Touching Lives in Eldercare and Hospice

Hello all,

I’m not one to pour my energy into politics but there are times when something catches my attention.  Here is one such thing that I think deserves passing along and following because it could positively affect funding for complementary therapies in hospice and palliative care.  The following information is from this web link http://warner.senate.gov/public/index.cfm?p=HealthCare

In June 2009, Senator Warner introduced the Senior Navigation and Planning Act of 2009, health reform legislation that will strengthen the quality and availability of counseling, support services, and care management for patients and families coping with life-limiting illnesses.  The legislation includes:

• Enhanced Medicare and Medicaid Coverage of Advanced Illness Care Management Services
• A Requirement for Physicians to Provide Certain Medicare Beneficiaries with Information on Advance Directives and other Planning Tools
• Incentives for Providers to Achieve Accreditation and Certification in Hospice and Palliative Care
• More Comprehensive Discharge Planning for Facilities
• Increased Public Awareness about the Importance of End-of-life Planning

Several prominent organization have endorsed the legislation, including the National Hospice and Palliative Care Organization and the Alzheimer’s Foundation of America. An important element of the legislation in my view is that it enhances much needed end-of-life education for physicians along with public education about advanced directive. 

I don’t bring this up to endorse a political stand but rather to shine a light on this important conversation taking place on a national stage about end of life care.  Take a look at the link– what do you think about its possible impact on funding for our services?

Until next time, enjoy the gifts of summer!
Many blessings,
Ann

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Hello all,

It’s been a while since my last post and it’s good to return.  I just returned from a beautiful and tranformative two weeks in Peru.  The focus of the journey was a combination of exploring some indigenous cultures and spiritual awakening.  Of course, you can’t go to Peru without visiting Machu Picchu and our group spent two days there. But one of the most powerful parts of the journey came near the end when I traveled to a small island in Lake Titicaca called Amantani.  Our boat was greeted by a group of the most heart-centered people I have ever met– men, women and children alike– and I lived among them long enough to get a sense of life there.  Their lives are based on the value of community and living in right relationship with both self and community.  Joy seemed to radiate from the eyes of these sweet people and I was so  moved by their generosity and their strong connection to nature.

I’m always curious about how different cultures care for their elders.  It was immediately clear that old age does not equal debilitation on Amantani.  Several older adults helped to carry our gear from the boat to the house by tying a large cloth around the gear and hauling it on their backs up a path.  I DO mean up, too, as the terrain is really hilly and the elevation is somewhere around 13,000 feet!   I saw old women herding sheep.  People walk everywhere– there are no cars.  Food is fresh and prepared simply.  At the end of my stay I asked our guide about the elders.  Elders who have needs are cared for by families as I assumed was the case.  But the thing I made note of is that she said they just don’t have many debilitating diseases such as stroke, Parkinson’s disease, Alzheimer’s disease, etc.  She said people there don’t expect to get sick in old age.

I’ve thought about this a lot since my return and have formulated a question about it and would love to get your feedback on it.  I wonder how much of our decline in old age stems from the “learned expectation” in our culture that as we age it is a given that our health will deteriorate. 

I understand that the answer is complex, but an idea worth pondering I think…

To a healthy and well old age,
Ann

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Hello everyone,

It’s been a month since my last post. As you may or may not be aware I’ve been pretty consumed with plans for a symposium I’m organizing along with my colleague, Lisa (Hand in Hand 2009: A Symposium Celebrating Massage Therapy in Eldercare and Hospice).  The reason I bring this up here is to tell you a little story that I hope may serve as a hopeful example for you.  We’ve all been bombarded with messages about how to handle this “economic downturn”.  It seems everyone is writing about the current economic circumstances and ways to survive them.  I have no doubt that it is affecting each of us in some way or other. 

It was nearly two years ago that Lisa and I decided that, together, we would create and organize our symposium.  We have worked tirelessly–well, maybe not tirelessly– how about diligently :)– ever since we decided that it was the right thing to do. Of course two years ago we had no idea of the challenges that the economy would present us.  You see we’re not trained event planners; nor do we have an organization full of various committees to share the work load.  It has been the two of us along with the assistance of a meeting and event organizing company which we hired to help with a few things.  Having never created a large event before we just rolled up our sleeves and took what steps we knew to take and a few we hoped would be the right ones.  Now it is only a couple of days before our event and I look back over the last months and recognize something more at work than just the two of us.  For me it is trust that I have been standing in my purpose and witnessing what happens when I do.  Most certainly the symposium has taken some hits. Attendance is less than we had hoped and there have been times when I questioned the feasabiltiy of moving forward.  But I continued to trust and affirm my purpose of assisting others wishing to serve in eldercare and  hospice.  The universe has answered with many gifts! Wonderful presenters and instructors; a grand location; even a harp player has emerged just in the last few days! We have been supported every step of the way by what I refer to as 1000 unseen helping hands. 

So I invite you to trust in YOUR purpose too.  Get clear on what your purpose is and trust that you have 1000 unseen helping hands at work on your behalf.  Take a little step in the direction you want to go and you will be met with resources that just might surprise and delight you!  Even during “these times”. 

Thank you in advance for your positive thoughts for our symposium.  I’ll let you know how it turns out!

Blessings and all good things,
Ann

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Hello all,

It seems the issue of providing massage for caregivers in hospice organizations is a bit of a sticking point for many organizations.  The points raised by Jennifer and Ann are well-taken and deserve some consideration.  I’m sure we can all agree that any caregiver in hospice or long term care give much of themselves physically, emotionally, and energetically.  Certainly massage would be an effective way to help them manage the stress and toll of taking care of others.  I’ve actually heard from several massage therapists about hospice organizations preventing them from working with staff because of organizational liability issues.  I’m prompted to explore this issue.  One thought comes to mind.  All long term care and hospice organization have a medical director.  I’m wondering if that might not be one solution to this issue.  I bring it up because one skilled nursing facilitly where I provide Compassionate Touch sessions had their medical director approve my services.  I understand that some organizations are more “guarded” than others.  But it might be worth exploring the idea of asking the hospice organization about having the medical director approve non-invasive, seated massage for stress management for staff. 

Have any of you tried this approach? I’d like to hear from you about this issue– what’s working, what’s not.  We have so much to offer those caregivers to help prevent burnout and compassion fatigue. 

Peace and blessings to you,

Ann

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Hold still… do you feel it? There is a wave of change underfoot.  It seems like EVERYTHING is changing– have you noticed?  Most certainly theres a lot of change happening in our profession. I like to think of the changes as growing pains.  A big change that we all are aware of is the aging of our population, with the fastest growing segment being 85 yrs and over.  Lately I’ve been exploring this question: With so many elders emerging in the United States — are massage schools acknowledging this as an emerging market for our profession?  After a little investigating it seems that the answer is mixed.  The emphasis schools place on massage for those in later life stages ranges from simply showing a video (quite possibly outdated); to  a few hours and visiting a local nursing home; to none at all.  While I know there is value in giving massage students a taste of many different approaches I believe what is being overlooked is how important this special population is, and will be, to a successful career. 

I want all massage therapists to succeed and have the career dreamed of when they decided to pursue massage school.  I think it’s the responsibilty of schools to prepare students in skill sets that are in step with current societal trends and needs to give their graduates a fair shake at success.  If more emphasis was placed on the growing need of an aging population, I think more massage therapists might feel a little more confident in reaching out to those potential clients.  At the very least, students would understand that serving this special populationis a viable choice. 

I’d like ask a favor of you.  If any of what I’ve said resonates with you, join me in the conversation with our massage schools.  Let them know this is important!  If massage schools put just a little more emphasis on this special population we, as a profession, will be there to answer the needs of millions.

Best regards,
Ann

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Hello all,

I had an experience recently that was such a great teacher about how my perception of a situation is truly only MY perception.  The situation also required me to have a clear understanding of my professional boundaries.  I want to share my experience with you because any of us who work in eldercare or hospice have frequent opportunities to see situations from another’s perspective and to respond while respecting our ethical boundaries.  I hope my little story will serve as a teacher for you, too.

For about six years I’ve seen a client for Compassionate Touch sessions in a long term care facility– a young woman who is in a comatose state.  Her grandmother is a devoted caregiver and spends about 40 hours a week at her bedside.  Since she is usually present I have developed a nice relationship with her and at times provide massage for her too.  She recently discovered a lump in her breast and she shared this with me.  Since she is a breast cancer survivor she was quite concerned.  She told me that if she has a recurrance of cancer, she doesn’t want to go through the intensive treatment like she went through before. Then she went on the tell me about when she told her grown son about her choice, he responded by scolding her that she was being selfish and not thinking about others in her family.  I have to admit that I was a little stunned to hear this because it was just not what I assumed his reaction would have been.  She then asked me what I thought she should do.

The challenge? First to leave my own perceptions and judgments out of it. It would have been inappropriate for me to somehow collude with her or say that I thougth her son’s reaction was not fair to her.  Secondly, it brought up some ethical issues about a person’s right to choose, or not choose, treatment for serious illness.  My role, as a massage therpist, when faced with these situations (and they DO come up) is to simply be an active listener– period.  I am not there to advise or give my opinion. 

It’s important to be able to recognize when our reaction to a situation is coming from our own perceptions.  With that awareness we then can be clear about our professional boundaries and respond within them.  Do you have a situation to share that brought up these kind of ethical concerns?  Take a minute to respond– we’ll all benefit from it. 
Warm regards,
Ann

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New Year’s Greetings!
I picked up a USA Today while traveling for the holidays and there was an article about how caregivers of people suffering from Alzhiemer’s disease handle the holidays.  It states that there are 50 million family caregivers in the U.S.– that’s a lot of people living with the daily toll of caring for the needs of their loved one.  How does that impact the massage therapy community?  Many of us have clients, friends, neighbors or family members who are, or will be, caregivers.  We can offer our support by acknowledging the situation and contribute to the quality of life of the caregiver. Don’t be silent about it.
The article states:
“Family members not directly involved in caregiving may want to focus on the caregiver’s needs.  Everybody asks ‘How’s John?’ or ‘How’s Dad?’.  They don’t ask how the family caregiver’s are. They’re the invisible ones. The research shows their health is very much at risk.”
We know the positive impact of massage on body, mind and spirit.  We have a lot to offer these caregivers and truly make a difference.
How do you think your service might ease the burden of a caregiver?
All the best to you in 2009! I look forward to hearing from you.
Ann

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Good day everyone! Today I want to share with you a few inspiring short stories I’ve had the priviledge of receiving from massage therapists who are working with elders.  Since I have the honor of instructing and mentoring therapists wanting to serve elders in nursing homes and those in hospice, I love to hear stories that remind me of just how special this form of service is.  So, today, I’m sharing that reminder with you!

“I volunteered at a “spa day” for an assistant living facility.  They were curious to see what i had to offer.   They tested me by bringing their most agitated Alzheimer resident.   She was doing the classic hand fidgeting and over all anxiousness.   I calmly went and sat beside her, asked her if I could hold her hand.  I put my hand under hers, she did not pull away.  In a few minutes her hands had calmed down and instead of fidgeting she was calmly holding my hand with both of hers.   I was also gently rubbing her back.  She began looking at me and trying to communicate.  I couldn’t understand her, so I just started telling her about my life, she would smile and every once and awhile tell me in a clear voice about her life.  She allowed me to sit with her for over 30 minutes before she calmly asked to go back to her room.  The staff was thrilled!”  S.T., LMT

“Working with senior citizens, as well as the serious and terminally ill has given me such joy. This is a population that is neglected in so many ways. I enjoy spending time at their bedsides when they are at their lowest. A touch of the hand, a stroke of the hair and a caring smile does so much for them. We not only teach love, we give love.” S.C., LMT

“My dear 92 year old client, with whom I worked for 20 years, died the other day. She suffered from Alzheimer’s disease for the last few years of her life and along with her memory; she gradually lost her ability to say much. The Compassionate Touch workshop has been so helpful for me in these past months, particularly since Nan no longer felt comfortable being transferred into her bed by anybody. She always consented to my touch though. When last I saw her on New Years Day, although she didn’t recognize me, we shared a smile that was authentic and deeply heartfelt. Her family kept saying that she was gone, that she wasn’t there anymore, but that day, for that moment, after a session of Compassionate Touch, there she was. What a gift for me.” K.P., LMT

May the work of your hands be blessed.
Ann

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Good day!

First I want to wish you many blessings and simple joys for the holidays.
I am not one to spend much energy on daily news reports, but my husband does so we get Newsweek delivered to our home.  Yesterday he called my attention to an article in this weeks issue.  The piece is titled ” Can a Massage Cause a Stroke?”. It’s a question and answer column written by Dr. Patrick O’Gara, director of clinical cardiology at Brigham and Women’s Hospital and a professor at Harvard Medical School.

Someone from Sante Fe asks: “I have a deep muscle massage every month or so, including the muscles of the neck.  Someone told me such massages could loosen plaque in my carodtid arteries and cause a stroke.  Could this happen?”  Dr. O’Gara’s answer: “It’s very unlikely that deep muscle massage would loosen an arterial plaque and cause a stroke.  Your therapist is likely to stay away from direct pressure over your carotid arteries in the neck.”  I’m glad to see such a  question addressed from a medical professional in Newsweek.  This question has come up for me from some of my elder clients as well as my Compassionate Touch® students. I believe it is our professional responsibility to be a source for education on these kinds of questions. 

Has this issue come up for you in your practice?  How do you handle it?  As always, I invite your comments!

Ann

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I think we all must agree this has been a remarkable week.  Regardless of one’s polictical views and alliances, we have witnessed an unforgettable point in our history as a nation.  In following the events of our election, a story about a 106 year old woman really caught my attention. It is the story of Ann Nixon Cooper who lives in Atlanta.  While the story is about her perspective of our country electing the first African American president, I was so moved to sit back and realize just how much this woman has witnessed in her 106 years. It’s stunning really. I am inspired by her continued engagement in her world and the fact that she is actively participating in it.  It seems that so many people equate old age with sitting back and disengaging– but Anna Nixon Cooper is showing us young whipper snappers that it doesn’t have to be that way.  She is a shining example that I, for one, would love to follow!  If you would like to read her story and see pictures and a short video of her, go to this link: http://www.cnn.com/2008/POLITICS/10/20/centenarian.votes/index.html

Enjoy!
Ann

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