Lost A Sale, But Initial Phone Consultations â€” A Big Part Of Brilliant Customer Service
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resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Medicine as Metaphor
The practice of medicine is both an art and a science. We study and learn the system so that when the time comes to apply it, there is a greater possibility of successfully helping others.
The Source-Luo Point Combination, Part 3
Dr. Nguyen Nghi (NVN) was born in Vietnam and is one of the most important scholars, writers, teachers and practitioners of modern time. Many of his theories and applications are the source of modern teachers from Europe and the United States.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
Merger Creates New Model of Care
Two San Francisco powerhouses of holistic healing, the American College of Traditional Chinese Medicine (ACTCM) and California Institute of Integral Studies (CIIS), are merging. Together they are building a visionary approach to applied integral health.
The Art of Creating a Healing Space
I always advise my graduates to examine their group practice or treatment rooms with fresh eyes after they leave my CE workshops. I tell them, "Ask yourselves - is your space qi filled, welcoming and healing? Or is it cold and clinical?"
Can Acupuncture Treat Knee Pain?
Recently, an article in the Journal of the American Medical Association concluded that, "neither laser nor needle acupuncture conferred benefit over sham for pain or function" among older chronic knee pain patients.
Exploring and Learning from the Gift of Life
I'm grateful to have had the opportunity to teach cadaver dissection classes and workshops with Stephen Cina at the New England School of Acupuncture over the past seven years, first through the Sports Medicine Acupuncture Program and later as a NESA elective course.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Online Marketing Basics: Google Ranking, Part 1
We all know there is so much opportunity with online marketing. And, let's face it, if you don't have a presence online with a website and social media, you are probably not where you want to be.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
Melatonin: A Promising Natural Agent in the Prevention of ALS
A number of years ago, experimental studies suggested melatonin could block key steps in the development of Alzheimer's disease, primarily by acting as a brain antioxidant and inhibiting the build-up of beta-amyloid plaque in the brain.
The Roots of TCM in Depression Treatment
In traditional Chinese medicine, there is historical precedent for the treatment of so-called "Shen" (Heart-Mind) disorder, or disorder/dysregulation of the spirit, which is also considered as distinct but not separate from the cognitive function of the brain.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Abdominal Acupuncture for Eye Healing: The Sacred Turtle and Ba Gua Map
Our ideas about western medicine have shifted in recent decades, while the public is asking more from health care providers.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
The Integrative Medicine Puzzle: Putting the Pieces Together
The conversation is changing in the broader healthcare community with patients actually moving the discussion toward more integrative topics. Patients today want to know their options.
Colon Health and TCM
I still remember many years ago, the loud "Yuck" from my wife at the time when we were together watching the Chinese movie "Last Emperor."
Adding Microneedling to Your Clinic for Results and Profit
Microneedling has taken the beauty world by storm over the last 10 years. Under the names dermaroller, microneedling or skin needling you will see these treatments listed in the services of nearly every fashionable beauty salon and day spa in the country.
September, 2009, Vol. 9, Issue 09
Massage and Alzheimer’s Disease, Part 2
What does the literature say?
By Ann Catlin, LMT, NCTMB, OTR
Mary, an 81-year-old female, has resided in a nursing home for seven months. Her medical history reveals that she has Alzheimer's disease; anxiety (state unspecified); dementia with behavior disorder; insomnia; osteoarthritis; osteoporosis; and recurrent urinary tract infections. She requires a wheelchair because she no longer is able to safely ambulate and has fallen several times; she has increasing difficulty communicating her needs because she cannot find the appropriate words to express herself; she has recently begun to yell out and, at times, bangs on her wheelchair for long periods of time. She relies on staff to assist her with activities of daily living; she is incontinent of urine; she attends group activities, but the yelling and banging is upsetting to the others and she is removed from the group. She spends much of her time in her room or in the hallway. She has difficulty sleeping and is often anxious at night, which increases her yelling behavior. This concerns staff because they have difficulty calming her and other residents are awakened.
Following a referral for massage therapy, I arranged for sessions twice a week and it was agreed the need for continued session would be determined after six weeks. I saw Mary in her room while she was sitting in her wheelchair. Each session lasted 20 to 30 minutes and typically took place in the morning before lunch. Mary was receptive to having massage lotion applied to her hands in the form of a hand massage and she seemed to enjoy the one-to-one attention.
Following three weeks of sessions, the activity director reported that Mary was able to remain in more group activities without disruptive yelling and only occasional banging on her wheelchair. This resulted in less isolation and opportunities for social interaction for Mary. After six weeks, I demonstrated a simple hand massage technique that the staff could use in addition to continued weekly massage therapy sessions. The nurse assistant reported that Mary was more cooperative during self care activities and that she had decreased restlessness and agitation at night. The overall impact of massage therapy was an increase in the quality of life for Mary and decreased job stress along with increased feelings of satisfaction for the staff.
This scenario illustrates that, indeed, massage appears to have a positive impact on the care and quality of life of an elder living with the effects of Alzheimer's disease. I'm not alone in witnessing these effects -- many of my colleagues share similar stories that point to the efficacy of massage in Alzheimer's care. But our stories may not be enough to substantiate what we experience during our sessions. As massage therapy becomes more recognized as a health care profession we are expected to back up our stories with data. Like it or not it is the world we live in. Fortunately there is a long-standing and growing body of evidence that substantiates the value of massage and touch in Alzheimer's care. While there is need for further research, studies indicate that the use of some forms of massage are effective in managing challenging behavior often exhibited by elders living with Alzheimer's disease and other forms of dementia. What follows is a brief report on a few such studies and articles. While this is surely not an exhaustive collection of articles, it will give you some interesting data on which to hang your hat (or your holster!). I've included Web links so you can access the full text of each article.
Studies in Dementia
Editor's note: The following abstracts were taken from various Internet sources; author, title, publication and Web links of each abstract are cited.
Hicks-Moore S, Robinson B. "Favorite Music and Hand Massage: Two Interventions to Decrease Agitation in Residents with Dementia." Dementia, 2008;7(1):95-108. http://dem.sagepub.com/cgi/content/abstract/7/1/95
Agitation in individuals with dementia living in the nursing home environment affects care and quality of life. Relaxation techniques such as music and massage are showing promise to decrease agitation and improve quality of life in individuals with dementia. Using an experimental 3 x 3 repeated measures design, 41 residents with mild to moderate dementia participated in a study to test the effectiveness of favorite music (FM) and hand massage (HM) in reducing agitated behaviors. Agitated residents were randomly assigned to either the treatment or control groups. Residents in the treatment group received each of three treatments, HM, FM, and HMFM, with each treatment lasting 10 minutes. Residents in the control group received no treatment. Agitation was measured using the Cohen-Mansfield Agitation Inventory (CMAI) at three different intervals. The results suggest that FM and HM individually and combined are effective in significantly decreasing agitation immediately following the intervention and also one hour post intervention.
Forbes D et al. "Nonpharmacological Management of Agitated Behaviours Associated with Dementia." Geriatrics & Aging, 2005;8(4):26-30. http://www.medscape.com/viewarticle/503816
Abstract: Strategies such as simulated presence therapy, pet therapy, light therapy, validation therapy, music, massage, therapeutic touch, aromatherapy, and multisensory stimulation have shown promising results in decreasing physical aggression, physical nonaggression, verbal aggression, and verbal nonaggression in older adults with dementia. Further research is needed to identify which strategies are most effective in managing symptoms of agitation associated with the different types of dementia and at different levels of cognitive impairment.
Nonpharmacological approaches have several advantages. They address the psychosocial and/or environmental reason(s) for the agitation, and compared to pharmaceutical interventions they avoid potential side effects, drug-drug interactions, and masking of behaviour that may serve as a signal for a need. The purpose of this review is, therefore, to assess and summarize research evidence on the efficacy of nonpharmacological strategies in managing agitated behaviour associated with Alzheimer's disease and related dementias.
Cohen-Mansfield J. "Nonpharmacologic Interventions for Inappropriate Behaviors in Dementia: A Review, Summary, and Critique." American Journal of Geriatric Psychiatry, 2001;9:361-81. http://focus.psychiatryonline.org/cgi/reprint/2/2/288
Abstract: Inappropriate behaviors are very common in dementia and impose an enormous toll both emotionally and financially. Three main psychosocial theoretical models have generally been utilized to explain inappropriate behaviors in dementia: the "unmet needs" model, a behavioral/learning model, and an environmental vulnerability/reduced stress-threshold model. A literature search yielded 83 nonpharmacological intervention studies, which utilized the following categories of interventions: sensory, social contact (real or simulated), behavior therapy, staff training, structured activities, environmental interventions, medical/nursing care interventions, and combination therapies. The majority are reported to have a positive, albeit not always significant, impact. Better matching of the available interventions to patients' needs and capabilities may result in greater benefits to patients and their caregivers.
Massage/Touch. Six articles report studies of massage or therapeutic touch. Usually, the procedure took about five minutes and was performed once or twice per day. One study reported unequivocal success (using a combination of massage and verbalizations). The other studies reported either a positive trend, partial effects (on physical and verbal behaviors) or no effect of the intervention (on aggression).
Snyder M et al. "Efficacy of Hand Massage in Decreasing Agitation Behaviors Associated with Care Activities in Persons with Dementia." Geriatric Nursing, March/April 1995:60-3. http://www.ncbi.nlm.nih.gov/pubmed/7774819
Summary: The purpose of this study was to explore if administering hand massage before care activities that were often associated with agitation behaviors would reduce the frequency and intensity of these behaviors during these care activities. Both aggressive and non-aggressive forms of agitation were studied. A hand massage protocol that took five minutes to give was chosen as the intervention. Hand massage was performed in the morning and afternoon for ten days. Results showed that hand massage decreased the frequency and intensity of agitated behavior during morning care routines, although not during evening care. Staff reported that reducing the intensity of the behavior made it easier to care for the elders.
Kilstoff K et al. "New Approaches to Health and Well-Being for Dementia Day-Care Clients, Family Carers, and Day-care Staff." International Journal of Nursing Practice, June 1998;4(2):70-83. http://www.ncbi.nlm.nih.gov/pubmed/9748936
Abstract: This study was conducted in one multicultural dementia day-care centre over a period of 18 months. It introduced a gentle hand treatment for clients using three essential oils. The study evolved out of the process of action research where the family carers and day-care staff participated with the researchers to choose, design, develop and evaluate a hand treatment program. Data was collected through in-depth interviews pre-and post-treatment, focus group discussions, client observation logbooks and a disability scale. The findings indicate a positive strengthening of the relationship between the person with dementia and their family carer, and an improvement in feelings of health and well-being for both. The specific improvements for clients include increased alertness, self-hygiene, contentment, initiation of toileting, sleeping at night and reduced levels of agitation, withdrawal and wandering. Family carers have reported less distress, improved sleeping patterns and feelings of calm. They also found the treatment useful in helping them manage the difficult behaviors exhibited by their relative with dementia. The benefits of this treatment for nursing practice are that it is safe, effective and easily administered by staff in any setting.
Want to learn more?
I invite you to explore this topic further. Who knows; maybe the next study will be conducted by YOU! Additional online resources that I have found helpful are:
I leave you with this quote: "If you have knowledge, let others light their candles at it." Margaret Fuller
Read Ann's previous article "Massage and Alzheimer's Disease, Part 1 What would Maslow say?"
Click here for more information about Ann Catlin, LMT, NCTMB, OTR.
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