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The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
If You Get a Request for Records, Respond!
In our previous two articles, we discussed two of the main reasons for denial when chiropractic records are reviewed by Medicare contractors.
The Truth About Herbs
I appreciate the effort and research put into the article written in the June issue of Acupuncture Today regarding pesticides and Chinese herbs.
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
Medicalization and Mindfulness
The past several years have seen a veritable explosion of research on mindfulness. Research abstracts we've published in each issue of Health Insights Today under the heading "Mind-Body News" have increasingly reported on studies about mindfulness interventions.
History of Animal Acupuncture: Part II
In Part I of this article, I had gone back to 1969 and tried to describe the atmosphere and events of that year that engulfed many of the younger generation, some who were all the core members of the National Acupuncture Association.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 1)
When we think of lower back pain, we tend to think in terms of the lower lumbar spine and the SI joint. These joints and their discs are obviously important. However, we tend to miss fixations that occur just above – in the upper lumbar spine. Three questions come to mind: 1) Why is the upper lumbar spine so important? 2) Why do we miss the fixations here? 3) How can we adjust them?
When Big Pharma Meets Chinese Medicine
Earlier this year, Bayer made a media splash with their decision to buy the Dihon Pharmaceutical Group Co., a Chinese TCM manufacturer.
The Problem With Prolonged Sitting
We need to constantly talk to our patients about spending less time sitting and about what can go wrong with poor sitting postures. The fact is we sit too long in repetitive malpositions.
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
Improving Our Political Effectiveness
The November 2014 elections are right around the corner; members of Congress, governors and state legislators are all running. Now is a good time to talk frankly about our overall political involvement.
News in Brief
NBCE Launches Computer-Based Testing Era; California Chiropractors Get Expanded DOT Exam Privileges; New Jeff Hays Documentary.
Help Secure Our Future by Sharing It
The National Board of Chiropractic Examiners (NBCE) conducts one of the most comprehensive surveys of the U.S. chiropractic profession every 4-5 years.
Thoracolumbar Syndrome: The Great Mimic
The thoracolumbar junction is a common area of joint dysfunction. The most obvious cause is dysfunctional breathing or lack of diaphragmatic breathing. Treating this breathing problem will ultimately be the long-term cure for the syndrome.
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
Rethinking GMO: Less Panic, More Context
Some of you may have noticed that after writing parts 1 and 2 of “Genetic Modification of Organisms for Human Consumption” a while back [Nov. 15, 2013 and Jan. 1, 2014 issues], part 3 never appeared.
Let the Patient Tell Their Story
Often when a patient presents with an injury, they want to tell their story. People by nature like to talk about themselves, particularly when they're worried about their health.
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
Uncle Sam Needs You
Scrutiny into the Department of Veterans Affairs (DVA) continues to grow after efforts to reform the DVA by the former Secretary of Veterans Affairs, Eric Shinseki, were deemed "a stunning period of dysfunction" by Senate Minority Leader Mitch McConnell (R-Ky.).
MPA Media Wins Seven Publishing Awards
MPA Media, publisher of Acupuncture Today, among other titles, has been recognized for editorial and design excellence with an unprecendented seven publishing awards by the ASBPE, the nation's largest organization for business-to-business publications.
November, 2010, Vol. 10, Issue 11
Hospice Massage: Ethical Considerations
By Ann Catlin, LMT, NCTMB, OTR
As a massage therapist, like other health care professionals, you are expected to adopt and uphold standards of practice that serve as "guiding principles" in scope of practice, client relationships, clinical decisions, and business practices.If you choose to work in hospice you enter a complex field of service that exposes you to ethical issues and dilemmas unique to end-of-life care. Of course, the standards of practice for massage therapy apply, but you will also need to be familiar with the ethical principles and guidelines found in hospice care to have a foundation from which to act. Some principles act as guidelines but many are highly individual, steeped in your own personal moral compass, providing a touchstone in situations where you search for the "right thing to do".
As massage therapy takes its rightful place in hospice care it is possible, if not likely, that you will be exposed to some ethical dilemmas of modern-day health care. Medical treatments and technology have changed the way we die in our culture. For many patients, their families as well as the professional caregiver, the experience becomes laden with conflict and moral choice.
Dr. Richard Fife,3 an ethicist, states: "In hospice care, staff members are constantly faced with the possibilities and realities of ethical dilemmas." He reports findings from a two-year study of ethical dilemmas faced by hospice staff. Some of the most common issues included:
Granted, as a massage therapist, you may not directly be involved in resolving these issues. But it's possible that you may be exposed to them. By anticipating these issues you will be more prepared and resilient when they do come up.
I will compare one area of standards of practice--the roles and boundaries as put forth by the National Certification Board for Therapeutic Massage & Bodywork6 and related ethical principle from the National Hospice and Palliative Care Organization (NHPCO)2 and how they impact day-to-day activities of providing massage services in hospice care.
Roles, Boundaries & Principle
Roles and boundaries: Adhere to ethical boundaries and perform the professional roles designed to protect both the client and the practitioner, and safeguard the therapeutic value of the relationship.
Related principle: Provide patients and their families with the highest possible level of quality end-of-life care and services, while maintaining professional boundaries that respect their rights and privacy.
Considerations for the massage therapist:
Case example: I know of a massage therapist, "Kim", who was working as an independent contractor for a local hospice organization. She was asked by the hospice nurse to see a woman with advanced Parkinson's disease. The massage therapist saw the patient for weekly sessions. I learned that Kim had, in addition, been hired by the family as a personal care attendant and was essentially "on-call" to run errands, drive the patient to doctor's appointments and stay with her in the home when the family needed to be away. Kim complained to me that the hospice had let her go because they saw her actions as inappropriate. She also complained that the family was calling on her more and more and hadn't paid her in some time. She stated that she couldn't bring herself to discontinue her service because the patient "needs me so much".
Reflection question: What is the ethical dilemma here? What would have been an appropriate course of action for Kim?
Anyone who chooses to serve those in hospice care recognizes that it is a privilege to do this profound work. Caring for the dying through the medium of touch can be an experience that forever alters your worldview of death and dying. You will be forced to examine your thoughts, feelings and behavior in this profoundly personal, yet professional work. By accepting the responsibility to explore the personal nature and impact of end-of-life care you will be more equipped to uphold the highest ethical standards of your professional role.
Click here for more information about Ann Catlin, LMT, NCTMB, OTR.
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