Are You Satisfied With Your Hospice Job? (Research, Video 1: 22)

              Pictured are members of the Guardian Hospice Care Team in Alexandria, LA.

           

Are you satisfied with your hospice job? If a poll were taken today, do you think most of your fellow employees would share your feelings? How people feel about their jobs can impact their lives greatly. Taking time to evaluate job satisfaction can be informative, particularly for improving quality of life.

Hospice workers face unique challenges as they interact regularly with terminally ill patients and their families. How do workers in the various hospice disciplines rate their job satisfaction? Researchers at the Center for Bioethics at the University of Pennsylvania School of Medicine evaluated 8,495 staff members from 177 participating hospices in 41 states. They used the Survey of Team Attitudes and Relationships (STAR) with these results:

The mean score was 28 on a 0-100 scale. Hospice-level scores ranged from 15 to 44 with 44 being the highest level of satisfaction. The following are categories and scores:

Physicians -- 42

Chaplains -- 30

Nurses' Aides – 29

Nonclinical staff and clinical staff -- 28

Bereavement Coordinators -- 27

Nurses -- 26

Social Workers -- 25

This research concluded that variations in job satisfaction among hospices and disciplines are significant. Do these results surprise you, or did you expect them to be similar?

In this video, Dr. Martha Twaddle, Chief Medical Officer of Midwest Palliative & Hospice CareCenter, explains the role of the hospice interdisciplinary team. 

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

Holiday Blues Grief Support

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

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."

© Frances Shani Parker, Becoming Dead Right

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

Holiday End-of-Life Conversations

The holidays often provide opportunities for families and close friends to get together, reminisce, and have a joyful time. But what about happiness in the future? Why not take advantage of this time together to engage in important end-of life conversations that can be crucial later in honoring end-of-life wishes of those you love and yourself.

Engage With Grace is a a movement aimed at promoting these kinds of conversations using the five questions below. They’re not easy questions, but they are important and shouldn’t be ignored. Sometimes we think we know what loved ones want, and we really don’t. Later in life, when several people are involved in making inevitable decisions about life threatening health matters, guessing, confusion, and hurt feelings can easily hinder progress. The key to preventing this negativity is having end-of-life conversations when they can be positive with personal input regarding what loved ones really want. Fortunately, many people actually enjoy discussing their answers with loved ones.

Add new meaning to your holidays by including thoughtful conversations that can improve quality of life. No one knows what the circumstances could be at future family gatherings during a healthcare crisis. You and your loved ones can benefit greatly from answering these questions and implementing the suggestions given. The Caring Connections website has information to help you with your plans. (Click on the questions below to make them larger):

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

Nurses’ Burnout (Research, Video 1:43)

Burnout among nurses can be costly, not only for nurses personally, but also in terms of litigation, staff turnover, and risks to patient care. While many nurses love their jobs, when frustration becomes overwhelming, burnout can set in. A University of Pennsylvania study of 95,499 nurses revealed that the highest job dissatisfaction was among nurses who worked directly with patients in hospitals and nursing homes.

One irony is that a major concern of nurses is healthcare benefits, which are less than other white-collar workers. Satisfaction levels of patients in hospitals are lowered when there are more dissatisfied or burned out nurses working among them. This can also negatively impact the quality of care patients receive. There is no one easy solution to the problem of nurses’ burnout. Various job issues have to be addressed.

At personal levels, nurses can benefit from the caregiving of others while they serve as caregivers themselves. Ohio State University Medical Center has started the Stress, Trauma and Resilience (STAR) program to do just that. Nurses and other healthcare providers receive support, particularly on reducing stress, crisis management, and peer counseling. This video describes the program:

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

Veterans: Hospice and Palliative Care Trends (Research, Video 4:46)

If you are involved in hospice-palliative care work, you have probably had the opportunity to serve a veteran. Nat was my most memorable veteran patient. Although he had fought in Viet Nam years before we met as hospice volunteer and patient, his stories about his life and military service were as raw and real as any I have heard:

“I’ve seen and done things you couldn’t imagine. Some of them were horrible, I mean really horrible. Don’t ask me to tell you what they were, because I can’t talk about it. They say time heals all wounds, but it’s a lie. I left Viet Nam, but Viet Nam never left me. I carry it with me everywhere I go. All these years later, I still have nightmares like you wouldn’t believe. The doctor says it’s post-traumatic stress disorder or PTSD. I wake up shaking, gasping for breath with tears in my eyes. In my dreams, I’m always running hard, trying to escape. Sometimes my enemies are close enough for me to touch. I almost stop breathing to keep them from hearing me. I’m constantly thinking I’m not going to make it. Some nights they kill me before I wake up.” (Excerpt from Becoming Dead Right)

Nat is like many men and women who have served our country and now find themselves in need of hospice care. The number of veterans receiving hospice care continues to become a major area of expansion for the Veterans Health Administration. Research by the Department of Aging and Mental Health Disparities at the University of South Florida reports that, of the millions of dollars being spent on veterans in hospice care, most of the funds are spent on younger veterans. Future trends indicate a growing need to allocate more funds for end-of-life care. Support and appreciation for the horrific sacrifices veterans have made are especially important during their death journeys.

This video titled Reaching Out to Those Who Served was produced by the Tennessee Hospice Association as part of a grant through the Veterans Administration and the National Hospice and Palliative Care Organization. It presents a detailed overview of hospice and palliative care services for veterans.

                  





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

Older Adult Sleep Problems: Drug-Free Solutions (Research, Video .25)

Older adults have sleep problems just like millions of others do. Unfortunately, they often find inappropriate treatments that they may think are effective. This sleep research, conducted by the University of Pennsylvania School of Medicine, focused on the perceived effectiveness of older adults’ various sleep treatments. Information was gathered through a mailed questionnaire to a community-based sample of older adults with 242 responding. These are examples of the sleep interventions older adults used:

1)    Watching television, listening to the radio, and reading were the most popular interventions.

2)    Taking medications such as pain medication and prescription sleeping pills were also common. Older adults perceived sleeping pills as being most effective.

3)    Drinking alcohol was another form of self-treatment.

About half of those using alcohol and prescribed over the-counter sleep aids had not discussed their sleep problems with their doctor. Not discussing sleep problems and treatments they are using with their doctors can worsen their problems and possibly put them in serious danger healthwise. Healthcare providers and caregivers should make it a point to initiate conversations with older adults about sleeping patterns.

In this video, Dr. David Schulman, Sleep Specialist at Emory University, recommends the following seven drug-free sleep tips. Older adults, in addition to keeping their healthcare providers informed, can use them:

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

Becoming a Hospice Volunteer Against My Will

People often ask me how I became a hospice volunteer. For the record, nobody is more surprised than I am. You know how some people can walk into a patient’s room, plump pillows, and make all the right comments? Years ago, I was not that person. I never really felt comfortable visiting sick people. Working in the healthcare arena seemed depressing. Besides, I had made a conscious decision to become an educator when I was in fifth grade. Unlike many who have chosen hospice volunteering, my motivation had no connection with professional choice or with anyone close to me dying, although I had experienced that several times.

So, how did I get into this situation? I was principal of an urban public school located in an area of high poverty, crime, drugs, prostitution, and homelessness. Major problems of others clamored for space on my always-crowded plate. Over a three-year period, I was thrust into life-threatening predicaments of two men I didn’t know well who were suffering with AIDS, an infectious disease of the immune system caused by the HIV virus. They were my introduction to serious caregiving of the terminally ill.

The first man, who was in total denial about his condition, also had dementia that included daily harassment by invisible people. After he died, I sighed, thinking that scenario would never happen to me again. A year later, the second man showed up. Both men lacked strong support systems, which were crucial during the 1990’s when infected people were ostracized and dying quickly. My mother warned me to stay away from them or I might “catch” it.

But I didn’t stay away. I served as these men’s hospice volunteer without even realizing I was one. It just made good sense, and we all benefited from the experience. I discovered significant layers of myself that I never knew. After my involvement with the men ended, I ran into a friend who said she was performing service as a hospice volunteer. Her description of what she did sounded very familiar. A few weeks later, I read a newspaper ad about hospice volunteer training classes. I decided to get certified to do what I had already been doing and become even more prepared if somebody else ill showed up.

As an official hospice volunteer for many years, I have served numerous terminally ill patients who  showed up. In addition, I have been writing Hospice and Nursing Homes Blog for several years and have recorded my hospice volunteer experiences and insights in a published book titled Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes. I enjoy consulting with groups, advocating for patients, and educating caregivers, healthcare workers, policy makers, and the general public.

End-of-life care for millions of aging baby boomers continues to challenge our healthcare system and society. More people are needed to dig into wells of themselves and provide solutions to these growing concerns. Consider becoming a hospice volunteer. Various assignments are available to accommodate your personal comfort zone. Your service as a hospice volunteer can be a win-win experience, even if you didn’t plan to be one.

© Frances Shani Parker, Author

Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes

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

Hospice and Nursing Homes Blog

Informal Bereavement-Grief Rituals After the Death Ritual (Research, Video 3:46)

The donation of bodies to medical science anatomy programs is a significant end-of-life legacy. In addition to enhancing research, donated bodies offer training opportunities that ultimately benefit public health. People who say they are donating their bodies are often asked,  “Why donate your body? Don’t you want a funeral, memorial service, or something?” A common belief is that bodies donated to anatomy programs are dissected, studied, and then “disposed of” in an uncertain manner. The assumption may be that the entire procedure is strictly medical and scientific with few displays of gratitude for the donations and certainly no death rituals of respect for families or persons whose bodies are donated.

What are some death ritual options available for those who want to donate their bodies to an anatomy program? If funeral services are desired with the body present, the family can contact the funeral home and make arrangements with the anatomy program before funeral preparations are made. Another possibility is to have a memorial service without the donor’s body present.

But a little known fact is that a number of U.S. anatomy programs hold memorial ceremonies of gratitude honoring body donors. These final tributes to human lives are usually planned by students and faculty and include invited guests. Various U.S. anatomy programs hold nondenominational memorial services that include theme celebrations with expressions of speech, music, poetry, essays, visual art, and dance.

Those interested in donating their bodies to anatomy programs should contact the organizations that interest them and request information. Some have websites explaining their procedures. A list of common questions and answers about the body bequest program at Wayne State University School of Medicine in Detroit, MI can be viewed. Some answers may be surprising. For example, age is not a consideration for body donation, but there are other factors such as not having major organs removed. Also, if the family wishes to have the cremains returned for burial, the University, if requested at the time of death, will return the ashes to the family.

The following video features a cadaver memorial service with more than 300 in attendance. It is presented as part of a long-standing tradition by first-year medical students at the University of North Carolina (UNC) School of Medicine.

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 Volunteers for Pet Owners: Pet Peace of Mind (Video 8:06)

What would you do if you were dying with no one to care for your pet? What would happen to your pet if you actually died? If you had no reliable support system in place, your pet could end up at an animal control shelter where it might not be adopted within a certain time frame and could be euthanized. A national program for non-profit hospices, Pet Peace of Mind provides help to hospice patients experiencing these problems.  Funded by Banfield Charitable Trust, this program works with hospices in providing temporary and permanent care for pets of hospice patients. Care includes training materials, routine pet care, and tools to facilitate adoption.

For many people, their pets are their family, sometimes their only family.  They love and worry about their pets in the same ways others express concern about their children. When hospice patients are too ill to care for pets or need others to take full ownership of pets after they die, knowing a hospice volunteer will provide that care can be the difference between having a death journey with peace of mind or having one feeling depressed and anxious about the pet’s well-being. 

This video titled Pet Peace of Mind from Banfield Charitable Trust shows the importance of having a pet adoption program available for hospice patients.

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

Hispanic, Mexican American Male Caregivers (Research, Alzheimer’s Video 2:48)

According to the National Alliance for Caregiving, in collaboration with AARP, more than 65 million people, 29% of America’s population, are caregivers for the chronically ill, disabled, or aged family members or friends. A family caregiver is usually a woman. Typically, she is 49 years old and caring for her widowed 69-year-old mother who does not live with her. She is married and employed. More than 37% have children or grandchildren under 18 years old living with them.

With these statistics, it’s little wonder we seldom hear about male caregivers, but they are out there with stories that need to be told. This post focuses on Hispanic, Mexican American male caregivers, particularly those taking care of parents. In a federally-funded study of 110 Mexican Americans who were caregivers in lieu of a female relative, the following results were reported:

1)   Caregiving strain and burden in Mexican American males may have more to do with physical and emotional costs than financial ones.

2)   Mexican American males providing personal care for their mothers adopt a matter-of-fact approach as they act "against taboo."

3)   This caregiving approach is a new way to fulfill family obligations

Ric Gomez quit his job and became a caregiver for his father who has Alzheimer’s disease. In this video interview with KPBS reporter Amita Sharma, Ric shares the triumphs and challenges of his caregiving experience.

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

Sexuality of Older Adult Residents: Nursing Staff (Research, Dementia Video 3:09)

“You just made me throw-up in my mouth a little.”

“How about old people just stop having sex?”

These are a few of the negative stereotypical responses, including “funny” photos of diapered seniors, that I received at a social media site. Some are too vulgar to print here. I was attempting to initiate an intelligent discussion on the life-threatening topic of older adults and the prevention of HIV/AIDS. No one took this matter seriously. Disgust and ignorance are still perpetuated by many regarding adults having sex during their senior years.

Sometimes healthcare workers also reflect these biases, particularly regarding older residents with dementia. Examples are discomfort, denial, and other reluctance by some staff members when they are confronted with the sexual behavior of older residents in nursing homes and long-term care facilities. A study involving an extensive search of electronic databases of nursing staff and reported in the International Journal of Nursing Studies revealed the following:

1)   Nursing staff shows rather positive attitudes toward later-life sexuality.

2)   The extent of the staff’s knowledge regarding sexuality in the aged seemed to be very limited.

3)   Staff caregivers hold rather conservative attitudes toward sexuality of institutionalized elderly.

4)   Responses to residents' sexual behavior were influenced by the nursing staff’s own level of comfort related to sexuality issues and the culture within the institution where they work.

More research and education programs are needed on this topic in order to foster positive attitudes about sexuality of older adults. This video titled Freedom of Sexual Expression presents sexual expression as a basic human right for all residents, including those with dementia:

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

Want Hospice Care? Refer Yourself. (Video 3:11)

How do you get hospice care? The usual response to this question is that you have to be referred, and doctors have to sign off to make it official. Many people assume this means a family member or a healthcare professional must initiate the referral procedure. Wrong. You can refer yourself.

Maria Hodges suffered for many years with emphysema. Eventually, her body deteriorated to a point where she knew she was dying and couldn’t handle it alone. She went to the Hospice & Palliative CareCenter in North Carolina and referred herself. Her biggest surprise was her discovery that they would treat her in her own home. This is Maria’s story about “the hospice touch” that made her feel cared for and safe after she referred herself:

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 Volunteering Relieves Dementia Stress (Research, Video 1:38)

I watched them playing together, both mesmerized by the rolling magic of a colorful ball slowly passing between them. One was two years old, and the other was eighty years old with dementia. I couldn’t help but smile. They had discovered the bridge that eludes many of the wisest and most educated.

The bridge is that universal connection between two people that makes them one in the moment. Too often, it is assumed that people with dementia, who may not even recognize their own children, are no longer capable of truly connecting as volunteers for others. Thoughts of having them improving their quality of life while performing intergenerational service can easily be dismissed. That’s when we have to be reminded about the bridge. The Department of Humanities at Penn State College of Medicine did just that when they set out to research whether an intergenerational volunteering intervention could enhance quality of life for persons with mild to moderate dementia.

This research involved fifteen participants forming intervention and control groups. Volunteering in hour-long sessions with kindergarteners and older elementary students, intervention group members participated in alternating weeks over a five-month period. Data were collected and analyzed regarding their cognitive functioning, stress, depression, sense of purpose, and sense of usefulness.

Results indicated significant decrease in stress and improved quality of life in three main areas: perceived health benefits, sense of purpose, sense of usefulness, and relationships. Results didn’t mention the bridge, but I know it was there. That’s what the bridge does when appropriate opportunities are created for it to transform lives.

In this video from the Alzheimer’s Society (UK), Lesley, who has dementia, has been fortunate in discovering many bridges that improve the quality of her life. She discusses her previous work with children, her current volunteering with learning disabled adults, and the “lucky” moments that inspire her to be herself.

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

Ground Zero Poem: Hotel Room View

Photo By Frances Shani Parker

Like many others, I felt compelled to visit Ground Zero in New York City after the September 11, 2001 terrorists’ attacks on the World Trade Center. I requested a hotel room with a view overlooking the excavation. An aura of heartache permeated the air, while numerous memorial displays comforted those who sought healing. After taking this picture, I wrote these poetic reflections:

Ground Zero

Scattered images of causalities,

thousands of love notes

blanket a former battlefield.

Whispered memories,

flowered tributes coax

closure of doors left ajar by trauma.

From my hotel window, I watch               

the Ground Zero real-time movie

of a 21st century grave excavation

where the World Trade Center

stood and fell, a kindling target

for terrorists’ fires.

Hills with human remains

transport like treasures

to a Staten Island landfill.

Conveyor trucks beep

warning chants of danger

to a world in global doom denial.

I view the sixteen-acre hole

in the heart of a grieving nation,

listen to victims’ voices

share their haunting horror:

“We fought to live and love

trapped in a fatal inferno,

marooned in a tomb of ruins.

We nursed at the breast of fear

until our spirits were free.”

© 2002 Frances Shani Parker

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 and e-book editions at many booksellers in America and other countries.
Hospice and Nursing Homes Blog