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Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
9 Common Causes of Thyroid Imbalance and How You Can Help
How you sleep, how easily you wake up, and how much energy and stamina you have during the day are directly related to levels of the thyroid hormones.
MPA Media Wins 7 Publishing Awards
MPA Media, publisher of Dynamic Chiropractic and DC Practice Insights, among other titles, has been recognized for editorial and design excellence with an unprecedented seven publishing awards by the American Society of Business Publication Editors (ASBPE), the nation's largest organization for business-to-business publications.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
Waking Up the Gluteus Maximus
In previous articles in this series, we expounded on the importance of the gluteus maximus (GM) in athletic performance and protecting the knee from injury. We also know there is a link between iliotibial band syndrome and GM weakness.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Pain Underfoot: Metatarsalgia
Foot pain can interfere significantly with normal activities and severely limit participation in sports. Metatarsalgia is foot pain involving the metatarsal bones in the forefoot – the complaint of pain on the bottom of the ball of the foot.
Why Young People Need Chiropractic Now More Than Ever
According to a recent study published in BMC Musculoskeletal Disorders, "It is now widely acknowledged that neck pain (NP), mid back pain (MBP), and low back pain (LBP) (spinal pain) start early in life and that the lifetime prevalence increases rapidly during adolescence to reach adult levels at the age of 18."
Don't Turn a 2 Into a 10
The Wong-Baker FACES Pain Rating Scale1 is so useful because it can be used by almost anyone. Patients can use the numbers associated with the faces depicted on the scale or select the face that demonstrates their current level of pain from 0-10.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
A Vibrating Capsule for Constipation? Relevance to Your Chiropractic Practice
The relationship between gastrointestinal (GI) complaints and back pain is not typically written about or discussed.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
CCE Finally Takes a "Baby Step" Toward Reform
During a 16-month period from October 2010 to February 2012, I devoted four separate columns to the heavy-handed attempt by the Council on Chiropractic Education to radically change the chiropractic profession through the accreditation process.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
Chiropractic Research in Review
Chiropractic Treatment of Lateral Epicondylitis; Cost / Benefit Analysis: Different Doses of SMT for Low Back Pain; Imaging for Occult Rib and Costal Cartilage Fractures; Treating Neck Pain: Thoracic Thrust Manipulation vs. Non-Thrust Mobilization.
News in Brief
National Chiropractic Health Month: Be Proactive; Collegiate Roundup: Academic Appointments at Parker, Logan.
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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