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Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
June, 2010, Vol. 10, Issue 06
Opening Doors to Eldercare and Hospice
By Ann Catlin, LMT, NCTMB, OTR
It's no secret that the fastest-growing segment of our population is over the age of 65 -- and the greatest increase is occurring in those 85 and above. At the same time, there is growing awareness of the benefits of massage for people who are affected by debilitating illness, injury or cognitive impairment.There is clearly a burgeoning market for massage therapists who want to work in eldercare or hospice. But the people whom massage may benefit the most -- and who make up a big portion of this market -- are often embedded in a system that is full of intimidating obstacles for the therapist. They are behind the doors of long-term care and hospice organizations. You may discover that the door into these organizations seems closed -- closed not because you lack skill or passion for the work, but because you don't know the system and its jargon or how to get past the gatekeepers to the potential client. This article offers a key to open that door: knowledge of the system and how to navigate through it to help you succeed in expanding your practice to eldercare or hospice settings.
Types of Eldercare and Hospice
First, you must become familiar with the various types of eldercare or hospice organizations: assisted living, skilled nursing (nursing home), continuing care retirement and hospice.
Assisted Living The emphasis in assisted living settings is to support mentally or physically limited persons who need help with activities of daily living, but do not need the skilled medical care provided in a nursing home. Facilities consist of private rooms or apartments as well as common areas. These facilities provide 24-hour staffing, meals, housekeeping, social activities and limited nursing services such as management of medications. Some assisted living facilities provide specialized care for elders with Alzheimer's disease.
Skilled Nursing (Nursing Home) People enter a nursing facility usually as a result of illness, injury or mental or physical debility that requires 24-hour nursing care and continuous assistance with activities of daily living. Some require this level of care temporarily, and then return home. Others require permanent care. Facilities consist of semi-private or private rooms, a common dining room and social areas. Services include 24-hour nursing and personal care, meals, psychological and spiritual support, and planned social and recreational activities. Physical, occupational and speech therapy, as well as specialized care for those with Alzheimer's disease, may be available.
Continuing Care Retirement Community This is typically a campus setting with multiple levels of care including independent living, assisted living and skilled nursing. Residents can remain in the same community even if their needs change. Communities provide an array of services and amenities including dining, housekeeping, recreational activities, health care services, personal care assistance and nursing care.
Hospice is not a place but a concept of care. Eighty percent of hospice care is provided in the patient's home, family member's home and in nursing homes. Inpatient hospice facilities are sometimes available to assist with caregiving.
Most of these organizations will not have considered massage as an ancillary service. The following questions will be on the mind of a potential employer--be proactive in answering them.
How does massage help our residents or patients?
Not all administrators share your awareness of the benefits of massage. Remember that YOU are the expert on how massage therapy impacts the body, mind and spirit. These points will make a convincing case.
1. Massage alleviates aches and pains, resulting in:
2. Massage increases circulation, contributing to:
3. Massage provides tactile stimulation, which:
4. Massage induces a relaxation response, leading to:
5. Compassionate and caring touch supports emotional well-being by:
6. Focused touch enhances spiritual well-being, resulting in:
"It is the position of the American Massage Therapy Association (AMTA) that massage therapy can improve the quality of life for those in hospice and palliative care." AMTA evidenced-based position statement 2009
How do massage services benefit our profession?
Eldercare and hospice organizations are in business, too. They will want to know how massage services will improve their bottom line. Tell them that an organization that offers massage:
How does massage therapy help meet federal guidelines?
Massage services can be integrated into the resident or patient's plan of care. Documentation of your service contributes evidence of:
Who pays for massage therapy services?
The answer to this question lies in the structure of the agreement you have with the organization. You may be hired as a staff member, in which case you would be paid a salary to provide massage with or without employee benefits. More likely, however, you would be brought on as an independent contractor. In this case, there are two possible options for payment.
Option #1: The organization pays you an hourly rate for a set number of hours per month.
This offers them two advantages: any resident or patient may receive massage, and they can offer your services as a "value added" amenity, something that may be attractive to their potential customers. The advantage to you is reliable hours of work. The organization may also agree to pay you for staff massages or educational presentations.
Option #2: The organization permits you to offer massage on a fee for service basis. In this case, the resident or patient or his responsible party hires you directly; therefore you would work only with those individuals who have contracted your services. With this arrangement, there is no cost to the organization, which may appeal to the management. The challenge is that you have to attract and retain clients Ask the administrator or director to distribute information about your services. One suggestion is to place
your service brochure in the materials that all new residents or patients receive upon admission. Offer to give a short presentation about massage at family meetings or create a display for the lobby to announce the new service.
Other funding sources may include:
Is a physician's order required for massage therapy?
No. There are instances where you should consult with the physician to insure safety--for example, if the resident or patient has had recent surgery, acute illness, or chemo-therapy.
Can our staff members receive massage?
Care professionals can benefit from on-site seated massage to reduce the effects of job-related stress and prevent burnout. Massage is perfect for incentive programs to reward employees for a job well done! Offer to provide this service on a regular basis.
What qualifications should the massage therapist have?
Provide your license or certification credentials and proof of professional liability insurance. Highlight any specialized training in meeting the needs people in later life stages.
Including this special population in your practice can be professionally and personally rewarding. It requires specialized skills, sensitivity, and compassion--as well as a bit of a pioneering spirit. You can succeed in opening the door to eldercare or hospice organizations and in doing so reach out to those who need your touch.
Eldercare and hospice has its own jargon. Knowing how to communicate with the professionals who serve as gatekeepers in these settings will help you establish credibility and build relationships. Here are some terms that will help you "speak the language:"
Click here for more information about Ann Catlin, LMT, NCTMB, OTR.
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