Urban Palliative Care: Low-Income Communities (Research)

I have spent my entire adult life working in urban, low-income communities. With a 96% poverty level, my school where I was principal in Detroit had more homeless students than any school in Michigan. If you are working to deliver palliative care to inner-city patients and caregivers in these communities, you must become knowledgeable about the social and economic barriers that can hinder their access to quality palliative care. 

A healthcare focus group consisting of community stakeholders including healthcare professionals, persons living with chronic illnesses, and caregivers in five inner-city communities reported these five themes:

1)   Lack of family support

2)   Communication barriers with healthcare professionals

3)   Stresses of being a person of color or another minority

4)   Caregiver burdens

5)   Lack of spiritual support

Community outreach is mandatory for reaching this population. Also needed are cultural sensitivity, available resources, and services to improve access to care. Low-income populations with chronic illnesses in urban communities are entitled to quality of life just like everyone else. This isn’t only a healthcare issue. It’s a moral one.

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.
Hospice and Nursing Homes Blog

Detroit Writing Workshop, Brush Park Manor: Stories of Successful Aging After 60 -- Frances Shani Parker, Facilitator

Heartfelt stories tucked inside had aged into whispers needing to be shouts. Stereotypes of life after 60 portraying them as declining old people waiting for life’s finale had persuaded some to even question their own testimonies. What energizes life after 60? What celebrates worth of the worthy? An exciting workshop partnership between Brush Park Manor, an independent living Presbyterian Villages of Michigan community for older Detroit adults, and Poets and Writers, Inc. was the answer.

Participants came together in a mutual quest to find out what really matters in life for them now and how they could inspire aging journeys of others. They created win-win personal narratives that helped them discover more about themselves and one another. An enlightening collection of stories representing their personal truths evolved through focused introspection and sharing.

These are some successful aging gems from their stories:

    1. Joyce Alfaro enjoys traveling to many countries now that she has time.

    2. Nathan Anderson stopped using drugs and counsels other addicts.

    3. Bessie Ardis keeps in touch with her family at reunions.

    4. Dorothy Bell cherishes her freedom to do what she wants to do when she wants to do it.

   5. Barbara Jean Carter plays music and crochets to relax and be creative.

   6. Mildred Everette enjoys meetings and trips with the Grandparents Raising Grandchildren program.

    7. Charity Jackson teaches the Enhance Fitness exercise program to fellow residents while improving her  own health.

    8. Thomas Jackson takes pride in photography and singing.

    9. Harriet Jenkins feels glad that her husband still thanks her for being his caregiver a few years ago.

   10. Edward Leonard shares with others life lessons he’s learned.

   11. Leila Marshall looks forward to new experiences and people in her work as an evangelist.

   12. Harold Massingille's post retirement job as Brush Park Manor service coordinator brings him appreciation and  smiles.

   13. Helen Presley reveals that life is truly worth living. She finds comfort in reading her Bible.

   14. Bettye Roseboro’s faith strengthens her through trials in life and makes aging wonderful.

   15. Dorothy Wise, a heart and kidney transplant and cancer survivor, declares she is a miracle.

   16. Barbara Young keeps busy with committee work and dating her male companion.
     
You probably noticed negative stereotypes about life after 60 are missing. Now, that's successful aging!

Bessie Ardis (above) was our oldest writing workshop participant at 93 years old.

 Workshop facilitator Frances Shani Parker (right) reviews another inspiring story.

You can read more details about this writing workshop at the Poets and Writers, Inc. 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 online and offline booksellers.

Hospice and Nursing Homes Blog

Caregiver Resentment: Would They Do It Again? (Research, Video 3:09)

Let’s be real about caregiving. Some caregivers feel depressed, guilty, and trapped in a hole with no way out, except the death of persons in their care. Maybe they were the only siblings living near the parents, the only relatives or friends with resources to provide care, or the only persons willing to step up when others refused. Whatever their reasons, they became caregivers reluctantly, never fully embracing the responsibility, and made the most of the situation. If they had a choice, would they do it again? Some say they would not.

In a study reported in the Journal of Pain and Symptom Management, factors associated with an unwillingness to become caregivers again were reviewed. Former caregivers of palliative care patients were interviewed. Comparisons between those who would do caregiving again and those who would not were made with these results:

1)   One in 13 (7.4%) former caregivers indicated that they would not provide such care again.

2)   One in six (16.5%) would only "probably care again."

3)   Increasing age lessens the willingness to care again and so does lower levels of education.

4)   Despite most active caregivers being willing to provide care again, a

proportion would not.

This video about relieving stress while caring for an aging parent or spouse presents ways for caregivers to cope.

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.

Hospice and Nursing Homes Blog