Touching Lives in Eldercare and Hospice

I’ve been exploring this question: Does Medicare reimburse for massage therapy– and what are the implications? It’s no secret that our health care system is in a state of flux and every kind of service provider is holding their breath about this. Besides being a massage therapist, I’m also an occupational therapist and recently recieved a call to action request from the national OT board (NBCOT) They are concerned about current Medicare caps for OT reimbursement. I’m often asked the question from my students,” Does Medicare pay for massage in long term care or hospice?” Well there is not a simple yes or no answer to this question. I’m writing to really see what’s on other people’s minds about the issue of Medicare reimbursement and to prompt a discussion about it. If you are working within eldercare or hospice has this subject come up for you? Has anyone found a successful way to navigate the Medicare waters? What do you think the ramifications are for massage therapists if Medicare reimbursement becomes more available for our services? I’m a bit jaded about it myself because in the 25 years I worked as an occupational therapist I experinced a lot of change in how I was able to go about my work and clinical decisions became so tied to reimbursement. Don’t get me wrong– I’m willing to view this issue with an open mind. What’s on your mind?
Take care,
Ann

13 Comments »

Good day,
I’ve thought some about the use of various technology and how it enhances lives of our elders. I came across a blog entry from Laurie Orlov of Aging in Place Technology

http://www.ageinplacetech.com/

Laurie brings up the value of Skype visits with elder family members and how these visits can help ease feelings of lonliness and isolation and bring families closer as well as help family members to monitor the condition of the elder. While I believe that these “Skype-visits” are a good thing for many, I do question if some families will skip the trip ‘over the river and through the woods’ to grandma’s and substitute a Skype-visit instead, actually increasing isolation. I believe there is no substitute for a real visit where a family shares in an experience; where the elder can feel and touch her grandchildren; where grown children take time to simply show up and be present. Technology will play a huge role in aging baby boomer’s lives– but let’s keep some good old fashioned visits along with it!
Be well,
Ann

No Comments »

Greetings all! I’ve been exploring the issue of the safe use of essential oils for clients who are in later life stages. After years of interacting with massage therapists who wish to serve this special population, I’ve come to the conclusion that there is a need for guideance. I’ve heard many bodywork practitioners refer to using essential oils for frail persons but have little actual training or a sound foundation of knowledge from which to act. Now, I’m not an expert in aromatherapy but as a leader in the field of massage for this special population I feel it my responsibilty to base the guideance I give on evidence-based findings and from our peers who are experts in this issue. So the question is this: Under what circumstances should the use of essential oils be used with elders or those in end of life care? And what would you consider to be “best practice” for use of oils? Should we encourage a minimum standard of skills for the use of essential oils for this special population? I would love to hear your thoughts.
Enjoy the moment!
Ann

7 Comments »

A very happy, healthy, and abundant new year to you! Lately, I’ve been exploring the concept of how to best assess the needs of frail elders who are living with the effects of debilitating conditions. It has become very clear to me that practically all assessments in health care have the intention of identifying what problems the person is having. Assessments mostly ask the question, ” What’s wrong with you?”
Elders who have been in care settings (hospitals, nursing homes) begin to identify with this question of ‘what’s wrong with you’. I’ve noticed that over time the condition becomes more and more the identity of the person. What if we were to have more a mindset of “What happened to you”? Doesn’t that question take on a whole different energy and intention? Doesn’t it acknowledge that this is a whole individual who has endured whatever effects his or her condition has created? I’m not suggesting that we throw out our assessment processes but rather to balance the process with a holistic and compassionate view of the person. To ask “What happened to you” either outloud or silently is powerful medicine in itself. Try it and let me know if it shifts anything for you.
Wishing you grace and good fortune for 2010.
Ann

1 Comment »

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

1 Comment »

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

1 Comment »

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

3 Comments »

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

2 Comments »

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

No Comments »

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

2 Comments »