Hospice Mystery Solved By Nurse Assistant (Video Story 5:13)

“Little White Box” is a hospice mystery that has been circulating on the Internet for many years. I first posted this video story by Roger Dean Kiser on my blog back in 2007. Recently, after not seeing the video for several years, I read it again, regenerated the same warm feelings, and decided to repost it.

Sometimes a nursing home patient needs someone to solve a special problem. The urgency becomes especially important when the patient is in hospice care, and death is imminent. Perhaps some of you have been in that position before. I know I have.

Without giving away too much information, I’ll just say the story is about an older woman named Mrs. Mathers. Dying in a nursing home, she keeps saying, “Before I die, my little white box, please.” Unfortunately, no one knows exactly what she means. To her rescue comes a caring and determined nurse assistant who successfully solves the mystery. With Celine Dion’s breathtaking singing in the background, reading this story just might grab the handle of your heart and make you smile (or even laugh) at the surprising conclusion. Happy endings! 

This story reminds me of a hospice mystery in my own life as a hospice volunteer. In my “Christmas in May” story, I helped to locate a missing key for a beautiful “musicless” box. You can read that “other worldly” story here. 

"To the world, you may be one person. But, to one person, you may be the world."        Anonymous

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

Nursing Home Hospice Impact on Certified Nursing Assistant (CNA) Staff (Research, Video 1:56)

Hospice care in nursing homes continues to increase as more people become aware that hospice services are available wherever they live. Back in the 90’s when I first started hospice volunteering, many people told me they thought hospice care was only at private homes or in free-standing hospice facilities. On the negative side, there were those who thought nursing homes would get kickbacks from hospice referrals. Speculation about nursing homes receiving additional staff hours at no cost, which could lead to decreases in nursing home staffing, was mentioned.

What has happened in terms of nursing assistant staffing with the introduction of hospice care in nursing homes? Researchers at Warren Alpert Medical School at Brown University studied this process for several years with these staffing results:

“The introduction of hospice services in a nursing home did not result in statistically significant changes in nursing assistant (CNA) staffing. Instead, increases in hospice volume resulted in small increases in CNA staffing.”

As a hospice volunteer working directly with patients, I had many opportunities to observe and communicate with CNA staff members who were often first responders in meeting resident needs. Many exhibited dedication and genuine care for residents in spite of their own expressed hardships on the job such as low pay, high staff turnover resulting in increased workloads, and lack of appreciation. The following video titled I am a Nursing Assistant shares their caregiving challenges and rewards:

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

Patient Violence Against Healthcare Staff (Research, Video 2:46)

The first time I saw a female nursing home resident with dementia attack a female nursing assistant (CNA), I really wasn’t surprised. Violence has become so embedded in our society that it’s expected, even in healthcare facilities. I was a hospice volunteer in an urban nursing home. The incident happened so quickly, I almost missed the facial punch that struck the CNA so hard I thought she would fall to the floor. What followed the punch is what impressed me most. There was a brief pause while the CNA steadied herself and walked away. Another CNA immediately interceded and calmed the resident who may have forgotten what she did later.

Long-tern care staff members are at high risk for experiencing aggression from residents. They need ongoing safety information to prepare themselves. Reported in the Journal of Clinical Nursing, results of a focus group study involving the interviewing of 30 nursing home staff caregivers revealed these three caregiver themes regarding patient aggression:

1)   Caregiver explanations regarding the occurrence of aggressive behavior and contributions of residents and caregivers

2)   Measures for handling the aggression of residents

3)   Caregiver self protection and coping with aggression

While staff caregivers use many interventions to reduce aggression, too often they ignore their own practical knowledge about connections between aggressive behavior, pain, and other physiological issues that may cause aggression. More education and emphasis on a systematic approach, including factors leading to aggression, is needed to help staff caregivers better manage resident aggression and their own coping strategies.

This video reminds us that violence against healthcare workers impacts everyone:

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