Hospice Racial-Ethnic Outreach for Cultural Diversity (Research)

It is no secret that hospice services are underutilized nationally among racial-ethnic minorities. While several barriers to utilization have been studied, solutions always include the necessity of more outreach to racial-ethnic groups by hospice organizations. For example, a study on the willingness of older Korean-American adults to use hospice services highlights the importance of prior knowledge in shaping attitudes toward hospice care. Researchers stress the need for  “community education and outreach programs for racial and ethnic minorities, with specific emphasis on dissemination of information and greater awareness of hospice services.” Sharing successful racial-ethnic outreach practices can be a great strategy for hospices in promoting cultural diversity.

These are a few examples of outreach practices implemented by two hospice organizations:

Hospice of Western Kentucky

1)  Starting a committee to identify, educate, and serve populations not being served

2)  Offering free health screenings at local minority churches

3)   Changing photos on brochures to reflect diverse populations

Montgomery Hospice 

1)  Making cultural diversity an important part of staff development and recruitment

2)  Having language interpretation services provided over the phone and available 24/7

3)   Participating in Latino health initiatives, festivals, and African American events

Many hospice organizations have cultural diversity best practices to share that can benefit other organizations in their quests for cultural diversity. Quality end-of-life care is an entitlement for everyone. That is the hospice philosophy. What is your hospice organization doing to promote racial-ethnic outreach? 

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

New Orleans Jazz Funeral: Homegoing Celebration With Second Line Dancing (7:39)

In New Orleans, my hometown, a jazz funeral is considered a homegoing celebration because the deceased is going home, crossing over to the other side. Emotions often run high as mourners are moved by the music and spiritual energy building up as the service progresses. Although there is sadness because the loved one is no longer physically available, there is joy in knowing that the deceased has gone to a better place where there will be no more sorrow and where they will be reunited one day with loved ones who went home before them.

Mourners come prepared to render a dynamic farewell. Death is an event that requires rejoicing. After services at the church or funeral home, a grand marshal leads a brass band and an assembled group of mourners, along with the hearse, in a procession to the cemetery to “drop the body.” The band plays solemn music at this time.  Stepping unhurriedly with the beat, participants walk a route down city streets. When they reach the cemetery, they “cut the body loose” as the hearse slowly enters for final services where the body is laid to rest.

After the procession of mourners leaves the cemetery, a rousing celebration begins with the band playing an upbeat song like “When the Saints Go Marching In.” The funeral procession continues, growing in size with many community members collectively called “second liners,” who join in the joy with curious bystanders. A spirited dance called the “second line” is prominent among the celebrants. Many participants bob umbrellas, some brightly decorated, and wave handkerchiefs in the air to the hot-sauce beat of the music. Surely, the deceased must be ecstatic with the large turnout of well-wishers expressing such jubilance in the send-off.

This video features part of the homegoing celebration of Juanita Brooks, who was a prominent jazz and gospel singer. Wanda Rouzan, a popular performing artist known as the Sweetheart of New Orleans, serves as grand marshal. The focus is on the musical transition from slow and somber to spirited as the funeral procession progresses with second liners.

You can learn more about New Orleans at my New Orleans Memories website.

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

“Defining Moments” Poem: Hospice Volunteering and Life

Each chapter of my book Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes ends with an original poem relating to the chapter. “Defining Moments” was written after I realized that a series of events having nothing to do with anyone close to me dying had led to my becoming a hospice volunteer. Previous to these events, I was not attracted to being actively involved in the healthcare profession as a caregiver and advocate for seniors. Nobody is more surprised than yours truly that I am an eldercare consultant, author and blogger now.

Several readers have told me that “Defining Moments” resonates with them. As a writer, I appreciate knowing when something I have written has connected with other people. But I was especially surprised one day when a reader who had actually memorized the poem approached me while reciting it. This was followed by a heartfelt explanation of a defining moment in his life. Perhaps this poem will remind you of a defining moment in your own life.


Defining Moments

They come without warning,

grab us in chokeholds of change,

fling us into outer space

where past meets future.

In this realm resonating

with first-time knowledge,

we awaken wide-eyed,

infused with wisdom

to turn around, stand still

or move forward with clarity.

No matter how they smack,

stroke, lift, drop, push, kiss

or kick us to get our attention,

when they finish their mission,

we are permanently scarred.

©Frances Shani Parker


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

Suicide Prevention and Older Adults (Video 3:10)

Older adults kill themselves intentionally over 50% more than young people do in America. Each year more than 6,300 older adults take their own lives. Unfortunately, suicide among the elderly continues to lack the intense prevention and research focus that it should receive. 

Older white men have been particularly at-risk for suicide for the past half century. They are eight times more likely to kill themselves than are women of the same age group. They have almost twice the rate of all other groups of elderly men. This situation continues to escalate with the increase of millions of baby boomers (born 1946-1964) reaching senior status. The continued rise in elderly male suicides has the potential for creating a national crisis in geriatric mental health if more prevention strategies are not used.

In this video, Dr. Yeates Conwell, Director, Geriatric Psychiatry Program Director, Center for Study and Prevention of Suicide, University of Rochester Medical Center talks about the four Ds that contribute to suicide risk in older adults.

 

Frances Shani Parker, Author

Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes

Hospice and Nursing Homes Blog

Nursing Assistant (CNA) Omar Cain With Loads of Inspiration (Video 6:38)

One of the extras that enriched my experiences as a hospice volunteer in Detroit nursing homes was the ongoing contact I had with staff members and residents.  I particularly appreciated my interactions with nursing assistants, also referred to as CNAs and nurse aides.  Because they worked closely with residents, I had many opportunities to talk with them. They seemed glad to have me there assisting my hospice patients while lightening their workload, especially at mealtimes. They shared their concerns about low pay, staff shortages, difficult work conditions, and not being appreciated.

Like employees on any job, CNAs were varied in their work performance. A famous American actress named Lena Horne  said, “It's not the load that breaks you down, it's the way you carry it.” Two people can experience exactly the same circumstances and respond in totally different ways. I found that many CNAs valued their jobs and relationships with residents, even during stressful situations. They made positive choices about how to carry their loads while working to improve conditions. Attitude was everything. This wasn’t always easy, especially on a daily basis or during the middle of a crisis. I have seen a CNA get slapped so hard by a dementia patient that she almost fell. But she maintained her composure and moved on while another CNA interceded. The passion they had for what they were doing helped them overcome adversity.

I don’t know Omar Cain, the CNA in the video that follows. But he demonstrates a spirit of caring commitment to residents he serves at Golden Living Center. A rapper and hero to many, he uplifts others with loads of inspiration. Omar models a message we can all embrace on how to carry our loads during daily encounters at work and in life.

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

Oncology Nurses, Cancer, and Palliative Care (Research, Video 1:39)

In an earlier post, I mentioned the confusion many people have regarding what palliative care is. One problem is the close association they make between palliative care and hospice care. Those with misinformation include some who work in the healthcare field.

Oncology nurses provide and supervise care for cancer patients who are chronically or critically ill. The “Oncology Nursing Forum” presents results from a study at George Mason University. Researchers examined how some oncology nurses define palliative care, their views about who should and should not receive palliative care, and their beliefs about palliative care decision-making. These nurses’ beliefs include who should be involved in making palliative care decisions and how decisions should be managed. Interviewed were twelve nurses representing different aspects of oncology nursing.

Findings indicate that most of the oncology nurses interviewed focused on symptom management and made no distinction between hospice and palliative care. Palliative care was viewed as care only for patients near the end of life. Nurses perceived their own involvement in decision-making regarding palliative care as limited and indirect. These perceptions cause concern because they could limit palliative care that is appropriate for cancer patients who may not be eligible for hospice care.

While this study involved a small group of oncology nurses, it reinforces the need for more education and clinical experience so palliative care can be used to benefit more patients. Dr. Diane Meier, Director of the Center to Advance Palliative Care, defines palliative care in this video titled “What is Palliative Care?”

Frances Shani Parker, Author

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

“Hospice and Nursing Homes Blog”