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Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
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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