Touching Lives in Eldercare and Hospice

My husband related this story as told to him by our friend, Jeannie’s husband.   It points to the capacity for moments of clarity in a person who is thought to be unaware of what is happening around her. Jeannie’s parents are both in their 90′s. Her  mother is in a skilled nursing facility and has advanced dementia. She seems to no longer recognise her family when they visited and is in a very debilitated state.    Her father had been living at home but his health was declining because of some form of cancer.  Although her father always thought he would like to die in his own home, when faced with the reality of his demise he chose to be with his wife in the nursing home.  They now shared a room and family spent time at the bedside of the father as he was nearing death. No one was sure whether or not his wife was aware of his presence or situation. At one point she called out “He’s nearing death!”  About two hours later, he died.  Seems to me that she was more aware of circumstances than one would assume.

Those of us who spend time with people with dementia witness these uncanny moments of awareness.  I appreciate the reminder that we never really know the inner world of another and any assumptions we make should consider  capacity for awareness and relationship.  Do you have similar stories to share from your own experience? 

Blessings to you this holiday season,
Ann

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Last week I had the honor of presenting two sessions at the AMTA National Convention in Portland. Both were well-attended. In fact every seat was taken and it was standing room only!  I was delighted to see how many of my colleagues are interested in how massage impacts the lives of people with Alzheimer’s disease and our role in hospice care.  Many therapists reported that they are working in clinical  massage programs and many others want to develop new programs. It was exciting to hear about others’ work and how their programs are structured.  It is clear that programs in hospice and eldercare vary a lot in size; scope; and how they are funded.  As a leader I feel a responsibility to continue to create clear models for massage programs in these settings. If you are a therapist working in either a long term care facility or hospice, I want to hear from you! I want to learn about your work and your program.  I’m sure others reading this will be interested, too.  So toot your own horn and tell us your story. We’ll all be glad you did. 
Many thanks to the convention organizers for a super job– well done!
Ann

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I watched a short presentation by Dr. Abraham Verghese where he describes the difference human touch makes in the doctor-patient relationship.  He discusses today’s health care delivery system where so many things are computorized that it has even further removed doctors from their patients. I’ve noticed gadgets are used more and more for certain things such as taking a person’s pulse rather than being done with a finger on the pulse point.  During doctor’s visits, the doctor and nurse spends quite a bit of time reading reports or entering data into a computor.  I understand that software systems in healthcare have streamlined exchange of information and I think that’s great.  As a massage therapist who works with frail people in long term care and hospice it’s really great to hear a physician talk about what we know to be true.   Touch is the medium for deep human connection and a catalyst for healing. Thank you, Dr. Verghese for helping us to spread this message !  In today’s era of healthcare there is even a greater place for massage and the gift of human touch to complement medical care.
Take care,
Ann

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Hi all,

I read an article written by Anne Kreamer with the same title. Each of the 5 things are reported by either an expert in the field of aging or an elder. 

1. You’ll be happier because you are no longer striving to achieve goals and can relax with less stress.

2. Wise decisions will come more easily because as we age we become better problem solvers.

3. The fashion police will be off your back. 

4. You’ll know yourself and have greater confidence to express yourself.

5. You’ll have time on your hands to do things you love.

What do you think about these points? Is this what you observe in the elders you know?  Think it’s true for  yourself?

Take good care,
Ann

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Hello all,

I often am asked how to go about identifying which eldercare facility may be open to the services of a massage therapist.  I received some information and wanted to pass along to  you.  It’s about a service called Senior Living Finder.  It is a data base of assisted living and skilled nursing facilities around the country.  If you are beginning your search this resource may be a good place to start.   http://www.SeniorLivingFinder.org  “We are home to the most comprehensive set of senior living facilities and assisted living resources online. Our free site allows you to search and sort through a nationwide directory of senior living communities to find the best option. Each listing on SeniorLivingFinder.org includes a facility description, list of amenities and services offered, monthly rates, and property contact information.” 

By looking at a profile of a facility you can gather at least a sense of the company culture.  You can also get a name and phone and/or email of a key staff person, taking away any anxiety about who to call.

If you know of any other relevant resources, why not share them here? 

Enjoy your day,
Ann

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Hello all,

Have you ever attended a health or wellness fair?  Most communities hold these events for older adults. I’ve been to several and they are good things. They bring people together and they offer a chance to learn while having a little fun.  My city has a big Senior Health Expo each year featuring a well-known speaker from the senior set– Jack LaLane and Art Linkletter come to mind. All good stuff, right? Of course.  But here’s another viewpoint.
One year I had a booth at the expo where I informed attendees about massage and Compassionate Touch.  A couple of massage friends offered seated massage at our booth.  I took some time to network with other vendors and soon came to realize this was more of a “disease fair” than a health fair.  In fact, I was the ONLY one offering a way to cultivate wellness.  The typical health fair offers things like:

• Blood glucose, blood pressure, foot health, skin cancer, vision & bone density screenings
• Balance/gait analysis
• Osteopathic manual medicine demonstrations
• Breathing test & cholesterol screenings
• Medication reviews (bring a list of your medications)
• General health information
• CPR & life support demos
• Nursing home information
• Funeral services
• Elderlaw

Most of these services and screenings have more to do with “lets see what’s wrong with you”, rather than ” here is how you can cultivate wellness and happiness.”  An interesting distinction  don’t  you think? 
Take  care and be well,
Ann

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Happy Friday!  I want to share an experience that taught me a lot about how a little act on my part made a big difference for someone else.  I was in Mount Dora Florida teaching a Compassionate Touch workshop along with my associate, Lisa.  We stayed at the retirement community hosting the workshop and as I was unpacking, I found a purse in the dresser. The contents made it clear it belonged to a little girl.  Wallet, ipod, lipsticks, etc.  Lisa and I found an identification card and called the phone number.  We explained to the girl’s mom what we found and she told us the story of the “missing purse”.  The girl’s grandfather lives at the retirement community and the girl’s family had visited him.  Upon returning home (in another state) they realized the purse was missing. The girl was heartbroken.  You see she took pride in the contents of that purse and thought it was gone. We agreed to get the purse to her grandfather who would mail it to the little girl.  Everyone was so excited!
Time passed. Yesterday, I got a letter containing a note from the little girl and one from her mom. Here is what they said.
Dear Ann and Lisa,  Thank you so much for finding my purse and returning it to me.  Most people would keep it so thank yall so much. And yall are a god send.  Thank you!  And from the mom,  You two were a real answer to our prayers. I cannot tell you how many people searched for this purse coming up empty handed. The day before you called we had finally resolved ourselves that it was lost forever.  My 7 year old daughter was the owner of this elusive purse. She had saved her own money for over a year to buy the ipod. It was heartbreaking to her to have lost it.  So to find out it was found was like Christmas all over.  Thank you for calling and taking time to care. Your kindness meant a lot to our family.

You can imagine how that letter warmed my heart! What a good feeling to know that such a small effort made such a difference. I like to think the little girl learned something about goodness in people, too.  So the take-away message? Maybe we shouldn’t underestimate the power of little acts.  Let’s all watch for them!
Take care,
Ann

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I grew up in a relatively small town in Kansas. I am a mid-west girl to the core (which I am quite proud of by the way!).  As a child I had little exposure to cultures other than my white, middle class, rural world.  My adult life has expanded my world view and I’ve had opportunities to relate to people from cultures other than my own.  Today our world is growing more culturally blended. Some see this as a challenge. I see it as an opportunity to learn from one another and see not only our differences but our shared humanity.  I came upon a piece written by Sister Barbara Sheehan called Honoring Cultural Diversity and You Accompany the Sick and the Grieving.   Sr. Sheehan offers some  guidance in caring for people of cultures other than our own.  She offers these insights:

• Take your cultural diversity temperature.  What do you think and feel about cultural diversity?
• Do a personal cultural inventory. Get to know yourself and your own attitudes and beliefs. What is your world view stemming from your own cultural roots?
• Reflect on your learned predudices. Explore the impact that stereotypes, historiacl narratives or lack or experience.
• Practice mindful listening. Listen to others with your whole being.
• Practice care-filled curiosity. Asking questions like “what is this person telling me about themselves?”

These perspectives seem like helpful touchstones for any professional caregiver today. I appreciate that  Sr. Sheehan’s guideance aligns with Compassionate Touch concepts about serving others.
Namaste (or as we say in Kansas, You take care now!)
Ann

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I hope you have enjoyed your week. I had the honor of presenting Integrating Massage Therapy as an Ancillary Service at the annual convention of the Advocate of Not-for-Profit Services for Older Ohioans (AOPHA) in Columbus, OH.  I took advantage of a chance to attend some other educational sessions and the overwhelming theme was, as Bob Dylan said in one of his early songs, “the world, it is a changing.”  I’d like to pass along some interesting tidbits of information I gathered regarding the changing face and future of eldercare facilities.
Bob Applebaum, Professor of Gerontology at Miami University, Oxford, OH reported in his presentation entitled Meeting the Long-term Care Challenges of an Aging Ohio:

• More people admitted to skilled nursing facilities are there for tempory stays rather than permanently.  After 6 months only 1/3 of admissions are still in the nursing home.
• Long term nursing home residents are more impaired than ever before and require more skilled care
• In the future, nursing homes will increase emphasis on dementia care and short-term stays for rehabilitation
• Technology may enter the eldercare scene in ways such as robotic personal care attendents (he reported that this technology exsists now but is cost prohibitive)

Jo Donovan is Director of Clinical Education for Skilled Care Pharmacy in Mason, OH and she offered an interesting presentation called Changing Course, Changing Focus… MDS 3.0 and the Voice of the Resident.  You may not be familiar with the term MDS (and if you are, did I just feel a little cringe?). The Minimum Data Set (MDS) is part of the U.S. federally mandated process for clinical assessment of all residents in Medicare or Medicaid certified nursing homes. This process provides a comprehensive assessment of each resident’s functional capabilities and helps nursing home staff identify health problems.  A couple of things in her presentation stood out that I think are relevant to massage therapists interested in serving elders in nursing homes:

• New mandates effective Oct. 1, 2010 emphasize person-centered care. This mean that personal choice and preferences must be honored. This gives each individual greater control and voice in his or her daily life.
• There will be greater focus on life-enriching activities and psycho-social well-being.

These are certainly areas where massage therapists can have a positive impact.  I am happy to report that many of the attendees to my session reported already having massage therapy or planning to add it to their facilities!  The world is a changing– in some very positive ways!

Take care,
Ann

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Hi again,

Last week I participated in the Florida State Massage Therapy Association convention in Orlando. Congratulations to those hard-working folks who organized and hosted a stellar event!  My role this year was to take part in the exhibit hall talking with therapists about serving people in eldercare and hospice.  The diversity of people in massage therapy is striking.  Believe me standing on a trade show floor for 3 days will give you a good look!  Today we have 20 year olds just starting a career; 55 year olds looking to have a new career in “retirement” ; and all ages in between.  Men and women.  Caucasian, Latino; African American; Asian.   How does this relate to serving people in eldercare and hospice?  Old age and illness knows no ethnic boundaries.  I see our long term care communities becoming more blended. The blend may change depending on what part of the country you live in.  For example in the Midwest we have more Spanish-speaking elders entering our healthcare system and nursing homes.  A facility I visited in the Northwest had many Asian residents.  A North Dakota facility had many Native American residents.  As the population of the United States becomes more diverse it is essential that care professions reflect that diversity. I’m glad to see that represented in the individuals making up the massage therapy profession.
Take care, Ann

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