Frances Shani Parker, eldercare consultant and Detroit, Michigan author of Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes, writes this blog. Topics include eldercare, hospice, nursing homes, caregiving, dementia, death, bereavement, and older adults in general. News, practices, research, poems, stories, interviews, and videos are used often. In the top right column, you can search for various topics of interest to you. You can also subscribe to this blog or follow it by email.
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:
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!”
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.
Do you have a role model for aging? Many young, middle-aged, and older adults do. Their role models are people they admire and want to emulate in their own aging. In a study on role models for aging, there were 150 people ages 18-99 who were asked if they had role models for aging and why. Results showed 85% indicating that they had at least one. Who are these people who play such important roles in the lives of others?
1) Most role models are family members such as parents and grandparents. Those with family role models had more positive views on aging.
2) Role models usually share the same gender as the people choosing them.
3) Role models promote successful aging.
With the average life expectancy continuing to extend to later years, we can all learn something from the increasing group of older adults living beyond 100 years and living well. These centenarians enjoy sharing their secrets. While genetics can play a role, there are several suggestions many of the centenarians agree we can do that are easy to incorporate into our personal lifestyles. Check them out in this video:
This sign from America's Jim Crow era reminds me of a painful history I share with many. After the Civil War ended in 1865 and continuing to the Civil Rights Act of 1964, government Jim Crow laws legally enforced racial discrimination, particularly against Negroes. These laws institutionalized numerous inferior economic, educational, and social practices far below and sometimes non-existent compared to advantages white people received. Negative ramifications continue today impacting victims, their families, their communities, and the entire nation with long-term burdens and losses of productivity.
In an urban nursing home, I was inspired to write this poem while watching my African American hospice patient sleep. I thought about our shared heritage that bridged our communication beyond her Alzheimer’s dementia. This poem is written in praise of her and everyone’s ancestors who have endured racial-ethnic oppression. Their resilience gifted us with sustaining stories of joy, pain, courage, and survival that go far deeper than words.
Deeper Than Words
The outside world arrives wearing my willing face. Toothless, your smile widens like a baby’s hungry for attention. Almost ninety-eight years old, your inner candle still glows.
A hospice volunteer, I lean closer, talk into your listening left ear, “Today is Sunday, Miss Loretta.” My news drifts away like smoke. You stare at me through dying coals. Whatever I ask, you whisper, “Yes.”
I stroke your age-softened arms while your hazed mind masters sleep. Watching you, I dream generations of women black and strong, each one a book of sustaining stories about joy, pain, courage, survival.
Within your warm brown frame, spirits from our common history linger. Aides say you have dementia, that you don’t know a word I say. Our language goes deeper than words. We speak to each other’s souls.
1) Visiting Someone With Alzheimer’s Dementia: Emotions Without Memories (Research) The post link below reminds us that the emotional lives of individuals with Alzheimer's can be greatly influenced by experiences, people, and places they do not recall.
2) Children Learn About Alzheimer's Dementia: School, Family Support (Video 3:51)
An educator who has been actively involved with introducing elementary-middle school children to the nursing home world and dementia for many years, I have always been impressed with the sensitive ways they embrace knowledge about this disease. Click link below for more information about this form of teaching-learning called service-learning.
