Integrative Therapy Benefits

Improves Quality of Life

There are more than 600 million visits a year between patients and alternative medicine providers in the US—and the number is growing.

You can call it alternative, complementary or integrated therapy—it is a group of diverse practices and products not considered a part of traditional Western medicine.  But whether you are a skeptic or a proponent, there is no denying that the public is looking for it. 

For those patients who want this kind of treatment, it undeniably works to improve their quality of life.  After all, a hand massage with aromatherapy and soothing music would improve most peoples’ moods and lower their blood pressure and stress.  As simple as that, quality of life is improved.

More and more hospices are adding Integrated Therapies to their armamentarium for achieving comfort and improving quality of life.  As far back as 2004 60% of hospices reported offering complementary treatments (the most popular being music therapy and massage).  The main obstacles to providing these services are lack of adequate funds, knowledge and qualified personnel.  Other Integrated Therapies include animal visits, guided imagery and art therapy.

Pathways has a robust Integrative Therapies Program that provides numerous benefits. Patients report:

• A sense of control when so much control over their lives has been lost
• Improved pain management
• Enhanced emotional wellbeing and decreased anxiety
• Opportunities to experience pleasure
• Better quality sleep and decreased fatigue
• Enrichment in their lives
• Decreased nausea and enhanced appetite

Integrative Therapies often do not lend themselves to randomized, double-blind, controlled clinical trials due to the very subjective nature of the discipline.  However, risk-benefit analyses demonstrate very low risk—won’t hurt, might help.

The holistic nature of hospice is a setting made for Integrative Therapies.  They have repeatedly been shown to provide physical, emotional and spiritual benefits to patients and their families.

One Patient’s Story

Advanced pancreatic cancer was Mr. B’s grim diagnosis.  A resident of a SNF, he had prognosis of a few weeks when referred to Pathways by the distressed facility.  During the admission to hospice, the patient disclosed that he was a Christian Science practitioner and was not open to using any medications to manage his rather severe symptoms.

With this limitation, Pathways quickly initiated several Integrative Therapies and held a stat inservice for the SNF staff and his family.  Hospice volunteers, personal care aides, spiritual care counselors, social workers and nurses all contributed their Integrative Therapy skills.  Mr. B received massages, aromatherapy, guided imagery, Reiki, music therapy and comfort touch.  We also involved the family, asking them to find movies, CDs and other forms of distraction that Mr. B would respond to.

Although his pain was never completely gone, the patient reported it was significantly decreased and that he noticed an improved ability to cope with the pain that remained.  Until he died about three weeks after admission, Mr. B reported that Integrative Therapies had helped manage his symptoms to a level he deemed acceptable. 

This article was originally published in Pathways Physician & Health Professional Bulletin - Issue 26.  To download this issue in PDF format, or past issues, visit our newsletter archives online at www.pathwayshealth.org/publications.

Power of Music

Music is a powerful force that can stimulate strong emotions within us.  Harnessing that power can benefit the seriously ill by improving their quality of life.  In a 3-year study Sandi Curtis, a music therapy professor at Concordia University in Montreal, Canada, divided university music therapy students and musicians in to pairs working with 371 participating terminally ill patients from 18 to 101 years old.  Participants were seen for a single music therapy sessions from 15 to 60 minutes long with the goal of enhancing pain relief, relaxation, mood and quality of life.

“Our study showed how music therapy was effective in enhancing pain relief, comfort, relaxation, mood, confidence, resilience, life quality and well-being in patients,” said Curtis.  The study was published in the journal Music and Medicine.

This article was originally published in Pathways Physician & Health Professional Bulletin - Issue 24.  To download this issue in PDF format, or past issues, visit our newsletter archives online at www.pathwayshealth.org/publications.

Acupuncture for COPD

It's Effective

Dyspnea during exercise can be debilitating.  This fact coupled with earlier findings that acupuncture has been shown to reduce dyspnea in cancer patients led a team of Japanese scientists to explore whether it would also help people with COPD.  They found that, in fact, it does help.

Researchers at Kyoto University conducted a randomized study of 68 patients who were taking standard medications for COPD in various stages.  They were randomly assigned to have actual acupuncture or a placebo treatment in which needles did not penetrate the skin.  Patients received treatment once a week for 12 weeks.

Results showed a statistically significant improvement in dyspnea ratings.  As their dyspnea subsided, patients also demonstrated in tests that they were able to tolerate exercise better and increase the distances they were able to walk.

The study was led by Masao Suzuki, PhD, and published in the Archives of Internal Medicine.

More information is available at: Suzuki M, et al “A randomized, placebo-controlled trial of acupuncture in patients with chronic obstructive pulmonary disease (COPD): the COPD-acupuncture trial (CAT)” Arch Intern Med 2012; DOI: 10.1001/archinternmed.2012.1233.

This article was originally published in Pathways Physician & Health Professional Bulletin - Issue 24.  To download this issue in PDF format, or past issues, visit our newsletter archives online at www.pathwayshealth.org/publications.

Music Can Mean Less Pain

Focusing on music can distract people who have significant anxiety about pain enough that they feel the pain less acutely, according to a recent study done at the University of Utah Pain Research Center.  The study found that pain was reduced as the demands of focusing on the task rose.

Researchers had 153 volunteers concentrate on following a melody so they could identify the tones that stood out.  During the session small pain shocks were administered through fingertip electrodes.  The authors explained that the effects of the music resulted from competition with the participants’ pain pathways.

Interestingly, those who had registered the most anxiety about pain became more absorbed in the task and were more likely to experience reduced perception of pain.  The study authors suggested that, “Clinicians should consider patients’ personality characteristics when recommending behavioral interventions like music listening for pain relief.”

Pathways has volunteers that can provide music sessions to our hospice patients as part of our Integrative Therapies program of care for body and soul.

The results were published in the December, 2011 issue of the Journal of Pain.

Managing Pain Without Medication

In addition to medication for pain, there are other things we can do to reduce pain.  Usually these are used in addition to medicine or while waiting for the medicine to work.  But if a resident refuses pain medication, using these techniques may help.

Alternatives to Try

Distraction:  This is an effective technique.  It’s as though the brain can only pay attention to one thing at a time.  Talking, watching TV, playing games or looking at photo albums are some examples.  If the pain is severe, these will not work.

Deep breathing / relaxation exercises:  Guide the person in deep, slow, rhythmic breathing.  There are many relaxation recordings available that are easy to follow.  You can suggest to family members that they purchase relaxation recordings and furnish a listening device.

Cold:  A cold pack (gel pack, ice pack, or zip bag with crushed ice) helps inflammation or muscle ache.  Wrap the pack in a towel; do not put the ice pack directly on the skin.  Even if this does not relieve all pain, it may help to numb the area somewhat.

Warmth:  A warm tub bath or warm packs can relax muscles that have tightened due to pain.  A warm, wet washcloth applied directly to the affected area may help.  Covering the cloth with plastic will help retain the heat longer.

Massage: This is an excellent way to distract from pain and relax tense muscles that make the pain worse.  Lotion may reduce friction.  You do not have to massage the painful area.  Massaging another area of the body may distract the mind from pain.

Prayer / meditation: Some people find this very comforting and perceive less pain during prayer.  There may also be rites or rituals that could comfort the resident.  Ask family members about this.

Music: Music is another form of distraction that research has shown relieves pain.  It does not matter what kind of music, whatever the resident likes will work.  Again, family members can help provide information about musical tastes and recordings and a CD player.

Energy work / therapeutic touch: These are hands-on techniques in which the practitioner places his or her hands on the resident’s clothed body to achieve a transfer of energy.

Acupressure / acupuncture: These techniques apply pressure or needles to specific points on the body to relieve discomfort in other areas that are associated with those points.

Reflection / life review: Those nearing the end of life often want to reflect on the events of their lives and the people they knew.  Asking about family members or the resident’s youth or birth place may assist in starting this kind of life review.

Pets: Research shows that pets improve mood, lower blood pressure and heart rate, and may serve as a good distraction from pain.

Innovative Program at Pathways

Pathways Hospice patients can take advantage of our well developed Integrative Therapies program.  It provides innovative therapies such as guided imagery, comfort touch, music therapy, aromatherapy, massage, and pet therapy.  These therapies are shown to reduce agitation in residents.

If you are interested in learning more about the Integrative Therapies program at Pathways, talk to Pathways staff, or visit our website:  www.pathwayshealth.org.  The Resources section includes downloadable information and simple tips for incorporating Integrative Therapies in your daily life too!