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What We Can Learn From Spine Surgery
Patients with lumbar stenosis presumably present for conservative care to improve their quality of life and avoid surgery. However, providing clear guidance to these patients can be difficult for a number of reasons.
A Q & A About Updated Codes
Yes, indeed there was an update to ICD-10 on Oct.1, 2016. This is a regular update to the diagnosis coding system and this type of update will occur every Oct. 1, just as it did when the ICD-9 system was in place.
Molecular Motors: Tiny Machines Behind the Rhythm of Life
In the clinic, we aim to restore healthy patterns of movement for qi that has gotten trapped or misdirected, or may have even collapsed. We may be focused on freeing stagnation, releasing heat or redirecting counterflow qi, but it often comes down to helping re-establish a flow of sorts.
DVT: Know the Signs and You Could Save a Life
I lost a friend several months ago. He died from a pulmonary embolism (PE) secondary to a deep-vein thrombosis (DVT) that originated in his lower leg. Bobby was in his mid-60s, soft-spoken and had a big heart.
A Simple Protocol for Holiday Stress
It's winter, a time when we should be deep in reflection, eating warming foods and sleeping long hours. Following nature's rhythms, we restore our bodies and minds in preparation for the renewal of spring.
All Fiber Is Not Created Equal
Sometimes the best place to start is at the end. So, the conclusion of this article is that all fiber is good ... but some fiber is better. Let's break it down. There are two main types of fiber: soluble fiber and insoluble fiber.
Southwest Acupuncture College Brings It to Division 1 Athletes
When Michael Phelps' photograph with the distinctive round marks left by cupping went viral, the Division 1 student athletes treated through the Dal Ward Athletic Center at the University of Colorado (CU) could relate.
News in Brief
New President / CEO Takes Office at Yo San University. Electroacupuncture for Constipation?
A First for the Profession: CCE Accredits First Chiropractic Residencies
The Council on Chiropractic Education (CCE) has awarded accreditation to all five chiropractic residency programs currently administered at Veterans Administration facilities, "the first residency programs in the nation ever to be awarded this distinction, a significant advancement in the evolution of chiropractic education," according to a VA press release announcing the milestone.
End of an Era Looms at NYCC
New York Chiropractic College recently announced that Dr. Frank Nicchi will retire in August 2017 after 36 years with the college, the past 17 as president.
Dedicated to Defending Chiropractic
Whether you're a veteran DC or a first-trimester student, the name George McAndrews should be part and parcel of your professional vernacular, as familiar as the word chiropractic.
Branding: Set Your Practice Apart
Dr. Brad started his practice seven years ago on a shoestring budget. He created his generic logo in five minutes using a website because he didn't have the time to figure out how to make something special.
Overuse Injuries in Young Athletes (Pt. 2)
Most overuse injuries are benign, but there are some high-risk injuries that, if unrecognized or inappropriately treated, can result in significant loss in time from the sport or even require leaving the sport.
6 Steps to Make 2017 Your Best Year Yet
People often ask me what defines success. Success, for me, is simple: doing exactly what you want to do in life. Whether it's the kind of practice you run, your life at home, your hobbies or something else, it's achieving anything you put your mind to.
A Letter to the Profession from the New President at AAAOM
Volunteering for a national, nonprofit organization brings with it such highs, lows, and accomplishments, as well as a steep learning curve.
Can a Multivitamin Reduce Breast Cancer Recurrence?
There is a great deal of controversy regarding the value of multivitamin supplements in cancer prevention. However, with respect to preventing breast cancer recurrence, an important study was published in the Journal of Breast Cancer Research and Treatment in 2011 by Kwan ML, et al.
Another Chance to Make a Difference
Just a few months ago, "the worst natural disaster to strike the United States since Hurricane Sandy" hit Louisiana. During this storm, one area experienced 31 inches of rain in 15 hours as almost 7 trillion gallons of water rained down in just one week across the state.
Little Sticker, Big Impact
It's the end of an election year. Hilary Clinton and Donald Trump were the subject of conversation for everyone, everywhere for the entire 2016 calendar year. I don't think any of us can deny that this election affected us all very deeply on a personal level.
Herbs for Digestion: The Power of Bitter
Many cultures (and indeed herbal clinicians) around the world have long respected the role of bitter herbs and foods for promoting digestion. For example, aperitifs – drinks consumed before a meal to stimulate appetite and digestion – were originally derived from bitter herbs.
Meshing TCM With Environmental Pediatrics: Where's the Overlap?
Pediatrics has a long history within Chinese medicine dating back to the late Han dynasty (i.e., the late 200s CE), with the two primary areas of emphasis being herbal medicine and xiao er tui na (pediatric massage).
2016: A Year in the Life of Acupuncture
Happy Holidays, may you, your family and friends have peace, joy and blessings throughout this special time of year. As 2016 comes to a close, we can look back and celebrate the many events and accomplishments for the profession of acupuncture.
Chiro School Reunion: Whatever Happened to...?
I opened the door to the closet slowly, carefully, since I knew it contained a large number of precariously stacked file boxes. It also held numerous outdated gizmos with electrical cords of various lengths that could trip or strangle a person.
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 more information about Ann Catlin, LMT, NCTMB, OTR.
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