Lesbian, Gay, Bisexual, Transgender (LGBT) Healthcare (Research, Video 4:13)

Most people will agree that their sex and sexuality are core components of their human experiences. Lesbian, gay, bisexual, and transgender (LGBT) people are no different in this regard. Unfortunately, they continue to be discriminated against in society based on these important components that reflect who they are as people. This discrimination exists in the healthcare system and negatively impacts the kinds of treatment they receive.

Scholarly research on the sex and sexuality of terminally ill lgbt people receiving palliative and hospice care, especially those from minority populations, is very limited. LGBT sexual expressions may change with advancing age and illness in ways that differ from more traditional concepts. While the U.S. Supreme Court decision regarding marriage equality has further advanced LGBT cultural views in society, much more research is needed to advance understanding of this population’s unique healthcare challenges.

All healthcare clinicians should focus on treating lgbt clients with patient-centered care that respects who they are and enhances their quality of life.

Produced by the American Academy of Hospice and Palliative Care Medicine, this video features the palliative care insights of Dr. Bruce Scott. He shares ways for healthcare professionals to improve their relationships with lgbt clients and positively impact care.

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

Homeless and Old (Research, Video 3:25)

Older homeless adults have high rates of geriatric conditions which may increase their risk for acute care and nursing home placement. In research interviews of 350 homeless adults 50 and older in Oakland, CA, the following results revealed their living environment over a 6-month period:

1) Participants stayed in 4 primary environments: unsheltered locations, multiple locations including shelters and hotels, intermittently with family/friends, and, in a recently homeless group, rental housing.

2) Overall, 38.9% of participants reported difficulty performing 1 or more activities of daily living, 33.7% reported falls in the previous 6 months, 25.8% had cognitive impairment, 45.1% had vision impairment, and 48.0% screened positive for urinary incontinence. The prevalence of geriatric conditions did not differ significantly across living environments.
The prevalence of these conditions was higher than that seen in housed adults 20 years older. Clearly, services addressing geriatric conditions are needed for older homeless adults living across varied environments

My Detroit Pk-8th grade school where I was principal had the highest student homeless population in Michigan. I have visited a well-run homeless shelter before. Unfortunately, the large homeless shelter where I visited regularly that housed several of my students had unacceptable conditions on many levels. Those conditions, along with having to follow certain rules, are major reasons why many homeless adults refuse to stay in shelters. Substance abuse was high. My primary focus was on getting the children out to school and meeting their needs there. On the day the shelter was permanently closed due to poor food and other conditions, there were several emergency units transporting victims of food poisoning to the hospital.

The following video gives a disturbing review of conditions in some homeless shelters in New York City. Possible solutions are also discussed.

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

Cancer Patients’ Last Year of Life (Research, Video 2:33)

Can general predictions be made about cancer patients and their healthcare experiences during their last year of life? The last year presents many challenges and is a critical period in terms of providing quality care for optimal patient satisfaction. In a study of 5,102 Medicare beneficiaries with cancer diagnosed within one year before death , various measures of healthcare experiences were reported.

1)    Patients with higher general or mental health status were significantly more likely to indicate excellent experience with nearly all measures examined.

2)    Sex, race/ethnicity, and education also were found to be significant predictors for certain ratings.

3)    Greater time before death predicted an increased likelihood of higher ratings for health plan and specialist physician.

4)     Clinical characteristics were found to have few significant associations with experience of care.

5)    Individuals in fee-for-service Medicare plans (vs. Medicare Advantage) had a greater likelihood of excellent experience with health plans, getting care quickly, and getting needed care.

Patients within a year before death from cancer experience critical issues related to health plans, physicians, and medical care associated with socio-demographic, insurance, and clinical characteristics. These conclusions are important in providing guidance for the development of programs to improve the experience of care among individuals with cancer.

Research shows dying patients tend to live longer at home than in a hospital after families have received training and support. In this video, Jennifer Glass' husband, Harlan, took her picture every day for a year, starting on the day she was diagnosed with lung cancer until she died the following year. 

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

Grandparents, Great-Grandparents Parenting Again (Research, 2:41 Video)

The number of grandparents raising children continues to increase in America. There are more than 13 million children living in homes with their grandparents. Without grandparents' loving support, many children’s lives would be in great jeopardy. But these grandparents’ own health and quality of life are often put at risk for declining after they make that child-rearing commitment. These are some of the statistics about grandparents raising grandchildren. I have listed a few below:

1)  There are 2.7 million grandparents raising grandchildren.

2)  Two events have contributed to large spikes in this statistic: the recession that occurred between 2007-2009 and the epidemic of crack use in the late 1980′s.
3)  Custodial grandchildren have higher levels of behavioral and emotional problems than children in the average US population.

4)  Families that have a grandparent raising a grandchild help to save taxpayers over $6 billion each year because they keep those children out of the foster care system.

5)  With 1 out of every 5 households in poverty, it is essential for grandparents to be given the information they need to access resources in their community to get resources they need. When this can happen, many grandchildren are given an extra chance to succeed. AARP offers several supportive resources.

While it is common now to read about the millions of grandparents raising grandchildren, very little is mentioned about great-grandparents in similar circumstances. Imagine parenting again after 65 years of marriage. When I think about great-grandparents accepting a responsibility of this magnitude with challenges legally, financially, physically, and mentally, I think about the Cooks. Their story is one of my favorite videos. They have reached that amazing stage where they can look back on their wonderful accomplishment with great pride in knowing they saved their great grandson's life “like a seatbelt.”

You can read more about grandparents raising children at this site.

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.
Hospice and Nursing Homes Blog