resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
April, 2009, Vol. 09, Issue 04
Hospice Massage: What is Our Role at Life's End? Part 2
By Ann Catlin, LMT, NCTMB, OTR
In part one of this series on hospice massage, I explored how massage eases the many dimensions of pain for the person suffering from a life-limiting illness. The value of massage therapy in pain management is an easy association to make. We feel confident in our role of easing pain and can point to concrete reasons why we know massage is beneficial. But what is our role in serving those who have entered the final stages of life? It's important to gain a broader perspective of the role of massage therapy in hospice care. We can start by understanding a few basics about the process and to recognize that the later stages of life are part of a continuum.
Life-limiting illness means the person has been diagnosed with a progressive condition that affects quality of life and death is eminent within a more or less predictable period of time. When a person enters hospice care, he agrees that the focus of medical care will be comfort and quality of life--not curative. An individual may enter hospice care at any point along the continuum. Some are referred to hospice services at the time diagnosis of a life-limiting illness and receive hospice care for weeks or months. Others don't seek out hospice care until entering the final stages, referred to as actively dying. Active dying is the term used when death is eminent and the body systems begin to shut down leading up to the individual's transition. Certainly our role is going to be very different in serving the person who is actively dying.
When visiting an inpatient hospice unit affiliated with a hospice in the Chicago area, I asked the nurse what the average length of stay is. She told me that it is three days and that many of their patients are actively dying upon admission. This hospice unit offers massage therapy services to patients and their families. So again, I ask, "What is our role?" I'd like to offer a frame of reference that has served me well as a foundation from which to act. These are simple ideas that I have gathered along my own path of service.
Frame of Reference for Serving the Dying Person
To be a healing presence. There comes a point when massage as we know it is no longer called for. Instead we are called upon to bring forth something that comes from deep within--our ability to simply be present. Rather than cling to prescribed techniques, we must trust the simplicity of human compassion and our capacity to offer it to another. Our best resources when serving the dying person don't come from the techniques we've studied but from within our own hearts. We become the space-holder, allowing the dying person his/her own process and experience, and sometimes serve as an anchor for family members and other caregivers.
To enhance the quality of life. Doing what is called for in the moment to ease any form of discomfort is the best approach to take. One minute you might be offering a gentle foot massage or holding a hand and the next, moistening dry lips or helping to turn someone on their side to make breathing easier. One of my favorite quotes is from Mother Teresa: "Let us touch the dying, the poor, the lonely and the unwanted according to the graces we have received and let us not be ashamed or slow to do the humble work." Hospice service is about doing the humble work of each moment as it unfolds.
"But what am I supposed to DO?" you may ask. "If I'm there as a massage therapist, aren't I supposed to be doing bodywork?" These are questions I've heard from my students over and over again. The answer is two-fold: First, we must be willing to let go of our idea of what a session looks like. A session with a dying person may include gentle massage, focused touch or no touch at all. The length of a session varies according to what is called for at the time. The key is sound clinical judgment but also letting the rules go to truly serve the person. Confidence in our skills allows us to listen to our inner guidance and respond accordingly. Sometimes we really have to stop doing and simply BE.
Secondly, it is essential to have a repertoire of skilled touch approaches that are appropriate when the situation calls for them. I understand the need and desire to know some techniques that are safe and beneficial. The following are some hands-on approaches that may be useful in serving the dying person.
Sometimes the most compassionate thing you can offer is holding a hand or the feet while you focus your attention on the inner wholeness of the one you are touching. It is important to center yourself prior to making any physical contact.
Lifting and Shifting.1 This technique involves moving a part of the body for positional change and to ease pressure. Change the adjustment of the bed or add support of pillows under the arms or legs. Mindfully adjust the pillows under the head. Lifting a part of the body and holding it up for a moment relieves pressure.
Synchronized Breathing.2 This technique is effective to help ease difficult breathing. It involves synchronizing your own breath with simple massage strokes. First synchronize the rhythm of your own breath with slow effleurage strokes; breathing in as your hands move distally (toward your own body). Then breathe out as your hands move away from you. Let the sound of your breath be audible. This is a silent interaction. No words are necessary to encourage a natural synchronization with the rhythms of your breath and touch. If the person cannot tolerate physical contact you may remove the touch and focus only on the breath.
Support for the Bereaved
Hospice services must provide bereavement support or counseling for the family of the dying person. Bereavement means the extended period of grief preceding the death and following (usually for one year) the death of a loved one, during which individuals experience, respond and adjust to the loss. Supporting those suffering the loss of a loved one is a way to extend the gift of your touch and ease the impact of bereavement. Other caregivers in the hospice organization may also benefit from your services to alleviate the effects of caregiver fatigue and prevent burnout.
The National Hospice and Palliative Care Organization recognizes massage therapy as a valuable contribution to end-of-life care, stating: "Therapeutic massage is becoming a significant modality in end-of-life care because of its effectiveness in relieving anxiety, pain, and discomfort."3 Serving those in hospice care can be profoundly rewarding as we contribute to the quality of life at a very personal and sacred time of another's life. And, just as importantly, we will influence the nature of end-of-life care.
Click here for more information about Ann Catlin, LMT, NCTMB, OTR.
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