reducing loneliness.

2)   The personal alarm model of care resulted in a sense of security and also helped with feelings of loneliness.

Both groups felt they could continue living at home longer with these forms of assistance available. Feeling that they were safer with a personal alarm or additional care hours improved their ability to live independently at home and successfully continue  daily living activities.

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.
Hospice and Nursing Homes Blog

Saturday, August 24, 2013

Creating Dementia, Alzheimer’s Pleasure in Long-Term Care (Research, Partnerships Video 2:35)

Some people think of pleasurable moments as random occurrences usually out of their control. In fact, moments of pleasure can be created on a regular basis. Activities that promote pleasure in long-term care skilled nursing facilities can be particularly beneficial for residents with advanced dementia.

Research reported in the Journal of Psychiatric Research about creating pleasure for residents with advanced dementia was done with 193 residents in 7 Maryland nursing homes. These residents were presented 25 stimuli from the following categories: live human social stimuli, live pet social stimuli, simulated social stimuli, inanimate social stimuli, a reading stimulus, manipulative stimuli, a music stimulus, task and work-related stimuli, and two different self-identity stimuli. Analysis indicated that all types of social stimuli (live and simulated, human and nonhuman), self-identity stimuli, and music were related to significantly higher levels of pleasure. Pleasure was most likely to occur in environments with moderate noise levels.

These results indicate that caregivers of nursing home residents with dementia should incorporate ongoing activities focused on increasing pleasure in these residents’ plans. Plans should encourage social, self-identity, and music stimuli. Implementation should be done in such a way that pleasure becomes a normal occurrence in their lives and not the exception.

This video features the Copperfield Hill Caring Companions, a group that brings together residents with dementia and those in independent and assisted living. They meet weekly in engaging activities that spark memories and create new ones.

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.

Sunday, August 18, 2013

Aging and Humor: Young and Old Responses (Research)

Laughing matters are enjoyed by both the young and old. But do they respond the same when they joke? Research on humor suggests that older adults love humor more than young people, but they have more difficulty understanding what certain jokes mean. Punch lines can be puzzling. Considering how much language changes over the years, that makes perfect sense. After all, acronyms such as “lol” meant “lots of love” back in the day, not “laughing out loud.” But cognitive processes in older adults can also play an important role in their misunderstanding humor.

What about the amount of laughter that the young and old exhibit? Although older adults love humor more than young people, the amount of laughter they display is less than the laughter of young people. Some things seem less funny as they age. Older adults also don’t like aggressive forms of humor as much as young people. They are especially sensitive to jokes about old age. Can you blame them?

I wanted to conclude this post with a few positive jokes about older adults or aging. Frankly, I had a very hard time finding jokes that weren’t critical of aging and with an emphasis on physical and mental decline. I would like to see more jokes in praise of aging without all the stereotypes that even some older adults believe so much that they have grown to become the stereotypes themselves. Now, new crops of young people are perpetuating the same stereotypes and worse at numerous sites on the Internet. Eventually, I found these two jokes to share.

Clever Hearing

An elderly gentleman had hearing problems for a number of years. He went to the doctor and the doctor was able to have him fitted for a set of hearing aids that allowed the gentleman to hear 100%. The elderly gentleman went back in a month. The doctor said, "Your hearing is perfect. Your family must be really pleased that you can hear again." The gentleman replied, "Oh, I haven't told my family yet. I just sit around and listen to the conversations. I've already changed my will three times!"

Best Thing

A reporter was interviewing a 104-year-old woman. 
"What do you think is the best thing about being 104?" the reporter asked.
The woman simply replied, "No peer pressure."

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.
Hospice and Nursing Homes Blog

Sunday, August 11, 2013

Unwanted Caregiving You Need (Video 5:01)

You have been knocked down flat on your back due to an accident, surgery, or a disease. A reluctant patient, you have never felt this bad before. With the flu, injuries, minor surgeries, etc. you figured out how to make do. After all, you are strong, smart, self-sufficient at taking good care of your own needs. Other people rely on you, not the other way around. Being an independent spirit is your trademark. But not today.

Caregivers mean well, but they basically remind you of your vulnerability, weakness, inability to control your own life, and, most of all, your dependence on them. They don’t always do things the way you want them done. They don’t know where all your stuff is, what you like or dislike, your intimacies that are none of their business. Surely, your life has not come to this. But it has. This is how to meet the challenge.

1)    Sooner or later (later is better), everyone needs help. It’s the nature of living, the reason you don’t live in a world where you are the only person. Oh, you may be a loner, a recluse, an “I don’t need anybody” person. You may even be a person who readily helps others, but you just don’t want help from them on a large scale. Lots of people fall into this category.

2)    It’s time to accept the true meaning of giving and receiving. They are reciprocal opportunities, win-win in every way when caring hearts and grateful acceptance guide them. This is the basis of real relationships. Your time has come for openness to potential growth that will impact your reality.

3)    To keep this relationship moving smoothly, remember to be respectful, flexible, patient, helpful, and grateful. Be as proactive as you can. You may be surprised at how many people really do want to help you. Spread out big and small caregiving assignments among several caregivers, especially if they are volunteering their time. No one wants be taken for granted. They have lives, too. For now, you and your caregivers can experience possibilities of other layers of living through one another.

Highly independent Ward Flynn, a cancer patient, understands your predicament well. In this video, he shares what he did when “the bottom fell out,” and he had to face the dreaded task of accepting caregiving support.

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.