“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”

Home Funerals: An Introduction (Video 4:17)

Many years ago, death rituals in America were a continuation of the family’s natural involvement with the deceased at home. Even today, some people view them as extensions of the hospice philosophy. After a death took place, the body of the deceased was prepared at home for viewing. Mourners came to pay their respects, console the family, and offer other forms of assistance. The family appreciated this outpouring of support from the community. After the funeral, the body was buried.

Involvement with death-ritual arrangements was and still is therapeutic. In addition to saving thousands of dollars, some families want to have more control over how the deceased loved one’s life is celebrated and cared for after death. Having a personalized home funeral is an option they embrace. Most states allow home funerals as long as legal documentation related to claiming the body and arrangements for burial or cremation are handled appropriately. Some families work with funeral homes on these matters.

This video titled “Home Funerals” is an introduction to this dignified death ritual, another alternative for family and friends to unfasten their earthly connections with loved ones who die. Comments are especially welcome from those who have participated in home funerals.

Frances Shani Parker, Author

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

“Hospice and Nursing Homes Blog”

Alzheimer’s Dementia Hospice Story: Coping With Grief

“She’ll rise out of her grave…”

This true story about a conversation with my hospice patient is one of many in my book Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes.

When Mamie Wilson became my hospice patient, she had several unusual qualities that made me wonder. At sixty-five with Alzheimer’s dementia, she was the youngest patient assigned to me after years of hospice volunteering. She had the same name as my grandmother, and I had her grandmother's name. When we made these discoveries during our first meeting, we took them as signs that we were destined to have a great patient-volunteer relationship. In time, I learned that the most unusual thing about Mamie was what she said.

“Is your mother alive?” Mamie asked me one day.

“No, she died a few years ago in her eighties,” I responded.

“You know, you can still be with her and talk to her if you want to.”

“Oh, I know we can still communicate.”

“No, I mean for real. You can be with her in person. Just get her clothes together and her shoes. Don’t forget her coat. They say it’s cold outside. Take them to the cemetery where she’s buried. Just set them on top of her grave and wait. She’ll rise out of her grave and put them on. Then you can take her home with you. In every way, she’ll be the same person you knew. Other people won’t be able to see her, but you will.”

“Hmm. I’ve never heard that before.”

“Most people haven’t. I know about it because I did it with my two grown sons. They were both murdered on the same day in a drive-by shooting. I didn’t know how I would get through the pain. Finally, I took their clothes to the cemetery and did what I just told you. Both of them came home with me. It was the best day of my life. I got my sons back.” Satisfied, she smiled.

Some people will dismiss this story as crazed comments of a demented woman. But, if you really listen, you’ll hear the magnificent empowerment in her words.

© Frances Shani Parker

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 several other countries at online and offline booksellers.

Hospice and Nursing Homes Blog

Help for Children Who Are Caregivers (Video 5:34)

Imagine being one of hundreds of thousands of children, some as young as eight, who must serve as a major caregiver to an adult on a daily basis. This is the reality of many school children, particularly in racial-ethnic minority communities and among low to mid-income families.

As a former school principal, it was not unusual for me to have students in elementary through high school grades with attendance problems due to caregiving responsibilities at homes when no one else was available to help. These children’s responsibilities included medicating, dressing, feeding, bathing, and more. The emotional stress of child caregivers can be even more harmful to them than the physical burdens. Unfortunately, as the economy struggles and the ranks of baby boomers expand, increasing numbers of children are being assigned caregiving responsibilities.

More people are recognizing this problem, and for some children, but not nearly enough, help is being provided. The Caregiving Youth Project sponsored by the American Association of Caregiving Youth provides in-school assistance and a caregiver camp for children who are caregivers. This gives them an opportunity to receive guidance, support, and social interaction with other children who can understand what they are going through as they manage adult responsibilities. This "New York Times" video shadows the lives of three children who are caregivers and highlights this national program that assists them.

Frances Shani Parker, Author

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

“Hospice and Nursing Homes Blog”

Hospice-Palliative Care Doctors and Burnout (Research, Video 5:48)

Every profession has the potential for burnout, even when workers love what they do. With the growth in hospice-palliative medicine (HPM), more research is shining a light on how doctors in this field prevent burnout and promote self-care among themselves.

This research by the Mayo Clinic was reported in the Journal of Palliative Medicine. Participants included 40 HPM doctors practicing in America. These doctors were surveyed online about burnout prevention strategies and ways to find fulfillment in their professions. These were strategies used by 30 of 40 HPM physicians (19 males, 11 females) for burnout prevention:

1)    Physical well-being (60%)

2)    Professional relationships (57%)

3)    Transcendental perspectives (43%)

4)    Oral communication with others (43%)

5)    Hobbies (40%)

6)    Clinical variety (37%)

7)    Personal relationships (37%)

8)    Personal boundaries (37%)

9)    Time away from work (27%)

10)  Passion for one's work (20%)

11)  Realistic expectations (13%)

12)  Humor and laughter (13%)

13)  Memories of patients (10%)

HPM doctors use a variety of strategies to avoid burnout and maintain resilience. This research highlights the importance of dealing with burnout as it relates to doctors’ self-awareness and self-care. More research is needed to help physicians recognize burnout and individualized strategies for supporting themselves and their colleagues. This video titled “Palliative Curriculum - Part 15 - Cancer Doctors and Burnout” presents a scenario about burnout concerns.

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

Healthcare Urban Legends Test-- Nursing Homes, Health, Senior Citizens

If you have opened forwarded e-mails or “chain letters,” you’ve probably read false information that you thought was true. Believing what you read may have caused you to panic. Wanting to help others, you couldn’t wait to forward the warning, protection prayer, or request for a donation to family and friends. But there’s a more constructive way to deal with this phenomenon. Today’s post offers a brief mental workout to help keep you informed about nursing homes, health issues, and seniors while squashing rumors.

Can you guess which of the following health-related stories are true or false? The correct answers are at the end.

1) While being transported from a nursing home to a doctor’s office for an appointment, an elderly patient died when the gurney to which he was strapped rolled away with him, overturned, and caused a head injury.

2) The artificial sweetener aspartame has been proved responsible for an epidemic of cancer, brain tumors, and multiple sclerosis. This story gives a detailed description of the health dangers of diet drinks.

3) Some senior citizens are choosing to live their retirement years on cruise ships where the amenities are much better and the average costs per day are cheaper than living in nursing homes.

Fortunately, there is a website that can help you decipher what’s true and what isn’t. Many of you are probably aware of snopes.com, which has been around for years. This website is the Internet reference source for urban legends, folklore, myths, rumors, and misinformation. If you haven’t already, you might want to bookmark this site and check out information you receive. You can delete the hoaxes and end the spreading of false information. 

Answers:     1. True    2. False     3. True

Frances Shani Parker, Author

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

“Hospice and Nursing Homes Blog”

Can Older Adults With Dementia Enjoy Life? (Research, Arts Video 3:04 mins.)

I have a friend whose mother has Alzheimer's disease. He and his father are her primary caregivers at home. He says that people generally feel sorry for them. When his mother’s name comes up in conversations, the tone changes to one of sadness. They also assume that his mother must be an unhappy person because of her mentally impaired condition. The other day, I smiled at his response when I asked him how she was doing. He said, “Mama is doing just fine. Pops and I focus on keeping her healthy and active. Most of the time, she is as happy as she can be.”

A research study in the “International Journal of Geriatric Psychiatry” supports that assessment. Consisting of interviews with 1,620 community-dwelling older adults, the study examined the following:

1) Overall life satisfaction with material circumstances and with social circumstances of older adults with no cognitive impairment, with cognitive impairment without dementia, and with dementia

2) The effect of cognition on life satisfaction across a broad spectrum of cognition

3) The effect of factors such as depressive symptoms, functional impairment, education, and social support.

While participants with dementia and participants with cognitive impairment without dementia did have lower life satisfaction than those with normal cognition, the effects were relatively small. The study concluded that, although cognition is associated with life satisfaction, older adults are generally satisfied with life.

Older adults with dementia have varied days like everyone else. Happy memories and enriching activities can slow dance into their realities and fill them with joy. This video titled “I Remember Better When I Paint: Treating Alzheimer’s Through Creative Arts” shows how creative arts activities can enhance the quality of their lives. A longer DVD version can be purchased at amazon.com, frenchcx.com, artistsforalzheimers.com, and hilgos.com.

Frances Shani Parker, Author

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

“Hospice and Nursing Homes Blog”

Hospice Volunteers Share Experiences (Hospice Poem, Video 3:25)

Each hospice volunteer has a unique story to tell.  This is my story poem about my hospice volunteer experiences in Detroit nursing homes:

Reflections of a Hospice Volunteer

By Frances Shani Parker 

I leave my car and walk into a world with many fates.

The people live reality where three words dominate:

“Nostalgia” brings memories that make them question why.

“Delusions” create fantasies that often come alive.

“Anticipation” beckons the beginning of each day.

A visit, party, special news, what is on the way?

Sedonia tells me stories of how life used to be.

Many things seem different now. She’s almost ninety-three.

Moochie shields unseen friends he pledges to protect.

I wonder if he sees and hears the friends he manifests.

Dexter smiles and says with pride while waiting for his son,

“All my children visit me, and each is Number One.”

Pearl yells, “I want some cake, and bring it just for me!”

She thinks that I’m employed here. She sees me every week.

An empty bed reminds me that someone else has gone.

Next week I’ll see someone new. Life’s cycle will go on.

Juan trails me through each room while planning his escape.

“I have somewhere to go,” he pleads. I stop him at the gate.

I leave this special world today with wisdom strong and rare,

Respecting every circumstance that brought each person there.

Our futures are unknown to us like roads with endless curves.

I drive away feeling good, happy that I served.

© Frances Shani Parker

Excerpt from 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 at many booksellers and in e-book form at Amazon and Barnes and Noble booksellers.

Hospice and Nursing Homes Blog

Intergenerational Partnerships Change Negative Stereotypes About Older Adults (Research)

Frances Shani Parker accepts flowers from Yvonne Butler-Woods at the Revelation Lutheran Church Senior Celebration. Keynote speaker, Ms. Parker spoke about intergenerational partnerships and the impact of negative stereotypes about older adults on children.

 
(Note: This is not her speech.)                                 

A former school principal, I encourage intergenerational experiences between students and older adults. I feel so strongly about them that I include a chapter on school-nursing home partnerships in my book "Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes”

At my school, we had students complete pre and post surveys as part of their nursing home visits. We asked them what their expectations were about nursing homes and the residents who lived there. Fourth graders told us they thought residents would be boring, slow, and nosy, trying to get into their "business." These were only a few of the negative stereotypes they had already developed about older adults. Students also participated in several classes on aging and eldercare before their visits. They learned how to perform, analyze, record, and disseminate scientific research. The lessons we created were integrated into the regular school curriculum supporting academic standards. This teaching approach is called service-learning.

Of course, students were amazed at how their opinions changed when they took the same surveys after returning to school from their visits. In addition, they witnessed dementia firsthand and developed a healthier understanding of aging, illness, caregiving, and acceptance of others' differences.

A research summary reported in “Medical News Today,” Source: Jamie Hanlon, confirms that negative stereotypes about the elderly can be present in children as young as three. The study reported that children with fewer contacts with seniors had more negative stereotypes about them. While children also learn negative stereotypes from the media and from observing how others treat seniors, they can learn many positive lessons about older adults through their early personal interactions with them.

The negative biases children embrace can impact them through the years in ways that are damaging in how they treat older adults, perceive themselves, and in how they perceive aging. Perhaps you have noticed some young people exhibit a strong lack of tolerance or empathy for seniors. I certainly have. Unfortunately, these youngsters may grow up to become the negative stereotypes they believe. Positive intergenerational experiences involving young people and older adults are wonderful win-win opportunities. 

Frances Shani Parker, Author

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

“Hospice and Nursing Homes Blog”

Palliative Care or Supportive Care? Which Would You Prefer? (Research, Video 3:04)

Would a rose by any other name smell as sweet?

I have met quite a few people who don’t have a clue as to what palliative care is. Some are even in the healthcare profession. To add to the confusion, many who do know what it is refer to palliative care using various pronunciations (sound pronunciation). Then there are those healthcare organizations such as the American cancer centers that have adopted use of the name palliative care but continue to get referrals late for those needing it. Is this due to an association of the name palliative care with hospice care?  Would all these problems regarding the name palliative care be resolved by just replacing the name with a more user friendly one such as supportive care?

Obviously, the name palliative care carries several barriers that need to be explored. That’s why this research caught my interest. This study by the Anderson Cancer Center in Houston, Texas reports how the name palliative care versus the name supportive care may impact cancer patient referrals.

Can a name be a barrier to patient referrals for care? Medical oncologists and their midlevel providers (advance practice nurses and physician assistants) at a comprehensive cancer center think so. 140 out of 200 of them participated in a survey to determine the impact of the name palliative care compared with the name supportive care on patient referrals and to determine whether there was an association between demographic factors and the perceptions of the two names. What were the results?

1)    The name palliative care compared with the name supportive care was perceived more frequently by medical oncologists and midlevel providers as a barrier to referrals, decreasing hope, and causing distress in patients and families.

2)    Participants significantly preferred the name supportive care compared with palliative care. They also stated more likelihood to refer patients on active primary and advanced cancer treatments to a service named supportive care.

While these results are not surprising, where does this leave the name palliative care? Is this a matter of educating the public more to the meaning and appreciation of what palliative care can provide? Or is this a matter of phasing out usage of the term palliative care with patients and replacing it with the name supportive care? What do you think?

This video explains palliative care: “Palliative Care: What is it and who is it for?”

Frances Shani Parker, Author

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

“Hospice and Nursing Homes Blog”