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Monday, June 18, 2018

Caregiving Marriage Vows (Research, Video 1:25)




“In sickness and in health” is said lovingly at many weddings before the journey of marriage begins. Many couples living longer and taking care of spouses are living to be quite old while experiencing their own healthcare challenges. Caregiving a dying spouse for a lengthy period is a possibility for many who commit to fulfilling marriage vows. Because most caregiving research focuses on younger adults, it’s very important that the needs of the older generations are addressed.

This research on older adult caregivers included 17 interviews from participants aged 80 or over. Results indicated that they demonstrated high levels of resilience and adapted well to their caregiving roles. They accepted this as part of the marriage contract they made years ago. While they appreciated support from family and friends, their own needs for care were not always recognized by health and social care services organizations. Their illnesses and end-of-life challenges needed more positive interventions from healthcare professionals.

Lee and Tom McNally fell in love 13 years ago. Tom is a hospice patient now receiving chemotherapy. He informed the hospice chaplain that he and his girlfriend Lee wanted to get married. They both say they take the marriage vow of “in sickness and in health” very seriously.


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.

Thursday, May 31, 2018

Older and Younger Adult Immigrants Adjusting to American Life (Research, Video 2:21)

Much has been said about immigrants in America. This post addresses older and younger adult immigrants who have settled here in recent years. Many older adults followed their adult children here, not knowing if they would ever find a sense of home that they left behind in a foreign country.

This older adult Chinese immigration study based on 21intensive interviews and 107 surveys reveals that they find a sense of home through comfortable living conditions and being around family members. Unfortunately, they struggle with not knowing the English language. This inability to communicate well with those outside the family can be unsettling for them as they try to maintain more independence from relying on their adult children. Social policies toward older adults, such as Medicare, Medicaid, low-income housing, and social services play important roles in easing their transition and quality of life a foreign land.

As this video demonstrates, young adult immigrants can build service bonds with older adults who are not immigrants. This kind of interaction could lead to jobs in the senior care field. For the past three years, adult immigrant students from the Crystal Learning Center have been visiting Covenant Retirement Village in Golden Valley, Michigan. In the usual win-win spirit of good service, students improve, not only their language skills, but also their knowledge about life in America from experts born and raised here.

The memory quilt in the photo above captures students' unique memories about a place or a person they want to memorialize on their small square on the quilt. Guess what immigrant students find most incredible about the older residents born in America? This video below has that answer.


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, May 21, 2018

Walking: Motivating Older Adults (Research, Video 2:58)



Walking. There is a great deal of evidence supporting the health benefits of regular walking for adults. Still, many have not embraced the practice and appear to need more outside motivation. In this study on motivating older adults to walk more, outside incentives included money and donations to charity. The effects of both of these incentives in terms of their improvement and retention in levels of walking were also evaluated. Participants included 94 older adults aged 65 and older living in a Philadelphia-area retirement community.

Using digital pedometers, participants kept tract of increasing their walking progress by 50% in daily steps. Weekly progress was recorded. Participants were randomly selected for these four groups:

1) Control Group: received weekly feedback only.

2) Financial Incentives: received payment of $20 each week walking goals were met.
3) Social Goals: received donation of $20 to a charity of choice each week walking goals were met.
4) Combined: received $20 each week walking goals were met that could be received by participant, donated to a charity of choice, or divided between the participant and charity.

At the end of this 16-week experiment, conclusions indicated that donations to a charity of choice, personal financial incentives, or a combination of the two can each increase older adults' initial uptake of increased levels of walking. People the world over are living longer, and now a new study shows who is likely to live the longest. The information could help doctors and others, including the elderly, plan goals for treatment and care.

Based on this experiment, do you think older adults in need of more motivation should be paid to walk? In this video, walking speed is associated with longevity because it often reflects how well many body systems operate. However, even slower walking is encouraged if that is the walker’s preference.

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, April 30, 2018

Dementia Spirituality Support (Nurse Research, Video 3:53)


Spirituality refers to people’s search for answers to the meaning of life and their relationship with the sacred. Involvement with a particular religion is not required to be spiritual. Coping skills related to spirituality often empower patients with a layer of strength to face each day with renewed joy in knowing their spirits are reinforced. This includes older adults living with dementia.

Nurses caring for people with dementia are in positions to provide spiritual support for them. In a study interviewing nurses providing dementia spiritual support, nurses indicated they viewed this practice as part of person-centered care. Through learning about residents individual spiritual backgrounds, their verbal and nonverbal expressions, nurses were able to understand and respect spiritual needs.

Person-centered, spiritual concern for people with and without dementia can come from a variety of perspectives. This consideration is important in the provision of comprehensive care. By understanding the importance of spirituality in patients’ lives, healthcare workers and other caregivers can create better plans of encouragement for them. These plans could include supportive practices for them such as music, yoga, meditation, nature, prayer, or referral to spiritual or religious counselors.

This video features an older adult in memory care at Peregrine Senior Living in New York. Her physical and emotional expressions of enjoyment reveal how favored gospel songs from the past continue to enhance her spiritual experiences in the present.


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, April 23, 2018

African American Research Recruitment: Building Trust (Research, Video 2:10)





African Americans have a long history of valid reasons to distrust America’s healthcare system, particularly regarding medical research. Incidents go far beyond the well known Tuskegee Institute Syphilis Experiment, in which the U.S. Public Health Service allowed almost 400 African American men with the disease to go untreated, while pretending to treat them. Ultimately, the men died and unauthorized autopsies were done as part of the experiment. Numerous researched atrocities of involuntary experimentation targeting African Americans, including those in military and prison environments, can be cited throughout history to the present.

It is critically important that African Americans are informed, vigilant, and empowered when dealing with researchers and healthcare institutions. The burden of establishing trust primarily rests with America’s healthcare system that caused the distrust, not the victims who continue to suffer from ongoing tragedies of cradle-to-grave disparities impacting them even when income, health insurance, and access to care are the same among various racial-ethnic groups. In addition to generational suffering and repercussions on many levels, illnesses create long-term economic burdens and major losses of productivity in society.

An example of a church-based end-of-life dementia education research project was conducted at four large urban African American churches. Serious trust building is needed in the church community to recruit African Americans for church-based hospice and palliative care research. Not surprisingly, church leaders voiced mistrust concerns, including mistrust concerns of previous researchers who conducted investigations in their faith-based institutions. The following strategies were used to decrease the mistrust concerns:

1) Face-to-face, in-depth interviews were conducted from a convenient sample of four established AA church leaders.

2) Interviews were held in the informants' churches to promote candor and comfort in revealing sensitive information about trust /mistrust.

3) Content analysis framework was used to analyze the data.

4) Elements identified from the analysis were then used to create themes about positive and negative experiences with researchers, violation of trust, and trust building strategies.


In conclusion, findings suggest that researchers who wish to conduct successful studies in African American religious institutions must implement trust-rebuilding strategies that include mutual respect, collaboration, and partnership building. If general moral practices continue to be violated, future hospice and palliative care research within the institutions may be threatened. If this happens, benefits of church members, the African American community, and advancement of end-of-life care all suffer.

In the following video, Dr. Janel Johnson of the National Institute on Aging emphasizes the important need for African American volunteers in research studies in order to treat various diseases effectively, particularly as disease treatments have become more person-centered and working better for different people.




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, April 16, 2018

Animal Hoarding Disorder (Research, Video 6:51)

Thoughts of hoarding generally center around people who live in households where excessive “things” have taken over in an unhealthy manner. Several television shows have featured this disorder while emphasizing causes and solutions to this addiction. Animal Hoarding Disorder, however, includes the takeover of animals and is viewed as a new mental disorder that is different from Hoarding Disorder

An Animal Hoarding Disorder study was done with 33 individuals with an average age of 61.39 years. They had all lived with large numbers of animals an average of 23.09 years. Over half of them also were hoarders of inanimate objects. The average number of animals per hoarder was approximately 41. The study determined that the following significant differences between this form of hoarding and animal hoarding:

1)    Unlike hoarded objects, hoarded animals generally do not obstruct the household environments.

2)    Animal hoarders have more of an affectionate bond with lives and not with objects.

What is the psychological mindset of animal hoarders? They explain their views in this video displaying the results of their collecting and controlling animals that love them back. Often in denial about their addiction, some hoard hundreds of animals and refer to them as their “kids” while their real relatives hope for successful interventions to help cure them. Most hoarders relapse without ongoing therapy.

Note: After the video starts, click the Watch on Youtube link on the last line.



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, April 9, 2018

Older Adult Yoga Benefits: Revisiting My Downward Dog (Research, Driving Video 4:05)

When yoga is recommended by AARP.orgformerly the American Association of Retired Persons, you know credible yoga research supported the endorsement. Years of research conclude that health benefits of yoga are especially effective for adults 50 years and older. Among the many reasons that encourage practicing yoga during these ages are improvements in blood pressure, bone strengthening, joint protection, weight loss, balance, mind sharpening, and reduced anxiety.

Downward dog is a popular yoga pose. What does it mean? Is it a dog fallen in battle? Or is it my older self  meeting yoga again after years of separation in exchange for fast-paced aerobic classes? I stared in awe as Ellie, my older adult teacher did challenging poses with ease. But, when I posed on the mat after being away so long, I worried that I might burn out before I finished. Ellie encouraged  the class by saying, “You are amazing! You’re moving your own blood!” with all the enthusiasm of winning the lottery.

Nowadays, I still take a few high-energy exercise classes to stay well-rounded, and my yoga is making progress. I enjoy chair yoga with classmates and my teacher Gail who ends sessions with peace and a joke. Chair yoga is popular for people of all ages for various reasons. Having many of the same benefits as yoga on a mat, chair yoga can often be done wherever someone is seated, even at work.

The following video illustrates how chair yoga is being used by older adults in California to extend the time they can drive their cars.
  

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, April 2, 2018

Incontinence Care: Racial Disparities in Nursing Homes (Research, Video 1:12)

Incontinence occurs when patients are unable to restrain natural discharges or evacuations of urine or feces. Their ability to control bowel and bladder functions ranges from needing toileting assistance to having no control and being completely dependent upon caregivers to prevent pressure ulcers and infections. Few actions toward patients are more disrespectful and humiliating for them than caregiver neglect of incontinence. In addition to promoting patient well-being, preventing incontinence can reduce healthcare treatment costs.

Research on incontinence care was done to determine the prevalence of older continent adults who received primary prevention of incontinence at nursing home admission, to assess whether there were racial or ethnic disparities in incontinence prevention, and to describe factors associated with any disparities. Disparities were analyzed for four minority groups with these results:

1)   Twelve percent of nursing home admissions received incontinence prevention.

2)   There was a significant disparity (2%) in incontinence prevention for Blacks. Fewer Black admissions were observed to receive incontinence prevention than was expected had they been part of the White group.

3)   The percentage of White admissions receiving incontinence prevention was 10.6%. No disparity disadvantage for the other minority groups was found.

Racial disparities such as this are not only healthcare tragedies, but moral ones. Like many other healthcare disparities, equitable incontinence prevention at the time of nursing home admission is an attainable goal that continues to go unmet. There is a tendency among some healthcare workers to assume that the solution to this problem rests with leaders of the institution when, in fact, it belongs to each person making up the institution. In spite of overwhelming research to the contrary, most healthcare workers continue to say they treat everybody the same. Recognition of the problem is the first step toward improvement.

Research on disparities often concludes with the need for staff training, organizational commitment, and monitoring to eliminate disparities. These are all obvious and appropriate strategies for eliminating disparities. But, until ongoing conscious commitment and actions in equitable practices are made by every healthcare worker to make that happen, vast numbers of particular patient populations will continue to be unjustly victimized. 

Disparities impact not only the victims, but also their families, communities, and ultimately our nation. In addition to generational suffering and repercussions on numerous levels, disparities create long-term economic burdens and major losses of productivity. Racial and ethnic disparities must be eliminated before America will ever realize true equality in healthcare among its diverse populations.

The following video explains the importance of incontinence care from the perspectives of patients and their caregivers:



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, March 26, 2018

Robots: What caregivers, patients think (Alzheimer’s Dementia Research, Video 1:53)

Whenever I write about robots being used to support caregiving, someone usually comments that robots can never replace people. Of course, that is the point. They can’t replace people, but they can provide services that allow people more time to be caregivers. They give patients more opportunities to be supported and stimulated in daily living activities. They allow technology to accurately assess and evaluate patient progress. Older adults with dementia gain a degree of independence with robots that encourage then to complete activities. 

Probably the best evaluators of how successful robots can be are patients and caregivers themselves. Few studies have investigated in-depth perspectives of older adults with dementia and their caregivers following direct interaction with an assistive prompting robot. This research on robots included older adults with mild-to-moderate Alzheimer’s dementia.

The adults had difficulty completing activity steps with their family caregivers. They were prompted by a tele-operated robot to wash their hands in the bathroom and make a cup of tea in the kitchen. Caregivers observed interactions. Individual interviews followed and categorized into themes.

Three themes summarized responses to robot interactions:

1)   Contemplating a future with assistive robots
2)   Considering opportunities with assistive robots
3)   Reflecting on implications for social relationships

While older adults with dementia welcomed opportunities for robots to help in daily activities, they still did not want to have one. Caregivers, on the other hand, were more open to opportunities robots provided. Several wanted to have a robot, possibly to decrease frustration, stress and relationship strain, and to increase social interaction via the robot. A negative consequence could be decreased interaction with caregivers.

In this video, meet Ludwig, a robot that helps older adults with Alzheimer’s disease and other forms of dementia. In addition to providing company and entertainment, Ludwig also monitors patients’ symptoms, cognitive decline, and depression. By the way, Ludwig is a robot and cannot replace a real person.



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, March 19, 2018

Aging in the City (Happiness Research, Video 8:48)

Do you live in a large city? Do you know what it’s like to age there in terms of health and happiness? Research indicates that there is definitely a connection. And, if you live your entire life in a major city, there are effects across your lifespan.

This study examined effects of city life on happiness. Participants included 5000 adults aged 25-85 years old. They reported their happiness levels and evaluated their city along place and performance dimensions. What do the findings suggest regarding city living and happiness over a lifespan?

1)  The happiness of younger residents is a function of having easy access to cultural, shopping, transport, parks, schools, sport amenities and the attractiveness of their cities.
2)  The happiness of older residents is associated more with the provision of quality governmental services that help them age in place. 
3)  Health and social connections are strongly linked to happiness for all residents.
In order to meet general needs of all ages living in the city, the findings above must be addressed when city living is planned. The video below shares examples of positive aspects of good city living for older adult New Yorkers.

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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