Tuesday, May 28, 2019

LGBT Youth Support: Schools, Grandparents (Research, Video 6:04)

Lesbian, gay, bisexual, and transgender (LGBT) youth have unique needs that need to be addressed on several levels. A former school principal and current eldercare consultant, I write this post with a focus on LGBT school practices and grandparent perspectives.

Compared to heterosexual youth, research on LGBT school practices indicates that LGBT youth are targeted for bullying at school in disproportionate numbers. It cannot be stressed enough that they, like all students, should be getting their education in a supportive environment through a variety of practices and professional inservices. Bullying of LGBT students is far too common. 

In terms of correctional practices, school administrators reported the following for creating a supportive LGBT environment in schools:
1)    Having a point person for LGBT student issues
2)    Displaying sexual orientation-specific content
3)    Having a gay-straight alliance
4)    Discussing bullying based on sexual orientation
5)    Providing professional development around LGBT inclusion     and LGBT student issues

Not surprisingly, students attending schools with caring LGBT climates reported lower odds of relational bullying victimization, physical bullying perpetration, and sexual orientation-based harassment compared to students in schools with less caring LGBT climates. An added benefit was that these LGBTpractices may be protective for all students, regardless of their sexual orientation. 

Intergenerational family experiences of the lesbian, gay, bisexual, transgender (LGBT) community are often not represented during family discussions within the larger heterosexual community. These relationships are important in order to understand better how LGBT individuals function within family systems.

     Beyond school, LGBT youth have family members to consider regarding their advocacy. What about relationships between gay grandchildren and heterosexual grandparents? Grandparents generally want good relationships with their grandchildren, especially those who live near them and with whom they have frequent contact. Positive socialization is helpful and healthy for everyone involved.

Unfortunately, sometimes these relationships can be difficult, even painful. But grandparents like Glen and Linda Marks demonstrate in this video that having a gay grandchild can be an opportunity for open acceptance of who he is. After learning that their grandson was gay, they expressed their determination to "walk" with him with continuing love and support.

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, May 20, 2019

Unbefriended Older Adult Seniors (Research, Video 3:02)

Older adults who have reduced decision-making capacity and no family or friends to compensate for these deficiencies are known as unbefriended. Being unbefriended jeopardizes a fundamental concept of American healthcare. These adults require public guardians.

Available research on unbefriended older adults in Canada and the United States is very limited. In fact, no Canadian studies or reports were located. Three things we do know about them are these: Unbefriended older adults are childless or have fewer children, are more cognitively impaired, and are older than older adults who were not unbefriended. We also know that more research on them is urgently needed.

Unfortunately, the process for making decisions on behalf of unbefriended patients is complicated and varies throughout the country. An example is this case of an unbefriended hospital patient admitted with cardiac arrest. The patient suffered significant brain damage and was in a vegetative state. This case occurred in a state where, unless an unbefriended patient will imminently die despite medical therapy, all measures must be taken to prolong the patient's life. With no surrogate with whom healthcare professionals could have a goals-of-care discussion, they were obligated to continue aggressive management despite knowing it would prolong, but not improve the patient’s condition. Prolonging life included a feeding tube and being transferred to a long-term care facility.

The importance of having early healthcare discussions regarding treatment and written advance directives including a surrogate (durable power of attorney) to make medical decisions cannot be stressed enough. If you were dying right now, would you be unbefriended? Would you be protected from overtreatment or undertreatment? Dr. Eric Widera explains solutions to this problem in this video brought to you by members of the American Academy of Hospice and Palliative Medicine.

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 13, 2019

Wheelchair Rides: Caregiving Friendships (Research, Video 3:15)

For older adults living in institutions such as nursing homes, socializing with others can play a very important role in their quality of life. A hospice volunteer in various Detroit nursing homes for many years, I always knew wheelchair rides were a lot more than just moving residents around in mobile chairs. They provided great bonding moments that presented priceless occasions for us to learn interesting information about our personalities and pasts. Most of all, wheelchair rides gave residents opportunities to extend boundaries beyond their rooms to include other residents, staff, visitors, activities, stimulating sights, sounds and even smells. One hospice resident I had even used her wheelchair rides with me as opportunities to remind everybody that she was indeed still alive.

Quality of life, particularly social relationships, may be perceived differently according to residential settings. This research study on quality of life compared World Health Organization Quality of Life scores of elderly community-dwelling residents and nursing home residents. A sample of 207 older adults (135 community-dwelling residents, 72 nursing home residents) was evaluated. Among other conclusions, socialization in nursing homes was supported as a way to improve residents’ perceptions of quality of life.

This post would not be complete without mentioning Nat, a white man who initially expressed reluctance about being assigned to me, a black volunteer. We discussed the matter and decided to begin visitations anyway and see how things progressed. Nat had a wheelchair-riding contest with himself every time we returned to his room from outdoors. He briefly pushed his wheelchair fast to beat the door buzzer that went off when we entered from the porch. This was a race he always won. He never tired of playing this game or bragging about how fast he was every time he won.

People sitting in the lobby began to expect that when Nat and I entered from his wheelchair ride, there would be a lot of hoopla over his beating the buzzer. Laughing with triumph, he enjoyed celebrating his victory. After a few weeks, however, something interesting happened. Nat proudly and jokingly started telling everybody I was his wife, totally ignoring the reluctance he initially had about being assigned to a black volunteer. He admitted to me that his feelings had changed and that he looked forward to my weekly visits with wheelchair rides. Nat had underestimated the power of wheelchair rides and socialization.

A strong proponent of intergenerational partnerships, I am happy to share another example of wheelchair ride socialization displayed in the following video. The young teenage boy named Aidan Knau is a volunteer escort at the St. Cloud, Minnesota Veterans Administration Medical Center. That’s where he pushes wheelchairs for veterans and provides a whole lot more in positive bonding.

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, May 6, 2019

Caregiver-Patient Joy (Dementia-Music Poem)

When caregivers approach patient care with win-win expectations, they can be surprised by them at any time. Meaningful conversations and feelings drift into a now/here place that are not forced, but still joyous and explosive moments. Many times the experiences are subtle, quiet with a settled satisfaction that brings whispered gifts of personal knowing about life lessons that strengthen the bond between caregiver and patient. One reason some people assume caregiving is always depressing is that caregivers don’t share their joyful caregiving moments enough with people who are unaware of powerful scenarios that occasionally occur between caregivers and patients.

I recall a few of the very special moments I have known as a bedside hospice volunteer caregiver in Detroit nursing homes. This poem describes one of my favorite caregiving moments. I had a very challenging patient whose name was Katherine. She usually lay in bed sleeping or looking up at the ceiling. I couldn’t tell if she was bored, unhappy, mellow, or all three. Rarely speaking, she never sat up on her own or walked. We mostly stared at each other while I talked. But I kept trying to think of ways to climb over the walls that separated us. That was my challenge as her volunteer.

Knowing that Katherine had been active in her Baptist church in the South at one time, I decided to use my CD player (old days) with headphones to help her enjoy music sung by Mahalia Jackson, whom many hail as the greatest gospel singer ever. After reading this poem, you’ll understand why it’s one of my favorite caregiver-patient joys and why I still smile every time I read it. If you have a special caregiver-patient moment of joy, share it so others can smile with you.

                          Sounds of Ecstasy

Headphones frame your head.
You look at me, your volunteer,
wonder what they can be.
Mahalia Jackson’s song erupts,
“When the saints go marching in...”
Sleepy eyes widen like popped corn.
“It’s a CD player,” I say.
Your mental video rewinds
through time from the nursing home
to an Alabama church service
where bodies rock to music.
I join you clapping with the choir.
Your stiffened hands move
with a powerful energy that rises
like a resurrected hot flash.

“It’s wonderful,” you whisper.
Mahalia responds singing,
“Walk all over God’s heaven...”
I picture you joking with Death
when it’s your time to holy dance
to the Other Side of Through.
Mesmerized by the music,
you soak in every song.
A CD player exhilarates you
with sounds of ecstasy.
Such an easy thing for me
to bring, but before I leave,
you say you love me twice.

                  © Frances Shani Parker from Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes (an original poem after each   chapter)

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