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Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
Primary Spine Care: Addressing Concerns & Criticisms
The Dec. 1, 2013 issue of Dynamic Chiropractic included an article describing the implementation of a training program for primary spine practitioners (PSP) within a metropolitan region and supported by a large BC/BS plan.
Impacting Chiropractic's Future With Technology
When it comes to electronic health records (EHR), Robert Moberg and Dr. Steven Kraus are two of the leading industry experts on the topic.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
Help Update the LBP Practice Guideline
The Council on Chiropractic Guidelines and Practice Parameters has announced the release of an updated Clinical Practice Guideline for Chiropractic Management of Low Back Pain for stakeholder review and comment.
Interpersonal Skills 101: Enhancing the Value of Our Patient Interactions
Recently, I read an interesting article in our local newspaper titled "The Value of Human Interaction." The article presented comments from a senior editor for Fortune magazine who discussed "Civility in the Business World."
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
Atypical Femoral Fractures and Bisphosphonate Use: What to Watch For
Bisphosphonates (BP) are popular drugs, with more than 8 billion in sales in 2008; however, profits have declined as patents began expiring. Nonetheless, BP remain the most commonly prescribed drugs for patients at risk of osteoporotic fractures, with several million prescriptions written every year.
B Vitamins Improve Memory, Prevent Brain Atrophy
The 2010 OPTIMA study showed that the accelerated rate of brain atrophy in elderly with mild cognitive impairment could be slowed via supplementation with homocysteine-lowering B vitamins, which included folic acid, vitamin B12 and vitamin B6.
Expanding Access, Branch by Branch
The big news coming from Capitol Hill isn't merely the recent introduction of a pair of bills designed to expand chiropractic services in the Veterans Affairs and military health care systems; after all, similar legislation has made its way through Congress before, never reaching the Oval Office for presidential signature.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
A Reality Check – and a Chance to Educate
Imagine working in the public relations department of nutrition retailer General Nutrition Corporation (GNC) and reading the The New York Times announce...
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
Low Back Pain: Posture and Movement Analysis
When performing static and dynamic movement analysis of the lumbopelvic hip area, begin with standing visual posture analysis of the pelvis, and then perform lumbar range of motion and assess what you might see during normal versus abnormal lumbar flexion motion.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
Avoid Random Treatment of Trigger Points (Part 2)
We must acknowledge that the fascia, which surrounds literally everything in our bodies, including every muscle fiber, is more than just a covering.
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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