Saturday, March 29, 2014

Caregivers Managing Home Medications (Research)

Back in the 90’s when I was a hospice volunteer and didn’t know it, I began helping a gay man who had AIDS. I didn’t know him well, but he had little family support. At that time, people with AIDS all over the country were dying quickly. I remember that a nurse taught him a system using pennies to help him keep track of the many medications he had to take around the clock. With great determination, he relied on that system  because he lived alone and knew his life depended on it.

Today, many patients still need more concrete ways to manage their medications at home safely. Not knowing how to do this may be what stands between patients’ tranquility and end-of-life pain and distress. When low-literacy patients leave a healthcare facility with only text directions, they may misinterpret or be confused by homecare directions they were given. Visual aides such as pictographs can be literal lifesavers for them. Aides have proven to be very effective, especially in explaining directions in sequence requiring multiple actions. Even those with high level reading skills may get confused about text-only directions.

In a study assessing family caregivers in managing medications for home hospice patients, survey responses from 98 hospice providers who were mostly nurses reported 68% rated ensuring proper medication management as most important in hospice care delivery. But 33% reported frequent encounters of caregivers with problems managing medications.

To help caregivers manage medications, three approaches emerged:

      1) Teaching them more about the medication to increase knowledge   
      2)  Simplifying the management process
      3) Counseling to overcome attitudinal barriers.

As many as 47% of these hospice providers stated they would benefit greatly from additional resources to help caregivers.

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.

Saturday, March 22, 2014

10 Steps to Becoming Dead Right

Life is a journey. Death will come when it comes, no matter how often the topic is avoided, how forcefully technology wrestles it to the ground, or how sincerely pleas for more earthly time are requested. Accepting the certainty of death can be so much easier when it’s approached like any other important life event. By following a workable plan, you can enjoy comforting closure when that ultimate destination is reached. Consider these 10 steps featuring scenic routes on your journey to becoming dead right:

10 Steps to Becoming Dead Right

      1. Accept death as part of life.

Death will come to everyone. Empower yourself by dealing with this reality.

      2. Listen to the Universe.

Some say it’s the Universe. Many use God, Higher Power, or other names. If you believe you are part of an infinite enlightenment, be still and listen.

      3. Expect rainbow smiles.

Rainbow smiles are joyous, healing, memorable moments that come more often when anticipated.

      4. Live a healthy lifestyle.

Practice habits of healthy living in all areas of your life.

5. Be informed and proactive.

Keep abreast of what’s happening in life. When circumstances arise that can benefit from your input, apply what you know.

6. Do your best.

You can’t solve every problem or be everything to everybody. Do what you can.

7. Give service to others.

Complement others by fulfilling needs through service. Both server and recipient benefit from this win-win partnership.

8. Be grateful for blessings.

Blessings come like wondrous celebrations held in your honor. Let appreciation reign!

9.  Put death wishes in writing.

Fulfillment of your end-of-life wishes will often depend on what you discuss and record now. Get medical, financial, and property decisions in order.

10.  Have a dignified death journey.

Breathe in your final phase of life with contentment. Experience a dying process that brings beauty and calm to your personal letting go.

© Frances Shani Parker
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes 

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, March 16, 2014

Adult Sibling Rivalry and Caregiving Support (Research, Video 2:32)

Most parents will say they love and treat their children equally, but this equality often becomes questioned by siblings through the years. At some point, many adults who were raised in families with one or more siblings have considered that at least one was their parents’ favorite. Siblings may discuss this topic among themselves and even with parents, especially when they feel they have been treated unfairly. But, when a parent becomes ill, the tensions relating to these feelings can create added stress to an already challenging situation.

This scenario is an example of adult sibling stress that you may have witnessed yourself on some level if you work with patients. Rosa is the primary caregiver for her mother. She lives closest to her mother, while three other adult children live in the city. Although Rosa has a job and family of her own to look after, she is the sibling caregiver who visits her mother at the nursing home most and who handles decisions. Although other siblings visit periodically, Rosa often feels frustrated and taken advantage of by them. They all say they have busy schedules as if she has no life of her own. But nobody frustrates her more than Eddie, the youngest sibling. He assumes that his other siblings should take care of his mother because they are better at that. Eddie says, “I just can’t deal with seeing Mom suffer.” Eddie is the perceived favorite child. His mother often asks about how he is doing and makes excuses for his not visiting her more. She has always babied him. Rosa still cringes when her mother makes excuses for Eddie while barely recognizing her caregiving contributions.

Research on adult siblings indicates that parents’ declining health can greatly
impact sibling relationships, particularly regarding who does the most caregiving and who is perceived as the favorite. The resulting tensions can have a negative impact on the quality of life of patients and siblings. Clearly, primary caregivers need support of other siblings, including those who live out of town.  These details should be discussed openly and resolved with assistance if needed. Solutions are often easier said than done. Readers’ suggestions are welcome.

This video features a primary caregiver sharing her concerns about caregiving from siblings:

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.