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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.
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.
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.
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.
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.
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.
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 It also held numerous outdated gizmos with electrical cords of various lengths that could trip or strangle a person.
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.
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.
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.
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.
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.
News in Brief
New President / CEO Takes Office at Yo San University. Electroacupuncture for Constipation?
Assessing Core Stability and ROM: 5 Basic Checks
One of the first steps in addressing core stability is assessing static posture, ranges of motion, and motion of the pelvic bones, sacrum, femurs, lumbar spine and thoracic spine.
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.
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.
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.
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).
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.
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.
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.
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.
October, 2011, Vol. 11, Issue 10
Hospice Massage Programs Provide Visionary Care
By Ann Catlin, LMT, NCTMB, OTR
Ten years ago, when I began teaching others about end-of-life care, I heard a lot of massage therapists say that they wanted to volunteer with hospice and realized they needed some additional knowledge and skills.Today, even more therapists I train say they want to work in hospice or develop a hospice massage program. The chances for them to do that are much better than a decade ago and I'm blessed to be a part of the expansion of holistic end-of-life care.
Rather than a place of care, hospice is a philosophy focused on comfort and support of people facing a life-limiting illness that no longer responds to curative treatment. The goal of hospice is to improve quality of life by easing the physical, emotional and spiritual burden of the patient and his or her family. Pain and other symptom management is a special area of expertise hospice offers. Eighty percent of hospice care is provided in the patient's home. "Home" is defined as wherever the patient is living at the time. It might be a family member's home or a nursing home. There are even hospice services provided in some prisons. The United States Medical Center for Federal Prisoners happens to be where I live in Springfield, Mo. The first prison-based hospice program was developed there in 1988. I once heard moving accounts by several prisoners who were trained as hospice volunteers and served at the bedsides of fellow inmates. They talked about the profound impact the experience had on them as they learned to care for a dying friend. I recall one man saying it was the first time he felt compassion for another human being and that it was making him a better person.
It might surprise you to know that hospice is a relatively new area of health care. The first hospice, St. Christopher's Hospice in London, was formed in 1967 by Dame Cicley Saunders, a nurse and physician who saw the need for more compassionate care of the dying. While lecturing at Yale University, she met Florence Wald who, at the time, was Dean of the Yale School of Nursing. Five years later Wald moved to London to work alongside Saunders at St. Christopher's Hospice. Meanwhile, Elisabeth Kubler-Ross published her landmark bestselling book, On Death and Dying, establishing her as an advocate for dignified home care of the dying. In 1974, Florence Wald founded Connecticut Hospice in New Haven, the first hospice in the United States. It's important to note that in 1982, Medicare Hospice Benefit legislation was passed, demonstrating that the federal government supported quality end-of-life care and was willing to pay for it with Medicare funds. Today, there are more than 5000 hospice organizations in the U.S. alone.
The Hospice Team — Where Does Massage Fit?
Every hospice patient has access to an interdisciplinary team depending on individual needs and choices. The patient and his or her family are central to the team. Each team also includes a nurse, physician, social worker, home health aide, spiritual and bereavement counselor, occupational, speech and physical therapist and volunteer. Not every patient requires help from every team member, but the hospice organization must have these services available. In fact, Medicare demands this standard of care in order to qualify for funding. I realize you didn't read "massage therapy" in that list of required services. So where do we fit in to the team?
The past ten years has seen remarkable growth in hospice massage programs in spite of the fact that there is no standard for how these programs are created, managed or funded. Since my own work includes training and preparing massage therapists to serve people in hospice, the question of how it's working is important to me. I'd like to give you a peek into what's happening at this point in time. I found one 2009 study published in the American Journal of Hospice and Palliative Medicine that surveyed hospices in the state of Washington to find out about complementary therapy use. Survey results revealed that 86 percent offered at least one complementary therapy. The three most common were massage therapy (87 percent); music therapy (74 percent); and energy healing (65 percent). A fairly significant number of hospice patients received complementary care, averaging 35 percent of all patients. So, if massage therapy was so widespread, how was it funded? Well, the good news is that hospices more than ever before are finding ways to compensate massage therapists for their service. The not so good news is that there still are a lot of hospice massage programs that rely on volunteer service. Of the 58 percent of hospices that paid massage therapists, funds came from donations, special funds and grants, direct pay from patients, and other hospice funds. Most hospices relied on a combination of paid and volunteer services. The authors concluded, "According to the results of this survey, the use of complementary and alternative medicine in Washington state hospices is so extensive that the official inclusion of CAM providers as part of hospice staff seems warranted (and these) providers should be considered health care professionals, and as such, be submitted to the same rule and benefits other health care professionals receive." I couldn't agree more! I'm happy to say there are some hospices that are doing just that.
Alternative Hospice in the St. Louis area is a great example. I interviewed Mary Magill, RN, Founder and Executive Director, to find out about their program. The most significant difference is that massage therapy is included in their standard of care, not just an adjunct to core care. From its inception in 2005, the use of complementary services has been central. In fact, it's in their mission: "Alternative Hospice provides holistic end-of-life healthcare by integrating complementary care with conventional medicine." Mary shared that her nursing background included work in long-term care facilities. She observed the profound impact of seniors living with the loneliness of touch deficit and wanted to alleviate that kind of suffering. Alternative Hospice currently employs four part-time massage therapists who work out of two offices, one in metropolitan St. Louis and one in a rural area. Besides wages, therapists earn paid time off and are covered by the company's liability insurance. Massage services are funded primarily by donated funds. Therapists not only care for patients and their family caregivers, but also other hospice staff. I asked Mary what special skills she looks for in the massage therapists she hires. She responded, "Love for elderly people; a compassionate heart; specialized training that includes not only clinical skills." Therapists are expected to function as a professional member of the interdisciplinary team and have sound documentation skills. Alternative Hospice benefits from the complementary care it provides in several ways, most notably, increased patient and staff referrals. Mary cited decreased staff turnover as a huge benefit. Personally, she is rewarded by witnessing the greater quality of life in their patients. "I know we are doing a great job and our families appreciate it."
I believe we will see continued growth in quality hospice massage programs as public interest in using complementary therapies increases, along with emerging evidence of the value of massage in end-of-life care. And those of us who feel drawn to serve this special population will have the joy of being a part of something that makes our world a better place.
"You matter because you are you. You matter to the last moment of your life and we will do all we can not only to help you die peacefully, but also to live until you die." – Dame Cicely Saunders, Founder of the Hospice Movement
Click here for more information about Ann Catlin, LMT, NCTMB, OTR.
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