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The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
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.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
May, 2010, Vol. 10, Issue 05
Connecting With the Person Who Has Alzheimer's Disease
By Ann Catlin, LMT, NCTMB, OTR
I remember a woman I'll call Grace whom I visited frequently in a skilled-care facility. She was a lovely 75-year-old woman, and her room was full of paintings she had created over the years as well as memorabilia from her travels around the world.I often would find her walking in the hallway and we would return to her room for our visit. She loved to entertain company and was very talkative. We had delightful visits together. Grace also had Alzheimer's disease, and I could not understand most of her words. Her speech was a series of indiscernible sounds and words. She enjoyed connecting through touch and massage.
One day while I was massaging her hands, she looked me straight in the eye and said, clear as day, "It's about connection!" A little stunned, all I could say was "Yes it is." She smiled and went back to talking in sounds I couldn't totally make out. How do we account for that moment of clarity in her speech?
Many people with Alzheimer's disease and other forms of dementia have difficulty forming words or organizing thoughts into language because the disease process damages the areas of the brain responsible for these functions. This creates a huge gap between people with dementia and others. Caregivers of all kinds struggle with how to communicate with people living with the effects of dementia. You may or may not have clients with dementia, but it is quite possible that you will come in contact with someone in your life in this situation. For years, I have had a fascination with how to connect with people with brain dysfunction. Here's a little of what I've discovered so far. I hope it serves you well.
Bridge the Gap
First, it's important to distinguish between the idea of talking to and being with the person you are trying to communicate with. Talking to implies that you have the right words and that your words will be understood and responded to, which is not always possible for the person with dementia. Being with is joining the person's world in the present moment. To be with someone is a mutual exchange, and the intention is connection rather than communication. Nancy Pearce, in Inside Alzheimer's, offers the following four tools of being with.
Touch: As massage therapists, we understand the power of touch to decrease pain and the effects of stress and to uplift mood. Touch provides a means of instant connection and decreases feelings of loneliness or fear. It can lead to recall of pleasant memories associated with touch from the past. Sometimes, touch can lead to profound moments where we witness unexplainable moments of clarity.
Observation: Tuning in to clues about a person's state is essential to bridging the connection gap. Pearce encourages us to observe the immediate physical needs. Do they need a drink or to go to the bathroom? Pay attention to what's going on in the environment that may be confusing to the person. I remember a woman who was afraid of a bush outside her window. She told me that when the wind blew, the bush seemed angry. She often had trouble sleeping because she worried about that mad bush. A simple thing like closing her curtain helped sooth her.
Encourage Expressions: Let the person know that you are present. Maintain a calm attitude and use your body language to demonstrate your interest. Good eye contact and mirroring the facial expression are ways to stay connected through body language. Ask simple questions to encourage the person to tell his or her story.
Listen Beyond the Words: Pearce says that to be with the person with dementia requires a different way of listening. Rather than trying to understand the words, attempt to identify the experience of the person at the present time. This results in the person feeling validated and worthwhile.
The most powerful communication tools I've ever learned came from my friend and mentor, Naomi Feil. She created Validation, a therapeutic way of communicating with people with dementia. Validation is a holistic approach that looks at the whole person and human needs, not just the condition of the disease. Naomi talks about stepping into the world of the old person as a way to bridge the connection gap.
I've distilled her concepts into a simple approach involving asking myself two questions. These questions help me to respond in situations when I was with someone who is confused or agitated. First, ask "What is their reality in this moment?" The answer will give you a clue to the world they are in at the moment. You can then be with them in their world. The second question is "What are they feeling?" Since we can't see a motion picture of what's going on in another's mind we can rely on clues about how they are feeling. What do their facial expression, body language or voice intensity tell you? Now comes the action part. First, reflect back or join in their reality and acknowledge their feeling.
Let me illustrate this with a story. There is a woman in a facility where I provide sessions who, each day around 4 pm, worries that she needs to get home to make supper for her family. She walks the hall asking everyone how she can get home. As time passes, she gets more anxious and upset. The staff is expected to take her to the dining room for dinner at 5 pm, not an easy task when she is determined to get home to her family.
I thought I would try having a session with her during this time in hopes of easing her anxiety. So I asked myself, "What is her reality?" Clearly it's time for her to be getting home to make supper for her family. In her mind her family would be home soon and she needed to be there. OK, now that I understood where she was at the moment, I could be with her in her world. Next question: "What is she feeling?" She seemed frustrated that she couldn't find a ride and she became increasingly angry and fearful.
I walked with her and asked her simple questions about her family and what they liked to eat for dinner. I acknowledged her feeling by saying things like "it's so frustrating to be late" and, with humor, "my son thinks he will just starve if I'm five minutes late with a meal!" She nodded her head and laughed with me. At one point, we sat down and I offered reassurance with touch by gently stroking her back and holding her hand. The touch seemed to bring her into more of an awareness of the immediate moment and she let go of her fixation on getting home. What created the shift in her was not so much what I said but the fact that she was seen and heard. She was validated and the intensity of her feelings was diffused allowing her to redirect her attention to the immediate environment. We walked again, but this time to the dining room where she joined her friends for dinner.
Click here for more information about Ann Catlin, LMT, NCTMB, OTR.
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