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Monday, January 29, 2018

LGBT Older Adult Dementia (Research, Video 4:48)


Varied forms of dementia and other cognitive impairments include unique concerns for those who are lesbian, gay, bisexual, and transgender (LGBT).  These concerns center around social isolation, discrimination, barriers to health care access, limited availability of and support for caregivers, and higher rates of certain chronic illnesses. The increasing size of this older adult population further escalates the need to find more researched based solutions to these problems.

This LGBT dementia research examines their unique risk factors and outlines key competencies for health care and human service providers to ensure culturally relevant care for those in need of help. This kind of care is also needed for their caregivers, families, and communities. Emphasized are the importance of early detection and support, as well as the development of policies and practices that promote community-level advocacy and education.

In Australia, the Commonwealth Government uses the initials LGBTI to refer collectively to people who are lesbian, gay, bisexual, trans, and/or intersex. This video features a gay couple named Tony and Paul. Paul was diagnosed with early onset dementia before the age of 65. Paul serves as his caregiver. Together they explain how they have adjusted in their relationship to accommodate Alzheimer’s disease.



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, January 22, 2018

Complicated Grief: Food, Thought Solutions (Research, Video 2:14

Sometimes grief doesn’t wind down like a slowly moving stream reminding us of loss. For some, the death of a loved one can become a threatening ocean of turbulent thought waves that disorder lives with chaotic confusion. Complicated grief involves traumatic symptoms such as disruptive flashbacks, overwhelming fear, and extreme anxiety. Everyday tasks of living such as basic meal planning and eating seem impossible to navigate in a mental state of aloneness and pain. These symptoms require cognitive behavioral therapy to assist the griever with irrational beliefs, depression or anger in adapting to life without a loved one.

Hospice programs include family bereavement counseling assistance after a loved one has died. In an effort to support those who were having difficulty with adjusting to meal planning, grocery shopping, and cooking for one, Heather Nickrand of Alexian Brothers Hospice, Laura Lerdal and David Kramer of College of DuPage started the Culinary Grief Therapy: Cooking for One Series. This series includes interactive therapy demonstrations and hands-on experiences for participants in hospice bereavement counseling.

Results of this culinary grief therapy have been very positive with participation increasing with each workshop session. This unique way of providing quality of life in a person-centered manner with meal planning, grocery shopping, and cooking for one is commendable.

Complicated grief is an under-recognized mental health problem that many people experience, particularly older adults. General therapy for depression may not be successful in resolving this form of grief. Dr, Katherine Shear of Columbia University has lead a successful study using another form of therapy in which patients “relive the loss.” In this CBS video, Dr.Max Gomez, Dr. Shear, and patient Iris Palley explain how it works.


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, January 1, 2018

Physician Bias: Sexual Dysfunction, Obesity (Research, Video 3:12)

More and more research continues to show that patients are too often diagnosed through biases of their physiciansOne example that involves older adults vs. younger adults focuses on sexual dysfunction. This age bias includes diagnosis, causation, proposed treatment and perceived prognosis.

An on-line survey was given consisting of one of two, randomly administered, case vignettes, which differed only by the age of the patient (28 or 78). In both cases, the patient was described as suffering from occasional erectile dysfunction with a clear psychosocial indication. A total of 236 physicians responded to the survey. Overall, 110 physicians received an "old" vignette and 126 physicians received a "young" vignette.

Biases were reflected in these results:

1)   The "older" vignette was more likely to be diagnosed with erectile dysfunction, whereas the "younger" vignette was more likely to be diagnosed with performance anxiety.

2)   The "older" vignette's dysfunction was more likely to be attributed to hormonal changes, health problems and decreased sexual desire.

3)   Physicians were more likely to recommend testosterone replacement therapy and inhibitors, as well as a referral to urology to the "older" vignette.

4)   In contrast, the "younger" vignette was more often referred to a sexologist and received a more positive prognosis than the older patient.

Another researched-based bias that many people experience in general in society, including the healthcare professions is bias against people who are obese. One-third of American adults are considered obese, In this video, Sheila Gray goes to medical school to see how future doctors are learning to keep bias out of the exam room.




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