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Insomnia Treatment Based on the Yu Theory
In recent years, acupuncture has risen in popularity as a form of alternative or supplemental medicine for the treatment of many different types of disorders.
What's Bugging You? Probiotics and Your Health
An estimated 100 trillion microorganisms representing more than 500 different species inhabit every normal, healthy bowel. Gut-dwelling bacteria keep pathogens in check, aid digestion and nutrient absorption, and contribute to immune function.
Scope of Chiropractic Practice: Why Now Is the Time to Expand
In my January article, "Scope of Chiropractic Practice: Is It Time for Change?" I discussed the use of the term primary spine care practitioner, the loss of privileges to diagnose in Texas, and the fact that the definition of "chiropractic" varied from state to state.
5 Ways to Enhance Your Family Practice
Every practice has a personality style. A practice that caters to athletes, PI cases or adults, for example, projects differently to patients than a family wellness practice.
The Qi Focus: A Guide to Managing Stress
Stress, are you experiencing heightened stress levels? Your own, and your clients? Is Trumpitis getting to you? I recently polled a cluster of acupuncturists, Asian Bodywork Therapists (ABT) and psychotherapy colleagues on the issue.
The First (Only) Choice for Spinal Pain
The study on NSAIDs for spinal pain summarized on the front page of this issue is intriguing on a number of levels, the most obvious being the conclusion that "compared with placebo, NSAIDs do not provide a clinically important effect on spinal pain, and six patients must be treated with NSAIDs for one patient to achieve a clinically important benefit in the short-term."
Integrative Cardiology: The Heart of TCM & Western Medicine
Patient centered therapy is a growing trend in hospitals that are expanding to boutique services.
Treating LBP the Right Way: Think Natural
An updated clinical practice guideline from the American College of Physicians (ACP) recommends spinal manipulation and other non-invasive, non-drug therapies as first options for acute, subacute and chronic low back pain, rather than pain medications, as stipulated in the original 2007 guideline.
Toxicity & Kids: The Importance of Environmental Intake
The old adage is true that children are not little adults. Traditional Chinese medicine (TCM) has long known that the physiology of children is unique, as are the diseases that plague them.
Chiropractic: A Great Fit for the White House
Dr. Eric Kaplan is a New York Chiropractic College alumnus; a No. 1 best-selling author whose books include Awaken the Wellness Within and The 5 Minute Motivator; a chiropractor for professional sports teams and elite athletes; and even served as an advisor under the Clinton Administration to the President's Council on Sports & Physical Fitness.
The Chiropractor's Guide to CRISPR
Science magazine's "Breakthrough of the Year" award for 2015 was described as "the gene-editing tool called CRISPR." CRISPR stands for "clustered regularly interspaced short palindromic repeats."
NSAIDs No Better Than Placebo for Spine Pain
A meta-analysis of randomized, placebo-controlled trials comparing the efficacy and safety of NSAIDs with placebo for spinal pain concludes that among 6,065 spine pain patients, "NSAIDs reduced pain and disability, but provided clinically unimportant effects over placebo."
How to Correct a Cuboid Subluxation
Cuboid subluxation is a poorly recognized condition, even though it is not uncommon. It has been described in the literature under various names: cuboid subluxation, cuboid syndrome, locked cuboid, dropped cuboid, cuboid fault syndrome or peroneal cuboid syndrome.
Treating the Terrain of Chronic Sinus Infections
Chronic sinus infections can be stubborn to treat, but the therapeutic path forward can be simplified when utilizing three distinct treatment principles which take into account the terrain of the body, and the way in which microbes grow.
Give Your Patients the Ergonomic Advantage
Prolonged sitting contributes to low back pain and is a health risk. When I discuss my POLITE technique practice recommendations with patients, ergonomics may be last, but not least!
Shedding Light on the Benefits of Heliotherapy
I can't imagine anyone not feeling good strolling in the sun on a beautiful spring day. The sun is responsible for all life on earth and is best illustrated along the equator touting the richest biodiversity on the planet, in stark contrast to the Arctic Circle and South Pole.
Making Sense of Liver Regulation
In Chinese medicine, the liver has the function of moving and storing qi and blood. In its moving function, the liver smoothly distributes qi and blood to the tendons, muscles and flesh through microcirculation.
Waist Circumference: A Conversation Starter (Part 2)
Now let's discuss the clinical approach to reducing WC and implementation in today's chiropractic practice. The primary intervention centers around dietary modification and lifestyle habits aimed to reduce adiposity, improve insulin sensitivity and ultimately, diminish systemic metabolic dysfunction.
Help Save an Important Chiropractic Landmark
The chiropractic profession has a splendid and varied history. Sadly, many landmarks have been lost to bulldozers and wrecking crews, such as the Ryan Building, Little-Bit-O-Heaven, Spears Chiropractic Hospital, and Clearview Sanitarium.
News In Brief
A "Modern" Business Model. Acupuncturists may have a new professional atmosphere to consider, as a new concept is on the horizon - at least for one business.
Good Works at the Canandaigua VA
Faculty and students of the Finger Lakes School of Acupuncture and Oriental Medicine (FLSAOM) of the New York Chiropractic College have provided acupuncture to veterans at the Veterans' Administration Medical Center (VAMC) in Canandaigua, New York since September of 2007.
September, 2010, Vol. 10, Issue 09
Take It From Your Peers: You CAN Get Paid to Work in Eldercare and Hospice
By Ann Catlin, LMT, NCTMB, OTR
My last article focused on keys to opening doors to eldercare and hospice. If you desire to work in these settings, my guess is you have wondered: 1) How do I get my foot in the door? 2) How do I generate a clientele? 3) How can I get paid? All very valid questions! A few months ago, Massage Today conducted a poll asking two questions: "Do you provide massage to people in eldercare or hospice? If so, do you provide this service as an employee, independent contractor or volunteer?" Here is what we learned from the 249 people who responded:
The good news is that long-term care and hospice organizations are including massage therapy services more than ever before. I'm honored to be a part of this trend and to assist folks like you along your path of service. I thought you might like to hear about therapists who are doing this rewarding work - and getting paid for it either as independent contractors or employees. I interviewed several massage therapists to find out how they are being compensated. Read on and learn from your peers what you might expect when working in this field. (To respect privacy, I have changed the names of the therapists and have not named the organizations.)
Jill, LMT, contracts part-time with a hospice. Hospices are structured as either for-profit or non-profit and this particular hospice is a non-profit organization. Funding for massage services come from grants and endowments. Jill receives referrals from either the nurse or social worker who obtains a doctor's order for massage therapy. Each patient is initially referred for an assessment session plus four visits. Jill can recommend continuation of services beyond the four visits. She has a consistent caseload of six clients and typically sees each client weekly; however, some are seen more often based on needs. Sessions last usually 30-40 minutes. Jill is paid $40/session, plus mileage. She educates the staff about her services by regularly presenting at staff meetings as well as sharing printed information. She reports that this has helped generate appropriate referrals and build relationships with other caregivers.
Doreen contracts with a 100-bed skilled nursing facility for 12 hours per month. The facility administrator acknowledges the value added by providing this amenity for her residents. The funds for massage come from a combination of general operations and marketing budgets. Doreen has permission to work with any elder in the facility. The medical director must approve of all resident activities and massage therapy is considered a resident activity in this facility. When Doreen arrives at the facility she checks in with the social services or nursing director who make referrals. Elders are selected based on needs such as pain, agitated behavior, social isolation, or newly admitted to long-term care. Sessions range from 15-45 minutes. Session documentation is kept in the activities department records. Doreen is compensated at a rate of $60/hour. She occasionally provides seated massage for staff upon request of the administrator for the same hourly rate.
Mary, LMT, contracts with a 60-bed skilled nursing facility. She has taken a creative approach. Like many facilities this one has a number of elders living there whose care is paid for by Medicaid. (Medicaid is the state-operated public assistance program that pays for health care for people with low income. Some states may have another name for it.) People who receive Medicaid benefits get a monthly personal needs allowance, which is a set amount of money each month for things like clothing, toiletries, recreation, snacks, etc. (For example, Missouri's allowance is $30/month.) Many people who receive this allowance don't use much of it and it builds up in an account. An individual must use the money or the benefit is reduced or discontinued. Mary is paid with money in the client's personal needs allowance account. The nursing home administrator refers residents who have money in their account. But the referral is not just based on the funds being available. People are referred based on needs. Mary has educated the administrator about the benefits of massage for frail elders and, together, they determine a plan of care. Reasons for referral include anxiety, depression, pain, dementia, social isolation because of lack of family. Massage sessions are scheduled either weekly, bi-weekly or monthly. Mary reports that sessions range from 15-45 minutes and she is paid a set fee per session. She consistently has a caseload of six clients.
Rita is a massage therapist employed by a for-profit hospice working part-time 20-25 hours/week. She is expected to actively participate in interdisciplinary team meetings where patient care plans are discussed. Her involvement in these meetings results in referrals. All patients and/or families are informed about complementary services and they often request massage upon admission. Rita's current caseload is about 23 sessions/week and each session lasts 40-50 minutes including documentation time. This hospice organization pays for massage services from the Medicare funds it receives to care for patient needs. Rita earns $24/hour plus mileage for travel. She also receives benefits for paid time off including vacation and holidays. She found this position through an online job search service at SimplyHired.com. She reports that because she had specialized training in massage for people in later-life stages was what secured the job. The massage program has been so successful that they have recently hired a second massage therapist!
Cindy, LMT, is employed full-time at a continuing care community that offers multiple levels of care including independent living, assisted living and skilled nursing. Cindy is considered a part of the rehabilitation/wellness department. She has a massage room within this department where she sees clients consisting of independent older adults and facility staff, as well as people from the community. Elders who are admitted to the facility for rehabilitation following an injury or illness benefit from massage therapy during recovery. She also sees elders in the assisted and skilled nursing facilities where clients are referred by staff and families. Clients pay the facility for massage which creates a revenue source for the organization. Cindy receives a salary of $45,000 plus paid time off and health insurance benefits.
A New Age of Care
In the last decade, massage therapy has gained recognition and acceptance. Hospice and long-term care facilities are recognizing the value of adding massage therapy services. Therapeutic massage is growing as a form of wellness care for older adults. Organizations that incorporate massage therapy as an ancillary service are on the leading edge of what will become standard in the future of care services and will meet customer expectations. Perhaps you will join me in ushering in this "new age" of care!
Click here for previous articles by Ann Catlin, LMT, NCTMB, OTR.
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