Adult Day Care Services Benefit Caregivers and Participants (Research, Video 6:11)

I recently had a fantastic time at an adult day care center for people with dementia. After a brief tour of the facility, I heard strains of a lively version of “When the Saints Go Marching In” coming from the activity room. A New Orleans native, I was not going to miss joining in whatever was going on there. What was going on was a small parade of participants who lured me right into the festivities. We were marching, singing, and clapping to a joyful beat as if our lives depended on it. In some ways, they did. For many who had been homebound often before joining that center, their lives were truly enhanced by being there. Going to day care, socializing with friends, having great meals, and participating in engaging activities had opened up a new world for them. And a new world for caregivers had also become available.

Lagniappe (lan-yap) is known as a free treat in New Orleans. For example, it could be a surprise mint candy at the bottom of your carryout bag. Good adult day care services have lagniappe as well. In addition to the rewards provided for participants at the center, family caregivers, especially those caregiving individuals with dementia, receive healthy intangible treats that make their lives better. Research on caregivers indicates that, on adult day care days, caregivers had lower exposure to care-related stressors, more positive experiences, and more noncare stressors. Using adult day care services lowered caregivers’ anger and reduced the impact  of noncore stressors on depressive symptoms. That’s a lot of lagniappe and an important endorsement of the positive impact of these services. Review examples of adult day care  benefits for caregivers and participants featured on this video:

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

Constipation: Older Adult Depression, Mortality (Research, Video 2:39)

Yes, we do need to discuss this. Constipation is a common complaint in the general population, but it is particularly common among older adults having fewer bowel movements or bowel movements difficult to pass. Back in the day, you may recall being asked, “How are your bowels moving?” at the first sign of being ill. That’s probably when you first learned how important bowel movements are in relation to good health. Unfortunately, through the years, many have neglected the diet, fluid intake, and even some medications that keep them regular. One unhealthy side effect of constipation and increased straining can be hemorrhoids, which are experienced by almost half of adults over age 50.

How important is persistent constipation in terms of quality of life and mortality? This constipation study on older adult community dwelling women is significant. 

Surveys were given to thousands of women who reported having persistent constipation, transient constipation, or none. Women with persistent constipation had significantly lower scores for quality of life and higher levels of self-reported depression. Mortality rates were increased when comparing women with persistent constipation with those who reported no constipation. Clearly, persistent constipation among older women is associated with very poor health outcomes. Older men can also take heed to these results.

In this video, Dr. John Bjork explains ways to maintain healthy bowel movements and avoid constipation. Advice includes high fiber diet, exercise, plenty of fluids, and more:

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

Chaplains, Veterans: End-of-Life Spirituality (Research)

Spiritually, many veterans near the end-of-life have a need to resolve suffering caused by combat-related events that conflict with their personal beliefs. During my weekly visits with him, my hospice patient Nat and I had several conversations about his military service. His comments reflected his unresolved pain:

“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.”

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

A pilot study with veterans and chaplains focused on understanding chaplains’ perspectives regarding the spiritual needs of veterans like Nat and the spiritual support chaplains can offer them. Having provided spiritual care to veterans at the end-of-life in a Veterans Administration hospital, these chaplains offered this information after being interviewed:

1)    Chaplains frequently encounter veterans at the end of life who are still suffering from thoughts or images of events that occurred during their military career.

2)    Although some veterans are hesitant to discuss their experiences, chaplains are successful with helping the veterans to open up.

3)    Chaplains use both religious (e.g. confessing sins) and nonreligious approaches (e.g. recording military experience) to help veterans heal.

This pilot study information is helpful because little research exists on the combat experiences of veterans as they relate to veterans' spirituality. Further studies are needed to examine the value of integrating the chaplain service more into mental health care for veterans. Including clergy and spiritual counselors, particularly those with specific PTSD training, on care teams for veterans can improve the end-of-life journeys for patients like Nat.

Many healthcare staff members who work with dying patients will tell you they have had patients share stories about seeing dead people, ghosts, spirits they recognize, and angels. View this post for my personal story and an informative video: https://www.linkedin.com/pulse/end-of-life-seeing-dead-people-angels-frances-shani-parker?trk=mp-author-card

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

Lesbian, Gay, Bisexual, Transgender (LGBT) and Asexual Long-Term Care Problems (Research, Video 2:48)

LGBT AND ASEXUALITY FLAGS

With many older adults focused on growing old and dying at home, it’s easy to forget that the likelihood of that happening is lower for certain populations. The lesbian, gay, bisexual, transgender (LGBT) community (same-sex partners) and those who are asexual (no sexual attraction to others) fall into that category. In recent years, asexuality has been scientifically researched as a sexual orientation.

In LGBT research controlling age, race-ethnicity, and education, it was determined that this population faces greater risks of needing long-term care than those living with different-sex partners. These were two of the activity limitations that indicate a need for long-term care:

1)   Difficulty dressing or bathing

Older women living with female partners were significantly more likely than those living with male partners to have difficulty dressing or bathing.

2)   Difficulty doing errands alone

Older men living with male partners were significantly more likely than those living with female partners to need assistance with errands.

These results emphasize further the need for more culturally sensitive education in the ongoing training of healthcare workers, particularly those involved with LGBT residents in long-term care settings. Lesbian, gay, bisexual, and transgender (LGBT) older adults living in nursing homes, assisted living, and even those receiving home care from healthcare workers have increasingly been discriminated against and abused by staff and fellow residents. Damage to their emotional and physical health has been so devastating that some LGBT residents have resorted to suicide.

In this video, Paige Faevre shares her personal concerns about living in a long-term care setting and her search for LGBT-friendly housing for older adults.

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

Nurse Bullies in the Workplace (Research, Video 2:35)

Bullying in the nursing profession seems to be far more prevalent than many realize. Why does bullying take place? What are the outcomes? How can bullying be prevented? Reported this year, research from Workplace Safety and Health states that bullying in the nursing workplace has been identified as a factor that affects patient outcomes and increases occupational stress and staff turnover.

Research on nurse bullying was done to assess registered nurses' exposure to workplace bullying. Pacific Northwest state professional nurses' association membership was solicited. Forty-eight percent of respondents admitted to being bullied in the workplace during the previous six months, with respondents choosing "being ignored or excluded" as the most common negative experience in the workplace.

The results of this study suggest that workplace bullying is a continuing concern. Reduction strategies must be devised as a means of retaining nurses and preventing these adverse outcomes. One strategy shown to be effective in curbing bullying is assertiveness and aggression training for nurses. The following video further explains nurses bullying other nurses and emphasizes the need to improve the environment in healthcare workplaces in general.

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