Cane-Fu: Martial Arts for the Elderly (Video 1:59 mins.)

Although the U.S. Justice Department states that the elderly are the least likely to be targeted by violent crimes, it doesn’t hurt for them to be prepared and in better physical shape if they are attacked. And a cane is one weapon that can be carried anywhere. Sure, everybody jokes about using the everyday walking cane as a weapon, but at a retirement home in Maryland and at about 100 locations around the country, they aren’t joking. Cane-fu classes have been going on about ten years.

The goal, of course, is confidence building, a trait that can help anyone feel stronger and more in control. Seniors learn specific skills to help defend themselves and incorporate physical exercise during the learning process. Just knowing that the cane can do more than help them walk is empowering. Many of the class participants say they don’t walk the streets alone anyway.

Hopefully, most seniors will never have to defend themselves with canes, and it’s certainly not encouraged for the weak. I have observed how many seniors enjoy exercises using the Wii games and doing Zumba dance aerobics to Latin rhythms. Cane-fu fighting is another sign of the times, particularly in terms of senior exercise.

In this video, seniors participate in a Cane-fu class.

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

Caregiver Abuse: Does Everyone Have a Breaking Point?

I often wonder if people realize the full impact of what they are saying when they make statements about what they would never do, particularly when they are judging others. Many things people said they would never do, regrettably, they have done. This brings up the topic of elder abuse by caregiving family members. More and more cases of abuse toward elderly patients are being reported. This abuse can be physical, psychological, and exploitative. Many times the abuse occurs in shared living situations with caregivers.

Many people believe everyone has a breaking point, a moral boundary that must not be crossed. Caregivers overwhelmed with depression, guilt, anger, and other stressors may have difficulty not crossing over this boundary, even though they know they shouldn’t. This is one reason why caregivers must always be mindful of taking care of and monitoring themselves. Often assistance from others is, not only helpful, but also mandatory, to prevent abuses from happening. Hospice team members and others can help with these needs and refer caregivers to those who can help them.

Caregivers need respite time away from patients, so they can share their experiences, gain
information from others, and relieve stress. They need programs that save them time and make them feel that they are cared about. They need others to be their caregivers by temporarily relieving their burdens, sharing an uplifting activity, being good listeners, and providing encouragement.

You can view a video about a caregiver confessing how she abused her mother here: https://www.linkedin.com/pulse/caregiver-confesses-abuse-mother-research-video-251-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 in America and other countries and in e-book form at Amazon and Barnes and Noble booksellers.

Hospice and Nursing Homes Blog

My Nursing Home Patient Leaves Hospice Care

Whenever I speak to groups and mention that one of my patients was released from hospice care, audience members seem surprised. This usually happens when I tell Raynell’s story. Raynell, my diabetic hospice patient with dementia, shared a room with four other patients at the nursing home. Her roommates included an imaginary admirer named Robert, whom she loved like the devil loves holy water. Conversing with Raynell required that I drop to the floor periodically and search for Robert under her bed. This was preceded by her screaming, “Get him! He’s going under the bed!” after he (affectionately?) pinched her tingling diabetic legs. But one day, she surprised me with talk about leaving hospice care and the nursing home:

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

Raynell requested my help by saying, “I was wondering if you could help me find another apartment. I’ve been thinking about looking for a new place to stay, maybe a place closer to where I used to live. This apartment building is too noisy. Just close your eyes and listen to all the talking, buzzers, and everything. People come into my place without even knocking. They just walk right in and go through my closet and drawers. It’s not right. Three ladies even moved in with me when I wasn’t looking. Now, I can’t get them out.”

“Whoa! That’s a surprise! I didn’t know you wanted to leave here. Are you sure moving is the best thing to do while you’re not feeling well?”

“Lately, I’m feeling much better. I need a change. Even Robert had to leave, so you know it’s bad. But I’m very glad about that. He’s gone to live in California. I don’t think he’ll be coming back again.”

“A lot sure has happened since I visited you last week. You never said you wanted to move before or that the other people who live here bothered you so much. All this really shocks me.”

I thought about this interesting conversation a while. It was the first time Raynell ever mentioned moving to an apartment and, even more astonishing, the first time she ever said Robert wasn’t hiding under her bed. Two weeks later, she was released from hospice care because her health really had improved. She moved to another nursing home near her son’s house. I guess Robert knew his time was almost up and decided to leave before he got left.

© Frances Shani Parker

Yes, it’s rare, but patients are released from hospice care. Some die within months of leaving, and some live at home or remain in nursing homes. Consider that with various diseases causing the need for hospice care, it is difficult to predict someone’s death with accuracy. Also, receiving quality healthcare and support from others can improve a patient's health. And when an imaginary admirer named Robert knows it’s time to leave, the patient may be moving in that direction, too.

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

Where Are All the Men (Hospice-Palliative Volunteers)?

When hospice-palliative volunteers look around the room during a typical meeting, it becomes obvious that women volunteer at a higher rate. This is not to say there aren’t great male volunteers, but more diversity in this area would be beneficial. Volunteers are motivated for various reasons such as serving and socializing with patients, pursuing career goals, and feeling good about themselves. But, if the rewards are so wonderful, why aren't more men joining? Fortunately, research reported in the “American Journal of Hospice and Palliative Medicine®” sheds light on this phenomenon with an emphasis on middle-aged and older men:

1) After 68 men read a brief description of the kinds of activities that hospice-palliative care volunteers do, 20% expressed an interest in this type of volunteerism. Those who were not interested stated such reasons as "being too busy" and "not being able to handle it emotionally." One third of the men who said they were not interested in becoming volunteers did express an interest in 10 of 13 other common volunteer activities such as driving.

2) After 59 men were presented with a list of 25 volunteer tasks from which they could choose, the men were least willing to serve on the board of directors (28%), provide hands-on patient care (38%), and work in the volunteer program's office (42%).

Men were most willing to talk to patients (97%), share hobbies and interests with patients (92%), listen to patients’ memories and life stories (90%), and provide friendship and companionship (88%).

These are the facts straight from men themselves. Hopefully, this information makes preferences of many potential male volunteers clearer. Volunteer coordinators can consider these male motivations as part of their recruitment strategies leading to more diversity.

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

Hospice Volunteer-Patient Wheelchair Rides

In my book “Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes,” I discuss wheelchair rides with my hospice patients. These rides provided great bonding moments. They brought patients in contact with the outside world and provided priceless occasions for me to learn interesting facts about their pasts and their personalities. They gave patients opportunities to extend boundaries beyond their rooms to include other patients, staff, visitors, activities, stimulating sights, and sounds.

A patient named Nat had a wheelchair-riding contest with himself every time we returned to his room from outdoors. He briefly pushed his wheelchair fast to beat the door buzzer that went off when we entered from the porch. This was a race he always won. He never tired of playing this game or bragging about how fast he was every time he won, as if he had hit a home run. People sitting in the lobby began to expect that when we entered, there would be a lot of hoopla over Nat’s beating the buzzer. Laughing with triumph, he enjoyed celebrating his victory and telling everybody I was his wife. This came from a white man who initially expressed reluctance about being assigned a black volunteer.

One day outside in the parking lot, I was taken aback when a patient named Gail explained, “I lived here in this nursing home on the fifth floor for years. Look up there. That open window on the corner is where my room was. I used to look out that window and see my car. I’d walk around on all the other floors and talk to people. Everybody here knows me, except the new people.” It never occurred to me that she had been in the nursing home so many years. I thought she had come after she was diagnosed as a hospice patient. I had wondered why she was so well known on every floor. A nurse confirmed her story later. Even as her memory faded, Gail still had a living history there that tapped her on the shoulder, whispered in her ears to remind her of who she had been and what she had done as a more independent woman.

Sharing time with patients on wheelchair rides, I sometimes felt like I was watching them perform a dance of seven veils as they gradually revealed new layers of interest about themselves. And because volunteering is such a win-win experience, I also learned a lot about myself. In every way, we were dance partners.

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

Sperm Retrieval From Terminally Ill or Recently Deceased Patients

Requests for sperm retrieval from terminally ill or recently deceased patients continue to increase along with controversy. Major reasons for this increase are the success and acceptance of techniques that assist reproduction such as in vitro fertilization. These requests are accompanied by several concerns regarding legal, ethical, and financial issues. Two areas of controversy involve consent for the retrieval of sperm and the validity of family consent. Obviously, family members and healthcare providers need some form of medical protocol to resolve the ongoing controversy that is not going away.

Some feel that men themselves, particularly those about to get married or enter into a similar relationship, can resolve problems related to consent by addressing retrieval of their sperm in advance in the same way a living will is handled. By documenting their wishes before a need occurs, sperm retrieval can take place during the terminal illness or recently after death. This research by the University of Maryland Medical Center examines sperm retrieval from terminally ill or recently deceased patients.

What do you think about this ongoing debate?

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

Nursing Home Compare Report Card Research and Nursing Home Tribute Video-1:53 mins.

The Nursing Home Compare report card, published by the Centers for Medicare and Medicaid Services, reports results of nursing home inspections that measure whether Medicare or Medicaid certified nursing homes meet minimum standards for a particular set of requirements. Do these report cards really impact improvements in nursing homes? A study by the University of California examined this by conducting a survey of over a thousand randomly selected nursing home administrators.

Survey results indicate that the report card does serve as an incentive to improve facilities. Most nursing homes reviewed their quality report card scores regularly and have made efforts to improve. Homes that were performing poorly were more likely to improve after the scores were published. The Nursing Home Compare report card seems to be serving a good purpose by encouraging nursing homes to improve.

Keep in mind that deficiencies that are not reported by the nursing homes are not reflected on the report card. Some feel that the reports should be more detailed. Results of inspections must be available onsite for public review. When looking for a nursing home, the report card should be used only as one part of the search. Several visitations to nursing homes and asking questions of concern are important before making decisions.

You can read more here about this study on the Nursing Home Compare report card.

This video titled “Nursing Home Heroes - a Tribute” celebrates the often unsung staff heroes in our nation’s nursing homes.

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

Preparing for the End of Life: Doing What We Say

An eldercare consultant, I often witness the contradictions many people make regarding end-of-life preparation. Therefore, it was no surprise when I read the results of the “South Dakota’s Dying to Know” statewide survey about end-of-life concerns. South Dakota surveyors wanted to gain understanding of attitudes, advance planning, knowledge, and preferences residents had about end-of-life issues. Surveys were sent to 10,204 randomly selected households. These are the results:

1) Most respondents said preparation for the end of life was very important, yet far fewer had actually taken steps to ensure their end-of-life wishes would be known or honored.

2) Most people did not want artificial hydration/nutrition at the end of their lives, preferred to die at home, and harbored misconceptions about pain; yet, most had not engaged in conversations with their physician, minister, or lawyer about these issues.

3) While some adults were unfamiliar with hospice care, when provided with a definition, a majority indicated that they would want hospice care if they were dying and preferably in their own homes.

Doing what we say we want is an ongoing problem when it comes to end-of-life preparation. Like most people, many South Dakotans have end-of-life preferences that they have taken no actions to implement. These results reinforce the continued urgency for patient conversations initiated by doctors and other healthcare workers, not only with the elderly who are near the end of their lives, but with all patients. More discussions by family and community members are also needed to bridge that long-standing gap between what we say and what we do.

You can read more here about"South Dakota's Dying to Know" statewide survey.

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

Video Poem: “Living Colors” (Nursing Home, Staff Shortage, Poor Vision, Alzheimer’s Disease, Hospice) 2:56 mins.

“Living Colors” is one of sixteen original poems included at the end of each chapter of "Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes.” With poems, stories, and general information, "Becoming Dead Right" explores urban nursing homes, hospice care, caregiving, dementia, death preparations, and bereavement. Strategies for improving eldercare and nursing homes are examined.

This poem was inspired by one of my hospice patients who had Alzheimer’s disease and poor eyesight. More sight problems could be corrected in nursing homes if residents received vision care regularly. My patient needed assistance to eat, but there was a staff shortage that day. Staff shortages in nursing homes negatively impact patients across the country. Using her fingers, she started feeding herself. I arrived to find her with food smeared around her mouth. After wondering what that experience might have been like for her, I wrote this poem:

Living Colors



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

What Do Young Adults Think About Hospice and Home Death?

We spend so much time discussing hospice and seniors, we may not be aware of young adults’ opinions about hospice or home death. Why are their opinions important? Hospice care impacts families, not just terminally ill patients. Young adults need education on death-related options that are available for their loved ones and for themselves.

The Department of Psychology at the University of Alabama did research exploring preferences of young adults. This study examined what influenced 1,035 psychology students’ opinions about hospice and home care. The sample was 66% female and 60% Caucasian, with females having more knowledge of hospice, more positive opinions about hospice, and a higher likelihood of recommending hospice.

Regarding home death, Caucasians had a more positive opinion of home death than African Americans. Individuals describing their prior experience with the death of a loved one as negative had a more positive opinion of home death than those with no prior experience or a non-negative experience.

What this study made clearer is the wide range of opinions young adults had about hospice and home care, particularly in terms of gender and race. In addition, a large amount of neutral responses indicated the significant potential for influencing more young adults’ opinions in support of hospice if they receive more hospice education.

You can read more about this research on young adults’ opinions on hospice and home death.

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

Culture Change: Nursing Home Dining (Video 2:13 mins.)

Broadwater Health Center (above) in Montana has cooked-to-order breakfasts and multiple-entree noon and evening meals.

The Centers for Medicare and Medicaid Services (CMS) guidelines for state surveyors give detailed information on accessing nursing home compliance with regulations. Recently, the CMS added that nursing homes must support residents' preferences and other efforts to transform nursing homes into homelike environments. Changes mentioned are both environmental and resident-centered. They include activities such as dining, scheduling, bathing, sleeping, and many more beneficial changes that will advance reform in nursing homes.

A hospice volunteer in Detroit nursing homes, I am aware of the great need for reform. Across America, best practices in many nursing homes are far ahead of those in too many others. But improving nursing homes requires much more than environmental enhancements and enrichment activities. Changing the culture of nursing homes successfully requires major shifts in thinking with input from all levels of staff, residents, and community. Incentives encouraging achievement of new and shared goals are also effective. A helpful resource is the National Consumer Voice for Quality Long-Term Care. This organization was formerly the National Citizens' Coalition for Nursing Home Reform (NCCNHR).

In this video titled "Culture Change Dining - Restaurant Style,” we see how residents and staff of Ballard Healthcare have implemented improvements in the dining program.

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

Video Poem: “Reflections of a Hospice Volunteer” (Hospice, Nursing Homes, Eldercare) 3:25 mins.

“Reflections of a Hospice Volunteer” is one of sixteen original poems included at the end of each chapter of "Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes.” With poems, stories, and general information, "Becoming Dead Right" explores hospice care, urban nursing homes, caregiving, dementia, death preparations, and bereavement. Strategies for improving eldercare and nursing homes are examined.

Dedicated hospice volunteers everywhere enhance quality of life during patients’ final days. This poem expresses the win-win experience of many volunteers.



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

Hospice Volunteer Training: End-of-Life Communication Issues

Sooner or later, hospice volunteers experience or observe communication concerns relating to patients or their families. In a research study by the Communications Department at the University of Utah, hospice volunteers reported that denial was the most common communication issue for patients, family members, and caregivers. The second most reported communication problems related to negative feelings and family conflicts. At personal levels, volunteers reported that their most common communication problems centered on interacting with patients who had diseases such as Alzheimer's or Parkinson's disease that impaired conversations. These results suggest that volunteer training programs should include more information to support volunteers in their communication efforts.

Personally, I enjoy coming up with ways to bridge gaps in communication. I never assume patients cannot hear me, unless they have been officially diagnosed as hearing impaired. I talk to them the way I would talk to hearing patients. I tell them what's going on at the nursing home and other news. Even when their eyes are closed, but I know they are awake, I tell them who else is in the room and say something positive about them to those present, so patients can feel included in the conversations.

I check their assignment forms and talk to their caregivers to find out what their backgrounds and interests are. This gives me more sources for topic ideas. If patients are able to leave the room, I take them on walks or wheelchair rides. I read to them, play music I think they will enjoy, touch them to reinforce my presence; I feed them, play games, sing, play the radio, and watch television with them, regularly making comments and always analyzing their body language to see if I'm making connections.

When I do a good job of this, I see signs that we are making progress. There may be smiles, alertness, something in their eyes that tells me our communication gaps are getting smaller, that we are forging relationships enhancing our lives. That's when the beauty of hospice volunteering sweeps me up like a great piece of music.

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

Video Poem: “Pieces of Our Minds” (Dementia, Alzheimer’s Disease, Hospice, Nursing Homes)

"Pieces of our Minds" is one of sixteen original poems included at the end of each chapter of my book "Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes.”

Dementia refers to a group of conditions that gradually destroy brain cells and lead to mental decline. Various conditions can cause dementia, but Alzheimer’s (Ahlz-high-merz) disease is the leading cause. There is no cure for patients with dementia, and eventually they need complete care. Their quality of life improves when they receive effective healthcare and support.

As a hospice volunteer in Detroit nursing homes, I learned that dementia is like a fluttering bee. I never knew when it would make honey or sting. I participated in adult fantasies often. An important lesson I learned is that I don’t know the extent of anyone’s mental boundaries. One thing I know for sure is that I visited their Oz weekly and became a better person.





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

Hospice Worker Strategies When Families Expect Miracles

The terminally ill and their families often expect miracles. What can hospice workers do when families firmly hope for miraculous recoveries of dying patients? Doctors are particularly challenged when families continue to speak of divine intervention after all earthly procedures have failed. Respect for the spirituality and religions of others is important during healthcare treatment. Knowing how to walk that fine line of balance can weigh heavily on the quality of death journeys.

Research by the University of Pennsylvania School of Medicine, USA has provided a practical approach to this concern that allows families' beliefs in miracle healings to coexist with practices of good medicine. The following strategies applied to meet the unique needs of families are involved:

1) Exploring the meaning and significance of miracles

2) Providing balanced, nonargumentative responses to families' expectations of miracles

3) Negotiating patient-centered compromises while demonstrating respect for families' spirituality and doing what is medically appropriate.

Using these strategies can provide a means for hospice workers to maintain good relationships with families expecting miracles while medical practices are implemented. Patients are always the first priority.

This Fox News video clip is an example of why many people believe in miracles, regardless of a medical prognosis. Viewers witness the miracle of Val Thomas, a woman who was technically dead for almost 18 hours after two heart attacks. Rigor mortis had even set in. Yet, she lives!


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

Caregiving with Music Enhances Communication

Are you a caregiver? Do you sing? Do you enjoy playing music? If you answered “yes” to these questions, you have the ability to add vitality and meaning to patients’ lives, especially those who have dementia. Music and singing can uplift their spirits.

A study was done to enhance vocally expressed emotions and moods in the communication between caregivers and persons with severe dementia. Participants included nine nursing home residents with dementia and five professional caregivers. The presence of background music and caregiver singing enhanced the communication between caregivers and residents. Background music promoted playfulness. Caregiver singing improved sincerity and intimacy in their interactions.

How do these results influence you as a caregiver who sings or plays music? They support your efforts to provide quality of life for patients with dementia. Take the time to find kinds of music you think patients will enjoy. Let the magic play.

You can read the research that was reported in the “International Journal of Nursing Studies.”

In this video, Mary Peakes, a hospice nurse, sings "I Wanna Go" to patient Pamela Rucker, who died a few days later. Pamela’s daughter stated, “I want to thank all the hospice nurses. I am so grateful for these angels who helped my mother and her family through this difficult time.”

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

Processing Grief Through Art: Drawing a Dying Loved One (Video 2:30 mins.)

Those of you who have grieved at the bedside of a dying loved one can probably recall the many streams of thoughts that confronted you. Grace Graupe Pillard experienced her own unique recollections while drawing pictures of her dying mother every time she visited her bedside.

Grace makes it clear that she and her mother had a rocky, but affectionate, relationship. Her mother, a refugee from Nazi Germany, was receiving hospice care at the time. While drawing, Grace began to experience her mother in an objective way for the first time. An intimacy evolved between them that she had not known before. Her mother knew she was being drawn. In spite of their turbulent differences, their similarities surfaced. In the last picture of this visual diary, her mother’s mouth is open.

After studying scanned pictures of her mother, Grace noticed clearly in the flow of the lines the different emotions she had felt while drawing. She says her artistic involvement in her mother’s dying helped her to process the grief of losing someone who was such an important part of her life. Grace created an exhibition of her drawings in a show titled “Stop Stealing My Face.”

This video showcases an interview with Grace Graupe Pillard and displays of her artwork.

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

Friendship, Loneliness, and Senior Women Living Alone (Video: 1:04 min.)

Do senior women with family members who live nearby really need friends as much as senior women without family members living nearby? According to this research, they do. Reported in the “Journal of Gerontological Nursing,” a study by the University of Northern Iowa in Cedar Falls examined the role of friends in predicting loneliness among women over age 65 who lived alone. Researchers hypothesized that those women who didn’t have family members living nearby would be lonelier than those who did. Well, that didn’t happen. It turns out that “close friends were important for women living alone, regardless of whether they had family living locally.” This information is noteworthy because it emphasizes the need for making social connections a priority in the lives of older women who live alone, regardless of their local family connections.

This video titled "Knitting Together" showcases a group of older women who socialize through weekly knitting sessions. A woman shares near the end, “I’m here to enjoy the company.”

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

Hospice Volunteer Book Review: Meeting the Death Monster in Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes

In America, death is still a terminally ill taboo in great need of palliative-hospice care. Too many people avoid talking, hearing, writing, or 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” or too “final.” Several months ago, this reluctance to deal with death visited a friendship. I had given a casual friend a copy of my book Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes. Not knowing her feelings about death, I decided not to talk to her about the book unless she brought it up. Recently, she did. I’ll call her Alice.

Alice works in the healthcare profession, so 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, she admits she could never be even an average hospice volunteer.

What is her feedback regarding my book? 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 caregiving, dementia, death rituals, and bereavement informative. The explanations about school-nursing home partnerships and the ideal nursing home described in the chapter “Baby Boomer Haven” 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 deal with 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. One person at a time, I believe conversations and writings enhance lives of the naysayers by slowly empowering them with death acceptance, even as they resist the message. I appreciate Alice’s frankness in sharing death’s painful 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 here at my 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 online and offline booksellers.

Hospice and Nursing Homes Blog

Impact of Death Rattle Sounds on Hospice Workers (Research, Video 3:27)

Anyone who works closely with dying patients may have heard death rattle sounds. Hospice workers, including volunteers, who have heard these sounds in the presence of patients’ relatives and friends may feel the need to explain to them what the patient is experiencing and reassure them.

According to Wikipedia, a “death rattle is a gurgling or rattle-like noise produced shortly before or after death by the accumulation of excessive respiratory secretions in the throat. Those who are dying may lose their ability to swallow, resulting in such an accumulation. While it is medically established that the death rattle is a strong indication that someone is near death, it can also be produced by other problems that cause interference with the swallowing reflex. It is sometimes misinterpreted as the sound of the person choking to death. In terminal care, drugs may be used to reduce secretions and minimize this effect.”

A study reported in Palliative Medicine was done to see how the death rattle sounds impacted hospice staff and volunteers. Most expressed negative feelings about hearing the sounds. Many felt the need to intervene to end the sounds using a therapeutic option. The study concluded that “doctors and nurses need to consider why, when and how they intervene and the consequences of that intervention.”

You can read more about this study here and more recent 2015 research here.

This video below features signs of a person approaching death:

Visit here for more research and other information about the death rattle experience, including a recording of actual death rattle sounds.

It would be interesting to read firsthand information from hospice workers, healthcare staff members, and other caregivers regarding their personal experiences with a patient during a death rattle experience.

Please scroll down to many comments below.

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