Empathy in Healthcare

Would you describe yourself as a person with empathy for supporting emotional needs of others? Were you born with this ability? It may surprise you to know that you were not. This fundamental force of morality, this psychological phenomenon is actually a learned behavior. Scientific testing with animals, infants, adults and robots suggests that empathy viewed as an automatic process that catches the feelings of others is actually constructed in the course of development through social interactions, not through genes.

The ability to empathize is especially important in healthcare professions where biases can contribute to healthcare disparities. Sometimes the bias is overt, even intentional. Other times, it is done implicitly, unconsciously, but still doing harm. Healthcare providers must be able to better recognize situations where they can offer empathy in addition to problem solving. Patient care is more than just physical healing. Good healthcare includes building a connection that encompasses a patient’s mind, body, and soul. It includes standing in someone else’s shoes, feeling what that person feels, and responding in the appropriate manner.

One way of learning empathy in general living is by consciously putting yourselves in the position of others in an effort to better understand what they experience. Older adults are a growing population that more people are having contact with as caregivers and in general living. By simulating the experiences of many older adults, everyone and especially young people can develop deeper understanding of various issues of old age that they may not have considered. This helps them develop more empathy for the older adult population and a better understanding of how they can navigate their own aging.

Frances Shani Parker is author of Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes available in paperback and e-book editions in America and other countries at online and offline booksellers. Her blog is Hospice and Nursing Homes Blog. Visit her website at http://www.francesshaniparker.com.

Healthcare Stereotypes: Hispanics, American Indians, Others (Research, Video 1:31)

Many research studies indicate that stereotyping patients of various racial-ethnic groups by healthcare professionals contributes to health disparities. Hispanic Americans and American Indians are two examples of groups facing significant disparities. The following research study focused on healthcare stereotypes related to these two groups: 

1) Health-related stereotypes both nursing and medical students hold about Hispanic and American Indian patients

2)  Nursing and medical students' motivation to treat Hispanic and American Indian patients in an unbiased manner

Participants completed a questionnaire assessing their awareness of stereotypes that healthcare professionals associate with Hispanic and American Indian patients. They also completed measures of their own motivation to treat these patient groups in an unbiased manner. 

Even though they were highly motivated to treat Hispanic and American Indian individuals fairly, the majority of participants reported stereotypes associating these patient groups with noncompliance, risky health behavior, and difficulty understanding and/or communicating health-related information. These kinds of negative health-related stereotypes about patient groups have no place in patient-centered healthcare.

Patient-centered healthcare applies to all patients. This video shares patient-centered comments that present various issues encountered by patients and providers in healthcare settings.

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

Rural vs. Urban End-of-Life Care (Nursing Home Research, Video 1:37)

Dying is universal, but what about differences and similarities in end-of-life (EOL) care? Most of my nursing home experiences with hospice care have been in an urban area. I was curious about this University of Rochester, NY research that compared rural and urban end-of-life care in nursing homes.

The purpose of this study by the University of Rochester, NY was to examine urban-rural differences in end-of-life quality of care provided to nursing home residents. A national sample of nursing homes was used. Three measured areas of focus were in-hospital death, hospice referral before death, and presence of severe pain.

Research results indicated there were urban-rural differences for in-hospital death and hospice quality measures, but not for pain. Compared with nursing homes located in urban areas, facilities in smaller towns and in isolated rural areas had significantly worse EOL quality for in-hospital death and hospice use. Differences were not statistically significant between facilities located in small towns and isolated rural areas. 

According to the report, this study provides “empirical evidence for urban-rural differences in EOL quality of care using a national sample of nursing homes.” This research data is important because it serves as a necessary first step toward improving EOL care for dying nursing home residents and for bridging the urban-rural gap.

This video titled End of Life: Burdensome Transitions from Brown University refers to another EOL study that addresses health care transitions such as moves from the nursing home to the hospital. These burdensome transitions can result in medical errors and lack of care coordination. For persons with advanced dementia, they can cause emotional distress and agitation. According to this study, such transitions are not consistent with goals of providing dying patients with comfort, and a fifth of them experience at least one during their last three months. African Americans and Hispanics were more likely than whites to experience these burdensome transitions.

Frances Shani Parker, Author

Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback at many booksellers and in e-book form at Amazon and Barnes and Noble booksellers.

Hospice and Nursing Homes Blog

BlogTalkRadio Interview with Frances Shani Parker and Viki Kind (30 mins.)

Recently, I was interviewed by Vikki Kind, a bioethicist and medical educator who specializes in end-of-life issues. A hospice volunteer with Hospice of the Conejo in Thousand Oaks, California, Viki is also host of the BlogTalkRadio Show “Kind Ethics.” BlogTalkRadio is the social radio network that allows users to connect quickly and directly with their audiences. Using an ordinary telephone and computer, hosts can create free, live, call-in talk shows.

Viki Kind and I covered several topics during our 30-minute interview. They included the following:

1) Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes
2) Writing
3) Urban Nursing Home Issues
4) Cultural Diversity
5) Racial-Ethnic Healthcare Disparities
6) Healthcare Research
7) Service-Learning (Definition, Implementation)
8) School-Nursing Home Partnerships
9) Ageism
5) Semi- Sensory Deprivation
6) Honoring Patients’ Histories

You can listen to the "Kind Ethics" interview here.

Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes
Hospice and Nursing Homes Blog

Healthcare Disparities: Do You Treat Patients Differently Based on Race or Culture? (Video 3:43 mins.)

During my healthcare research, I have repeatedly come across data revealing major disparities in America’s healthcare system. Overwhelming evidence indicates that these disparities negatively affect certain racial and ethnic groups. America’s long history of overt and covert racism, with all its stereotypes and discrimination, continues to pervade its institutions in ways underestimated by many people, including those who are victimized by it. In my book Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes, I address this urgent matter:

“The responsibility for changing attitudes that cause disparities within the healthcare system rests with that system. This is not only a healthcare issue, but also a moral one. This system cannot continue to sit down in the middle of an unjust road, cause harm to others, and not be held accountable. Healthcare providers must own the fact that a large amount of research on disparities in racial and ethnic minority healthcare is true and make every effort to demonstrate equitable practices.

Better education in racial and ethnic cultural sensitivity, however, is not enough. Negative stereotypes are activated with and without intent, particularly in high-pressure work environments. Serious accountability from healthcare providers must include rewards and penalties. Incentives should be offered to encourage healthcare institutions to work diligently at lowering their incidents of disparities negatively impacting racial and ethnic minorities, as well as women and low economic groups. Solutions must be implemented with ongoing monitoring. Disparities of the magnitude that exists now will not be willed away.”

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. The question “Do you treat patients differently based on race or culture?” is one that every healthcare worker must explore at a personal level with honesty. In spite of overwhelming research to the contrary, most responders still say, ”Oh, I’m colorblind. I treat everybody the same.” Recognition of the problem is the first step toward improvement. Racial and ethnic disparities must be eliminated before America will ever realize true equality in healthcare among its diverse populations.

You can read more about cradle-to-grave African American healthcare disparities here: https://www.linkedin.com/pulse/african-american-pain-treatment-disparities-emergency-parker?trk=mp-author-card

This video defines and addresses the need for healthcare cultural competency:

Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes
Hospice and Nursing Homes Blog