Grief Support for Co-Workers and Classmates (Video 1:05)

Comforting co-workers and classmates who are struggling with grief symptoms is uncomfortable for many people. While they may have good intentions, they often lack confidence regarding what to say or do that will help mourners adjust to a loss. At the workplace and at school, many staff members and classmates may feel that only experts should handle grief support. Worried that they might cause hurt feelings, they may remain distant from those mourning. Holding back their support, however, can negatively impact their colleagues who are suffering.

Although counselors and others trained in grief management play an important role, colleagues can also make beneficial contributions. Workshops, meetings, and classes at the workplace and at schools should include time for sharing strategies everyone can incorporate to alleviate grief as a community representing individuals of the organization. Implementation of these strategies can help create workplace and school cultures where everyone feels inspired to support one another in whatever ways they can during times of grief.

Sandi Sunter, director of community development for the Hospice of the Florida Suncoast, offers suggestions for coping with a co-worker’s death 
in this video titled “Hospice Care & Grief Counseling: Dealing With a Co-Worker's Death.”

Frances Shani Parker, Author

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

Hospice and Nursing Homes Blog

Fears of Lesbian, Gay, Bisexual, and Transgender (LGBT) Older Adults: Healthcare Staff Training and Housing (Research, Video 5:11)

Lesbian, gay, bisexual, and transgender (LGBT) older adults living in nursing homes, long-term care, assisted living, and even those receiving home care from healthcare workers have increasingly been discriminated against and abused by staff and fellow residents. Damage to their emotional and physical health has been so devastating that some LGBT residents have resorted to suicide.

In a study at Yeshiva University in New York, elderly participants in community and long-term care settings reported the following fears:

1) Fear of being rejected or neglected by healthcare providers, particularly personal care aides

2) Fear of not being accepted or respected by other residents

3) Fear of having to go back into the closet and pretend their sexual orientation is different

Important solutions to this problem include a national drive to train long-term care providers in equitable and compassionate care. University of Iowa findings from a nationally representative mail-in survey of over a thousand nursing home and social service directors revealed that three-fourths of the sample had not received even one hour of homophobia training over the past five years. Directors with the most experience reported having the least training. More development and dissemination of homophobia training is critically needed along with policy changes that positively impact the quality of life of LGBT older adults.

A move for separate, but equal housing is another solution that has been implemented to counteract the inequities many LGBT seniors experience. The nonprofit, 104-unit Gay and Lesbian Elder Housing (GLEH) Triangle Square in Los Angeles, California is the first affordable housing facility for lesbian and gay seniors. “A Place To Live - The GLEH Triangle Square Story,” a film by Carolyn Coal and Cynthia Childs, chronicles the journey of seven seniors attempting to secure a home there before it opened a few years ago.

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

Successful Hospice-Nursing Home Partnerships (Research)

A hospice volunteer in Detroit nursing homes for many years, I am familiar with the benefits and problems that can occur when hospices and nursing homes operate as partners. These partnerships can work very well when certain best practices are followed. What do successful partnerships between hospices and nursing homes look like?

This study by Brown Medical School uses case studies of six nursing homes and hospices working collaboratively. Interviews were held with care providers and chief executive and financial officers regarding seven domains critical to successful collaboration. These were the results:

1) Nursing home-hospice collaborators were philosophically and otherwise aligned; they had similar missions, understood their differing approaches to care, and administrators demonstrated an openness and support for the collaboration.

2) Hospices developed infrastructures to correspond to the uniqueness and complexity of the nursing home environment. For example, they hired nurses with nursing home backgrounds, created teams dedicated to nursing home care, and trained hospice staff in problem solving and conflict resolution.

3) Care collaboration processes focused on the importance of two-way communication by actively soliciting and sharing information with nursing home staff and responding to nursing home staff and administrators' concerns.

This successful partnership model demonstrates how well collaboration can work when hospices and nursing home leaders commit to operating strategically using communication, flexibility, and skills to match staffing to the nursing home environment. 

Frances Shani Parker, Author

"Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes”

“Hospice and Nursing Homes Blog”

Curative Medical Care vs. Non-Curative Hospice Care: Two Men in Love with the Same Woman

Curative medical care and non-curative hospice care are like two men in love with the same woman. The curative man, who has enjoyed many wonderful years with her, is reluctant to let her go. But their joy together has declined with time. While she appreciates the fulfillment they shared in the past, she now feels a lack of commitment to him and an urgency to move on with her life. The hospice man, the new love in her life, fills the void she is experiencing and brings an essential enhancement to her well being. He longs to stay with her because their relationship has reached a mutually meaningful level. The woman he loves embraces the happiness his hospice presence brings.

Unfortunately, many experience this love triangle in varied ways. Patients may resist the prediction of death within months and the prospect of involving outsiders as caregivers. Some doctors and caregivers may be reluctant to admit that a patient cannot be saved. Medical staff focused on curing all patients may not totally commit to the hospice philosophy of non-curative care when working with hospice patients.

Love triangles like this that exist in nursing homes and other institutions must be resolved with focus on the best interests of patients. In order to improve treatment of the terminally ill, institutions that have hospice programs must be dedicated to promoting staff expertise in hospice practices. This commitment must include clear administrative support with ongoing education and monitoring of staff practices. This will ensure that hospice patients receive services appropriate to their non-curative condition. 

What’s love got to do with it? Everything. In some institutions where these positive partnerships have been implemented, hospice practices such as better pain management have naturally become part of the care given to terminally ill patients who are not in hospice programs. True love can be contagious like that.

Can two men be in love with the same woman? Sure, if they respect each other’s boundaries, strive for a healthy relationship including the woman’s needs, and understand that, when lovers lose their mutual joy and loyalty, moving on can be love’s greatest expression.

Frances Shani Parker, Author

"Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes”

“Hospice and Nursing Homes Blog”

Culture Change in a Baby Boomer Nursing Home (Video 2:20 mins.)

In my book "Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes,” Baby Boomer Haven refers to an imaginary nursing home based on best practices of some, but not nearly enough, nursing homes that exist today. In the last chapter, Ruth, a patient in a wheelchair, takes readers on a nursing home tour where residents and employees thrive in a culture where they feel empowered and respected. Many aspects of culture change are discussed and in evidence.

Roger Woodruff, Director of Palliative Care, International Association for Hospice and Palliative Care, Austin Health, Melbourne, Australia says of this book tour “I particularly enjoyed the guided tour, conducted from a wheelchair, of Baby Boomer Haven."

Book Excerpt:

“Management and staff have a great working relationship. Together they wrap us in a warm family quilt woven with reassurance. Everybody participates in decision-making and attends workshops, classes, and conferences to keep abreast of best practices in their fields. Various staff members are included in the hiring of new employees and, when appropriate, involved in their training. Periodic meetings are held with all shifts represented, so more in-depth information can be provided concerning patients. Employees take pride in their work and strive to continue our tradition of excellence. We’re all part of the same team, and we’re all cheerleaders.”

In this video, viewers are given an overview of how to implement resident-directed care.

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

Nursing Home Neglect and Abuse

What causes a staff person in a nursing home to neglect or abuse a patient? There could be several reasons. But there is still no excuse for neglect or abuse. I once saw a patient slap a nurse aide so hard, I thought she would fall to the floor. To the nurse aide’s credit, she stopped, took a deep breath, and walked away. Another nurse aide took over. The patient, who had dementia, probably didn’t remember the incident later. I bring up this case to illustrate the kind of stress under which many staff members operate. Working in some nursing homes is not an easy job, especially when staff shortages and increased workloads are often the norm. But stress is not the only reason for neglect and abuse.

All staff members need ongoing training in patient care, as well as ongoing strategies for coping with the kinds of problems that are inherent to their positions. I know nursing home staff members who love their jobs and genuinely care about their patients’ well being. But working in a nursing home requires a special kind of person. Employees who have demonstrated an inability or unwillingness to perform their duties correctly should be held accountable and not allowed to continue working. The same goes for nursing homes that continue to get cited for violations.

Nursing home abuse includes behaviors such as residents being verbally degraded and physically punched, slapped, and even kicked by staff. Sexual abuse has also been reported. Nursing home residents are very vulnerable and sometimes cannot or will not report abuses. That’s why it is so important for caregivers and others to be to be watchful, protective advocates for patients, particularly those with dementia. They should look for signs of abuse, ask patients and other staff members questions, and vary the times of frequent visits.

Most of all, patient advocates should follow through until they get satisfactory results when abuse or neglect takes place. This can be accomplished by reporting what happened to appropriate authorities such as the nursing home administration, the state ombudsman, and the state health department that investigates complaints. Private legal action can be taken against the nursing home. Staff should be aware that certain forms of patient abuse are felonies that will result in prison time.

For more information, contact the Nursing Home Abuse and Neglect Resource Center.

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