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Monday, October 15, 2018

Terminal Illness: Patients’ Attitudes, Views (Research, Video 2:39)

Some days, feelings of despair try to take over. Other days, simple joys in life seem bigger than ever imagined. Most people experience varied moods from time to time. However, with so much focus being placed on treatment, terminally ill patients may need to focus more on maintaining positive outlooks. A lot depends on how they view themselves and their condition. Attitude really is everything.

What are some palliative care patients’ views on coping with mood swings?
A study of terminally ill advanced cancer patients revealed the following regarding their attitudes and helpful coping strategies, life narratives, and spirituality:

1) Resources were found in meaningful contacts with others.

2) Personal attention of professional medical caregivers for their well-being was also appreciated.

Kathleen was a terminally ill nurse who was told she had only six months to live. Her life advice to others who are terminally ill is embodied in her actions after her diagnosis. When the cancer storm came, she made positive adjustments. She shared her heartfelt sentiments in this video that teaches about living, making good choices, and being remembered.




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, October 8, 2018

Elder Abuser Profiles (Research, Financial Abuse Video 2:13)



Who are the perpetrators of the vulnerable elderly population? Do similar profiles and risk factors motivate elder abusers to mistreat others? Research suggests their profiles and risk factors differ among them. They can be categorized for successful intervention approaches. One way is through analysis of their behavior profiles.


This data comes from the Older Adult Mistreatment Assessment administered to victims by Adult Protective Service (APS) in Illinois. Abusers were categorized using victim and caseworker reports on abusers' harmful and supportive behaviors and characteristics. Results indicate that abusers fall into the following profiles:

 1) Caregiver (lowest in harmful characteristics and highest in providing emotional and instrumental support to victims)

2) Temperamental

3) Dependent Caregiver

4) Dangerous (have the highest levels of aggression, financial dependency, substance abuse, and irresponsibility) 


This is the first quantitative study to identify and characterize abuser subtypes. These profiles differ significantly in average age and gender of the abuser, the relationship to victims, and types of mistreatment committed.

Adult Protective Services (APS) is a social services program provided by state and /or local governments nationwide serving older adults and adults with disabilities who are in need of assistance. They can offer assistance in cases of elder abuse. State adult protective services program numbers in your area are available at this website: http://www.napsa-now.org/get-help/help-in-your-area

Dr. Peter Lichtenberg, Director of the Institute of Gerontology at Wayne State University in Detroit, MI is a national expert on financial elder abuse.You can read about him, the Lichtenberg Financial Decision-Making Screening and Rating Scales, his community engagement component SAFE, Success After Financial Exploitation, and more here: https://iog.wayne.edu/research/financial-decision-making


The following video from the WKRG News 5 Scambuster Report is one example of how financial abuse by an elder abuser can take place.



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, October 1, 2018

Die Laughing: Hospice Balloon Humor




Contrary to what some people think, many terminally ill patients continue to maintain a comic state of mind and often initiate and enjoy participating in humorous activities. Sometimes the humor is unintentional, but the energy is just as exciting. That has definitely been my experience as a hospice volunteer.

I’m a balloon lover. My favorites are Mylar foil balloons with special shapes, themes, and messages. Many of my patients with dementia enjoy balloons as much as I do. Funny scenarios have often resulted after I brought them balloons. This true story came about after I offered to get a seasonal spring balloon in a flowered shape for Miss Robinson, a patient with Alzheimer's disease, the most common form of dementia. But she decided she preferred a green balloon instead. This heart-warming balloon adventure followed.

Excerpt from my book Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes:
Miss Robinson was very emphatic about choosing a green balloon. She couldn’t explain why the color green meant so much to her, except to say it was her favorite color. The party-supply store had many flowered balloons, but green ones were scarce. After a lengthy search with my help, the salesperson found one green balloon in the entire store. Later that week, I brought the balloon to Miss Robinson, tied it to her wheelchair, and took her for an indoor ride around the nursing home to show it off.

“Look, everybody! Look at my red balloon! Did you ever see a red balloon this pretty? It’s my red spring balloon! Hey, everybody, look at me! I’ve got my own red balloon!” she exclaimed.

A few days later, I visited Miss Robinson. Her balloon hovered over her bed like a shiny green pit bull on guard. She could enjoy watching it bobbing around doing its doggie dance and even talk to it if she felt lonely.

“Hi, Miss Robinson, it’s me, the hat lady.

“Sure, I remember you. You’re the hat lady who brought me my purple flag. See, it’s still waving in the air. I just love my purple flag!”

I smiled, thinking of the evolving green balloon that had developed a life of its own. In fewer than two weeks, it had evolved at three different levels with hidden powers I had not known. It was enough to have gone from a green to red balloon. Now, it had become a purple flag. I couldn’t wait to visit Miss Robinson again before the balloon deflated completely. I looked forward to hearing more about her happy adventure with the green balloon and its miraculous makeovers. 

© Frances Shani Parker


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, September 24, 2018

Death Notification Problems (Research, Video 1:44)


“We regret to inform you of the death of _______.” If the last word in that statement is the name of your loved one, you are about to be impacted by a death. Death notifications can affect not only the grief experience of loved ones, but also the well-being of physicians who were involved in the death. That’s why the delivery of this information warrants great care. Unfortunately, too many places have no standard procedure for making death notification phone calls.

Efforts were made in this research on procedures for making death notification phone calls to rectify this situation by using results of a literature review and open-ended interviews with faculty, residents, and widows to develop a survey regarding resident training and experience in death notification by phone. All internal medicine (IM) residents at the university conducting the research institution completed the survey. These were the results:

1) Eighty percent of residents felt inadequately trained for this task. Over 25% reported that calls went poorly.



2) Attendings (an attending physician or surgeon) were involved in 17% of cases. Primary care physicians were not involved at all.

3) Nurses and chaplains were not involved.

4) Respondents never delayed notification of death until family arrived at the hospital.

5) There was no consistent approach to rehearsing or making the call, advising families about safe travel to the hospital, greeting families upon arrival, or following up with expressions of condolence.

Imagine how the poor communication listed above could potentially complicate grief for surviving loved ones and create stress among physicians. Clearly, more training is needed and could be combined along with training in disclosure of medical error.

Regarding errors related to death notifications, the case featured in the video below is an example of a worst-case scenario. What if loved ones are notified about a deceased person who really hasn’t died? This actually happened to a family that was told their grandmother had died at a hospital in Brooklyn, New York City.



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, September 17, 2018

Aging: How old are you really? (Research, Video 2:48)


Do you only think of aging as lost youth, or do you think of it more as new opportunities for growth in another phase of your life? Several research studies show the way we feel about aging affects how we live our lives. Stop worrying about your age or other people’s ages. Don’t believe stereotypes about how people should look or act at a certain age.

Ask me how many hard lessons I learned, how many times I overcame, how much music spoke to my soul, how many words lifted me higher, how many people loved me back, how many mornings I woke up grateful. That’s how old I am. 

About the process of aging, people of all ages have worries. A study about worries of various ages concluded the highest degree of worry includes future financial security and memory loss. Surprisingly, however, most Americans are optimistic about aging, especially older adults who have learned resilience through their years of living life.

Aging is a fascinating process. The following video includes 10 interesting facts about aging that may surprise you.


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, September 10, 2018

Nursing Home-School Similarities, Connections (Video 2:40)


Years ago, I was principal of a schoolwide, service-learning school where all staff and students performed service in the community. Students' service was connected to the school curriculum, giving them opportunities to use what they learned to improve the community. For example, fourth graders learned how to write biographies by interviewing residents of a local nursing home. Later, each resident was given a booklet with all the residents’ biographies so they could learn more about one another.

My own service included weekly hospice volunteering in Detroit, Michigan nursing homes. It didn’t take long before I observed that nursing homes and schools have several important similarities. Both have cultures that impact people in institutions. A paradigm shift in how these institutions are often perceived, not only by the public, but also by those who work in them, was long overdue. This needed transformation is often referred to as person-centered culture change, a movement that focuses on values and practices that respect the input of everyone involved with the institutions.

Through the eyes of an educator and hospice volunteer, I focused on person-centered care with residents. In order for a person-centered climate to fully enhance quality of life in nursing homes and other residential institutions for older adults, residents must have experiences similar to what students should have in schools. Like students, residents must first know that the nursing home is a real “home” where they are welcomed and cherished at all times. They must feel that their environments are safe, that trustworthy employees care about them and listen to them with their hearts. Residents must know that their progress as individuals with specialized needs is the primary motivation for everything that goes on. Those with dementia should be challenged to learn new skills in non-threatening ways.

Residents must know that the personal histories they bring matter. These life stories help create who they are, not labels like “dementia” which are too often used to judge them and put them in stereotypical categories during their later years. They need ongoing encouragement to use their strengths in productive ways to improve their self-esteem and enhance lives of others. Their talents and accomplishments should be shared with the larger group so they can be appreciated and praised. Finally, their “graduations” (deaths) should be recognized as revered events.

Sometimes older adult communities and schools have the great pleasure of bonding into something wonderful together. The following video features Providence Mount St. Vincent in Seattle, Washington. It is a typical community home to about 400 residents. What really sets this facility apart from many other communities like this is the preschool, the Intergenerational Learning Center, which provides children and older adults with opportunities to bond. These young children learn about acceptance of older adults while they are being nurtured. At the same time, the older adults develop a greater sense of self-worth and foster social interactions. That's a win-win relationship for everyone.




Note: Winner of the National Service-Learning Partnership Trailblazer Award, Frances Shani Parker, a hospice volunteer, writer, and eldercare consultant has been instrumental in implementing service-learning in school districts across the country.

You can read about our fourth graders' nursing home research on ageism stereotypes here.


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.