Hospice Team Meetings and Caregivers (Video 2:25 mins.)

Many traditional hospice team meetings do not include caregivers. Much discussion has been generated regarding whether this practice is beneficial or not. Research at the University of North Texas assessed hospice team meetings with and without the presence of caregivers. This was done by videotaping both kinds of meetings. An analysis comparing them had these results:

Team meetings with participating caregivers had

1) better team outcomes.

2) more patient-centered goals.

3) increased discussion of biopsychosocial problems.

4) interdisciplinary care plans occurring more often.

These research findings on hospice team meetings indicate that having caregivers present at hospice team meetings adds significant benefits that can positively impact patient care.

Family caregivers provide almost 80% of caregiving in America. This

video addresses concerns of caregivers with hospice patients.

Frances Shani Parker, Author

Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes

Hospice and Nursing Homes Blog

Mental Health Services in Nursing Homes after Disasters

Earthquakes like the recent one in Haiti and hurricanes like Katrina remind us of the devastating effects of environmental disasters. Living with the traumatic reality of being surrounded by many deaths, experiencing tremendous personal loss, and suffering physical injuries take a tremendous toll mentally on survivors. While physical needs receive more immediate attention, mental health intervention issues must also be addressed.

Research from the University of South Florida on mental health services in nursing homes after hurricanes provides helpful information about how residents should be treated after disasters. Representing two-thirds of Florida's counties, a questionnaire was administered to 258 directors of nursing, administrators, and owners of nursing homes. Residents stated their mental health needs and service use. In addition, focus group meetings with 22 nursing home administrators evaluated residents' use of services.

Results revealed that disaster-related mental health services were not routinely provided to residents. When residents involved in a disaster did receive treatment, it was more likely to come from facilities where they were taken after the disaster, not the facilities from which they were evacuated.

This mental health research indicates a serious need for training nursing home staff members in the delivery of disaster-related mental health intervention. They also need training in the procedures for making referrals for follow-up evaluation and formal intervention. Mental health training would be beneficial in healing many disaster survivors who suffer from depression, grief, and post-traumatic stress disorder.

Frances Shani Parker, Author

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

“Hospice and Nursing Homes Blog”

Palliative and Hospice Care for Latinos

By the year 2050, Latinos, who currently make up 15 % of America’s population, will account for 30 % of the population.  Latinos are a diverse population with unique healthcare end-of-life needs that must be addressed if they are to receive quality care everyone deserves. Many have difficulty as immigrants adjusting in America to the dominant English language and Anglo-centric culture.

Non-Latino and non-Spanish-speaking healthcare workers must make every effort to communicate with Latinos and eliminate cultural misunderstandings that can negatively impact their healthcare. In terms of end-of-life care, the following challenges of immigrants must be addressed:

1) Geographic distance as well as political and economic realities which separate patients from their families

2) Undocumented immigrants who are frequently uninsured and fearful of deportation

3) Language and literacy barriers

4) Concerns about discrimination, culture, religion and spiritual influences

Professional interpreters can be helpful in alleviating barriers in communication. Ongoing staff development in working with diverse populations is also important. Everyone is entitled to quality palliative and hospice care when it is needed. You can read more here about palliative care for Latino patients and their families.

Frances Shani Parker, Author

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

 “Hospice and Nursing Homes Blog”

Ten Steps to Becoming Dead Right

                    

                                     Ten Steps to Becoming Dead Right

                                        By Frances Shani Parker, Author

             Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes

1. Accept death as part of life.

Death will come, no matter how often you avoid the topic or how forcefully technology wrestles it to the ground.

2. Listen to the universe.

Some call it the universe, while many use other names. If you believe you are part of an infinite enlightenment, be still and listen.

3. Expect rainbow smiles.

Rainbow smiles are joyous, healing, memorable moments that come more often when you anticipate them.

4. Live a healthy lifestyle.

Practice habits of good health. Commit to including them in your daily living.

5. Be informed and proactive.

Keep abreast of what’s going on. When circumstances arise that can benefit from your knowledge, apply what you know.

6. Do your best.

You can’t solve every problem or be everything to everybody. Just do all you can.

7. Give service to others.

Complement others by fulfilling needs through service. Both server and recipient benefit from this partnership.

8. Be grateful for blessings.

Blessings come like wondrous celebrations held in your honor. Let appreciation reign!

9. Put death wishes in writing.

Fulfillment of your end-of-life wishes will often depend on what you discuss and record now.

10. Have a dignified death journey.

Breathe in your final phase of life with contentment. Experience a dying process that brings beauty and calm to your personal letting go.

Copyright © Frances Shani Parker

Frances Shani Parker, Author

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

Hospice and Nursing Homes Blog

Hospice Veteran Gets Last Wish Granted (Video 3:29 mins.)

                                            

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

During this season of giving, honoring wishes of veterans is especially important. However, the Bay Pines VA Medical Center in Florida cares all year long about hospice veterans and their last wishes. They have created the Bay Pines VA Medical Center Make-A-Wish program primarily to grant last wishes of hospice veterans who have no close family or friends. Since 2002, they have helped over a hundred hospice veterans realize dreams.

Christopher Glenn, a hospice Navy veteran, wished longingly to take a plane flight over his hometown. As time went on and his terminal illness progressed, he had given up hope of ever having his wish come true. But Stuart Sidell, recreation therapist at Bay Pines VA Healthcare System, had other ideas. He decided to make Christopher’s dream a reality and even had him serve as plane pilot.

This video report from “The American Veteran” captures the wonderful results that this thoughtful act of consideration accomplished in enhancing the quality of Christopher’s life. Two weeks later, he died with his last wish fulfilled.

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During this holiday season and throughout the new year, be love(d).

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

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Uninsured Patient's Poetic Cries (Video Poem)

Having no health insurance is a serious problem. Aurora Harris, a friend and fellow poet, has been living the unlivable with a torso serving as “a tomb of womb pain.” Like millions in America, she bears the added hardship of having no health insurance. In addition, she is the primary caregiver of her 89-year-old mother, who is very ill.

Throbbing with pain from an unknown infection, Aurora wrote the poem "On Deaf Ears: A Poem Before Turning Fifty." She hopes her anguished voice will be heard and help the many people agonizing in a healthcare system in need of urgent reform. 

Note: During a recent conversation, Aurora shared that her health is improving. She credits the intervention of a concerned friend who led her to appropriate medical care. Too many sufferers without health insurance are not as fortunate.

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 booksellers such as Amazon.

Hospice and Nursing Homes Blog

Advice for Adult Orphans

More and more of my friends are becoming adult orphans. Many have one or no parents alive. Others are caregivers who will possibly
 become orphans in the near future. These suggestions can help adult orphans coping with life’s new reality:

1. Flow with the grieving process. Each person’s bereavement is unique. Maintain good health, accept assistance from others, and get counseling support if needed.

2. Remember that you are responsible for your own happiness. Hobbies, travel, social functions, volunteer service, and other enjoyable and fulfilling activities add quality to your life.

3. Establish new holiday traditions and family rituals if you think you should. You can include ways to commemorate deceased parents. Keep their stories alive for generations to come.

4. Help your children and others plan for their future roles as adult orphans by preparing yourself and encouraging them to discuss and record their end-of-life wishes. 

5. Remember that life is for living. Deceased parents would want you to move forward productively on your journey. Doing so is another tribute to them.

Frances Shani Parker, Author

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

“Hospice and Nursing Homes Blog”

Christmas in May Story: Hospice Volunteer and Nursing Home Patient

Have you ever celebrated Christmas in May? A hospice volunteer in Detroit nursing homes, I shared a wonderful Christmas in May experience with one of my patients. Sometimes patients needed me to help them solve problems. One day, Inez and I had an especially great visit. I had been thinking about how to find a key for a music box her niece had given her for Christmas. She loved that music box and liked to have it on display, so she would have a good excuse to talk about it. She had never heard it play because the key was missing when she received it. She said her niece had tried to find a key, but with no success.

The music box was a lovely piece of handiwork. A wooden base supported a clear glass container. Inside the container lay a beautiful butterfly resting on a small floral bouquet. Underneath the box was a hidden switch that made the seasonal display enchant with spurts of brightness. Inez, my ninety-two year old patient, said that she often sat and watched the softly glowing scene blink on and off. One night, she and I quietly watched it together. That's when I realized how much this silent little music maker meant to her. Unfortunately, neither of us knew what song it was supposed to play. We imagined the Christmas song we thought it should play and hoped one day we could solve the mystery.

Getting the music box to play became my project, but I knew I would need some help. The next day, I explained the problem to Burton, a teacher at my school. He decided to become a part of the solution by checking out some stores that might have the missing key. It sounded like the search for Cinderella's shoe. After looking for two weeks, Burton finally found a matching key at a large toy store. The sales lady was so touched by his story about Inez's "musicless" box that she gave him the key free of charge. We couldn't believe our good fortune, which became Inez's thrill maker.

In the second week of May with spring showing off nature's fashion makeover from winter, Inez heard her cherished music box play for the very first time. She picked it up gently and carefully placed it near her hearing aid. The song we had wondered about for months, the song that had driven us to discover its name finally played the sweetest version of "Joy to the World." Just hearing the music box fulfill its purpose felt like a miracle. Inez grinned widely, thanked me, and told me to thank the nice man who found the missing key that made her music box come alive.

The mystery had been solved, and Inez was ecstatic. I thought nothing else that day could outdo the pleasure of hearing the music box play, but I was wrong. After Inez set her mechanical miracle on the window sill, so we could admire it playing and revolving, something wonderful occurred that surprised us both: The brightly colored butterfly started moving, slowing creeping up to the opening red flower. Inez and I gave each other eerie "Twilight Zone" looks. Then we shared rainbow smiles about the joy in our own little world.

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

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

Engage With Grace: Talk About End-of-Life Wishes

Last year during Thanksgiving weekend, many of us bloggers participated in the first documented blog rally to promote Engage With Grace - a movement aimed at having all of us understand and communicate our end-of-life wishes.

It was a great success, with over 100 bloggers in the healthcare space and beyond participating and spreading the word. Plus, it was timed to coincide with a weekend when most of us are with the very people with whom we should be having these tough conversations - our closest friends and family.

Our original mission - to get more and more people talking about their end-of-life wishes - hasn't changed. At the heart of Engage With Grace are five questions designed to get the conversation started. We've included them at the end of this post. They're not easy questions, but they are important. Think about them, document them, share them.

Over the past year, there's been a lot of discussion about end-of-life issues. And we've been fortunate to hear a lot of the more uplifting stories, as folks have used these five questions to initiate the conversation. One man shared how surprised he was to learn that his wife's preferences were not what he expected. Befitting this holiday, The One Slide now stands sentry on their fridge.

Wishing you and yours a holiday that's fulfilling in all the right ways.




To learn more, please go to www.engagewithgrace.org. This post was written by Alexandra Drane and the Engage With Grace team.

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

Aging, Sick Dogs on a Caregiving Trip (Video 3:49)

Two years ago, I did a blog post on sick, aging dogs enjoying a life-enhancing trip. The dogs were showcased in a heartwarming video, actually a “dogumentary,” titled "Seven Days with Seven Dogs." Like an old tune with different singers, the video continues to mesmerize about terminally ill older adults of the non-human kind.

Living at a refuge similar to a canine nursing home, the dogs 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 often have to remind ourselves to smell. A great way to do this was to take all the dogs on an adventurous trip to dog-friendly locations immersed in nature.

This video shows another application of quality caregiving with an ill, older adult population that has supported others unconditionally for years. Join this soul-stirring, dog-centered trip where floral fragrances permeate the air, where wounded spirits soar, and where we are reminded at personal levels 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

Holiday Grief Support (Video Poem 4:00 mins.)

The holidays can be a troubling time for many who are grieving the loss of loved ones. Through the years, people associate holiday traditions with familiar people and places. These suggestions offer bereavement support for those dealing with grief during the holidays:

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

"Mourners have to decide the best ways they can adjust to the holidays. One option is to create new holiday traditions. If holidays were celebrated as a family, new traditions can be planned as a family, so everyone can have input. This will give family members an opportunity to discuss their feelings about the deceased loved one and possibly include something in the new tradition that commemorates that person in an uplifting manner. This could be a type of memorial that adds pleasure to holidays in the future, something that would have pleased the deceased.

Whether celebrating the holidays alone, with others, or not at all, people should always follow their hearts and do what feels best for them. There is no one way for everyone. There are different ways that work well for different people. Some people who found the holidays stressful, phony, or too commercial before their loved one died may want to redirect their holiday focus. They might choose to participate in an activity that is calmer and more meaningful to them such as volunteering at places where they can help others or sharing with others in another capacity. Others may want to celebrate alone or with a few friends, take a trip to another state or country, or just be involved with something they enjoy doing that may or may not have anything to do with the holidays, but everything to do with their own quality of life."

This video by TheLightBeyond.com offers bereavement support based on the sympathy poem “Do Not Stand at My Grave and Weep.” The poem comforts with thoughts that the deceased loved one is reflected in nature.

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

Hospice Chaplain Planned Detroit Nursing Home Memorial Service

The need to honor the deceased in an atmosphere of healing and support from others has been a common manner for mourning the dead. But sometimes people die without family and friends available to handle funeral or memorial services that recognize, honor, and bring closure to death. Such was the case with my hospice patient named Lelia, whose memorial service was planned by the hospice chaplain:

Excerpt from Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes

A small group gathered in the recreation room at the nursing home. Most people present were other patients who knew Lelia. Essie, Lelia’s sister, came with a friend named Nola. The hospice chaplain opened the memorial ceremony with a prayer and a reading. Taking turns, we shared our memories of Lelia. Some comments were hilarious, while others revealed Lelia’s demons. We all discovered new layers of Lelia that came together in a mental mural of colorful qualities.

Essie spoke last, “I’m sitting here in shock listening to what you all said about my sister. I can’t believe we knew the same person. The Lelia I knew hardly ever said anything funny, and she sure wasn’t thoughtful, at least not to me. Even when I helped her get into this nursing home, she still acted like she hated me. She was grouchy and liked to criticize people all the time. Nobody was really close to her. To tell you the truth, nobody in our family was close to anybody else in the family. There was just too much drama going on all the time. That’s why I’m the only one here. I started not to come myself, but now I’m glad I did. I learned something new today. I feel better about Lelia after hearing your stories.”

Although the chaplain hadn’t known in advance how many would attend the ceremony, she had brought twelve helium balloons, the exact number needed for each person present to have a balloon to release later. Like colorful hula dancers swaying from strings tied to a chair, the balloons added a festive energy to Lelia’s homegoing. Riding down with the group on the elevator, Nola mentioned that she and Essie were both singers. We all agreed they should lead us in song when the balloons were released during our tribute to Lelia.

Our humble circle stood in the front yard of a Detroit nursing home to perform our final death ritual for Lelia. People riding by in cars on a busy street observed a lively group of ecstatic mourners looking upward, enthusiastically singing “Going to Shout All Over God’s Heaven.” Passionate voices resonated like rockets. We released our buoyant balls of bliss floating in a hurry to get somewhere. I imagined Lelia looking on, bobbing her head to the gospel beat. She grinned her toothless rainbow smile that colored our hearts with joy from the Other Side of Through when we all yelled, “Bye, Lelia! Have yourself a good time!”

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