Nurses and Nurse Assistants (CNA’s): Stress in Nursing Homes

Who knows stress better than the people who carry it around everyday? These research results came directly from nurses and nurse assistants (CNA’s) in twenty-five nursing homes in North Carolina. This is what they had to say:

Nurses:

The situations most stressful for nurses were not having enough staff, having too much work to do, interruptions, having non-health professionals determine how they do their jobs, poor pay, and being responsible for patients' outcomes. Nurses were more likely than nurse assistants to report stress because non-health professionals (e.g. surveyors) determine how they must perform their services.

Nurse Assistants (CNA’s):

The most stressful situations for nurse assistants included poor pay, not enough staff, and too much work to do. Nurse assistants were more likely than nurses to report stress because they do not have adequate information regarding patients' conditions.

Conclusions:

The findings of this study support the need to increase recognition for nursing, improve staffing, and provide competitive compensation in nursing homes. Were you surprised by these results? I wasn’t either. But it’s still another validation of the staff stress problems and the need for positive changes in nursing home reform.

You can read more about this research in the "Journal of the American Medical Directors Association.”

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

Hospice Team: Jewish Funeral Practices (Video 4:15 mins.)

Being aware of various cultural and religious traditions in our diverse society is especially important for hospice workers because we are often invited to attend rituals such as funerals of deceased patients. Families appreciate sensitivity and respect regarding practices they embrace. However, even within various cultures and religions, there are differences, so asking family members questions is far better than making assumptions or creating stereotypes about large groups of people.

The first time I attended a Jewish funeral, I was surprised by how different it was from Christian funerals I had experienced. The casket was closed; there were no flowers; the service was short and simple. I welcomed the new ritual and asked questions about procedures I didn’t understand. After I became a hospice volunteer, I benefited from the knowledge gained at that Jewish service and services of other groups.

These are some examples and explanations regarding Jewish funerals:

1) The casket is closed out of respect for the deceased.
2) Embalming and cremation are not allowed, so the body can deteriorate naturally.
3) Flowers are not killed to honor someone who has died.
4) Burial takes place soon out of respect for the deceased.

This video titled Jewish Funeral Practices 101 gives a detailed description of Jewish funeral practices.

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

“The Bucket List” Movie: A Hospice Nursing Home Volunteer’s Review (Video Trailer 2:28 mins.)

All these years, we’ve joked about “kicking the bucket,” and now we learn there’s a list inside the bucket. “The Bucket List” is a movie starring Jack Nicholson and Morgan Freeman as terminally ill cancer patients. They meet as strangers with seemingly nothing in common, except a hospital room they share. Gradually, they bond and commit to leaving the hospital in order to accomplish adventurous goals on their bucket list. Fortunately, Nicholson’s character is a billionaire who can foot the globetrotting bills. With only months to live, the two men forge a special friendship through laughter and tears. They savor some of life’s final thrills by skydiving, racing cars, and visiting world wonders.

That’s a summary of the movie I saw today while enjoying my “kiddie pack” refreshments. What the summary doesn't mention is that the movie nudges audiences into thoughts of personal end-of-life journeys, that it helps them unravel philosophical lessons they tend to ignore, that it attracts people in large numbers in spite of critics who pan it. There are those who snicker with condescension and label "The Bucket List” a feel-good movie about death and mortality. A hospice volunteer, I smile, just thinking what a compliment that is.

What’s on your bucket list?

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

Therapy Dogs and Cats Improve Human Health (Video 2:37 mins.)

A few years ago, my elderly friend and her dog were in a serious car accident. The experience was very traumatic for her and the dog. Because of my friend’s physical injuries, she and her dog were separated immediately after the accident, so she could stay at a rehabilitation center.

Slowly, my friend made progress, but she missed her dog a lot. The picture with this post shows their happy reunion the day I brought her dog to visit. I also noticed the heightened joy of many staff members when they interacted with the dog. His presence brought many smiles.

I didn’t need research to tell me that some healing had taken place, but it’s good to know that the results of positive exchanges between pets and people are scientifically measurable. The American Heart Association verifies that heart failure patients who spent 12 minutes with a dog or cat had lower stress hormones and blood pressure levels.

Pets are being certified to improve patients’ health in nursing homes and hospitals. Pets’ many contributions include helping stroke survivors with physical therapy and assisting mentally disabled patients in learning chores. It doesn’t matter what breed the pets are, as long as they have sound temperaments and can pass the AKC Canine Good Citizen Test. Thousands of dogs and smaller numbers of cats serve as therapy pets. They seem to know instinctively that they are there to help patients. And this video shows that’s exactly what they do.

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

Nursing Homes and Hospice Organizations, How Can Students Serve You?

Note: Winner of the National Service-Learning Partnership Trailblazer Award, Frances Shani Parker, a national consultant and former schoolwide service-learning principal, has been instrumental in implementing service-learning in school districts across the country. Her book Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes includes a chapter on intergenerational partnerships between schools and nursing homes.

Nursing homes and hospice organizations, how can students serve you, at your locations or elsewhere, under the supervision of their teachers or service coordinators? Service-learning is a teaching and learning approach that connects classroom learning with meeting community needs. For example, after learning how to write letters, students extend that learning into the community by writing real letters to nursing home residents, if that meets a need at that nursing home. Everyone involved benefits from the experience. As a former school principal of an urban public school with all 600 students involved in service-learning, I know how successful this approach can be.

Hospice organizations, most students have no idea what hospice is or the role students (K-college) can play in supporting you in the office or elsewhere. This kind of early hospice involvement with young people will do a lot to promote hospice on a long-term basis. While student involvement in nursing homes is more well known, perhaps the kinds of involvement can be extended. This is how students are introduced early to healthcare career choices in fields that have serious staff shortages today.

So, what are your needs? These are the grade-level categories to consider:
Elementary School, Middle School, High School, and College
If you would leave me a few comments stating what students in any or all these grade-level categories can do that would meet needs of nursing homes or hospice organizations, I will compile this information and pass it on to teachers and service coordinators I consult with across the country. Please state the grade-level categories and the service students can perform.

This is a sample response that you can write at the bottom of this post on the right. Just click "Comments" (next to the pencil).

1) Your Name or Name of Organization, City/State (all optional)

2) Grade-Level Category (elementary school, middle school, high school, college) You can choose more than one category.

3) Student Service Activities:

We need students to provide these services:

1)____________________________________________

2)____________________________________________

Thank you for your participation in supporting service-learning partnerships. There is a chapter on school partnerships and nursing homes in my book,Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes.You can also read more about service-learning at this previous post titled “Service Learning and Nursing Homes: Intergenerational Partnerships.”

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

Latinos, African Americans, and Alzheimer’s Disease (Audio 5:55 mins.)

According to a study reported in “Neurology®,”
Latinos and African Americans with Alzheimer's disease live longer than Caucasians who have the disease. Variables such as education level, age when symptoms began, living situation, and other factors that could affect how long the study participants lived did not change the results. The study involved about 31,000 people who had Alzheimer’s disease.

Latino participants lived about 40 percent longer than Caucasian participants, and African American participants lived 15 percent longer than Caucasians. Asian and American Indian participants lived about as long as Caucasians. Author of the study, Kala Mehta, DSc, said, "Possible explanations may be underlying genetic or cultural factors." Other possible factors were varying levels of social support from extended family, varying levels of health and diseases in addition to Alzheimer's disease, varying levels of treatment of other diseases, and differences in measurement or earlier diagnosis in some groups. Another factor could be length of stay in the United States. These findings can impact healthcare planning of Alzheimer’s disease.

You can hear more about Alzheimer’s disease and treatment, including additional information about African Americans, at this NPR.org. website.

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

Culture Change: Transformation of Four Nursing Homes (Video: 5:16 mins.)

The following includes an excerpt from 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.

“Welcome to Baby Boomer Haven! It’s a treasure to have you. My name is Ruth, and I’ll be your tour guide today. The first thing you need to know about our nursing home is that it’s real for some, but imaginary for too many others. Everything we enjoy here already exists in nursing homes scattered throughout America, but not in nearly enough. We’re having this tour today, so you can become familiar with possibilities that all nursing home residents should be experiencing, no matter where they are located.

When baby boomers seeking institutional healthcare show up in the millions, nursing homes like ours should be ready to receive them with welcoming lights shining in every window. Now, more than ever, nursing homes should be focused on ongoing state-of-the-art improvements. The comfortable life we live is as close as society’s handshake with commitment to quality healthcare, particularly for the ill and elderly.

We love many things about living here, but what we enjoy most is that we’re treated with dignity as adults. Our feelings and opinions matter. You’ll understand this better during the tour when you see our physical environment, the freedom we have in deciding how we live within our limitations, and the nurturing manner in which all employees interact with us.”

There are several models of culture change for nursing homes. They all respect and incorporate input from residents and staff members in such areas as decision-making and scheduling. This video from the Pioneer Network captures the transformation of four nursing homes in Anywhere, USA.

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

Hospice and Palliative Care Reflections: Quality of Life for Elderly, Ill Dogs (Video 3:49 mins.)

Today’s post may seem different from my usual ones. There’s no link to scientific data or a story about humans receiving hospice or palliative care. The featured topic literally goes to the dogs, rescued dogs that are mostly elderly and ill.

Living at a refuge similar to a nursing home for dogs, they struggled with health challenges ranging from deafness, epilepsy, hip dysplasia, heart murmur, and a lymphatic mass on one “hospice” dog predicted to live only a few more weeks.

Caregiving humans decided it was high time these canine seniors had their chance at smelling the roses we humans have to remind ourselves to smell. A great way to do this was to take all the dogs on a wonderful trip to dog-friendly locations immersed in adventure and nature.

This post shows another application of “quality of life” care for an elderly, ill population that has so often supported others. A soul-stirring video, “Seven Days with Seven Dogs” takes us on a “dog-centered” trip where floral fragrances permeate the air, where wounded spirits soar, and where we are reminded that the best things in life are not things.

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

Hospice Art Therapy (Audio 5:59 mins.)

Julia Balzer Riley is a holistic nurse and artist from Florida who helps hospice patients through art therapy. She visits them wherever they receive hospice care. Starting this art therapy with cancer patients, she introduced them to painting on silk pieces.

Riley's therapy begins with centering exercises to encourage patients to set the intention for a healing image to come. Emphasis is on the art process, not the product. Patients say they don’t feel pain while they are painting.

Riley explains that patients move into a relaxation response, “fall into the process,” and often smile. Because images are in patients’ minds before words, they represent patients’ emotions. Riley believes art therapy promotes expressions of patients’ feelings and improves their well-being.

You can listen to a more detailed description of this form of hospice art therapy at this website.

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

Hospice and Nursing Home Poem: Inside Dementia, Alzheimer's Disease

This post includes the poem “Pieces of Our Minds” from my book "Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes.” Each chapter ends with an original poem.

Do you ever wonder what it might be like inside the minds of patients with dementia? I do. Dementia refers to a group of conditions that gradually destroy brain cells and lead to mental decline. Alzheimer’s (Ahlz-high-merz) disease is the leading cause. Most people who have the disease are over sixty-five, with eighty being the average age of diagnosis. There is no cure for patients with dementia, and they eventually need complete care.

As a hospice volunteer, I have spent many hours, individually and in groups, interacting with patients who have dementia. When I am with them, I consciously try to view the world from their perspectives. This helps me understand them better and interpret needs they can’t always verbalize. That process inspired me to write this poem:

Pieces of Our Minds

On the border, on the brink,
we shiver like quivering tears
swollen to fullness with distress,
reluctant to spill an excess.

Strapped in delusions
wondrous and weird, we ride
roller coasters of reality
through joy and fear.

On the brim, on the rim,
like balls circling in frustration,
we scramble for thoughts
lost in nets of uncertainty.

Invaded by memories,
peeping, creeping, weeping,
we laugh and cry to the
rhythm of nostalgia.

On the fringe, on the edge,
changing, adjusting, impacting,
we crave compassion in our
search for society’s sanctuary.

© Frances Shani Parker



You can hear me reciting this poem on YouTube.

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

Conversation with Dr. Ira Byock on End-of-Life Care (Video 7:19 mins.)

Dr. Ira Byock is Director of Palliative Medicine, Dartmouth-Hitchcock Medical Center and a major advocate for improving end-of-life care. Past president of the American Academy of Hospice and Palliative Medicine, he is the author of several books, the most recent one being “The Four Things that Matter Most.”

This video conversation with Dr. Byock covers beneficial information for the healthcare profession and society in general regarding what should be done to improve the final chapter in our lives. His comments include the following:

1) Palliative care and how it differs from current medical practice
2) Personal preparation for the last chapter in life
3) Family preparations for one another’s end-of-life care

Dr. Byock explains that nationally we must face the inevitability of death and stop making prolonged life the main goal of mortal beings. He emphasizes the importance of addressing our emotional, social, and spiritual needs by deciding what our values are, considering what matters most, sharing with our families in whatever forms they exist, and putting our decisions in writing. April 16, which is National Healthcare Decision Day, and Thanksgiving Day are days selected to encourage end-of-life conversations; however, any day is a good day to discuss this crucial information.

You can view this video of Dr. Byock’s conversation about what we should be doing individually and nationally to improve end-of–life care.

Frances Shani Parker
Hospice and Nursing Homes Blog

Nursing Home Residents’ Vision and Quality of Life

Imagine that life is a blur with moving shadows of people wearing fading faces. What if you have to give up reading newspapers and watching television because they’re too hard to figure out? Suppose a time when you really could see well was only a memory, and you miss the joy you felt when life was sharp and clear. Did you know that large numbers of nursing home residents see the world in a blurred manner? Sure, it’s expected that eyesight could be declining in later years. But did you know that the lack of eye care for nursing home residents is widespread in America? If any population needs regular eye exams, it’s seniors in nursing homes.


University of Alabama researchers studied nursing home residents and discovered that residents who received eyeglasses had higher scores for general vision, reading, activities, hobbies, social interaction, and fewer depressive symptoms. It’s no surprise they concluded that basic eye care services (spectacle correction) have significant implications for improving quality of life.

Patients with vision that can be corrected easily should not have to guess which foods are on their dinner plates or wonder how their surroundings and people in them really look. Our seniors deserve so much more. The study states that steps should be taken to improve delivery and eye care utilization in America. I certainly hope this “revelation” opens eyes and produces results. This research study can be found in the JAMA Archives of Ophthalmology.

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

Hospice and Palliative Care: Puppets, Depression, and Dementia (Video 3:20 mins.)

Although various forms of therapy are used to help terminally ill patients who are depressed or who have dementia, I was not familiar with puppet therapy for adults with these conditions. Puppets are used as tools for the puppeteer to communicate with these patients. The goal is to break down barriers that patients are experiencing and replace them with feelings of love and improved levels of communication.

The previously posted video to help hospice and palliative care patients with depression or dementia was removed from Youtube by the owner.

Frances Shani Parker, Author

"Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes” (paperback, e-book)

“Hospice and Nursing Homes Blog”

Hospice Volunteer Vigils: Final Days and Hours

This post is dedicated to Marcelyn Ann Stoddard, a hospice patient I never met. She died this week on October 29, 2007. Marcie had struggled with metastasized breast cancer for several years. Last month, Frank Pruett, her loving husband and caregiver, started a blog titled Moments of Marcie, in which he chronicled their final days together. I recently discovered this honest and heartfelt blog. Frank and Marcie were an inspiration for many who supported them through the hospice vigil.

Thousands of hospice volunteers are being recruited daily just like I was years ago. People follow that path for different reasons. For many, it is a unique opportunity to serve others at a critical time in their lives. Hospice volunteering has everything to do with using good common sense and applying knowledge gained through ongoing training. When it comes to patients, it is more about the volunteer being there with them than what the volunteer actually does. The patient senses and appreciates the volunteer’s presence.

The importance of being with a patient who doesn’t want to die alone is the reason many hospice programs are providing specialized volunteer vigil training. During vigil training, a volunteer is taught how to provide bedside support during the final days and hours of a patient’s life. Assistance for families is included. At some facilities, staff members also volunteer for vigil assignments. Vigils, which are based on a patient’s wishes, can include talking, praying, inspirational reading, playing music, performing rituals, touching and, of course, sharing silence. Reflecting the hospice philosophy, volunteer vigils help provide the patient with a more peaceful end-of-life experience.

Many healthcare staff members who work with dying patients will tell you they have had patients share stories about seeing dead people, ghosts, spirits they recognize, and angels. View this post for my personal story and an informative video: https://www.linkedin.com/pulse/end-of-life-seeing-dead-people-angels-frances-shani-parker?trk=mp-author-card

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

Nursing Home Culture Change: Residents with Dementia (Video 4:06 mins.)

With all my experience as a hospice volunteer in nursing homes, I still have to be consciously aware of how I respond to patients living with dementia. Today I saw an approaching friend pushing her husband in a wheelchair. I immediately called out to her with a greeting. Within three seconds, I realized that I had only greeted her and had not said her husband’s name. I then called out to him.

My friend’s husband has dementia, which refers to a group of conditions that gradually destroy brain cells and lead to mental decline. I’m pretty sure that I would not have forgotten to say his name if he did not have dementia. I would have greeted them together. This is an example of the kind of conscious paradigm shift many of us must make in our thinking if we are serious about improving our interactions with people who have dementia. Culture change in nursing homes must include their unique needs. It is so easy to forget that they are adults with mental challenges.

No one wants to feel ignored, and residents with dementia are often very sensitive. They need to be recognized as contributors to conversations and honored as decision makers. Activities should be available for them to practice organization and communication skills that help them feel more like the adults they are. Time must be taken to investigate and implement activities that will help them experience life as adults with limited abilities.

Culture change in a person-directed environment includes meeting everyone’s needs. In this video, Megan Hannan explains the person-directed needs of residents with dementia.

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

You’re Invited to a Nursing Home Wedding and Reception (Video 4:18 mins.)

One day, 75-year-old Virginia Hailey and 87-year-old Frank Foskett decided it was time to tie the knot at the Life Care Center of Plymouth nursing home where they met. Love had a lot to do with their innocent bingo games evolving into a wedding so beautiful and exciting that Frank almost cried. And the best part, after sealing their vows with a kiss, is that they’ll spend the rest of their lives sharing a room at the nursing home where it all began.

The Beauty of Love

The question is asked, "Is there anything more beautiful in life than a young couple clasping hands, and pure hearts in the path of marriage? Can there be anything more beautiful than young love?"


And the answer is given. "Yes, there is a more beautiful thing. It is the spectacle of an old man and an old woman finishing their journey together on that path. Their hands are gnarled, but still clasped; their faces are seamed, but still radiant; their hearts are physically bowed and tired, but still strong with love and devotion for each other. Yes, there is a more beautiful thing than young love. Old love." Unknown

Welcome to a celebration of old love.

Frances Shani Parker
Hospice and Nursing Homes Blog

Hospice Volunteer Story: Meeting My New Patient

Pointing her out to me, the nurse aide said, "That's Henrietta sitting by herself at the table." I followed her finger to a caramel-colored woman who sat humming. She had just finished eating and still hadn't wiped her mouth. A light coating of chicken grease looked like high-priced lip gloss when I walked closer to her.

Henrietta was going to be my new hospice patient, my first at this particular nursing home. Later, she would become my first patient whose health improved so much she was discharged from hospice care. For now, she knew nothing about me, including the fact that I was coming that day to serve as her hospice volunteer. I only knew she was seventy-nine and declining mentally with dementia. I pulled up a chair next to her and said, "Hi, Henrietta. I'm Frances Shani Parker.”

Looking me straight in the eyes, like she'd known me all her life, she responded, "Girl, I know who you are, long as we've been friends. I've been waiting for you all day. I kept wondering when you were coming. I hoped you hadn't forgotten me, and here you are. What took you so long to get here?"

"Well, actually I got lost," I stammered, processing these new details concerning my whereabouts.

"Shucks, I get lost all the time. When you get lost, go to the lady at that desk over there. She'll tell you where you are. She'll tell you where you want to go. She knows everything. I'm surprised you didn't go to her before. We all do. How about some dinner? The chicken is something else, nice and tasty, just the way I like it. And I ought to know because I just had a wing that almost made me fly," she laughed.

"No, thanks. I'm not too hungry now. I'll eat when I go home. Some leftovers are waiting for me. I just came to visit you. I want to know if it will be okay with you if I come see you every week."

"Okay with me? Of course, it's okay. Look at all the years you've been coming to see me. If you stopped coming, I'd be wondering where you were just like I did today. So much is on the news, I'd be worried something happened to you. Keep on coming. I don't ever want you to stop."

"I'm looking forward to seeing you, Henrietta. We can talk together, and I can take you on wheelchair rides when I come. We'll get to know each other better. That is, better than we already know each other," I added, remembering our extensive "history."

"Sounds good to me. It's been working for us a long time. I think what you need to do now is eat something. You must be hungry after being lost all that time. Call the waitress over here and order some food. Don't worry about the money. Just put it on my tab. They know me at this restaurant. I eat here a lot."

So, this was Henrietta, an interesting oasis of serendipity. What would the future hold for us as patient and volunteer? I smiled to myself, buckled my mental seat belt, and prepared for another intriguing ride.

© Frances Shani Parker (excerpt from my book Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes) 

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

Hospice and Nursing Homes Interview (Podcast) with Frances Shani Parker, Author of “Becoming Dead Right”

With the publication of my book, “Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes,” I understand now why other authors refer to this occasion as giving birth. There was definitely a great deal of labor involved with many new people, experiences, and lessons learned along the way. As with any birth, this milestone represents a beginning that continues to evolve with time.

It is my hope that “Becoming Dead Right” will encourage more death conversations, empower the reluctant, and bring visions of overlooked death-related plans into reality. I want this offspring of mine to support caregivers, share perspectives of diverse people, and foster intergenerational partnerships. Most of all, I want my progeny to improve healthcare and nursing homes for everyone, especially the elderly and terminally ill. I want a lot. A parent should.

I thank everyone who supported me throughout this process. You were my standing ovations when I didn’t know when, where, or why you were clapping. Writing is such a solitary activity, it’s easy to get swept away by inner images and voices. But I know and honor who you are.

“Becoming Dead Right,” a guide to scenic routes leading to successful end-of-life journeys, can be purchased at my Web site, Amazon.com, Barnes and Noble bookstores, and other booksellers.

You can listen to a podcast interview with Jake D. Steele and me at www.AuthorsAudio.com.

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

Caregiver Stress Solutions (Video 1:40 mins.)

Caregiving and stress hug too much. While many caregivers welcome the opportunity to give of themselves to their loved ones, they still find the challenge overwhelming sometimes. Then there are caregivers who never wanted the job. Perhaps they were the only ones available who would step up and accept responsibility for a difficult problem. They need help the most. Stress can take a serious physical, mental, and emotional toll on caregivers. For that reason, caregivers must always be mindful of taking care of themselves.

Probably what caregivers need most is for others to be their caregivers in some ways. The Alliance for Aging and Research reports that surveyed caregivers expressed these concerns:

1) They want programs that save them time, give them a rest from caregiving, and make them feel that they are cared about.

2) Six in ten caregivers say they would be somewhat likely to use the services of an expert they could talk to about their stress. About the same percentage would use a mobile health service in their neighborhoods.

The average person can help a caregiver in several ways:

1) Offer to assist a caregiver by temporarily relieving some of their burden physically or financially.

2) Share an uplifting activity with them.

3) Keep them informed about services that can help them. Aid them in getting the services.

4) Be a good listener and offer encouragement.

This video shows the stress of caregivers and their need for support.

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

Advance Directives Written and Sung ("My Advance Directive" Song 4:35 mins.)

Advance directives are important legal documents that guide medical professionals in how to treat patients in such situations as resuscitation. While some patients may want aggressive medical treatment, others may not. Patients can modify these directives at any time.

Healthcare providers are legally responsible for honoring advance directives, and they should be held accountable for implementing them. However, there is no guarantee that procedures patients request will always be followed. That’s why caregivers must be vigilant in keeping abreast of procedures involving patients and making patients’ written requests available.

Caregivers and others can contact local medical facilities for information on the appropriate documents for advance directives. They are not the same in every state. Forms can also be obtained from state health departments, legal offices, and on the Internet. Most states require that the documents be witnessed.

In addition to having written directives, people who want to make their death wishes even more emphatic can sing a song about how they want to die. A rousing song, written and sung by Vickie Hannah Lein, with music by Suzannah Doyle, “My Advance Directive” is a musical declaration celebrating death with dignity.

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

Nursing Home Poem on Lonely Residents (Video 1:54 mins.)

This post includes the poem “Missing” from my book, Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes. 

As a hospice volunteer, I have seen too many lonely residents. More than once, I have been the only non-staff person regularly visiting a resident. Several of these residents had relatives and friends living in or near the city. One day, a woman at my resident's funeral thanked me for visiting her dying aunt. She said her aunt had been wonderful to her when she was growing up. She added that she didn’t visit her aunt during her years in the nursing home because she lived “on the other side of town.”

I’ve also heard relatives and friends excuse themselves from visiting by saying, “Mama doesn’t recognize me anymore, so she doesn’t know I rarely visit” and “I can’t bear to see my brother in this condition. I don't visit him because I want to remember him the way he was.” Unfortunately, for many residents, loneliness has become a way of life.

A study by Robert S. Wilson at Rush University Medical Center in Chicago concludes that lonely people may be twice as likely to develop dementia linked to Alzheimer's disease late in life than those who are not lonely. Research by University of Chicago psychologists Louise Hawkley and John Cacioppo concludes that lonely people go through life in a heightened state of arousal that becomes more apparent with aging. They also have a poorer quality of sleep, resulting in more daytime dysfunction.

The following poem speaks to the loneliness of residents everywhere, especially in nursing homes:

Missing

She waited,
hoping her years of caring
endured in grown-up minds,
rested in distant hearts,
conveyed how much she missed them.

She waited,
living real-time movies
of restless nights, anxious days
with inhaled hopes of fellowship,
exhaled sighs of deep despair.

She waited,
wishing nostalgic winds
flowed through cotton curtains,
brought relatives and friends
she cherished through the years.

She waited,
grasping like a New Year’s resolution,
like a second suspended in time
until her clock stopped ticking
for visitors who never came.

© Frances Shani Parker

This brief video demonstrates caregiving that helps prevent loneliness.

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

Detroit Hospice Volunteer Book Review By Dr. Naomi Long Madgett: Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes

Book Reviewer: Dr. Naomi Long Madgett - Teacher, Editor, Publisher, and Poet Laureate of Detroit, MI
Book: Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes
Author: Frances Shani Parker, www.francesshaniparker.com


Before I read this non-fiction book, I knew very little about hospice care. I thought a hospice was an establishment where patients with only a short time to live went to die. They were kept as comfortable as possible in pleasant surroundings where family members could spend unlimited time with them. I knew several people who were released from the hospital to hospice care at home during their last days. But I was not aware of any other hospice situations. My knowledge of hospice care has increased greatly.

This book is divided into two sections. The first is titled "Everybody’s Story, Ready for the Telling" and consists of nine chapters. The second section, "Footsteps to Caregiving, Death, and the Future of Hospice," consists of seven chapters. Each chapter ends with a related, well-crafted, original poem by the author.

In the first section, readers are introduced to true stories involving a series of unique individuals. They motivate Ms. Parker, a public school principal, to become a certified hospice volunteer and interact with her during her years of service in Detroit nursing homes. She brings these individuals vividly to life, like characters in a good novel, and makes readers feel that they are present during every situation. Topics such as nursing homes, dementia, pain management, and death are covered in an easily understood manner.

Hospice care, I learned, focuses on a holistic approach to caregiving and supports the dying and their families through high-quality patient care physically, emotionally, socially, and spiritually. The volunteer provides companionship, assistance with normal tasks, and advocacy for patients. Ms. Parker realizes that, although her specific assignments target hospice patients, her compassion extends to other patients. Interesting references to her upbringing in New Orleans, Louisiana enhance her storytelling. She is a dedicated volunteer with a deep understanding of human nature and an intuitive sense of what to do to make death as peaceful and satisfying as possible.

The second part of the book shares information that caregivers can use before, during, and after a loved one dies. Various death rituals and bereavement supports are mentioned. This guidance is helpful to all readers, even those who are young and in excellent health.

Improvements needed in hospice and nursing homes in general are examined. Recommendations include better implementation of the hospice philosophy, upgrading of nursing home conditions and procedures, and the elimination of racial and ethnic healthcare disparities. A significant and original comparison is made between schools and nursing homes. The similarities are remarkable in terms of patients’ and students’ needs, employees’ duties and accountability, and methods that promote success. Service-learning partnerships between schools and nursing homes are encouraged.

The final chapter, "Baby Boomer Haven," consists of an imaginary tour guide escorting readers through a wonderful nursing home. The environment and procedures described during the tour are based on best practices of nursing homes that actually exist today. These practices are lacking in many nursing homes in America. This tour provides a very appropriate conclusion to a fascinating book. A bibliography, resources, and an index follow.

Reading this book was extremely enlightening. Not like any other book I have ever read, it is so interesting and well written that I could hardly put it down. While maintaining universal appeal, perspectives of people of color are emphasized. I highly recommend this book for every individual who has ever experienced the illness and death of a loved one or who ever will. That includes everyone.

© Naomi Long Madgett, Ph.D.

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Becoming Dead Right (Scary Hospice Volunteer Book Review)

Many people avoid talking, writing, or even reading about the end of life. This reluctance to face death is reflected in this review of Becoming Dead Right by a reader who thinks death is her enemy: https://www.linkedin.com/pulse/scary-hospice-volunteer-book-review-frances-shani-parker?trk=mp-reader-card

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More Praise for Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes from Roger Woodruff, Director of Palliative Care, International Association for Hospice and Palliative Care, Austin Health, Melbourne, Australia

"A school principal and hospice volunteer, Frances Shani Parker relates her experiences with dying people in nursing homes. The second part of the book is about what we as individuals and as a society must do to improve things for those who are dying. I particularly enjoyed the guided tour, conducted from a wheelchair, of Baby Boomer Haven."

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Book Endorsements:

Dr. Peter Lichtenberg - Director, Institute of Gerontology, Wayne State University, Detroit, MI
Alice Hedt - Director, National Citizens Coalition for Nursing Home Reform
Karyne Jones - President, National Caucus and Center on Black Aged
Dr. Naomi Long Madgett - Editor, Publisher, and Poet Laureate of Detroit, Michigan
Dr. James C. Kielsmeir - President, National Youth Leadership Council
Nelda Brown - Executive Director, National Service-Learning Partnership at the Academy for Educational Development

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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