Touching Lives in Eldercare and Hospice

People often avoid visiting loved ones with Alzheimer’s disease. They avoid it because they assume that the visit won’t be remembered so what difference does it make? Today on NPR I heard a great interview with Justin Feinstein, a graduate student in neuropsychology at the University of Iowa. He reported on a fascinating study published in the National Academy of Sciences that finds that that the emotion tied to a memory lingers in the mind even after the memory is gone. This concept validates what I’ve observed in my work with elders with dementia. While the elder doesn’t remember me or previous sessions, there seems to be a sense memory of the pleasure of a Compassionate Touch session. The study revealed that people with severe memory loss retain the emotion of an event long after the memory of the event fades. In other words, the pleasurable feelings that touch and massage elicits live on even though the person can’t say why she feels good. This is important information about how massage positively impacts quality of life—the touch lives on! If you have a relationship—professional or personal– with anyone with dementia, consider showing family members how to use simple massage to enrich their visits. Maybe they won’t feel such a need to avoid it.
Blessings to you,
Ann

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Healthcare reform has been on the minds of all of us. With passage of the new legislation this past week, I was curious to see what leading organizations in eldercare and hospice had to say about it. The American Association of Homes and Services for the Aged (AAHSA) offer a Health Reform Hub described as “your “one stop shop” for information about the health care reform debate”. The Hub highlights how the new law will affect aging services. The National Hospice and Palliative Care Organization (NHPCO) offers a recap of what passed and what it means for end-of-life care. For massage therapists who serve those in eldercare and hospice the new legislation may have an effect on services, the impact of which will not be know for some time. Meanwhile we can stay informed and advocate for complementary therapies in these special settings. Take care, Ann

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Spring has sprung– finally! I hope you are enjoying yours. I discovered an interesting site from the M.I.T. AgeLab and found an interesting article about the impact of baby boomers on the workplace. I was struck by one point in particular. When we boomers were young parents we demanded on-site child care. Evidently now some employers are looking at adding services and policies to support employees who are caring for aging parents to retain experienced staff. I haven’t thought of this but it sounds like a great idea! So many people are caring for aging parents– or, at least, helping out in some way. I think employers would be smart to take an innovative look at this. If you want to see the article, here is a link.

http://www.disruptivedemographics.com/

What do you think of this idea?
Take care, Ann

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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

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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

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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

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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

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Friends,
While driving I mostly listen to NPR and yesterday heard a report that caught my attention since I am passionate about issues of aging. The report was about a Florida initiative to actively screen older drivers to ensure safety. An agency has been formed (sorry I don’t recall its name) to handle the screening and testing. An elder can be referred for screening by family, friends, police or anyone. Referral sources are kept confidential. Then the elder goes through testing to determine if driving restrictions should be placed upon him or her. I was glad to hear the spokeperson for the agency talk about how they hold the dignity of the elder in high regard and will try their best to allow the highest level fo independence. It’s no secret that our country does not have many options for transportation other than our cars. When an elder can no longer drive it seems to signal a loss of indepence that cuts to the core. This is such a tough issue for families to deal with. There is not an easy answer. What are your thoughts about the issue of older drivers?
Best regards,
Ann

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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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