Monday, July 9, 2018

Bullying in Older Adult Communities (Staff Research, LGBT Video 4:55)

These are a few incidents I have witnessed or personally experienced from some bullies in older adult communities. At mealtimes and special events, I have observed residents selfishly saving empty seats for their friends who may or may not even come and denying seating choices to those who are already present when they request an empty seat. As a visitor one day, I was denied seating at an older adult community at four different tables, each with two or three empty chairs. Poor welcome. I have also experienced this as a member. A simple solution to this problem is to have groups who want to sit together wait until all group members arrive and are seated at the same time without saving seats. When implemented consistently, this system works well. 

While I was a member at a senior center that had years of resistance by members over age 62 convincing management not to allow members 55- 61years old to join (unlike most centers in this metro-area), a woman I did not know stood outside my bathroom stall screaming, “People under 62 are not welcome here! Go home!” I have reported these and other bullying incidents I witnessed among residents to facility administrators who generally responded they were “working on the problem.” I have advised residents to seek help from an ombudsperson, family members, and friends. An ombudsperson is a government official who hears and investigates complaints by private citizens against other officials or government agencies.

Staff members who work in older adult communities also observe resident-to-resident bullying. This research on bullying is based on interviews with 45 long-term care staff members who reported the following:

1. Verbal bullying was the most observed type of bullying, but social bullying was also prevalent.

2. Victims and perpetrators were reported to commonly have cognitive and physical disabilities.

3. More than half of staff participants had not received formal training and only 21% reported their facility had a formal policy to address bullying.

The results above emphatically support the need for detailed policies and training programs for staff to effectively intervene when bullying occurs.

A former school principal, I know bullying is a problem that only gets worse when it’s ignored. Too often the victims are vulnerable and defenseless. Some residents, such as those targeted because of their sexual orientation, have become so depressed they have attempted or committed suicide. Observers are often too afraid themselves to take a stand. The administration must be seriously involved. These are some guidelines that can help solve problems of bullying:

1. Commit to and promote principles of equality and respect for all residents/members.

2. Do a confidential needs assessment on bullying to determine how severe the problem is. General needs assessments should be done annually.

3. Have open discussions involving residents, staff, and community members about bullying, its causes, and solutions. Consultants with expertise in bullying, conflict resolution, diversity, etc. can be especially helpful.

4. Provide extensive staff training in how to handle bullying among themselves and those they serve. Continue to educate residents/members. Victims need the support, and bullies need to be reminded that eliminating bullying is an ongoing priority.

5. Review and change procedures that can decrease the power of bullies.

6. Create and disseminate a zero tolerance policy on bullying along with channels for reporting incidents and resolving them.

7. Keep in mind that the goal is to create a culture where no bullying is the standard embedded in how the institution operates. There must be consistency in implementation and visible recognition of everyone’s dignity and rights.

Many older adults don’t have a lot of time ahead of them. No one should have to spend their golden years being victimized daily by mean-spirited bullies. In the following video, Martha Wetzel, an older adult lesbian, shares her story about being targeted by bullies in a long-term-care setting because of her sexual orientation. She ultimately sued the facility.

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, June 25, 2018

Suicide: Older Adult Risk Factors, Prevention (Video 3:20)

Are you aware of these facts about suicides? Worldwide, both men and women have increased risks of committing suicide as they age. In America, older adults kill themselves intentionally more than young people do. The highest suicide rate is among white men, and older adult white men are the largest in that group. This situation continues to escalate with the increase of millions of baby boomers (born 1946-1964) reaching senior status.

We can all help prevent older adult suicides in these two ways:

1)   Be aware of the National Suicide Prevention Lifeline which can be reached at 1-800-273-8255. The Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals.
2)   Another way everyone can help prevent suicides of older adults is by looking for four risk factors that all begin with the letter d. In this video titled “The Four D’s of Suicide Risk in Older Adults,” Dr. Yeates Conwell, Director, Geriatric Psychiatry Program Director, Center for Study and Prevention of Suicide, University of Rochester Medical Center talks about specific problems we can address to prevent suicides.

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, 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