Alternative Medicine and Hospice

Hospice care, very briefly, is geared toward palliative, or "comfort" care, for those who are deemed to be in the final stages of life. The medical care provided is not directed toward curing the condition or disease, but toward controlling symptoms and pain, providing physical and emotional support to the patient and their family, and allowing the patient to live out their final days in relative comfort, independence and dignity. I know; I've been there.

The hospice network employs a large staff who are trained in a multitude of disciplines, and many of these are considered alternative therapies. These include therapeutic massage, music therapy, aromatherapy, and guided imagery/visualization, among others. Hospice also works closely with patients and families in determining what sort of medical support is needed; for example, some patients prefer natural or herbal remedies, as opposed to standard pharmaceuticals. In that case, hospice works with the family, the doctors, and the pharmacists to suggest and/or supply alternative medicine or products. For example, one patient suffered dramatically from constipation, but was opposed to standard drugs on the market; hospice recommended sorbitol, a bulk sweetener usually found in food products. It worked wonders.

I believe massage therapy to be one of the most effective alternative medicine choices to be used in conjunction with palliative care. As we all know, the skin is the largest organ of the body, and sensation, along with hearing, probably the last sense remaining as we approach death. Thousands of studies have been done on the effects of touch and close contact with infants, adults, and even animals. The results of these studies indicate that gentle touch, stroking, and massage affect the heart rate, blood pressure, respiration, and even hormone levels. Touch can trigger the release of endorphins, those "feel good" hormones, which can also act as the body's natural painkillers. Gentle massage also promotes better circulation, particularly important in those with impaired mobility or who are bedridden. I began to use massage when my husband's feet swelled after kidney surgery, and it worked remarkably well in aiding circulation to his feet and reducing the accumulation of excess fluid. Our local hospice organization provided a massage therapist for us, and although my husband was reluctant to have a massage at first, he was soon eagerly awaiting the visits. The benefits of the massage were mental as well as physical; it allowed him to relax, to feel more soothed and less anxious about what he was going through, and it also helped him to reduce his anxiety medication. He was able to spend far more time in an alert, serene state.

As a type of alternative medicine, music therapy first came into vogue in the 1940's, to help treat the psychological damage of war veterans. The National Association of Music Therapy was established in 1950; in Great Britain, the British Society for Music Therapy was formed in 1958, in response to cellist Juliette Alvin's work with children who had learning difficulties. I also work with children who have various mental, emotional, and behavioral problems, and music is an integral part of our curriculum. It allows them a new outlet for creativity, as well as an additional means of communication for those who have difficulty with verbalization.

In the elderly, music can not only be soothing; it can also trigger pleasant thoughts, and uncover long forgotten memories. Some dementia and Alzheimer's patients cannot remember where they are, or recognize spouses and family members, but they can sing along with songs from their past.

Music therapy can be performed in groups, or one-on-one. The idea of the therapy is two-fold; to help to soothe and release tension, and also to help express emotions non-verbally. Depending on the type of effect desired, the practitioner may play music for you, or encourage you to play an instrument yourself; you don't need to know how to play, or read music for that matter. The idea is for you to use rhythm and song to express yourself in a safe and accepting environment. Patients suffering from stress, pain, or limiting physical factors may choose to have a variety of soothing music played for them, including instrumentals or even recordings of nature sounds, like birdsong or wave action. Although music therapy may or may not affect illness of body systems directly, it has been shown to help patients relax, focus, and give voice to their feelings and emotions.

Visualization as alternative medicine has been in use since at least the 1970's. One of our culture's current catchphrases (and I'm not sure where it originated) is for someone to "go to their happy place". This means, of course, that one should have a set of happy, stress-free images, of a vacation spot perhaps, which one can call upon during times of emotional upheaval. Guided visual imagery is now commonly used in sports training, personal development, and biofeedback. It has also been used by patients with various diseases, including cancer, as a way to help boost the body's defenses and replace negative emotions with positive ones. Often, the patient will be asked to visualize the body "attacking" the cancer cells, for example, or to form an image of pain as something that is flowing out of the body and being replaced by a "river of love and joy" flowing from family and friends. This can help the patient feel as though they are more in control of the situation. A British Medical Journal published in 1988 contained a study which noted that women with breast cancer received greater psychological benefits when visualization therapy was added to relaxation methods. The Encyclopedia of Healing Therapies by Woodham and Peters (DK Publishing, New York, 1997) states that "Some cancer specialists in the US, Europe, Australia and New Zealand now include visualization as part of care programs to improve quality of life."

As far as palliative care for the dying, I think visualization is a wonderful way to allow patients to review their lives (which they are probably doing anyway) with the help of a trained specialist, who can help them to resolve troubling issues (an estranged child, a messy divorce) in a helpful and non-threatening manner, as well as guiding them through the joyful and meaningful moments in their lives. It can also give patients an additional tool for managing pain and stress; often, a family member will be asked to provide visual cues, such as photos and treasured objects, to surround the patient and remind them of happy times.

As more and more of the population ages, and the demand for hospice grows, I believe that alternative medicine will become far more popular and accepted. The hospice "team" approach, dedicated to providing a network of professionals in a multitude of disciplines, is a shining example of how mainstream and alternative medicine can work together to treat disease and comfort the dying.

Sources: Encyclopedia Of Healing Therapies; Woodham and Peters, DK Publishing, New York, 1997
Hospice Of Lancaster County, personal involvement in program