Stillness in Motion

 Hello all,

Millions of people in the United States find themselves caring for aging parents or partners.  They’re often the last to ask for help, but when caring for another, they are themselves among the neediest.  I know of one case that illustrates this common situation so clearly.  An 80 year old woman I’ll call Ruth, living with dementia and other health conditions, was a hospice patient being cared for by her daughter, “Helen”  in her daughter’s home. Helen is a very attentive caregiver in her family.  In addition to her ailing mother, she also took care of her grandbaby during the day.  I received a referral from hospice to see Ruth for massage.  Ruth was consistently content, happy and obviously her needs were being met.  The home was a constant whirlwind of activity– grandchildren in and out,  phone ringing, hospice caregivers coming and going, etc.  On about my third visit, there appeared another woman who was about Ruth’s age– she was Helen’s mother-in-law and she was also going to be staying in the home! Well, if Helen wasn’t overwhelmed by all the activity, I sure was!  Helen seemed at first to take it all in stride, responding to everyone’s needs with a smile and a patience that I admired.  But I began to notice little clues that it was taking a toll– fewer smiles, taking the opportunity for a couple minutes of rest when I was attending to Ruth.  One day, I offered Helen a ten-minute massage.  When I asked her if she would like to receive a massage, her eyes teared-up and her lips trembled.  She seemed so profoundly grateful that someone acknowledged her weariness.  In those first 10 minutes, she talked about how exhausted she was becoming and about her fears of not being able to do it all for much longer. That was 8 months ago– she is still there caring for all those people!  She has continued to receive massage regularly and she reports that it has helped her deal with the stress and feel cared for. 

Massage is a powerful way of caring for the caregiver and I think we should at least invite the caregiver to consider massage to help cope with a difficult situation.  It can make such a difference and uplift the lives of all involved– our own included!

Until next time, enjoy the beauty of Spring!
Ann

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Recently I was in Nebraska volunteering at the Rowe Sanctuary, a nature center along the Platte River where thousands of Sand Hill Cranes gather on their way to points north.  People of all ages from around the world visit the sanctuary to witness this spectacle of nature.  One day, I was given the task of operating what is called the Crane Cam.  It is a remote camera located on the river and images are sent to the web through the National Geographic website.  While I was operating the camera, a curious couple approached.  After I explained how it all worked, the woman told me about her mother who is in a nursing facility in another state. Evidently her mother has been to the sanctuary several times and has been an avid bird watcher for many years, but now that she is in a facility she has not had the chance to do it.  Well, her daughter became so excited because she had recently set up a personal computor in her mother’s room at the facility.  Her mother could peek in on the Cranes via the internet!

A gentleman I provided Compassionate Touch sessions to for several years used a PC to write poetry and letters to his family. It seemed to me that since he was a successful business man in his career, having a desk and computor in his room helped him to retain a part of his identity that was important to him.

A young man with cerebral palsy who resides in a facility I visit regularly plays games and records music on a PC in his room (sounds like a typical 20 year old, doesn’t it?).  His keyboard has been modified to compensate for his poor upper body coordination, so he can manage things independently. 

I think we will be seeing more and more individuals in facility care with computors and more facilities able to accommodate them.  It might serve as one way to lessen the feelings of isolation and boredom that plague so many who must reside in long term care. 

What are your thoughts about the link between technology and quality of life for those in facility care?  I’ll look forward to hearing from you.
Enjoy the day,
Ann

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What Are Old People For? is the title of an interesting book by William Thomas, M.D. who explores the social significance of our elders.  One particular statement jumped out at me that I want to share with you: “A society that cultivates the ability to bring a life worth living to the least among us enriches itself beyond measure.  When we honor those who can do nothing for others, we enlarge a capacity for compassion that serves all people”. 
I’ve witnessed this on an individual level when I offer massage and touch the very old person who is no longer able to do for others, but rather must rely on others for daily survival.  During those moments, my own heart’s capacity for compassion is open and expanded.  But Dr. Thomas takes that personal experience to a different level- a collective one.  If we, as a society, are willing to honor our old people, then we will be rewarded with a greater sense of compassion for the whole.  I’ve often told my students that when we touch the one, we really touch the whole because our caring intention ripples out into the world.  It seems Dr. Thomas would agree!   So, what are old people for?  Your thoughts?

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I read something today that affirmed my belief that our shared story about the power of the human touch connects us and uplifts us all.  Marianne Williamson, in her book Everyday Grace, writes, “Spriritually, we do not exist in isolation.  …we’re like sunbeams of the same sun and waves of the same ocean.”  For this entry, I want to continue to share our stories– there is power and connection in the story of our work with those in facility care and hospice.  Over the years, I have collected stories from therapists and other caregivers about the power of the human touch.  I want to share a couple of them with you here. How have you witnessed the power of touch in your work with this special population?

“I have a story to tell about my work with a hospice patient who has Alzheimer’s disease. For the first few weeks, he didn’t want to be touched.  He is not at all communicative, so it was a challenge to keep approaching him.  I figured out that I needed to say or do something different instead of asking the same questions each time.  On the third visit, I reached out for his hand and started doing gentle compressions up his arm and asked if it felt good.  He said “yes”. He also said yes when I asked to put lotion on his hands.  It went on this way for several more weeks.  Then last week, after about 10 minutes, I was massaging his right arm and he reached out with his left arm and began massaging my arm!  He also looked right into my eyes with a very clear look in his eyes and a slight smile on his face, as if her were remembering something.  It was really a wonderful moment; we had made a connection and communicated on a deep level.” Linda V., LMT,
Lawrence, Kansas 

“My closest friend was hospitalized with cancer. It was a very aggressive form of liver cancer and she passed away yesterday. During the time of her hospital stay, I went regularly and was able to provide Compassionate Touch® massage.  One of the doctors independently suggested that her children arrange for her to receive massage and was quite pleased that she already was.  She had decided against having visitors and I, as a massage therapist was the exception.  I had the very real privilege of being able to provide her with some comfort and it afforded me an exceptional opportunity to give to a dear friend, by extension to her family and helped me through a very painful time.  Being able to provide a service to a friend enabled me to get past feeling helpless in the face of her disease.  Joy S., LMT, New York, New York

Share a story of your own– we’ll all be uplifted by it!
Enjoy the day,
Ann 

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Those of us who touch the dying know what a profound experience it is– for the one we touch, and sometimes the family, and for ourselves.  We bear witness to how our touch and presence truly makes a difference in the quality of life at life’s end.  We have a story to tell.  Our stories capture the essence of this powerful work and honor those whose lives have touched our own.  Sharing our stories uplifts our intention and allows us to support one another.  It also is a meaningful way to bring awareness to the role we can play in the care of those who are dying. So let’s share our stories!  I believe they uplift us all.  Here’s one of mine:

As a hospice volunteer, I saw a 47 y/o man  in his home for massage. Casey was a loving father and husband and a respected police officer.  He suffered from late stage ALS. Although he no longer could move his body, he still was able to speak with effort.  He asked to have his massage in the evening to help him sleep through the night.  So, when I arrived, he was already in bed, his beloved dog sitting at his side.  One night while I was massaging his arm, he said , with great effort, something so profound that it has stayed with me ever since.  He said, “When you massage me, it’s the only time I don’t feel like a sick person.”  I have reflected on those words many times and I think I understand the meaning behind them. When Casey received my touch, he was only asked to receive.  He didn’t have to struggle against the disease. I think he felt himself as whole again. 

What stories do you have to tell? 
Be Well,
Ann

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Last night I saw the excellent movie The Savages starring Laura Linney and Philip Seymore Hoffman.  The theme of the film is how these adult children handle  care for their father who has dementia and physical debilitation.  The dynamics of this family were portrayed with intensity and sensitivity.  There was a realness to this movie: the stunned reactions of the “children” who are wrestling with trying to do the right thing for their father; the process of finding a care facility for him; the portrayal of the staff in the facility.   But the thing that really moved me was how no one touched the father as he clearly grieved for his losses and struggled to make sense of his new world.  I kept thinking “if I were there, I would at least reach out and take his hand.”  But nobody did.  Then I realized that this family’s history and old wounds simply got in the way of reaching out and touching him.  I could have touched him with  compassion and an open heart because I didn’t have the baggage of the past.  And through my presence and my touch, his family could have offered him love.  For me, that is the essence of my work.
Be Well,
Ann

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 Hi All,

Lola’s comments reflect the question that many massage therapists ask: “How can I get paid for providing services to hospice or elders who reside in nursing homes?”  This is an important question and the answer is multi-faceted.  Over the years I have met many massage therapists who generously volunteer their services to care for individuals in hospice care.  I’ve even had some therapist say to me ” This is such sacred work, I don’t feel right charging for it.” 

I think the decision to provide our services as volunteers is a highly personal decision.  I do some hospice volunteer work myself.  For me, it is a way to give something back- a gesture of gratitude.  That said, I’d like to offer this for you to ponder.  The service we provide as massage therapists has value, no matter what the setting and we should be asking to be compensated for what we do.  That includes nursing facilities, hospitals, home care and hospice settings.  We offer those we touch a profoundly healing experience that requires our professional skills.  So the question still stands- how can I get paid? 

I am seeing massage therapists around the country being paid by hospice groups, by nursing facilities and by  families of elders who are in facility care.  Things are shifting in our favor.  Here are three situations I know of, representing three different funding resources.

1. A nursing facility in pays a massage therapist an hourly rate for up to 12 hours per month to provide massage for the elders there.  The administrator sees the value added to her facility by offering this innovative complementary service.  The money comes from the marketing budget because it is attractive to her potential customers.

2. A hospice pays for massage sessions for their patients by using money from a fund that was created for added services.  The money for the fund comes from donations.

3. Elders in a facility who recieve state medicaid money each month may use some of the monthly “personal needs” money for massage.

What are you seeing regarding this issue?  How do you feel about it?  How might we be agents of change? I would love to hear from you. Let’s talk!

Be Well,
Ann

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 Hi All,

Over the last 6 years I have had the opportunity to see massage therapists around the U.S. successfully expand their practices to settings like long term care settings and hospice.   Some cases in point:

• Helen G., LMT in
  Portland, Oregon contracts with a senior retirement community that provides her with a treatment room on-site.  Her practice is thriving!
• Ellen M., LMT in
  Lady Lake, Florida is employed full time by a hospice organization
• Lu R., LMT in Hampton, Iowa regularly provides massage to elders with Alzheimer’s disease in a local care facility
• Jeff F., LMT  in Loveland, Colorado is the director of the wellness program in a continuing care community.  He has developed an extensive touch program for elders there. 

It’s my observation that massage is finding its way to these non-traditional settings; nursing homes, assisted living, senior retirement communities, community and residential hospices.   Clearly the therapists I mention are working in these settings.  It raises a few questions that I think are worth pondering and sharing our thoughts. 

1.       What are you seeing in your own community? Are massage therapists serving those in these special settings?  If so, are they being paid or are they volunteering their services?

2.       What do you think are the reasons why the doors are opening for massage in eldercare and hospice? 

3.       What is essential for a therapist to succeed at practicing in these settings? 

Those of us who feel drawn to work with people in later life stages can support one another in our pioneering efforts to take massage to this special population.  Take a minute to share your thoughts—we’ll all be listening!

Happy Holidays to you,

Ann

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Ann Catlin, LMT, NCTMB, OTR has more than 25 years experience working with older adults and people with disabilities using both her skills as a massage therapist and occupational therapist. She is the director of the Center for Compassionate Touch and trains massage therapists, health professionals and other caregivers across the nation in Compassionate Touch®, a therapeutic modality created specifically for the elderly, ill or dying person. Ann lives in Springfield, Missouri where she has a massage practice serving elders in facility care and is a hospice volunteer.
She may be reached at www.compassionate-touch.org

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