Older Adult EnhanceFitness Exercise Program (Research, Video 3:12)

Whenever I talk to older adults about exercising, I usually hear comments like these:

1)   I attend a weekly hustle class that energizes me.

2)   Twice a week, I walk in the mall where I feel safe.

3)   I keep busy babysitting my grandkids every day.

4)   Mostly, I keep active going places and doing things around the house like gardening.

It doesn’t take long to conclude that many older adults associate exercise mainly with simply moving around. Unless they participate in strength training and flexibility exercises in addition to aerobic conditioning, many who are able to perform all of these activities are not benefiting from a total fitness program. Sometimes I wonder what would happen to those who lack strength training if they fell and were stuck on the ground with a good heart rate, but little strength to get up.

I was especially pleased when I read this strength training research done by Wayne State University in Detroit, MI. The purpose was to determine the effects of 16 weeks of strength training on measures of functional ability in elderly who are functionally limited. Divided into an exercise and control group, the 87 participants (ages 65-93) were living independently, but with functional limitations. Three days a week over a 16-week period, exercising participants attended 13 different strength training exercises using Thera-Band resistive bands. They exercised in a group setting once a week and were given a home exercise book to follow for two additional sessions per week.

Results showed significant upper-body strength improvement for the exercisers’ strength as measured by bicep curls and lower-body strength as measured by chair sit-to-stand. The control group participants achieved minimal changes. Having good functional ability is inversely correlated with short-term morbidity and the need for assisted living in older adults. It’s important that this population becomes more educated and receives more opportunities for resistance training to maintain their independence.

EnhanceFitness is a well-rounded exercise program implemented nationally in many older adult communities. An award-wining program backed by over ten years of scientific research, EnhanceFitness participants work out three days a week with certified instructors. Funders of the program like the low costs, the sustainability, and especially the positive outcomes. 

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

Hospice Book Review Haunted by Death Monster

Don’t be afraid to read this. Death in American society is still a terminally ill taboo in great need of palliative-hospice care. Too many people avoid talking, hearing, writing, or even reading about the end of life. As an author and consultant on hospice and eldercare, I have been told on several occasions that the topic is just too depressing and final. If you’re a hospice worker, you may have noticed that people often think we’re a little strange because we choose to work with people who are dying.

This reluctance to deal with mortality visited a friendship of mine. I had given a casual friend a copy of my book Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes. Wanting to be sensitive  and not knowing her feelings about death, I decided not to talk to her about the book unless she brought it up. Eventually, she did. I’ll call her Alice. She approved my writing this post.

Because Alice works in the healthcare profession, I was somewhat surprised to discover that she feels strongly that death, a frightening stalker of her dreams, is her enemy. She shared that death has stolen too many of her loved ones, including pets. She helplessly dreads the thought of losing even more. My own acceptance of death, which comes across clearly in my conversations and writings, seems inappropriate to her. She finds my views too accepting of her enemy, too casual a regard for life. While she says she would consider hospice care along with other options in the future, she admits she could never be even an average hospice volunteer. It would be too painful.

What is her feedback regarding Becoming Dead Right? She loves the patients’ stories and my comments about interacting with various people in the nursing home world. The original poetry, which concludes each chapter and probably nudges her own poetic abilities, pleases her. She finds the discussions on hospice, nursing homes, caregiving, dementia, death, and bereavement informative. The explanations about intergenerational school-nursing home partnerships and the ideal nursing home described in the last chapter are particularly enjoyable. But she dislikes emphatically the premise that there is a “right” way to die.

I am not sure if her hostility toward death has changed much, but I hope that this book meeting with what she refers to as “the monster” has impacted her positively on some level. Those of us who embrace the topic of death will continue to be viewed with dismay by those who manage mortality through avoidance and resignation of themselves and loved ones as victims of death’s malicious powers.

Alice’s revelations reinforce the importance of promoting death as a natural part of life that should be experienced with dignity by everyone. I believe conversations and writings enhance lives of the naysayers one person at a time. These efforts empower them slowly with death acceptance even as they resist the message. I appreciate Alice’s frankness in sharing death’s distressful presence in her life and in giving feedback on my book. Most of all, I commend her willingness to become a ball of courage rolling into the high weeds where the death monster lives.

You can read book endorsements, excerpts, and more at my website.

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

Hospice, Long-Term Care, and Dementia Quiz

Hospice, Long-Term Care, and Dementia Quiz

What's your response to these statements?

By Frances Shani Parker, Author

Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes

               

1)   Death is a terrible thing.

Fact: Death is a natural part of life that everyone will experience. Accept, discuss, and prepare for becoming dead in your future.

2)   It’s always better to die at home.

Fact: “Home” can be the presence of love and comfort wherever a terminally ill patient may be. Most people die in institutions.

3)   Hospice speeds up death.

Fact: If two similar people had the same terminal illness, the one receiving hospice care would probably live longer.

4)   Pain is a natural part of aging and dying. Under-treated pain slows down the death process.

Fact: Pain medication is available to offer appropriate relief to patients. Under-treated pain worsens the process unnecessarily.

5)   Patients with dementia don’t miss visits from relatives and friends they don’t recognize.

Fact: Patients with dementia are often aware of their surroundings on some level. Loved ones should focus on patients’ current abilities and make every effort to spend quality time with them.

6)   Patients with dementia are always suffering.

Fact: Patients with dementia have varied days like everyone else. Happy memories and enriching activities can slow-dance into their realities and fill them with joy.

7)   Caregivers must only focus on their patients.

Fact: Caregivers must focus on their own care as well. They should seek supportive resources and monitor their sleep habits, irritability, and general health, always with a willingness to seek help when needed.

8)   Caregivers should not question decisions of healthcare professionals who are the experts.

Fact: Caregivers should be proactive as patient advocates. They should stay informed about patients’ symptoms, diseases, treatment purposes, and side effects.

9)   Long-term care facilities are not good places for children to visit.

Fact: Intergenerational experiences help children understand life’s passages. Children should experience opportunities that encourage them to become nurturing people, eliminate ageism stereotypes, and expose them to possible career choices.

10) Hospice work is mostly depressing.

Fact: Millions of hospice workers view their involvement with patients as privileged occasions for mutual growth and fulfillment.

© Frances Shani Parker

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

Assisted Living Facilities Provide Hospice Care (Research, Video 3:48)

Many people have told me that they didn’t know hospice care exists in nursing homes. Even more seem surprised to learn that hospice care can be provided for residents in assisted living facilities. I can’t emphasize enough that hospice care is available no matter where a qualified person lives at home, in an assisted living facility, in a hospital, and even in prison.

What does good quality care at the end of life look life for hospice-enrolled residents in assisted living facilities? A study was done by the Oregon Health & Science University to get detailed descriptions of end-of-life care provided by medication aides, caregivers, nurses, and hospice nurses in urban and rural settings. Interviews were used to gather information. Having worked as a hospice volunteer in urban nursing homes for several years, I was interested in the results. They were very similar to what I would have expected from a nursing home or any other institutional care:

1)   The quality and nature of resident-staff and assisted living-hospice staff relationships are critical in promoting good end-of-life care for residents.

2)   Length of the resident's stay in the facility and how well staff knew the resident were associated with the quality of the resident-staff relationship.

3)   Respectful collaboration, clear communication, use of complementary knowledge and skills of staff, and shared expectations about the care were associated with positive staff relationships.

4)   Administrative support for hospice patients in assisted living facilities was important.

Assisted living facilities and hospice organizations that are committed to working together with hospice programs must both support staff, patients, and families. There is a need for more successful models of this partnering system of care to meet the needs of our growing population of older adults.

This video titled Hospice: At Home, In Assisted Living, In Hospitals relates the positive experiences of patients receiving hospice care in different settings:

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

Person-Centered Care: Nursing Home Culture Change (Photograph Research, Video 4:00)

Change is not always easy, especially if there is widespread acceptance that practices are working well the “wrong” way. Fortunately, the growing movement of nursing home culture change across America is transforming beliefs in what the “home” part of nursing home really should look and feel like. In many cases, reluctant staff members who resisted change at first are seeing the benefits, particularly regarding improvements in residents’ health.

Even something simple like automated historical digital displays of residents' photographs to remind staff of each resident’s personhood can positively impact patient-staff communication. Researchers at the University of Kansas School of Nursing displayed residents’ historical photographs in digital frames in their rooms. They compared audio-recorded staff-resident conversations before this intervention with conversations afterwards. Results indicated increased staff person-centered talk and less task-oriented talk. Residents spoke more about interpersonal topics. Their engagement and reminiscence improved. Implementing low-cost historical photo displays in residents' rooms enhanced person-centered communication. 

Many other interventions can advance person-centered care in nursing homes. Staff members who have made the paradigm shift from traditional nursing home settings to nursing homes with person-centered environments and practices can best explain the transformations of themselves and residents. 

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

Clown Doctors for Older Adults: Dementia Research, Video 1:58

It’s no joking matter that laughter has important therapeutic value that can improve quality of life. The best laughter is spontaneous. Not only can we create reasons to laugh ourselves, other people can trigger the laughter response from us. It just makes good sense that the benefits of laughter should be integrated into the prevention and treatment of illness.

How about older adult clown therapy performed by clown doctors? Limited research shows that practitoners are increasingly using clown doctors in geriatric settings, including with people who have dementia and their caregivers. Clown doctors can help dementia patients improve well being, promote social interaction with their environment, and reduce problematic behavior. Benefits for the nursing staff include reduced workloads and stress relief. The overall work atmosphere becomes more positive. Keep in mind, however, that there are people who are very fearful of clowns.

The video Volunteer Clowns Visit Hospital Patients shows adults enjoying visiting clowns in California hospital.

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

Nursing Home Hospice Impact on Certified Nursing Assistant (CNA) Staff (Research, Video 1:56)

Hospice care in nursing homes continues to increase as more people become aware that hospice services are available wherever they live. Back in the 90’s when I first started hospice volunteering, many people told me they thought hospice care was only at private homes or in free-standing hospice facilities. On the negative side, there were those who thought nursing homes would get kickbacks from hospice referrals. Speculation about nursing homes receiving additional staff hours at no cost, which could lead to decreases in nursing home staffing, was mentioned.

What has happened in terms of nursing assistant staffing with the introduction of hospice care in nursing homes? Researchers at Warren Alpert Medical School at Brown University studied this process for several years with these staffing results:

“The introduction of hospice services in a nursing home did not result in statistically significant changes in nursing assistant (CNA) staffing. Instead, increases in hospice volume resulted in small increases in CNA staffing.”

As a hospice volunteer working directly with patients, I had many opportunities to observe and communicate with CNA staff members who were often first responders in meeting resident needs. Many exhibited dedication and genuine care for residents in spite of their own expressed hardships on the job such as low pay, high staff turnover resulting in increased workloads, and lack of appreciation. The following video titled I am a Nursing Assistant shares their caregiving challenges and rewards:

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 Adults, Seniors Celebrate Mardi Gras (Nursing Home Residents in Video 1:26)

Mardi Gras celebrations in New Orleans, my hometown, and in other cities greatly enhance older adults' quality of life. Mardi Gras Day will be next week on February 21 on "Fat Tuesday," the day before the Christian season of Lent starts. Older Adults celebrating this world-famous Carnival season often have parties and small parades. Many nursing homes and senior communities participate in the fun. Street parades attracting thousands of local residents and curious tourists occur daily. Parades are held during the day and at night.

Growing up in New Orleans, I loved this magical season. Mardi Gras parades created wonderful memories for me. The excitement of swimming in an ocean of festivity, the buoyancy from living fantastic fantasies thrilled my senses. They connected me with the same wave of wonderment flowing through every child who ever lived on this planet.

I store my New Orleans memories in a marvelous, mental, treasure chest painted with purple, green, and gold brush strokes, the official colors of Mardi Gras. All grown up, I still smile when I look inside. No doubt, many older adults will be smiling during Mardi Gras season now and in the future.

Upcoming Mardi Gras Day Dates

• February 28, 2017
• February 13, 2018
• March 5, 2019
• February 25, 2020
• February 16, 2021
• March 1, 2022
• February 21, 2023
• February 13, 2024
• March 4, 2025
• February 17, 2026
• February 9, 2027
• February 29, 2028
  March 5, 2030
  February 25, 2031,
  February 10, 2032
  March 1, 2033
  February 21, 2034
  February 6, 2035
  February 26, 2036
  February 17, 2037
  March 9, 2038
  February 22, 2039
  February 14, 2040
  March 5, 2041
  February 18, 2042
  February 10, 2043
  March 1, 2044
  February 21, 2045
  February 6, 2046
  February 26, 2047
  February 18, 2048
  March 2, 2049
  February 22, 2050

This video includes nursing home residents in small Louisiana communities participating in outdoor and indoor Mardi Gras celebrations that entertain all ages:

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

Hospice Volunteer End-of-Life Vigil (Video 1:58)

The body knows when it’s time to slow down and die. Each body will die in its own way and in its own time when the process starts. The importance of being with a patient who doesn’t want to die alone is the reason many hospice programs are providing specialized volunteer vigil training. When it comes to patients, it is more about the volunteer being there than what the volunteer actually does. The patient senses and appreciates the volunteer’s presence. During vigil training, a volunteer is taught how to provide bedside support during the final days and hours of a patient’s life. Assistance for families is included. This can be an overwhelming time for patients and their families because so much of the experience is unchartered territory.

At some facilities, staff members also volunteer for vigil assignments. Vigils, which are based on a patient’s wishes, can include talking, praying, inspirational reading, playing music, performing rituals, touching and, of course, sharing silence. Vigils may last hours or days and can be done in shifts. Reflecting the hospice philosophy, volunteer vigils help provide the patient with a more peaceful end-of-life experience.

In this video, Doris, a hospice volunteer at the Hospice of Western Reserve shares her hospice experiences that include end-of-life vigiling with patients actively dying:

Many healthcare staff members who work with dying patients will tell you they have had patients share stories about seeing dead people, ghosts, spirits they recognize, and angels. View this post for my personal story and an informative video: https://www.linkedin.com/pulse/end-of-life-seeing-dead-people-angels-frances-shani-parker?trk=mp-author-card

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 Online Love: Internet Dating (Research, Video 3:59)

Believe it or not, the Internet is a good place to find out about the current status of older adults looking for romantic love. If you think they aren’t searching for love there in substantial numbers, you probably aren’t aware of numerous websites with a specific focus on meeting their matchmaking needs. I know several older adults myself who have found love on the Internet, but I’m also aware of some horror stories.

Older women looking for romance with men are at a particular disadvantage due to the shortage of eligible men available to them. Should they lower their standards or keep them high? After all, many older women are happier with lifestyles free of romantic obligations? What about men with the advantage of choosing from a much wider pool of women? How selective are they? Do older adults approach romance in a different manner than younger adults?

Research on older adults and romance was undertaken by the Department of Psychology at Georgia Southern University to determine these answers. They compared Internet dating profiles of 100 older adults and 100 younger adults. These results give insight into how older adults are approaching romance these days:

1)   Older adults, especially older women, were more selective than younger adults when it came to age, race, religion, income, and height of a prospective dating partner.

2)   Older adults were willing to travel substantially farther than younger adults to meet the right partner.

Note: My personal research at a popular matchmaking website indicated that many older adult men want women at least five to ten years younger than they are. That certainly doesn’t help older women, especially those who are more energetic and vibrant than most women and men their age.

What does all this research say about older adults in their search for love? They are eager to find that special someone, but not willing to settle for just anyone. Apparently, age and experience have made them pickier.

The older adult couples in this video from The Early Show met online and have been successful in finding love. Some older adults however, do find online meeting to be distrustful because potential dates don’t always tell the truth about themselves. Others still want to try to find soulmates there and not give up. All four couples who met online and married thought there were advantages in meeting on the Internet such as being able to ask more questions and getting to know more dating candidates faster. What about you? Would you try Internet dating? Do you have an Internet love story to share?

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 form at Amazon and Barnes and Noble booksellers.

Hospice and Nursing Homes Blog

Hospice Poem: Michigan Volunteer Honors Alzheimer’s Patient and African American Ancestors (Ruby Bridges)

Guarded from angry mobs by federal marshals in 1960, first-grader Ruby Bridges integrated William Frantz Public School in New Orleans, Louisiana, my hometown. In protest during the first year, most parents withdrew their children from the school.

Because my hospice volunteering is primarily in Detroit, Michigan, many people assume that all of my patients are African American. Actually, I have had several Caucasian patients who were in my care for years. Dying is universal. My patients and I come together as strangers and often discover that we share similarities that bond us to higher levels of understanding of one another and ourselves. Shared similarities can include race, language, talents, occupations, travel, values, joys, and pains.

I was inspired to write this poem while watching my hospice patient sleep. I thought about our shared African American heritage that bridged our communication beyond her Alzheimer's disease. This poem is dedicated to her and our ancestors, especially those strong and inspirational like Ruby Bridges.

Deeper Than Words

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.

© Frances Shani Parker

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

Honoring a Nun Who Has Alzheimer's Dementia

You can also read my tribute to a nun who positively impacted my life as a child and later developed and died from Alzheimer’s disease here:

https://www.linkedin.com/pulse/honoring-nun-who-has-alzheimers-frances-shani-parker?trk=mp-reader-card

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 also in e-book editions at Amazon and Barnes and Noble booksellers.

Hospice and Nursing Homes Blog