Death Notification Problems (Research, Video 1:44)

“We regret to inform you of the death of _______.” If the last word in that statement is the name of your loved one, you are about to be impacted by a death. Death notifications can affect not only the grief experience of loved ones, but also the well-being of physicians who were involved in the death. That’s why the delivery of this information warrants great care. Unfortunately, too many places have no standard procedure for making death notification phone calls.

Efforts were made in this research on procedures for making death notification phone calls to rectify this situation by using results of a literature review and open-ended interviews with faculty, residents, and widows to develop a survey regarding resident training and experience in death notification by phone. All internal medicine (IM) residents at the university conducting the research institution completed the survey. These were the results:

1) Eighty percent of residents felt inadequately trained for this task. Over 25% reported that calls went poorly.

2) Attendings (an attending physician or surgeon) were involved in 17% of cases. Primary care physicians were not involved at all.

3) Nurses and chaplains were not involved.

4) Respondents never delayed notification of death until family arrived at the hospital.

5) There was no consistent approach to rehearsing or making the call, advising families about safe travel to the hospital, greeting families upon arrival, or following up with expressions of condolence.

Imagine how the poor communication listed above could potentially complicate grief for surviving loved ones and create stress among physicians. Clearly, more training is needed and could be combined along with training in disclosure of medical error.

Regarding errors related to death notifications, the case featured in the video below is an example of a worst-case scenario. What if loved ones are notified about a deceased person who really hasn’t died? This actually happened to a family that was told their grandmother had died at a hospital in Brooklyn, New York City.

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

Aging: How old are you really? (Research, Video 2:48)

Do you only think of aging as lost youth, or do you think of it more as new opportunities for growth in another phase of your life? Several research studies show the way we feel about aging affects how we live our lives. Stop worrying about your age or other people’s ages. Don’t believe stereotypes about how people should look or act at a certain age.

Ask me how many hard lessons I learned, how many times I overcame, how much music spoke to my soul, how many words lifted me higher, how many people loved me back, how many mornings I woke up grateful. That’s how old I am. 

About the process of aging, people of all ages have worries. A study about worries of various ages concluded the highest degree of worry includes future financial security and memory loss. Surprisingly, however, most Americans are optimistic about aging, especially older adults who have learned resilience through their years of living life.

Aging is a fascinating process. The following video includes 10 interesting facts about aging that may surprise you.

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-School Similarities, Connections (Video 2:40)

Years ago, I was principal of a schoolwide, service-learning school where all staff and students performed service in the community. Students' service was connected to the school curriculum, giving them opportunities to use what they learned to improve the community. For example, fourth graders learned how to write biographies by interviewing residents of a local nursing home. Later, each resident was given a booklet with all the residents’ biographies so they could learn more about one another.

My own service included weekly hospice volunteering in Detroit, Michigan nursing homes. It didn’t take long before I observed that nursing homes and schools have several important similarities. Both have cultures that impact people in institutions. A paradigm shift in how these institutions are often perceived, not only by the public, but also by those who work in them, was long overdue. This needed transformation is often referred to as person-centered culture change, a movement that focuses on values and practices that respect the input of everyone involved with the institutions.

Through the eyes of an educator and hospice volunteer, I focused on person-centered care with residents. In order for a person-centered climate to fully enhance quality of life in nursing homes and other residential institutions for older adults, residents must have experiences similar to what students should have in schools. Like students, residents must first know that the nursing home is a real “home” where they are welcomed and cherished at all times. They must feel that their environments are safe, that trustworthy employees care about them and listen to them with their hearts. Residents must know that their progress as individuals with specialized needs is the primary motivation for everything that goes on. Those with dementia should be challenged to learn new skills in non-threatening ways.

Residents must know that the personal histories they bring matter. These life stories help create who they are, not labels like “dementia” which are too often used to judge them and put them in stereotypical categories during their later years. They need ongoing encouragement to use their strengths in productive ways to improve their self-esteem and enhance lives of others. Their talents and accomplishments should be shared with the larger group so they can be appreciated and praised. Finally, their “graduations” (deaths) should be recognized as revered events.

Sometimes older adult communities and schools have the great pleasure of bonding into something wonderful together. The following video features Providence Mount St. Vincent in Seattle, Washington. It is a typical community home to about 400 residents. What really sets this facility apart from many other communities like this is the preschool, the Intergenerational Learning Center, which provides children and older adults with opportunities to bond. These young children learn about acceptance of older adults while they are being nurtured. At the same time, the older adults develop a greater sense of self-worth and foster social interactions. That's a win-win relationship for everyone.

You can read about our fourth graders' nursing home research on ageism stereotypes here.

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Read “10 Rules of the Education Game for Educators” by Frances Shani Parker here.

Note: Winner of the National Service-Learning Partnership Trailblazer Award, Frances Shani Parker, a hospice volunteer, writer, and eldercare consultant has been instrumental in implementing service-learning in school districts across the country.

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

Dying: Real and Imagined Perspectives (Research, Video 3:19)

Even though most people say they dread dying, the good news is that the reality of dying isn’t so bad after all. Many people imagine that dying is worse than it is in reality. This became apparent in two death research studies comparing the affective experience of people facing imminent death with that of people imagining imminent death.

The first study revealed that blog posts of near-death patients with cancer and amyotrophic lateral sclerosis were more positive and less negative than the simulated blog posts of non-patients. Also, the patients' blog posts became more positive as death neared. The second study revealed that the last words of death-row inmates were more positive and less negative than the simulated last words of non-inmates. The last words of these studies suggest that the experience of dying, even from terminal illness or execution, may be more pleasant than one imagines.

Why are some people so afraid of death? Dr. Ira Byock, a leading palliative care physician, author, and public advocate for improving care through the end of life, thinks it's partly a human thing that has become more exaggerated during the last century. The American way of dying has gradually become dying in the hospital, maybe in the intensive care unit. Many Americans are dying tethered to machines. Dr. Byock emphasizes the best care possible in a way that is not always seeking to prolong life.

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

Frances Shani Parker: Black Aging Matters Webinar

American Psychological Association 

Black Aging Matters Webinar: How to Better Address Racism-Related Stress in African American Older Adults
(three presenters, audience questions)

https://www.youtube.com/watch?v=DqvF_7O0lSY

Perspective of an Older African American Advocate (Excerpt)

My name is Frances Shani Parker. I was born and raised in the Jim Crow segregation of the South. I sat behind the sign for whites on the public bus when I wasn’t standing, drank water from the colored fountain, attended segregated schools, and endured America’s daily misery of racial injustice. Like many African Americans who remember being Negro, colored, and Black, every day was a reminder of our unimportance to the larger society. No doubt, these constant atrocities and indignities have taken a toll on us as we continue in our ongoing struggle to overcome.

Quality of healthcare always depends on the context in which it is given. Context includes all resources available, including biases of healthcare providers. Research studies indicate many healthcare providers have implicit bias in terms of positive attitudes toward white people and negative attitudes toward people of color. Systemic covert and overt racism against African Americans continues to flourish. Health disparities persist in large numbers year after year harming us, our families, our communities, our future generations, and ultimately the entire nation in loss of productivity and in economic burdens. This is not only a healthcare issue, but a moral issue.

A hospice volunteer, I know that many older people with dementia also have stored memories similar to mine that create shared connections with other older adults. I was moved to write this poem titled “Deeper Than Words” while watching Miss Loretta, my hospice patient, sleep. I thought about our shared African American history that bridged our communication beyond her dementia.
 

                                             Deeper Than Words

                                             By Frances Shani Parker

                                              The outside world arrives

                                              wearing my willing face.

                                              Toothless, your smile widens

                                              like a baby’s hungry for attention.

                                              Almost ninety-eight years old,

                                              your inner candle still glows.

                                              A hospice volunteer, I lean closer,
                                              talk into your listening left ear,
                                             “Today is Sunday, Miss Loretta.”
                                              My news drifts away like smoke.
                                              You stare at me through dying coals.
                                              Whatever I ask, you whisper, “Yes.”

                                              I stroke your age-softened arms
                                              while your hazed mind masters sleep.
                                             Watching you, I dream generations
                                             of women, black and strong, each one
                                             a book of sustaining stories
                                             about joy, pain, courage, survival.

                                            Within your warm brown frame,
                                            spirits from our common history linger.
                                            Aides say you have dementia,
                                            that you don’t know a word I say.
                                            Our language goes deeper than words.
                                            We speak to each other’s souls.

My hope is that audiences will increase their awareness of disparities, develop an urgency to eliminate them, especially if they are participants in causing them, and become more proactive in their own and others’ healthcare. I honor those who have died much faster than they should have, too often from causes that were preventable. I speak for those whose voices have been silenced.

Frances Shani Parker, Author
Website: www.francesshaniparker.com
Book: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.
Blog: Hospice and Nursing Homes Blog