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Monday, December 10, 2018

Alzheimer's Dementia Emotional Communication (Research)

Have you ever seen an uplifting movie or heard a passionate song that stirs up rousing emotions when you experience them years later? Those remaining feelings are wonderful scars that continue to heal us as we age. Maybe you can’t remember the names of the movie, the song, the actors, or the singers. But the feelings they generated in a sacred place inside you still resonate.

I thought about this powerful retention of feelings when I read Alzheimer’s research about emotions that people with the disease have long after memories that caused them have disappeared. A sample of 17 participants with probable Alzheimer’s disease and 17 healthy comparison participants underwent separate emotion inducing procedures in which they watched film clips. The clips were intended to induce feelings of sadness or happiness. An evaluation of the emotions later revealed that participants with Alzheimer’s had severely impaired memories of both the sad and happy films. But they continued to report high levels of persisting sadness and happiness beyond their memory of the actual films. The sadness associated with the films lasted more than 30 minutes. This research reminds us that the emotional lives of individuals with Alzheimer's dementia can be greatly influenced by experiences, people, and places they may not recall later.

Caregivers and others must be sensitive to making pleasant emotional memories when managing, interpreting, and responding to behaviors of those with dementia. Loved ones who avoid visiting them because “She doesn’t know who I am” or “I can’t deal with his confusion” must be mindful that the purpose of their presence has nothing to do with anyone's ability to remember anything or anybody, including them. People with dementia should not be greeted with a memory test (What’s my name?) they will probably fail. Names and relationships can easily be told to them.

Interactions with people who have dementia can refine our mastery of thinking outside the box by taking us to an Oz we can learn to respect. We should focus on spending quality time generating emotions that help them feel better and experience love even after our time with them has ended, and we have gone. And there is something in this quality time for us. We can leave with satisfying personal memories of pleasant emotions we inspired and can recall later, too.

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, December 3, 2018

End-of-Life Care: Doctors’ Political Views (Research, Video 3:01)




Are your primary care doctors Democrats or Republicans? Do you think their political affiliations will impact your end-of-life care? Political affiliations of people we know can often impact how we relate to them or how they relate to us. With so many biases already researched in healthcare, can politics also influence healthcare we receive during terminal illness?

This research compared the delivery of end-of-life care given to U.S. Medicare beneficiaries in a hospital by internal medicine doctors with Democrat versus Republican political affiliationsPatients included random samples of Medicare beneficiaries who were admitted with a general medical condition to a hospital and later died in a hospital. Patient demographics and clinical characteristics were similar between groups. The proportion of patients discharged from a hospital to hospice did not vary with doctors' political affiliations.

Conclusion: This research provided no evidence that doctors' political affiliations are associated with the intensity of end-of-life care received by hospitalized patients. Were you surprised? Why?

Regarding terminal illness, many doctors struggle with what to say to patients who are dying. This video shows how they can have these hard conversations with emphasis on four important questions they should ask patients.



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, November 26, 2018

Grant Writers and Researchers (Research, Video 2:22)



Early Career Grant Writers and Researchers

I have been attracted to research most of my life. I like the credibility it can add, the focus on detail, the high discovery possibility of the undiscovered that research brings to a given topic. But the playing field of grant writing and research has changed through the years. Junior tenure-track faculty who have embraced this field are reporting high levels of stress and low satisfaction. Some have even considered quitting. 


Data from a program evaluation of an interdisciplinary research mentoring program in an academic medical center reflects this. View this surveyed research about adults considering quitting research: Mentees were asked if they had considered quitting research in the past year. There were 39 out of 44 mentees who answered the question with 17 (44%) answering in the affirmative. Factors associated with thinking about quitting included lower confidence in research skills, reduced job satisfaction, and higher levels of burnout.

Early career researchers are encouraged to develop habits and skills that keep them excited, curious, successful and, of course, employed. This video titled “Seven Habits of Successful Early Career Researchers” can help them through the maze of collaboration, research skills, and academic publishing.



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, November 12, 2018

Holidays Your Way


What's best for you during the holidays? Many people associate holidays with particular traditions that may include familiar people, places, rituals, foods, music, and more. They may even internalize that if all or most of these components are not present, then their holidays are lacking, not whole, maybe even a failure. These feelings can lead to depression, helplessness about too much of their personal needs not being met.

Particularly troubling for some may be their adjustment to holiday customs after the loss of loved ones. In cases where memories remind them of traditions that are difficult to do without people no longer there, mourners may want to consider other ways they can better embrace the holidays. One option is to create new holiday practices. If holidays were celebrated as a family, new traditions can be planned as a family with input open to everyone. This will give them opportunities to discuss their feelings about the deceased loved ones and possibly include something in the new traditions that will commemorate the deceased in an uplifting manner. This could be a type of memorial that adds pleasure to holidays in the future.

Caregivers have special considerations and should not totally neglect their own needs. With a focus on the positive, they should create a workable plan to have holidays as stress-free as possible. They can consider including the essentials of what they hope to accomplish and eliminating activities that are not really needed. They should encourage assistance from others and be mindful of balance in their own lives. AARP suggests these 10 holiday tips specifically for caregivers.


Whatever situations the holidays bring, remember that there is no one way of participation for everyone. There are different ways that work well for different people. Their choices should be respected and not judged negatively because they are not the norm. For those who find the holidays frustrating, phony, or too commercial, they may want to redirect their holiday focus and participate in activities that are calmer and more meaningful to them. One example could be volunteering at places where they can be helpful to others. Some may want to celebrate alone or socialize with one or two friends. Another choice could be taking a trip to a location they love or want to experience.

Whether celebrating the holidays alone, with others, or not at all, people should follow their hearts and do what feels best for them. Person-centered holidays can include activities that may not have anything to do with the holidays at all, but everything to do with their own quality of life.

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, November 5, 2018

Emotional Intelligence: Haiku Poetry Improving Health (Nurse Research)


When you think of healthcare, what do you envision? Is your focus mostly on physical heath in terms of food, exercise, or illness? What about your  spiritual health? Are your concerns mainly about improving personal growth through religion or other practices promoting a more meaningful life? What do you think about when the topic is your emotional health? Are you as conscious of that part of yourself and what you can do to improve it?

Emotional intelligence is the ability to identify and manage your own emotions and the emotions of others. Improved self-esteem and decision-making are two bonuses when emotional intelligence is addressed. In fact, research in nursing and other disciplines has demonstrated that emotional intelligence abilities “improve communication, support constructive conflict resolution, and improve individual and team performance.” These qualities can also improve safety of patients.

I facilitated a poetry workshop focused on the improvement of emotional intelligence with adult student participants (ages 20's through 70's) and volunteer tutors at Siena Literacy Center in Detroit, MI. I thought using haiku poetry would work particularly well for them because several are African immigrants becoming more familiar with 
the English language.


Students


Haiku is a form of traditional Japanese poetry focused on thoughts that capture special moments in time. Meaningful feelings are written in a small space. Haikus vary, but our workshop focused on including three lines with 5, 7, and 5 syllables. These are examples of haiku poetry:



 My oldest son died. (5 syllables)                             My daughter Fatou, (5)

 His sickness made me feel sad. (7 syllables)           I am proud she is reading. (7)

 I feel better now. (5 syllables)                                 She works hard in school. (5)

Arthur Cogshell                                                        Tamsir Ndow



Students




Adding the emotional intelligence theme combined with haiku in a supportive environment was ideal for us. Successfully expressing in poetry their heartfelt emotions and reading about emotions of others were great ways to engage everyone in win-win conversations with empathy. 

Tutors





We created healthy haikus about our joys, sadness, fears, and hopes. Poems were published in a wonderful anthology, which students proudly display in these photos. You can read a few of their haiku poems on this post. This project was done in partnership with Poets & Writers, Inc.
                                                               
When I was a child,                                                  Working is much fun.

a man scared me with a knife.                                  I like being a cashier
That was horrible.                                                    making good money.

Nzi Kouadio                                                             Aletha Lewis

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, October 29, 2018

Hospice Volunteer Magic


I have been a hospice volunteer 20 years, many in service as a bedside volunteer in Detroit, MI nursing homes. I often view those experiences as magical because there were always mind-blowing surprises that I had not anticipated. For example, Jim, who had dementia, thought I was his deceased wife and gave me opportunities to share stories I made up about our old-school dates when we were young and in love. There were unexplained victories that revealed hidden sides of myself when my solutions finally unraveled mysteries. Sometimes I even enjoyed fascinating fun that seemed to come from nowhere on earth when patients explained their supernatural visits to a spirit world with family and friends.

One illusion of hospice volunteer magic is the common belief among many who are not hospice volunteers that this form of service must be depressing, even insisting that is the reality. Do they really think I would go somewhere weekly to embrace gloom? They don’t understand the magic beyond the curtain of appearances. They don’t know that I disappeared to a place of enchantment they cannot see, a place where I became a better person and a gratified magician after I picked the lucky hospice volunteer card.

Consider taking a chance on the magic of hospice volunteering. You might even discover that this service chooses you. Congratulations, if you have already made the commitment and want to continue your lucky streak. I recommend the following 10 charmed maneuvers for making more hospice volunteer magic:

Hospice Volunteer Magic in 10 Steps

By Frances Shani Parker

1) Remember why you serve.

There’s a reason you feel compelled to enhance lives of the terminally ill. Cherish that inspiration. Move forward committed to an amazing and rewarding healthcare adventure.

2) Believe it’s all win-win.

Providing end-of-life service is a privilege, not a calling to be a savior. You and those you support come together in relationships of mutual healing and growth. Honor your win-win journey.

3) Be present.

By all means, show up. But be present with patients after you arrive. Evaluate appearances, behaviors, surroundings, and interactions with others. Listen with your heart. Even silence speaks. Really try to understand living from their perspectives. Focus on advocacy for improving their quality of life.

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.

5) Know your piece in the puzzle.

Adherence to rules of protocol and professional ethics should be routine. Be aware of boundaries such as confidentiality regarding yourself, your patients, and their loved ones. Follow guidelines of your hospice organization and seek help when needed.

6) Untie your knots.

There may be times of doubt, confusion, sadness, and guilt. These are normal knots of the caregiving process. Untie them by seeking support for your total well-being. Maintain proper rest, nutrition, exercise, and balance in your life. Do your best. Don’t be surprised when you discover reasons to kiss yourself.

7) Spread the word.

Be knowledgeable about hospice and palliative care. Share information so others can benefit from these specialized areas of healthcare. Encourage involvement in hospice and palliative care career and service activities.

8) Pick up a turtle.

If you see a turtle sitting on a fence post, you know somebody helped to put it there. Be on the lookout for turtles aiming for fence posts. Be a role model for other volunteers. Participate in organizations, conferences, workshops, and discussion groups where you can share best practices while learning new ideas.

9) Write death sentences.

Death will come no matter how often you avoid it or wrestle it to the ground. Have your advance directives, finances, and property in legal order. Urge others to do the same. Don’t burden loved ones later with important decisions you can record now. As you unfasten yourself from this life, be satisfied knowing your death sentences will be carried out according to your wishes.

10) Expect rainbow smiles.

Rainbow smiles hug you so tightly you can feel ribs of joy press against your essence. Hospice volunteering provides ongoing moments for you to positively impact lives. When you make those connections happen, rainbow smiles will come.

© Frances Shani Parker

You can read about my personal journey in becoming a hospice volunteer without even realizing I was one here: https://www.linkedin.com/pulse/hospice-volunteer-me-frances-shani-parker?trk=mp-author-card

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, October 22, 2018

Teaching Children About Death


What do we teach our children about death? Unfortunately, too many children are encouraged to believe that cemeteries, corpses, and spirits are sources of gloom and terror. While some may say this is all done in fun, the reality is that many people never stop attaching fear to certain practices, images, and places connected with death. These learned experiences have become entrenched in their thoughts and are considered normal, even though they are totally unnatural to the death experience itself. When children have nothing positive to balance with these fears, it is no wonder that many adults never stop fearing and avoiding even the topic of death in conversations.

A former school principal, I noticed that children began associating death with fear at early ages. They often arrive at erroneous conclusions about death experiences, especially when no one has taken the time to counsel them personally. I have heard children say the deceased person is sleeping, as if death is temporary or that the sleep process can go on forever. Believing this can also cause sleep problems. I have heard them struggle with anguish, believing the deceased left them because they stopped caring about them or as a result of their wrongdoing. These children needed comforting closure that they could not garner on their own.


When a loved one dies, too often adults become focused on their own grief and after-death preparations that can consume much of their time and energy. In-depth discussions with children about what has happened may not occur. This leaves children in a very vulnerable situation of having to move through their own pain with little guidance. They may be overwhelmed with anger, guilt, sadness, and even relief, depending on their relationship with the deceased and how the deceased died. Their outward behavior may not be any indication of their inner turmoil. Even when they appear to be handling their grief well, it’s still important for adults to initiate discussions with them about their feelings, reassuring them that they are supported and loved, that their thoughts and comments are respected.

Children should be taught positive information regarding death, so they will have healthy perspectives about the life and death process. When appropriate for them, they should be present at death rituals to have their grief addressed. They can experience growth opportunities through their voluntary participation at wakes, funerals, and memorial services. These are occasions for children to bond with family members and friends in celebration of a loved one’s life. This helps children learn the meaning of community, the concept of village members taking care of one another, and beliefs about an afterlife. 

When a family grieves after the death, children can also play an important role in their mutual healing. They can help with the preparations and sending of thank-you notes to those who sent condolences and flowers. They can be involved in a general way with helping to bring physical closure regarding items the deceased left behind. Children’s input can be included in any revisions of holiday rituals that may recognize the deceased. Keeping stories alive about those who have died is another way children can continue family legacies. Through the years, children can be guided in understanding the importance of living a life that culminates in death. Maybe then they will grow up to become adults who welcome discussions about this special event that everyone will eventually experience.

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, 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