Touching Lives in Eldercare and Hospice

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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In a November issue of USA Today (11/13/07) there was an article about retired Justice Sandra Day O-Conner’s husband, John.  John has Alzheimer’s disease and lives in a Phoenix care facility.  The article focused on the fact that John found a new love in the facility- a woman who also has Alzheimer’s.  Mrs. O’Conner’s reaction to this development was one of relief and gladness that her husband had found a bit of happiness in the midst of  suffering from dementia.
I recently saw the 2007 movie Away From Her starring Julie Chistie who beautifully portrays a woman with Alzhiemer’s disease and she, too, finds a satisfying relationship with a man in the faciltiy where she resides.  Her husband in the film responds with bittersweet understanding and compassion for his wife.
I wonder how common this occurs in couple’s struggling with the challenges of this disease. 
In the USA article, Peter Reed, senior director of the Alzhiemer’s Association is reported as saying that “ the underlying causes of this are fairly common.  Though paitients lose their cognitive abilities and experience mood changes, one of the things that doesn’t go away is the need for relationships”.  It would seem that this part of our humanity remains intact no matter what life may throw our way.
What do you think?

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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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The last visitor to my feeder is surely well on his way along his epic journey to South America where he will spend the coming months. I am fascinated by hummingbirds—those fairy-like creatures of the bird world. When “hummers” are in my garden, my heart is joyfully uplifted and if I take time to notice, there is a stirring of awareness deep in my soul.

Have you ever watched a hummingbird? How he darts playfully about forwards and backwards and his wings seem to be but a flutter in flight. He hovers above the flower as he literally drinks of the nectar of life. At that moment, he is stillness in motion.
Perhaps the greatest gift we offer those we touch is stillness in motion. Even in the midst of chaos, we provide a place for our clients to hover for a few minutes, pausing to drink of life’s sweetness before moving along their own personal journeys. It is in this stillness where we discover our own healing presence. What this messenger, the hummingbird, has taught me is that only in stillness do we see the perfect reflection of our innate healing presence. In stillness, we can be healed and be a healing presence to others.

This blog is about serving individuals who we consider to be in “special populations”: our elders, those who are seriously ill, and the dying person. The foundation of our service is healing presence, which is why I chose to begin our conversation here with this topic. Providing massage for this special population is a unique form of practice. My hope is that this blog become a place for sharing about our experiences, relevant information, and practical tidbits. Mostly I hope it builds community.

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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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