Ensure Posterity: Invest in Safety For Comfort

Kathy Kolcaba Crossing Guard in Chagrin Falls, Ohio 2012

“Grandma, Why did the shooter have an automatic rifle?" 

As some of you may know, I am a crossing guard in my small idyllic community, one which is similar (although not as wealthy) as Newtown, Connecticut.  

After the horrific shooting at Sandy Hook, Connecticut, last Friday, December 10, 2012, my eight grandchildren, who all live locally, dealt with their thoughts and emotions over the weekend.

I don’t know how their parents told them about the carnage, nor how their discussions progressed into questions. But this morning, one of my grandsons crossed at his usual spot where I am posted with my big STOP sign and my neon jacket and hat, designed to get the attention of drivers in a hurry. 

The irony struck me this morning, as I was waiting for my kids to show up, that my motivation for doing this seemed sooo insignificant compared to the FACT that, indeed, we are not  “keeping our children safe” in our nation and my small act of volunteerism was truly insignificant, or at the best symbolic...But anyway, I am there for the kids.

Listen To Simple Insights

Along came my grandson, right on time, animatedly talking to me as soon as I was within range. 

“Grandma, why did the shooter have an automatic rifle?  Why are they legal?”  Clearly, he had been thinking about prevention of such an event in the future.

   
“They didn’t used to be legal,” I said.  Clearly, I heard the voice of pure reason here; maybe HIS generation can do something about this.

He continued, “Why does anyone NEED an automatic rifle?” 

My feeble reply, “They aren’t for hunting, that’s for sure.”   And he walked on...puzzled. 

A Call For Leadership Accountability 

Please, America; please, fellow health care workers, please, Right to Lifers...let’s help our politicians find courage to protect the lives of our born children. And for those of you who belong to the NRA, please help your leaders think about the safety of our grandchildren in their schools. This shooter had body armor, for heavens sake, and he easily bypassed the “safety” measures the school had innocently followed. 

The preamble to our U.S. Constitution states,

"We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America."

Invest in Safety For Comfort 

Safety and comfort are not the same thing, but safety IS a necessary condition for comfort. 

Can any citizen be ever truly comfortable again, if we continue to do this to ourselves?

What do you think? How did this tragic event affect how you think about safety and comfort where you live? Leave your comments below, I'd like to know what has changed for you?

- Kathy Kolcaba

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Copyright 2012 Katharine Kolcaba, RN, MSN, PhD. Creative Commons 3.0 Attribution-Noncommercial-No Derivative Works. Katharine Kolcaba, RN, MSN, PhD, The Comfort Line, Chagrin Falls, Ohio 44022. E-mail: kathykolcaba@yahoo.com Phone: 440-655-2098 Web: http://thecomfortline.com/

- Betsey Merkel, The Comfort Line and Comfort Is Strength Communications

Animals As Healing Agents For Children in Pain

Dog Tag. Image © Alice Merkel. All Rights Reserved. On Flickr.

Doggie Visits Provide Comfort and Healing

Emphasizing and Quantifying Comfort for Hospitalized Children with Animal-Assisted Therapy, is a well documented student project investigating the comforting effects of Doggie visits to reduce pain and enhance comfort for patient healing. 

Do you have a dog or cat? How do animals bring you comfort in your daily life? The paper below details a research study quantifying the effect of animals as healing agents for children in hospital environments.

Please note that children had no problems documenting their increased comfort with the Comfort Daisies designed by Kolcaba, and that comfort was different than pain.  These two findings are particularly important for anyone wanting to do comfort studies with children.

Read the complete paper published to Scribd below. 

Emphasizing and Quantifying Comfort for Hospitalized Children

Add your stories and comments in the "comment box" below we'd like to hear from you! 

How do you employ forms of comfort in your life, for your children and loved ones? What methods do you use to bring on relief, ease and transcendence from hurts and pains that may be encountered in daily living? What tips can you offer? 

For more information about research in Comfort Theory, please visit the website, The Comfort Line.

Find, Friend and Share Comfort Is Strength!

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Copyright 2012 Katharine Kolcaba, RN, MSN, PhD. Creative Commons 3.0 Attribution-Noncommercial-No Derivative Works. Katharine Kolcaba, RN, MSN, PhD, The Comfort Line, Chagrin Falls, Ohio 44022. E-mail: kathykolcaba@yahoo.com Phone: 440-655-2098 Web: http://thecomfortline.com/

- Betsey Merkel, The Comfort Line and Comfort Is Strength Communications

Comfort As Advertising

Comfort For Everyone? 

I admit to being puzzled by the Hanes ComfortBlend – Softer Than A Kitten Video even though the entire campaign supports the importance of comfort in its simplest form.  And we know from nursing research that Comfort is a basic human need; further, it is important for Strength in our patients and ourselves…but 25 years of Comfort Theory development (Kolcaba) tell us that comfort is also related to performance, as measured by better outcomes, goal achievement, or productivity. 

So Hanes, please tell us, what is the purpose of comfortable underwear?  

Strength of erection comes to mind, but that could be inconvenient in the workplace (LOL). Other possible purposes might be to concentrate on a task, to get rid of that unpleasant distraction of underwear that is NOT soft (LOL??), or to encourage sociability.  

From the Research 

Comfort Theory also presented types of comfort revealing that:  an important part of comfort was the ability to transcend, overcome, or rise above stressful situations in order to achieve optimal health outcomes.  The theory states that if nurses helped patients with their comfort needs in the context of health care, then patients were strengthened to engage more fully in health seeking behaviors. Later, the application for nursing was broadened to include all the healthcare disciplines, both for patients and practitioners. 

Comfort Applied to the Health Care Industry 

For practitioners, Comfort Theory was utilized for improving their working environment – that is, for healthcare teams to create a “comfort zone” for each other in which renewal occurred following experiences with multiple life and death stressors. During those times of stress, health care providers had to come out of their comfort zones in order to perform at their highest levels, and often for prolonged periods of time.   When those situations were resolved, practitioners could then return to their comfort zone, both at work and hopefully at home for renewal. 

But Comfortable Underwear?

If comfort is a basic human need, and it is linked to the desired outcomes of strengthening or renewal for patients and health care providers,  what is the desired outcome for men wearing soft underwear?  And do we dare ask if comfort is limited only to patients in hospitals or for those who buy Hanes?  

If we want our fellow citizens to have good outcomes, shouldn’t comfort be available for all of them, too? There are many guides for what constitutes comfort including food, shelter, clothing, meaningful work, warmth, rest, safety, compassion, support, and hope. These essentials are provided during hospital care, but what about afterwards?  

How do we as citizens address the comfort needs of our vulnerable brothers and sisters and children and elders so that they can all do better?  

Comfort as a Basic Human Value for Everyone

Where are our values placed as a society, as evidenced by how money is spent?  If we value comfort, as advertisers want us to do, let’s also value the purpose of comfort---for everyone.  Let’s put our money where our values are!!

Let me know what you think. Post your comments and share the discussion. I'd like to hear from you about your reactions.

(sigh...) If only comfort was as simple as having soft underwear…..

- Kathy Kolcaba

Links of Interest

• Kolcaba's Comfort As Advertising Video Response http://youtu.be/bi9P87fFtWI
• Hanes ComfortBlend – Softer Than A Kitten Video http://www.youtube.com/watch?v=D2ph3eoLGf4 
• Hanes ComfortBlend http://hanescomfortblend.com/ 
• Ads of the World http://adsoftheworld.com/media/tv/hanes_comfortblend_softer_than_a_kitten 
• Adweek August 7, 2012 Ad of the Day: Hanes Brand's ComfortBlend T-shirts are even softer than wearing kittens http://www.adweek.com/news/advertising-branding/ad-day-hanes-142582

 

Find, Friend and Share Comfort Is Strength!

• The Comfort Line http://thecomfortline.com/
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Copyright 2012 Katharine Kolcaba, RN, MSN, PhD. Creative Commons 3.0 Attribution-Noncommercial-No Derivative Works. Katharine Kolcaba, RN, MSN, PhD, The Comfort Line, Chagrin Falls, Ohio 44022. E-mail: kathykolcaba@yahoo.com Phone: 440-655-2098 Web: http://thecomfortline.com/

- Betsey Merkel, The Comfort Line and Comfort Is Strength Communications

Aging in Place

Mom, Dr. M and KK

Aging in place is generally thought to mean staying in one’s home when frailty sets in, instead of moving to a nursing home or assisted living. It occurs, not by chance, but through careful planning. So, sometime shortly after retirement, one puts oneself and significant other into a house or apartment which is suitable for aging bodies and perhaps aging minds. The reality of future aging is embraced instead of denied; longevity into one’s 80’s or 90’s is accepted and planned for. Conditioning one’s body and mind to age in healthy ways is, of course, important but not the only ingredients to aging in place.

The ability to “age in place” also requires a simpler life style and a community where one can walk or take public transportation safely (preferably to useful shops and services to reduce dependence on cars). Other basics consist of few or no steps inside or out, good lighting, a bedroom, full bath, and laundry on the main floor, affordable rent, mortgage, and/or utilities, and family or neighbors in close proximity. 

As a nurse who specializes in gerontology and care management for elders, I know from experience where potential pitfalls exist for aging adults, most of whom do not anticipate needing any housing modifications in their futures. But before they know it, steps become an issue, followed by transportation, decreased vision, and inability to launder clothes or bathe oneself because facilities are on the second floor or in the basement. And of course, decreased income and holes in the customary safety net for elders exacerbates all of the pitfalls and makes spur of the moment modifications costly and often impossible.

Recently, a gerontological nurse from Japan visited me to talk about Comfort Theory. She also wanted to attend a class at the university where I still teach when I want to. (I am fortunate to be in nursing, where faculty are scarce and I can pick up courses when I want them.) During that class, a case study about home-care was discussed in depth, revealing to my guest a value system in our country that she said was not present in Japan. That is: try to keep elders in their home for as long as possible with the supports they need, because they usually DO BETTER. 

After that class, I thought we should visit my mother, nearly 92, who lives alone in her own home with help from nursing aides for a few hours every morning. After she retired, she decided to move near me, her only remaining adult child. She bought a bungalow that we have adapted over the years as her physical capabilities diminished. She can no longer walk unassisted, her vision and hearing are very poor, but she is thriving in mind and spirit. She entertains herself with books on tape, the news, and our hapless Cleveland sports teams. She knows where all her handholds are in her house, she has Meals on Wheels and warms things in a microwave, and she has Lifeline and a walker. I pour her meds, renew her prescriptions, and watch her health status. Financially, she is assisted by Medicaid and reduced utilities through a state run program for people in need. She is oriented and humorous, loves visitors, and keeps her house tidy. She says that is where she wants to die (although not in the near future!).

My visitor was amazed and said, “In Japan, our frail elders are almost always in nursing homes.” Finally, something we do well in the U.S. – at least for right now. With looming cuts in social services, I am not so confident that my adult children will have the same safety net that my mother does. But I do know, I will be set up physically in my perfect elder-friendly home and community where I can walk to stores, wash myself and my clothes, and keep my little home clean. This is where I have the most comfort, and where I will do better,  just like my mom.

- Kathy Kolcaba
 

Find, Friend, Follow, and Share Comfort Is Strength

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·      You Tube

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Copyright 2012 Katharine Kolcaba, RN, MSN, PhD. Creative Commons 3.0 Attribution-Noncommercial-No Derivative Works. The Comfort Line, Chagrin Falls, Ohio 44022.  E-mail: kathykolcaba@yahoo.com Phone: 440-655-2098 Web: http://thecomfortline.com/ 

-Betsey Merkel, Comfort Is Strength Communications

Comfort Theory and the GLBT Community

Turquoise Running. Image © Alice Merkel.

Comfort Theory for GLBT

By Kathy Kolcaba RN, MSN, PhD, TheComfortLine.com

Pondering the role of Comfort Theory for GLBT teens and adults: a response to the New York Times Editorial, Sept 2nd, 2012 by Frank Bruni, Excluded From Inclusion.

Bruni begins his column by commenting on the politics of exclusion, which he saw in full force at the recent Republican Convention. Being gay himself, he was acutely aware that of all the speakers who were invited to speak, no one was openly gay, nor were policies that would include gays and lesbians mentioned. When Bruni asked a fellow gay Republican about this, the response was “Our messaging within the party has been: if you can’t say anything nice, don’t say anything at all.”

The columnist continues, “But that’s not progress enough. Silence does nothing for gay and lesbian teenagers racked with self-doubt about what the world has in store. “ So I decided I would no longer remain silent about what I think is a very helpful instrument constructed by one of my graduate students nearly 15 years ago.

This student came to me with a passion to focus her dissertation of the plight of the gay, lesbian, bisexual, transgender (GLBT) community. She was a nurse and a counselor, and now was seeking the PhD degree, an important credential for a counseling career. She adapted my General Comfort Questionnaire for the GLBT population, which then could be used for assessment, intervention (when indicated), and evaluation of what works. She then conducted an instrumentation study in which the GLBT Comfort Questionnaire proved to be very strong psychometrically. You can see her brief summary of results by clicking on this link: http://www.thecomfortline.com/resources/cq.html Scroll down to Instruments created by others and look for the one currently titled “Self Comfort With Sexual Identity Questionnaire.” (I will ask my web master to change the title to the GLBT Comfort Questionnaire). When analyzing data, please use total scores (higher scores indicated higher self-comfort).

After her successful defense, I urged my new PhD nurse to publish her story – she had done extensive background research, which demonstrated the need for such a questionnaire for GLBT folks of all ages, especially for those who were having difficulties in “the world.”  

For nurses and counselors, a measure of which interventions worked to increase comfort in the GLBT client should be very helpful.  As a tool to measure the success of  strategies to prevent discrimination or judgment, this questionnaire could be used to compare self-comfort across GLBT populations some of whom were exposed to innovative policy changes.  A psychometrically strong questionnaire could be used across high school or college campuses or even across state lines. In a just society all people with a sense of compassion will need quality data to support the GLBT community, or any community,  in the quest for basic civil rights.

Alas, my new PhD nurse did not follow through with an article or an official publication of her valuable questionnaire. Immediately after graduation, she allowed me to post it on my web site, Comfort Line, and I let it go at that. She stopped answering my communications, and then I felt I had no further recourse…

But now I have a professional blog, on which I can post some of my current thoughts about applications of Comfort Theory. I hope this time around, this wonderful GBLT questionnaire gets a wee bit more traction.

 - Kathy Kolcaba

Find, Friend, Follow, and Share Comfort Is Strength Links!

·      Website http://www.comfortisstrength.net

·      Blog http://comfortisstrength.blogspot.com/

·      Daily News http://paper.li/KathyKolcaba/1339102308

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·      The Comfort Line http://thecomfortline.com/

·      Twitter https://twitter.com/kathykolcabahttps://twitter.com/kathykolcaba

·      You Tube

http://www.youtube.com/channel/UCWbUr6J85eSZQaY5CC0HVVQ

Copyright 2012 Katharine Kolcaba, RN, MSN, PhD. Creative Commons 3.0 Attribution-Noncommercial-No Derivative Works. The Comfort Line, Chagrin Falls, Ohio 44022.  E-mail: kathykolcaba@yahoo.com Phone: 440-655-2098 Web: http://thecomfortline.com/ 

-Betsey Merkel, Comfort Is Strength Communications

Comfort Theory & Peaceful Death

,

Ordinary. Image © Alice Merkel.  
Take Me To The Oklahoma City Cars Set on Flickr.

Comfort Theory & Peaceful Death

By Kathy Kolcaba RN, MSN, PhD, TheComfortLine.com

Response to the New York Magazine article, A Life Worth Ending

http://nymag.com/news/features/parent-health-care-2012-5/

      "I have very strong feelings about a peaceful death - and before I get as bad as this poor mom in the article you linked me to, I have decided to just stop eating and drinking ANYTHING once I receive a terminal prognosis and feel my capacities deteriorate at a rapid pace. I will gather my family about me, and try to make them understand that I highly value escaping a long, no-exit, agonizing death.  I want to spare them watching me helplessly and wasting scads of money. I have experienced, through relatives of mine and my friends, this kind of death.

     I want loved ones to remember me as a vital force, not as a helpless and dependent shadow of myself. There is a solution. It occurs when one decides to stop eating and drinking.  It takes two weeks to die this way, no one has to assist, and hospice will help (if there is a terminal disease with advancing symptoms). This is my exit strategy, my legacy, - to die as I lived, making my own decisions with love and peace while I still am able.

      My mother is 91 and I am her "care manager." I worked professionally in this capacity for about 10 years, and we always strove for some kind of peaceful death in our clients (most of whom were in their 90's). Thus, I pray my mother dies "suddenly," in her home, in her easy chair, or while sleeping. 

     She, however, does not seem at all ready to do this - as she investigates every new sensation in her body with a doctor visit (she arranges her own transportation with her vast repertoire of helpers). She is extremely frail physically, extremely sharp mentally (occasionally sharp-tongued too). She can barely walk, although she manages pretty well in her own home with minimal assistance in the mornings. She is quite hard of hearing, and nearly blind. 

     And yet, she now states that her advance directives, which I had her fill out about 15 years ago, are only if she is "terminal." So there you are.

     Perhaps my generation will wise up a bit to how we really want to die and to prepare our families to honor and respect our wishes. It helps that I am a nurse. It helps that I am a former care manager. 

     Most of all, it helps that I have been thinking about the comfort of my family and myself for a long time. And for me, comfort is planning for my own peaceful death one way or another."

- Kathy Kolcaba, Comfort Theory

Find, Friend, Follow, and Share Comfort Is Strength Links!

·      Website http://www.comfortisstrength.net

·      Blog http://comfortisstrength.blogspot.com/

·      Daily News http://paper.li/KathyKolcaba/1339102308

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·      The Comfort Line http://thecomfortline.com/

·      Twitter https://twitter.com/kathykolcabahttps://twitter.com/kathykolcaba

·      You Tube

http://www.youtube.com/channel/UCWbUr6J85eSZQaY5CC0HVVQ

Copyright 2012 Katharine Kolcaba, RN, MSN, PhD. Creative Commons 3.0 Attribution-Noncommercial-No Derivative Works. The Comfort Line, Chagrin Falls, Ohio 44022.  E-mail: kathykolcaba@yahoo.com Phone: 440-655-2098 Web: http://thecomfortline.com/ 

-Betsey Merkel, Comfort Is Strength Communications

Sharing Best Practices in Comfort Theory For Certified Registered Nurse Anesthetists (CRNA)

 

Color of Sharpness. Image © Alice Merkel

Social Media Conversations Accelerate Knowledge Sharing 

Erin Carline RN BSN CCRN hosted Sharing Best Practices in Comfort Theory For Certified Registered Nurse Anesthetists (CRNA) on Monday June 25, 2012.

Following Erin's presentation of The Comfort Theory for Certified Registered Nurse Anesthetists (CRNA) at the Goldfarb School of Nursing at Barnes-Jewish College in St. Louis, Missouri to 25 nurse anesthesia and nurse practitioner classmates, everyone enjoyed a quick Twitter conversation with Katharine Kolcaba, RN, MSN, PhD, author of Comfort Theory and Practice: A Vision For Holistic Health Care And Research. 

We've posted the conversation thread below:

Sharing Best Practices in Comfort Theory For Certified Registered Nurse Anesthetists (CRNA)

How do you apply Comfort Theory to your patient centered care? Post your comments below this article - we'd like to hear from you! 

Find, Friend, Follow, and Share Comfort Is Strength Links!

• Website http://www.comfortisstrength.net
• Blog http://comfortisstrength.blogspot.com/
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• The Comfort Line http://thecomfortline.com/
• Twitter https://twitter.com/kathykolcaba
• You Tube http://www.youtube.com/channel/UCWbUr6J85eSZQaY5CC0HVVQ

Copyright 2012 Katharine Kolcaba, RN, MSN, PhD. Creative Commons 3.0 Attribution-Noncommercial-No Derivative Works. The Comfort Line, Chagrin Falls, Ohio 44022.  E-mail: kathykolcaba@yahoo.com Phone: 440-655-2098 Web: http://thecomfortline.com/ 

- Betsey Merkel, Comfort Is Strength Communications