Touching Lives in Eldercare and Hospice

Hello again,
I have great news to share!  The value of massage in hospice care has been endorsed  by the AMTA.  I offer my thanks to my collegue Lisa Parenteau and others who worked very hard to present a position statement to the 2009 House of Delegates at the 09 convention.  Read on…

AMTA House of Delegates approves two position statements (from www.amtamassage.org)
The AMTA House of Delegates debated proposals for association position statements that express the sense of the membership on matters pertaining to massage therapy. This year, the delegates approved two position statements, which are now official positions of the association.Details on the approved position statements will soon be available on the AMTA website and will become part of the association’s efforts to promote the value of massage therapy, supported by research.

The approved statements are:
- It is the position of the American Massage Therapy Association (AMTA) that massage can aid in pain relief.
- It is the position of the American Massage Therapy Association (AMTA) that massage therapy can improve the quality of life for those in hospice and palliative care.

This kind of endorsement will help to call attention to the role massage therapists play in end of life care.  Those of us who have been serving this special population surely know the value of our work– but the good news is that it’s not just us saying it now!

Grace and good fortune to you,
Ann

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I may be showing my age, but I absolutely love listening to Prime Time Radio, a weekly radio program sponsored by AARP.  Last week they interviewed BillThomas, the founder of The Eden Alternative, an organization that is dedicated to transforming care environments in eldercare.  The program went from health care reform to the need for more geriatric specialists in the medical community.  He made one comment that really caught my attention. I’m wondering what  you all think about it.  He said, ” Aging is a women’s issue.”  He went on to explain that in the U.S. women are the ones who are dealing with many of the current cultural impacts of our aging population.  He noted the following points:

• Most of the “anti-aging” efforts are directed at women and that a woman is more inclined to fight the effects of her own aging.
• Women are the ones who handle most of the care of aging or ill relatives.
• Women are more apt to be the ones who take care of parenting issues related to grown kids (and their kids).

So, do you agree or disagree– is aging a women’s issue?
I’ll be really interested in your comments!
Ann

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Good day!   I like to ask my students “What moves you to work with those in eldercare or hospice?”  Over the years, some themes have emerged from the responses I’ve heard.  I’d like to share them with you here because I assume if you are reading this you have some degree of interest in working with elders or others with life-limiting illness. So, here’s what folks have told me.

“I’ve had a personal experience that led me to want to serve.”  These experiences range from having a grandmother in a nursing home to a close family member receiving hospice care to having grown up around older adults.  Those who identify with this report having both a comfort level and a desire to ‘give back’.

“I’ve been a massage therapist for a number of years and it’s taken a toll on my body.  I want to prolong my career and perhaps working with this population would be a good option.”  These therapists have a number of years in the profession and desire to find work that isn’t as physically taxing, thereby extending the longevity of their career.

“I don’t know exactly, but  I want to do this work– I just feel called in my heart to do it!”  This is the most common reason I hear.  The circumstances leading to the desire to work with this population can’t be pin-pointed, however there is a strong pull toward this form of service. 

Is one reason better than another? Of course not.  I think the most important thing is for each of us to ask the question and come up with our own answer. So, I ask you, “What moves YOU to want to work with this special population?”  I’d love to hear!
Take good care and enjoy the summer,
Ann

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Hi there,

If you are reading my blog you are probably an advocate for quality of life of those at the end of life.  The doors for massage therapy in hospice have been opening the past few years, but proposed Medicare funding cuts for hospice could close those doors once again.  I have recieved the following information today from a colleague at the Suncoast Institute in Florida and want to pass it along to you so you can evaluate the situation for yourself and act if you feel so moved.

Hospice Needs Your Help

Over the past few months Hospice advocates from around the country have written, faxed, called and visited members of Congress urging them to help stop the Hospice rate cuts scheduled for October. Our efforts have paid off so far, as over 200 Representatives and Senators have signed a letter requesting President Obama to prevent the cuts from occurring. We must keep up the pressure as the President has not yet acted.

As tough as these cuts will be, the stakes may have just been raised even higher. This past week a new report detailed across the board Medicare spending cuts being considered in health care reform legislation. We are ready to do our share, but the combination of the rate cuts already proposed and these new Medicare cuts will be devastating to all hospices nationwide: we estimate a 6.4% decline in revenues if these cuts are enacted. We must work hard to prevent this from occurring.

You can continue to make a big difference. On Wednesday, we will participate in a national “Virtual Advocacy Day” to urge the President to preserve hospice care and prevent these cuts. Please stand by as more information on how you can help will be sent tomorrow. In the meantime, here are a few things you can do today to fight these cuts:

• Write a letter to the editor of your newspaper )
• Send an email to the White House:
  http://www.whitehouse.gov/CONTACT/
   
• Send a letter to the President urging him to stop the cuts:
  The White House
  1600 Pennsylvania Avenue NW
  Washington, DC 20500
  (Please include your e-mail address)
   
• Call the White House Comment Line:
  202-456-1111

 Visit:  http://www.capwiz.com/nhpco/home/ and our advocacy website http://www.thehospice.org/help/voice/stop_cuts.aspx  for more information

Many massage therapists have worked long and hard to pioneer our valuable place in hospice care. I think we all would hate to see our steps forward pushed back.  We have so much to contribute to hospice and palliative care and I, for one, want to see that continue to grow!

With kind regards,

Ann

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Hi all,

Reading Eileen’s blog entry inspired me to chime in.  Eileen talks about how important it is to consider where potenital clients receive their information.  What is THEIR prefered method– not YOURS.  I couldn’t agree more!  I had the privilege of contributing to Massage Magazine’s expert advise column in the June 09 issue where I provided guidance on the question of how to best connect with and market to elders.   I’ve worked with older adults for thirty years– the last ten years as a massage therapist.  In order to market our services effectly to older adults it’s important to understand that there is quite a difference between someone who is 65 years old and the 80 year old in terms of where they might learn about the value of massage therapy.  The 80 year old will most likely turn to print publications for information– newspapers; newsletters, etc.  However those 65 year old “boomers” might be relying on the web for information.  Here is a link to some interesting statistics about computor use by older adults. http://www.retirementhousingonline.com/UsageStats.aspx

I have a friend who develops senior housing complexes in Springfield, MO where I live.  She told me that she is now including internet access as an amenity in all her developments and that she expects to see long term care facilities offer computor access.  I’ve seen this in the retirement communities where I teach. Many have computor labs available for residents. I believe we will see even more emphasis on the use of the web to reach older adults now that the first wave of baby boomers have reached retirement age. 

How do you connect with older adults in your practice? 
Enjoy the beauty of summer!
Ann

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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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