June 18, 2012

Enhancing Hospice With Complementary Therapy

The holistic interdisciplinary nature of complementary medicine makes it a natural extension of hospice.

Betty suffers from the disabling dyspnea of her advanced COPD. Despite use of oxygen, opioid analgesics, and antianxiety agents, Betty finds that her fear of breathlessness worsens her anxiety, making her breathing more difficult. Twice weekly reflexology sessions provides symptom relief and stress reduction. As Linda deals with advancing neurological illness, the aroma from the essential oil of lavender combined with relaxing music every night helps Linda to decrease anxiety and improve her sleep each night. By resting comfortably at night, Linda has more energy each day to spend her with her family and friends.

The stress of daily caregiving of his wife Carol has taken its toll on John. He recognizes that in order to provide Carol with optimal care each day, he must also care for himself. Weekly comfort massage sessions reduce stress and improve coping while providing brief respite and relaxation, enabling John to continue caring for Carol as she lives with advancing dementia.

Bill has a difficult time expressing his emotions and saying goodbye to friends and families. Working with the music therapist, music enables him to express his thoughts and feelings, opening the door to meaningful dialogue and experiences.

State-of-the-art Western medicine is an advantage that, as Americans, we use aggressively and with great trust. Patients suffering from serious illnesses can also benefit from complementary therapies, which are provided in conjunction with conventional medical care to provide optimal comfort, promote disease fighting abilities and minimize side effects. When illness is advanced or life threatening, complementary therapies provide palliative benefits by easing the severity of stress-related symptoms and improving quality of life.

Complementary and alternative medicine (CAM) constitutes more than 1,800 therapies worldwide including biologically based therapies such as vitamins, herbal preparations, or diet; bodywork practices including massage and reflexology; mind-body interventions such as mindfulness and meditation practices, guided imagery, and hypnosis; creative art therapies such as music and art therapy; energy therapy such as healing or therapeutic touch, reiki, acupuncture, and acupressure; aromatherapy and many others. Complementary and integrative medicine recognizes that the mind, body, and spirit are interactive. The holistic interdisciplinary nature of complementary medicine makes its use a natural extension of hospice services.

One of the greatest benefits of many complementary therapy modalities is their ability to alter the fight or flight response of the body. When facing serious illness, fear, worry, and anxiety are common feelings that may trigger a natural stress response. The automatic response of the nervous system to stress can result in an increase in heart rate, blood pressure or breathing rate. It may decrease the blood flow to some of our major body systems and result in muscle tension, slowed digestion and a decreased in urine output. These changes often result in physical symptoms such as pain, breathing difficulties, indigestion, constipation or insomnia. The body’s natural stress response can also compromise the immune system, making it more prone to infection. Many complementary therapy modalities can break the physical symptoms of stress that often accompany illness.

The use of CAM interventions can offer benefits over traditional measures alone. They are typically low cost and side effects are rare. Their use may result in lower doses of pharmacologic therapies, which leads to less medication side effects. The principles of healing that are emphasized in the use of CAM include enhanced self-care and active participation of the patient and family.

  • Commonly used complementary and alternative modalities include, but are not limited to:
  • Comfort massage, which is different from the pampering at a spa in that it is lighter and is aimed at reducing muscle tension and rehydrating skin, while bringing nurturing touch to the bedside.
  • Reflexology, which stimulates the thousands of nerve endings in the feet or hands that correlate to organs, glands, and other structures, reducing the stress response and bringing symptom relief.
  • Energy therapies, including healing touch, therapeutic touch, and Reiki, which are biofield therapies that affect or rebalance the body’s energy fields and produce deep relaxation.
  • Acupressure and acupuncture, which involve working on the meridians.
  • Manual lymphatic drainage to provide symptom relief from lymphedema.
  • Aromatherapy, which is a noninvasive modality that uses essential oils to balance, regulate, and maintain itself. When used by a certified therapist, aromatherapy can produce relaxation, symptom relief from nausea or dyspnea, promote wound healing, or reduce odors for many patients.
  • Creative arts and other modalities, including music therapy, art therapy, pet therapy, and horticultural therapy.

There are as many models for CAM integration as there are programs and many hospice providers rely on the generosity of volunteers to provide access to these therapies. Others hire certified practitioners such as massage therapists, reflexologists, music and art therapists. Regardless of the model used, these practitioners employ bodywork therapies, cognitive and behavioral therapies, creative arts, and aromatherapy to ensure optimal comfort and quality of life for patients and families facing life-limiting illness.

Original article published on AdvanceWeb.com