resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
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 previous articles by Ann Catlin, LMT, NCTMB, OTR.
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