Saturday, October 25, 2014

Asexuality: Biological Markers and Older Adults (Research, Video 2:16)

Asexuality has only become scientifically researched as a sexual orientation in recent years. For those who are not familiar with the term, it refers to people who intrinsically have never had any interest in sex or sexual attraction to others. Several biological markers of asexuality have been determined through an Internet research study investigating the relationship between self-identification as asexual and specific biological markers. This study is important because it is one of the first studies to test and provide preliminary empirical support for an underlying neurodevelopmental basis to account for the lack of sexual attraction characteristic of asexuality.

A total of 325 asexuals (60 men and 265 women), 690 heterosexuals (190 men and 500 women), and 268 non-heterosexuals (homosexual and bisexual; 64 men and 204 women) completed online questionnaires with these results:

1)   Asexual men and women were 2.4 and 2.5 times more likely to be non-right-handed than their heterosexual counterparts.
2)   Asexual and non-heterosexual men were more likely to be later-born than heterosexual men.
3)   Asexual women were more likely to be earlier-born than non-heterosexual women.

Regarding older adult asexuals, the media focus is predominantly on younger asexuals. These older adults have a more difficult time finding support and resources they need. They have unique issues adjusting to a predominantly heterosexual sex-oriented society. Some have the need to “come out of the closet” and explain their identity in order for others to understand them better. Others may feel ashamed, isolated, or confused because they are different from what society conveys as normal sexuality. They are a diverse community with people experiencing relationships in various ways. For example, some may experience close relationships with sexual or asexual partners, although the asexual partners have no sexual attraction. Emotional or romantic attraction is not the same as sexual attraction.

Asexual Visibility and Education Network (AVEN) hosts the world's largest online asexual community and a large archive of resources on asexuality. This video features asexuals sharing their experiences:

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, October 19, 2014

Hospice Long-Term-Care Social Activities

Hospice patients are not always able to participate in some long-term-care social activities. But they should be encouraged to become involved whenever they can. Social interactions can improve their sense of belonging, distract them from being depressed, and bolster their independence. Sometimes they can watch from the sidelines while still expressing their opinions and creativity. As a hospice volunteer in Detroit nursing homes for many years, I found it very rewarding being a catalyst for my terminally ill residents’ involvement at festive gatherings. 

Richard, my hospice patient in his eighties, seemed depressed some days. He gave me the impression that leaving his room to spend time with other residents was too much of a bother. I suspected he would respond that way if I invited him to an upcoming program, so I came prepared with ideas to change his mind. I focused on ways to help him turn his indifference inside out, even as death’s footsteps slowly moved down his path. After a great deal of motivating conversation, I finally convinced him to allow me to give him a wheelchair ride to a theatrical performance in the blue room at the nursing home. I reminded him that was where he had previously enjoyed listening to children sing songs they had learned at school.

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

 “Along the way, Richard greeted other residents and staff members who were headed down the hall in the same direction. Some shuffled along with canes and walkers, while others moved with little or no assistance. Caressing her blanket, a white-haired woman with dementia told Richard she was on her way to the airport to catch a plane. A man broke out in song with “We’re Off to See the Wizard.” I couldn’t help rolling my eyes in disbelief when Richard started telling other people to hurry, so we wouldn’t be late. With each turn of his wheelchair, I could feel his energy growing as we approached the big blue room, a place that made him feel good.

Exhilaration ignited as the show started. Accompanied by the soft thunder of drumbeats, speakers shared stories and poems in praise of their elders. Residents were given small instruments to play and were coaxed to join in singing lively songs. Dances from back in the day inspired some audience members to sway in their seats. For a soul-stirring while, the nursing home disappeared. We were all transported to a fabulous planet where euphoria was our oxygen. I watched a radiant Richard wave at people he recognized, holler when the emcee gave the signal, and clap like his life depended on it. And the quality of his life really did.”
© Frances Shani Parker

Read about who leaves hospice alive. Discharges can occur for several reasons:

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.

Friday, October 10, 2014

Death Rattle, Families, Signs of Dying (Research, Video 3:27)

A crackling, gurgling sound emanating from a dying person’s throat can distress onlookers who have not been prepared for this occurrence. Overwhelmed with fear and guilt, they often assume a loved one is choking to death. Caused by terminal secretions, these rattle-like breathing sounds which occur near death are commonly referred to as the death rattle. 

The level of consciousness in patients who appear to be actively choking while experiencing the death rattle is usually so low that it is generally assumed that they are not in pain. Death rattle research advises healthcare providers to reconsider the use of drugs to treat death rattle symptoms. Some of the drugs involved have negative side effects. Caregivers and loved ones should be educated regarding the death rattle experience and reassured about the unlikelihood of patients’ pain.

Supporting this need for more education is additional death rattle family research focused on bereaved family members who had witnessed the anxiety of watching a death rattle experience. This study involved 663 questionnaire surveys conducted in 95 palliative care units, Among family members who participated, 46% of respondents had witnessed the death rattle. Of these participants, 66% reported high distress levels, and 53% perceived a strong need for improved death rattle care.

This research concluded that family distress could be reduced by having medical staff lessen patients' symptoms with comprehensive and supportive care strategies. These strategies would include decreasing secretions and uncomfortable smells along with alleviating torment of family members through education.

Like every life, every death is also unique. This video explains other end-of-life signs of approaching death and gives a more complete description of what to expect. 

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.
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Saturday, October 4, 2014

Dementia and Sexuality: Nursing Homes, Long-Term Care (Video 2:15)

It's a common belief that people with dementia are perceived as being asexual, having no real sexual attraction toward others, as their condition progresses. The reality is that many couples living with dementia remain sexually active. People with dementia have sexual needs similar to younger people, but may vary in ways of expression and how often they occur. Sometimes their expressions of sexuality may be inappropriate or hypersexual as they become less inhibited and more forgetful of social acceptance.

In nursing homes, residents with dementia should be allowed the full expression of their sexuality when their expression is appropriate. Privacy should be provided when needed. Strategies must be explored regarding solutions to inappropriate behaviors such as hypersexuality. The context in which situations arise is important. Solutions can include possible medical problems, the need for more engaging activities, or environmental conditions. Caregivers and loved ones should be educated about concerns and assessments.

In this video, Dr. Doug Wornell shares advice about how caregivers in nursing homes should address sexual behaviors of residents with dementia.

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.