Clowns in Dementia, Alzheimer’s Care (Research, Video 4:59)

For years, I never thought anyone couldn’t love a clown. I finally met such a person in my neighborhood. She has coulrophobia, an irrational fear of clowns. Doctors and scientists say that the fear comes from not knowing the identity of the person behind the excessive makeup. The clown’s makeup and ability to break social behavior norms create a state of panic causing the observer to have difficulty in breathing, irregular heartbeat, sweating, nausea, and feelings of fear. My friend has explained her fear to me, and it is very real. She refuses to go to McDonald’s restaurant for that reason. I mention this to emphasize that successful engagement between patients and clowns does not apply to everyone.

However, for many long-term care residents with dementia, elder clowning brings numerous rewards. This research on elder clowns focused on residents with moderate to severe Alzheimer’s disease in nursing homes. A pair of elder clowns visited all residents twice weekly for 12 weeks. They used improvisation, humor, empathy, and expressive modalities such as songs, musical instruments, and dance to individualize resident engagement. After measuring outcomes, researchers determined that elder clowning reduced moderate to severe behavioral and psychological symptoms of dementia (BPSD) of nursing home residents primarily with Alzheimer's. Elder clowning is a promising intervention that may improve Alzheimer's care for nursing home residents.

This video highlights the dynamic elder clown program of the Humour Foundation. Elder clowns are highly skilled professional performers trained by the Humour Foundation to work in aged care and dementia facilities. Using the healing power of humour, elder clowns aim to improve quality of life by working in partnership with facility staff and residents: 

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

Transgender Veterans’ Healthcare Disparities, Veterans' Benefits (Research, Video 6:37)

Healthcare disparities are inequalities that exist when members of certain populations do not benefit from the same health status as other groups. Although transgender veterans served proudly, they suffer as a result of significant disparities. The Veterans Health Administration is the largest healthcare system in the United States, an ideal place to do research on how equal medical and mental health services are between transgender veterans matched with non-transgendered veterans. Transgender veterans’ healthcare research is particularly important because no large controlled studies like this one existed before.

This study included 5,135 clinically diagnosed matched transgender veterans and non-transgender veterans. The purpose was to determine whether medical and/or mental health disparities existed with the transgender veterans. 

Results indicated that statistically significant transgender disparities were present in all 10 mental health conditions examined, including depression, suicidality, serious mental illnesses, and post-traumatic stress disorder. Transgender veterans were also more likely to have been homeless, to have been incarcerated, and to have reported sexual trauma while on active duty. Significant disparities in the prevalence of medical diagnoses for transgender veterans were also detected, with HIV disease representing the largest disparity between groups.

On a global level, transgender veterans were also found to have disparities in psychiatric and medical diagnoses compared to matched non-transgender veterans. The Transgender AmericanVeterans Association (TAVA), is an organization that acts proactively with other concerned gay, lesbian, bisexual and transgender (GLBT) organizations to ensure that transgender veterans will receive appropriate care for their medical conditions. Unfortunately that equality does not exist. In terms of policy, healthcare screening, and service delivery in Veterans Health Administration and other healthcare systems, it is critical that corrective policies are implemented and monitored to eliminate these inequalities in treatment of transgender veterans.

This following informative video produced by Erica Elizabeth Ravenwood, a former veteran, was created to give transgender veterans and the public a better understanding of the Veteran Administration benefits and procedures as they relate to transgender veterans starting the transition process which does not include reassignment surgery, follow-up care, and review of their rights.

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

Empathy: Do Your Healthcare Providers Express Any? (Research, Video 4:23)

You expect that your medical needs should be addressed by your healthcare providers. But what about your emotional needs for understanding and support as a whole person? Shouldn’t your providers also be able and willing to express feelings about what you are going through? If they don’t, why don’t they? And what can be done to improve their responses? Empathy research studies have repeatedly found that healthcare providers miss 70-90% of opportunities to express empathy. These are high percentages. 

In this research study on healthcare provider empathy, there were 29 empathic opportunities within 21 visits. Provider responses were categorized as ignore, dismiss, elicit information, problem-solve, or empathize. Empathic statements occurred in only 13 of 29 opportunities (45%). When problem-solving was the initial response, empathic statements rarely occurred in subsequent dialogue. Among the 16 instances with no empathic statements, providers engaged in problem-solving in 8 (50%). Like many studies in the past, providers missed most opportunities to respond empathically to patients’ emotions, even when problem solving was done.

Healthcare providers need to be able to better recognize situations where they can offer empathy in addition to problem-solving. Patient care is more than just physical healing. Good healthcare provider care includes building a connection that encompasses a patient’s mind, body, and soul. It includes standing in someone else’s shoes, feeling what that person feels and responding. This video is a reminder of the various emotional needs both patients and healthcare providers may have.

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

Want to Have a Baby in Your 60s? (Research, Video 2:58)

Are you age 50 or over and thinking about getting pregnant or fathering a child? If so, you are among an increasing number of older adults considering and making that choice. Are you planning to start a new family or extend a current one? According to AARP on births by older mothers in 2013, an average of 13 children were born every week to mothers 50 and older. The Centers for Disease Control and Prevention report that births by women ages 50 to 54 rose by more than 165 percent from the year 2000 (255 births) to 2013 (677 births). Most women used donor eggs fertilized by sperm and implanted in a womb. This process is known as in vitro fertilization (IVF).

Not that it should affect your decision, but how do you think your family and friends would react if you had a baby this late? Would they be happy and supportive that you have chosen this new direction in your life?  Or would they think you are too old to be effective parenting a child at this stage in your life when you should be taking it easy and certainly not taking on unnecessary medical risks for both you and your child. Complications such as hypertension, diabetes, organ damage, genetic defects, etc. are real, but good health and care can go a long way toward successful results.  After all, people are living longer and taking better care of themselves.

Some people think the government should have pregnancy limits on age in case older parents die before children are able to take care of themselves. Do you think it's fair for taxpayers to pay for raising your child? While everyone may not approve of your reasons or even the technology of the procedure itself, the decision ultimately belongs to you.

This CNN news video features a 60 year-old mother who may be the oldest in America to deliver twins. She and her husband have been married for 38 years and also have adult children and a younger child.

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