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