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Forgotten Options for Musculoskeletal Health
Challenges with musculoskeletal health are of tremendous concern for many people today.
Do Doctors Lie to Patients? (Do You Lie to Yours?)
In a previous column ["When Patients Lie (Bribe or Flatter)," Oct. 1, 2015], I discussed the issue of patients lying to doctors, and the many reasons why this can occur.
The MRI: What to Do With the Results
As I wrote in my previous article on this topic, it is my goal for you, the doctor, to be an expert in interpreting MRI images yourself; and to be able to independently make decisions based upon a combination of clinical presentations and findings, followed by the MRI images.
Integrative Medicine Can Shape the Profession
As the AOM profession struggles to define the role of "integrative" medicine within their practices their schools and organizations, students, faculty, alumni and administrators at schools wrestle with discussions of how much, where, how, and what to "integrate."
Diet, Nutrition and the Context of Risk (Part 1)
Food and supplement safety is a topic that often comes up when I speak to chiropractors for CE relicensing, even when it is not the advertised subject.
Lab Rats (Roaming the Streets)
The title of this article is an accurate description of American consumers (regardless of age) in the modern era.
How to Humanize Your Content to Create Stronger Relationships
Content marketing is about building relationships, whether that is through updates on social media, offers on your website, blog posts, email campaigns, or even printed material. Now days a business needs to make a human connection.
From Antiquity to Modernity: Huang Qin Tang at Yale Medical School, Part 1
Traditional Chinese medicine is a coherent medical system with several unique characteristics: it originated almost 3,000 years ago; in its area of origin, it has been practiced without interruption since its inception.
Percussion Therapy: An Experiment
My study of qi began more than 20 years ago — long before my study of TCM, points or pathways. It all started with an awareness in my hands and physical manifestations in the way of blockages while working on clients.
The Roots of Insomnia
One of the most common clinical presentations is insomnia. Next to digestive disorders, sleep disorders are one of the most common complaints the clinician will encounter in daily practice.
Asking the Insurance Rep the Right Questions
One of the first or last questions a potential patient often asks is: "Do you take insurance?" An ill-informed or optimistic, "yes" can result in delayed or non-payment. Instead, just say: "Let me check if you are eligible first."
Treating Pain: The Hypermobile Coccyx
When I write about the coccyx, I recognize that I am talking about a relatively small subset of patients. When I write for Dynamic Chiropractic, I am trying to reach 60,000 chiropractors.
Chiropractic Around the World: WFC Country Reports December 2015
The following country updates are reprinted with permission from the December 2015 World Federation of Chiropractic (WFC) Quarterly World Report. Information is excepted for space and edited to DC-specific style guidelines.
Taking Another Step Toward a Secure Future
In 2008, the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) released a literature review on chiropractic care for low back disorders.
East Meets West
Gung Hay Fat Choi. Welcome to the year of the Monkey. There will be fireworks for both January and February this year. What great celebrations.
RAND Study Recruiting DCs
Dr. Ian Coulter, RAND / Samueli chair for integrative medicine and senior health policy researcher for the RAND Corporation, has issued a call for participation, recruiting doctors of chiropractic for a practice-based research study that will examine "the impact of evidence, outcomes, costs and patient preferences on the choice of treatment for chronic low back pain and neck pain."
Interprofessionalism: What it Means and Why You Should Care
Interprofessionalism in education and in practice is a growing trend across health care in the United States. The idea that team-based care and collaborative practice can improve health care has been around more than 50 years.
Window of the Sky Points
The acupuncture points known as Window of the Sky are a modern creation. There is no reference in Chinese medical texts for an acupuncture point category called Window of the Sky.
Is There a Neurological Basis and Correction for Macular Degeneration?
Macular degeneration, aka AMD (age-related macular degeneration), is a common eye disease and a leading cause of blindness in people age 50 years and older, according to the National Institutes of Health National Eye Institute.
Yo San University Helps Make LA Communities Healthier
An element of healthcare training often overlooked is the residual benefit to communities served by Acupuncture and Oriental Medicine (AOM) schools nationwide.
The Clinical Versatility of Milk Thistle (Part 2)
Evidence is growing that the silymarin complex of flavonolignans from milk thistle can impact serum ferritin and iron overload in various clinical circumstances.
Changing the Cultural View of Medicine
Many hospitals in the U.S. are incorporating integrative clinics that include Traditional Chinese Medicine. Cleveland Clinic has led the charge for adding a traditional Chinese herbal medicine clinic to their existing acupuncture program.
Billing and Coding for Moxibustion
Q: I am trying to locate a code for cupping and moxibustion, and have had various fellow acupuncturists indicate that they bill using the existing codes for heat, 97010 hot packs or 97026 infra-red for moxa and 97016 vasopneumatic device for cupping.
Ethics: The Glue That Holds Us Together
Kudos to the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) for creating a code of ethics for the nationwide profession and for deciding to make courses in ethics a requirement for certification renewal.
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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