Room Blessing Death Ritual: Nursing Homes, Long-Term Care, Hospice (Research)

I visited Mandy, my hospice patient, at the nursing home one day and immediately noticed the bed of Della, her roommate for over a year, was stripped of all linens. I knew Della had probably died, and I wondered how Mandy was responding. After extending our usual greetings, I asked Mandy if she knew what had happened to Della. Sadly, she looked down and said, “She’s gone.” I waited to see if she wanted to say more, but she changed the subject. These two women had been close friends I had seen interacting happily many times. I knew Mandy was grieving on some level, and, eventually, we expressed our feelings about Della’s death.

I thought about this incident recently when I read a research article titled “They Don’t Just Disappear: Acknowledging Death in the Long-Term Care Setting." I knew exactly what "they don’t just disappear” meant. In a long-term care setting, death of a resident is not always acknowledged with a formal ritual at the location where staff and residents who knew the deceased can mourn with closure. A room blessing with prayers, songs, and sharing of stories about the loved one who has died can provide great comfort. 

This research describes the value of a room blessing ritual held within a long-term care facility. These are the perspectives of 29 staff, residents, and family members who were interviewed after participating in the ritual. Interview results indicated the following about the room blessing:

     1) Those who attended the room blessing felt they received positive closure and grief relief as a result of the formal acknowledgement of the resident’s death.

2    2) Staff members and residents appreciated the opportunity to connect with family members of the deceased and express their condolences during the ritual.

     3) Participants also liked how inclusive the ritual was with staff, residents, and family reminding one another of their shared grief.

     4) Staff members felt that blessing the room for the new resident was important in helping to bridge the gap between mourning and welcoming a new person.

     5) Staff, residents, and family members felt that the room blessing positively reflected the mission and values of the facility.

     6) The most highly valued aspect of the ritual for all attendees was the sharing of stories about the deceased to celebrate that person's life.

Long-term care facilities that are not using a death ritual to assist staff, residents, and family in their closure needs may want to consider using a room blessing ritual as a means of making the end-of-life care transition easier. After the blessing is over, a card is left behind for the next occupant, explaining the room has been blessed to make it a “welcoming and safe home."

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.

New Year’s Resolutions for Older Adults (Video 3:15)

Happy New Year! It’s that time of year again when the resolutionaries sit back and reflect on their yeas and nays of the past and possibilities for the future. Many will make commitments to long-term lifestyle changes and short-term acts that will improve confidence, make them healthier, and bring peace of mind. While general changes such as not smoking, saving money, and exercise are well known, older adults have unique needs that require specific attention for healthy living.

Dr. Alicia Arbaje from Johns Hopkins School of Medicine knows what older adults need and has created a list of the top ten resolutions they should implement if they haven’t already. Briefly stated, they include the following list, but I highly recommend that you view the short (3:15) video for her helpful comments about each resolution. Several need further explanation.

Do you have any more suggestions?

1) Get vaccinated.

      2) Get screened.

      3) Clean house to prevent falls.

      4) Improve sleep patterns.

      5) Do advance directives.

      6) Volunteer.

      7)  Update health records.

      8) Schedule a medication check-up.

      9) Decide if you need a geriatrician.

      10) Get moving.

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

Older Adult Support: Do They Want or Need It? (Research)

Have you noticed that the older people get, the more they are viewed as being in need of support? The problem with this generalized way of thinking is that support can be a very complex consideration. First of all, how do older people really feel about being receivers of support? Researchers of older adults set out to find that answer by interviewing community-dwelling, childless, older adults who were perceived by many to be “at risk” of lack of support.

The real meaning of support became more evident when the level of receiving support had to be defined. When researchers and assessors asked participants if they had enough support, responses regarding support and the experience of receiving it were explained in diverse ways:

   1) Some participants received support resulting from particular circumstances such as illness. They  viewed this kind of support as acceptable due to qualities of the support giver, and/or by being part of  reciprocal exchanges across time.

   2)  Participants resisted support, however, when associated with difficult interpersonal dynamics or the  giver’s assumptions about the receiver’s incapacity.

   3)  Some expressed concerns about wanting to be independent and not needing support.

   4)  Some felt the idea of being old and the equivalent of being in need of support was negative in terms of  being a support receiver.

Where do these responses leave researchers, needs assessors, and potential support givers? These responses emphasize the importance of examining how support receivers view themselves and their particular support needs before attempting to fulfill them. Support givers must not make misleading assumptions about “at-risk” groups. Although childless participants were perceived to be unsupported, many of them had a lifetime of self-support or an intentionally developed  “web of contacts” that satisfied them just fine.

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

Widowhood: Holiday Friendships and Choices (Research)

Men and women experiencing widowhood during the holidays can experience especially difficult times when they are grieving the death of loved ones. Through the years, they may have associated holiday traditions with familiar people and places that they shared as a couple. Research on widowhood involving 328 men and women over age 50 indicates that voluntary social support and interactions from friends have significant impact during this stressful transition, particularly during the early phases of spousal or partner loss.

The following suggestions from my book Becoming Dead Right offer additional bereavement support options for those experiencing widowhood and others 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, 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

School-Healthcare Volunteer Partnerships: Students Help Hospice Patients and Families (Video 1:46)

Most young people have no idea what hospice means or what role they can play in improving lives of terminally ill patients and their families. When partnerships take place between schools and healthcare organizations such as hospice, there are several bonuses. In addition to improvement of academic and affective skills, students become more familiar with aging, illness, caregiving, death, and grief. They also learn about career choices they may not have considered. Patients and families benefit from the many services these young volunteers can provide.

Some hospices and other healthcare facilities have teenage volunteers doing the following assignments:

1. Perform in-office work including filing, faxing, and preparing admission packets.

2. Host tea parties, movies, and other social events at nursing homes.

3. Provide one-on-one time and attention by reading to, writing letters for, playing games with, or simply talking and listening to patients.

4. Videotape, record, or make booklets of patients’ life reviews.

5. Assist families with yard work, cleaning out the garage, planting flowers, small paint jobs, and home-building projects (i.e. wheelchair ramp).

6. Assist patients and families by doing errands, walking dogs, picking up groceries, etc.

My earliest memory of feeding a nursing home patient was not after I became an adult hospice volunteer. It was during my high school days when I joined a school club that encouraged me to make a positive difference in people's lives through service. Cleveland High School art students share a partnership with Hospice of Chattanooga that also creates service opportunities. In this video, students create ceramic hearts for hospice families. The hearts serve as symbols reminding families of their deceased loved ones. Grateful heart recipients have the support of knowing that students cared enough about their healing to make special hearts to connect with theirs.

Note: Winner of the National Service-Learning Partnership Trailblazer Award, Frances Shani Parker, a national service-learning consultant and former school principal, has been instrumental in implementing service-learning in school districts across the country. Her book includes a chapter on intergenerational partnerships between schools and nursing homes.

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