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Monday, August 14, 2017

Keeping Older Adult Volunteers (Research, Video 2:15)


The presence of older adult volunteers in many nonprofit organizations is increasing steadily along with their numbers in the general population. But how can they be persuaded to keep returning? When it comes to keeping older adult volunteers, being mindful of what motivates them and their needs are significant. A critical clue lies in the reasons they find their service satisfying. That’s what will tell you when and how to hold them.

A research sample of 172 older adult volunteers reported that, in addition to enjoyment of the volunteer tasks, the degree of satisfaction with management is an important predictor of older volunteers’ intention of remaining in service. These answers have important implications on how organizations manage volunteerism and the relationship between paid staff and volunteers.

Numerous volunteer programs exist that provide varieties of tasks that need to be done. One popular program in America that is designed specifically for older adults is Senior Corps RSVP (Retired and Senior Volunteer program). It is one of the largest volunteer platforms for individuals at least 55 years of age. Their motto is “lead with experience” because experience is what these volunteers have and what our community needs.

Sharing with volunteers the many research-based benefits that they can receive is another means of encouragement. As this video highlights, those benefits include improvements in health, longevity, brain function, depression, and a sense of purpose.



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, August 7, 2017

Caregiver Guilt, Gender, Forgiveness (Research, Video 1:32)


Women and men who are caregivers don’t always want to be caregivers. Some enjoy nurturing their patients and find the caregiving experience challenging, but rewarding. Few people talk about caregivers who feel depressed, trapped in a hole with no way out except the death of persons in their care. Even reading this may sound scary. Imagine the guilt a caregiver might have when these feelings rise to the surface during their daily living.

This study analyzed guilt among family caregivers of dependent patients from a gender perspective. Interviewed were 73 family caregivers and 23 health professionals (family medicine, community nursing, and social work) with a focus on the following areas of guilt:

1) Guilt for abandoning family and friends

2) Guilt for the relationship with the dependent person

3) Guilt for placing the relative in a nursing home

Results indicated that women report more guilt than men for abandoning family and friends because of their relationship with the dependent person. Regarding nursing home placement, no difference was observed as a function of gender.

Guilt is a major problem that must be addressed by caregivers and healthcare professionals. Not finding solutions for guilt can lead to mental health issues. Caregivers need respite time away from patients, so they can share their experiences, gain information from others, and relieve stress. They need programs that save them time and make them feel that they are cared about by others. They need people to be their caregivers by temporarily relieving their burdens, sharing an uplifting activity, being good listeners, and providing encouragement.

One important beginning for caregiver relief of guilt is forgiveness of self.
In this video, Dr. Alexis Abramson discusses various ways for accepting and alleviating caregiver guilt.
    

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

Monday, July 31, 2017

Predicting Your Future Health (Research, Video)

Can people accurately predict their own health? Can self-rated predictions of mortality or decline in instrumental daily living activities be mostly true? This study of self-rated health predictions and decline in instrumental activities of daily living included community-dwelling older adults 65 years or older (2,638 males and 3,346 females). 

Results reported that poorer self-rated health was significantly associated with decline in both men and women and confirmed that self-rated health is an independent predictor of decline in instrumental activities of daily living among non-disabled community-dwelling older adults.

For those interested in a personal comprehensive diagnosis of their future medical health and health risks, a company started by a geneticist can provide this service at a cost of up to $50,000. Some say knowing the future in such detail is not natural. View other pros and cons in this “WHDT World News” video that includes a brief “60 Minutes” interview. Would you pay thousands to have your future health predicted? 


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, July 24, 2017

Dementia, Long-Term Care Sexual Intimacy Views (Research, Video 4:54)


When the topic of long-term care sexual intimacy regarding people who have dementia arises, family members, loved ones, and staff have varied views. While research is limited on the best ways these residents can express themselves sexually within guidelines respectful of others, this particular study investigated this issue.

Through interviews, this dementia long-term care sexual intimacy research
explored the views of relatives and care workers of new relationships or sexual intimacy between care home residents with dementia who were still married to other people. The following themes emerged:

1) The views of care home staff and relatives had similarities in general terms regarding the problems arising around expressions of sexuality in care homes.

2) A light-hearted or non-physical connection between residents is deemed acceptable. The moment it becomes a sexual relationship, decision-making becomes more complicated.

3) Staff were inclined to turn to managers for advice and to consider separating residents. They expressed familiarity with distracting residents from situations that were of concern.


4) Relatives were considerate of the difficulties and dilemmas faced by care home staff.


Older adults with dementia can and do express sexual intimacy that is appropriate. Mutual consent is an important factor.  However, sometimes sexual behaviors can be inappropriate. Dr. David Conn explains in this video some causes of inappropriate sexual behavior and how these behaviors can be addressed by caregivers and family members:


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, July 17, 2017

Age-Friendly Communities for Older Adults (Research, Video 3:41)

Older adults have made their voices very clear about wanting to age in place at home. But without a great deal of support from the community in addition to varied and better services, aging in place will be hard to meet mental and physical needs of a rapidly growing population. More emphasis should be on prevention-focused and community-based approaches.

Fortunately, initiatives such as the World Health Organization's Global Age-Friendly Communities (AFC) Network, with 287 communities in 33 countries, and AARP's Network of AFCs with 77 communities in the United States have stepped up to meet the challenge. What should be provided to create successful age-friendly communitiesThese are necessary considerations:

1) Older adults should be actively involved, valued, and supported with necessary infrastructure and services.

2)  There should be affordable housing, safe outdoor spaces and built environments conducive to active living, inexpensive and convenient transportation options.

3)  There should be opportunities for social participation, community leadership, and accessible health and wellness services.

4)  Active, culture-based approaches, supported and developed by local communities, and including an intergenerational component are important.

5)  Academic geriatric psychiatry needs to play a major role in the evolving AFC movement to ensure that mental healthcare is considered and delivered on par with physical care.

Age-friendly West Chester, PA, which is featured in this video, is a great example of a World Health Organization's Global Network of Age-Friendly Cities and Communities. Older adults there are socially integrated, diverse, and connected to younger generations.



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, July 10, 2017

Family Caregivers Managing End-of-Life Pain (Research, Video 2:05)


This is the face of serious pain, a face that many who work in the healthcare fields have seen. I remember describing in a poem a hospice patient of mine in this way: “Eyes that have seen ninety years squint tightly as daggers of pain pierce his cancerous form.” Imagine how family caregivers must feel witnessing their loved ones experiencing intermittent frustration and distress of an internal battlefield of pain.

According to several research studies, pain management was the most identified burden faced by family caregivers in end-of-life caregiving. These fourteen research papers focused on family caregivers' experience of pain management and strategies in end-of-life care. 
These were the major areas of pain management research focus:

1) Family caregivers' engagement in pain management and
    communication with the hospice care team about pain control

2) Family caregivers' knowledge, skills, and effectiveness in treating pain

3) Family caregivers' concerns and experience of pain management


Results confirmed what previous studies have already reported with these themes:

1) Inadequate knowledge and assessment skills in pain management

2) Misunderstanding of pain medications

3) Poor communication with the care team


Efforts in understanding and supporting family caregiving pain management needs are areas that must be addressed far better if patient-centered care is to be realized. Implementation is critical to patients’ care and family caregiver empowerment. In addition, more diverse patients and caregivers must be participants in the research. In this video, Dr. Mimi Pattison, Director of Franciscan Hospice, discusses beneficial pain management for those who are dying:



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, July 3, 2017

Volunteering, Making Friends with People Who Have Dementia (Research)


A hospice volunteer many years in Detroit, Michigan nursing homes with residents who had dementia, I was delighted to find research about volunteers “befriending” people with this disease. This study included a small group of nine volunteers who were younger and older adults. Responding to interview questions, they shared their friendship experiences in detail. They emphasized numerous complex and unique processes that generated issues of power, equality, and boundaries. These are some of the rewards they received from volunteering. Remember, good volunteering is always win-win:

1)   Making friends with people who have dementia was described as “a deeply personal and human experience, often with emotional power and profound meaning.”
2)   Volunteers were able to see past dementia stereotypes.
3)   Volunteers’ personal assumptions and boundaries were challenged.
4)   Volunteers became more reflective about love, life, and humanness.

This research concluded that future studies should consider the experiences of those receiving the volunteer service, ways of making the mutual friendship more effective, and more exploration of volunteer difficulties and support.

The recommendation that I would make to all volunteers and anyone else making friends with people who have dementia is based on what I have learned while making friends with my hospice patients and others who have dementia. I have included this advice in number four of my list titled Hospice Volunteer Success in 10 Steps:” 

4) Try other doors.

Patients will have challenges such as dementia that may not respond to your usual front-door communication. Try other doors and even windows. Obstacles are enrichment opportunities in your partnerships with patients. Touch, music, pictures, stories, and fantasies are a few entry points. Let patients help you navigate your way into their world.

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

Monday, June 26, 2017

Lesbian, Gay, Bisexual, Transgender (LGBT) Patients: Research on Nursing Students (Doctors' Support Video 2:43)



Lesbian, gay, bisexual, and transgender (LGBT) patients have a history of being discriminated against in the healthcare system and society in general. Very little research is available on the attitudes of nursing students toward this marginalized population. The purpose of this research on LGBT nursing students’ attitudes was to appraise findings on this issue through an electronic search. Medical subject headings using search terms such as gay, lesbian, transgender, bisexual, LGBT, nursing students, etc. were used.

These were the results:

1) Fewer than 50 percent of the studies (5 out of 12) suggested more positive attitudes of nursing students toward LGBT persons.

2) Six studies reported negative attitudes, and one study reported neutral attitudes.

These studies indicate that nursing students' attitudes are becoming more positive. Studies published before 2000 reported a preponderance of negative attitudes toward LGBT patients. Negative attitudes impact disparities.


UC Davis Health System has incorporated a practice with doctors that provide LGBT support they believe can reduce LGBT healthcare disparities. Doctors ask patients sexual orientation and gender identity questions as part of the routine clinical assessment. By standardizing the collection of this information through the electronic health record, UC Davis officials believe this gives doctors a better understanding of each patient and helps them provide more well-informed medical advice and care. The following video explains the outcomes:




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

Monday, June 19, 2017

Hospice Staff, Volunteers Cope with Death, Burnout (Death Ritual, Research)



Sometimes patients die without family and friends available to handle any death rituals that recognize, honor, and bring closure to death. Such was the case with my hospice patient named Lelia, whose memorial service at the nursing home was planned by the hospice chaplain. This informal ritual of only 12 participants included staff, residents, one relative, one personal friend, and myself. 

Death Ritual Excerpt from Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes


A small group gathered in the recreation room at the nursing home. Most people present were other patients who knew Lelia. Essie, Lelia’s sister, came with a friend named Nola. The hospice chaplain opened the memorial ceremony with a prayer and a reading. Taking turns, we shared our memories of Lelia. Some comments were hilarious, while others revealed Lelia’s demons. We all discovered new layers of Lelia that came together in a mental mural of colorful qualities.

Essie spoke last, “I’m sitting here in shock listening to what you all said about my sister. I can’t believe we knew the same person. The Lelia I knew hardly ever said anything funny, and she sure wasn’t thoughtful, at least not to me. Even when I helped her get into this nursing home, she still acted like she hated me. She was grouchy and liked to criticize people all the time. Nobody was really close to her. To tell you the truth, nobody in our family was close to anybody else in the family. There was just too much drama going on all the time. That’s why I’m the only one here. I started not to come myself, but now I’m glad I did. I learned something new today. I feel better about Lelia after hearing your stories.”

Although the chaplain hadn’t known in advance how many would attend the ceremony, she had brought twelve helium balloons, the exact number needed for each person present to have a balloon to release later. Like colorful hula dancers swaying from strings tied to a chair, the balloons added a festive energy to Lelia’s homegoing. Riding down with the group on the elevator, Nola mentioned that she and Essie were both singers. We all agreed they should lead us in song when the balloons were released during our tribute to Lelia.

Our humble circle stood in the front yard of a Detroit nursing home to perform our final death ritual for Lelia. People riding by in cars on a busy street observed a lively group of ecstatic mourners looking upward, enthusiastically singing “Going to Shout All Over God’s Heaven.” Passionate voices resonated like rockets. We released our buoyant balls of bliss floating in a hurry to get somewhere. I imagined Lelia looking on, bobbing her head to the gospel beat. She grinned her toothless rainbow smile that colored our hearts with joy from the Other Side of Through when we all yelled, “Bye, Lelia! Have yourself a good time!”


Research on Death Rituals

This research on hospice staff and volunteers examines the role of personal death rituals in increasing compassion and decreasing burnout. Members of the National Hospice and Palliative Care Organization (NHPCO) completed an online survey which inquired about personal death ritual practices. Responses came from 340 participants, mostly Caucasian females, from 38 states.

Results indicated that 71% did use personally meaningful rituals after the death of their patients to help them cope. In addition, those who used rituals demonstrated significantly higher compassion satisfaction and significantly lower burnout with professional support, social support, and age playing significant roles.


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.