Monday, June 27, 2016

Hospice Inpatient vs. Home Care: Family Views (Research, Culture Video 2:26)

No matter where people receive hospice care, the quality will always depend on the context in which the care is given. Families consider communication and support when they evaluate the kinds of experiences they and their loved ones have had. In order to determine family experiences in evaluating care in inpatient hospices such as nursing homes vs. home hospice care in their own homes, research of the two settings was done with comparisons made. The following study was done to compare inpatient and home care hospice family satisfaction in the two settings.

Survey data from bereaved family members of approximately 1600 patients from a nonprofit, midsized hospice in western Pennsylvania were used. Responses were separated into two groups including general inpatient hospice care and routine home hospice care. Both settings indicated three variables associated with greater overall family satisfaction:

1)   Being kept informed about the patient's condition
2)   Being provided with clear/consistent information
3)   Having the perception that patients were provided with  adequate treatment for anxiety

The following two variables indicated greater satisfaction in routine home hospice care only:

1)   Having sufficient discussion with hospice team members  concerning family members' religious or spiritual beliefs
2)   Being provided with the correct amount of emotional support  after the patient's death

 These results conclude that good communication is strongly associated with greater family satisfaction across hospice care settings. Hospices must ensure that they provide patients and families with consistent information and support.
An important part of communication includes the culture of the hospice families. In a society increasing rapidly in diversity, hospices and other healthcare providers must make every effort to be sensitive and proactive in providing ways to improve communication so a common language can be facilitated. VITAS Innovative Hospice Care demonstrates that in this video in which a patient's family talks about what it means to have a Creole-speaking caregiver bring home care to their 116-year-old patriarch.

Are you curious 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.

Monday, June 20, 2016

Childhood Sexual Abuse Health Impact on Older Adult Survivors (Research, Video 3:29)

"If you tell anyone, I will kill you." Childhood sexual abuse is an extremely under-reported crime that often includes a threat of serious harm to victims or their families. Many victims choose not to discuss the abuse with anyone. A major concern is that 90% of these sexual abusers target children they know. The stigma and shame of sexual abuse fester inside, impacting females and males for years as they age through adulthood. 

Numerous older adults live with long-term mental and physical repercussions from being sexually abused as children. According to the Centers for Disease Control and Prevention, children who are abused or neglected are at higher risk for health problems as adults. These problems include alcoholism, depression, drug abuse, eating disorders, obesity, high-risk sexual behaviors, smoking, suicide, and certain chronic diseases.

This study reported in International Psychogeriatrics examined the long-term association between childhood sexual abuse and mental and physical health of 8,178 older adults. These were the results:

1)  Six percent of respondents reported childhood sexual abuse with little variation by gender.
2)  A significant association was found between childhood sexual abuse and mental health with victims more likely to have depression, anxiety, worry, loneliness, and low quality of life. Poor self-reported health, lung disease, arthritis, peptic ulcer, chronic pain, and high levels of total cholesterol and low-density lipoprotein were associated with childhood sexual abuse.
3)  Those who reported childhood sexual abuse were more likely to report doctor and hospital visits than those without that history.

This study concludes that childhood sexual abuse can have long-term mental and physical consequences for older adults. RAINN (Rape, Abuse, and Incest National Network)  is the nation’s largest anti-sexual assault organization. The National Sexual Assault Telephone Hotline  800-656-HOPE (4673) can connect callers with trained staff members from sexual assault service providers in the callers’ areas and provide a range of free services.

Sexual abuse of boys has particularly been neglected by the media and in general conversations. Pressures from society teach boys that real men are not victims. But 200 brave men came forward on the Oprah show to publicly acknowledge that sexually abusive adults who were often relatives or friends of their families victimized them as children. The men share their stories in 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.