Revisiting Compassion in care through complementary therapies€¦ · Revisiting Compassion in care...
Transcript of Revisiting Compassion in care through complementary therapies€¦ · Revisiting Compassion in care...
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Revisiting Compassion in care through
complementary therapies
Niamh Hulm
CNS Complementary Therapies for the Older
Person
Claremont Complex
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Overview
Background, meaning and place of complementary therapies
How Complementary therapies supports the values of compassion in care.
To encourage and support nurses in reconsidering the meaning of holistic nursing.
Compassion in Nursing
You should be kind and compassionate in your practice”
(Nursing and Midwifery Board of Ireland,2014)
Compassion, respect & creativity: essential nursing skills in a
person centred environment.
.... key to caring relationships, it is empathy, sensitivity,
kindness and warmth (Haslam,2015)
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Inspiration for service
Began as a compassionate nursing intervention in response to
the many health problems experienced by the older person and
the lack of choice in their healthcare in 2000.
Prompted by the dominance of the biomedical model and the
overreliance on medication particularly psychotropic drugs in
older person's nursing.(Known as “Geriatrics “ at the time )
A practical response to this required a more creative and
interdisciplinary approach to health problems
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Background to service Claremont Complementary therapy service commenced in
2000 in St Clare’s with 12 hrs allocated initially following a successful pilot scheme supported by director of nursing assistant director and key staff
Fulltime CNS post in Complementary Therapies for older people approved (1st in Ireland) in 2009/2010. Initially job share until 2010.Single fulltime post April 2015.
This post provides complementary therapies to three units, based in St Clare’s to clients in day-care, respite and residential care.
Staff can also avail of therapies when resources allow.
Holistic nursing care
Complementary therapies had been integrated in hospice
care for over 20 yrs in Ireland, Uk and USA.
Contribution in support, improved quality of life and
symptom relief (Kassab & Stevenson 1996 )
The philosophy that underpins older peoples nursing has
moved away from the biomedical model and embraces a nurse
/healing philosophy that can be expressed through the use of
touch therapies.
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Art of Holistic nursing and Complementary
therapies
The Art of holistic nursing insists that we establish therapeutic
relationship and create a healing environment and thus
empower the patient through trust and hope. It has a similar
philosophy to that of complementary therapies
(Benner,1984, Antigoni & Dimitrios, 2009)
The integration of these philosophies from a theoretical and
practical view has the potential in addressing the health needs
of the person from a holistic and meaningful perspective.
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Definition of Complementary
Therapies Complementary Therapies are described as treatments
employed alongside, or integrated with orthodox medical
treatments. They are based on a healing philosophy that offers
health related advice and treatment that is of a different use,
acceptance, study and understanding to conventional medicine
(Dept. of Health and children 2006)
• Touch therapies through massage and reflexology can help
alleviate many common symptoms in the older person which
are precipitated and exacerbated by stress responses,
particularly in dementia where stress can contribute to
agitation and distress (Moyle et al 2013)
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Compassionate care
Compassion refers to a deep awareness of the suffering of
another coupled with the wish to relieve it, It is something that
is felt, beyond simply intellectual appreciation. Compassion
can be conveyed by any form of communication, spoken or
unspoken-that shows some recognition of the human stories
that accompany illness.” (Chocinov 2007)
For the older person living with many co-morbidities and an
altered body image, touch through massage can ease suffering
and transform how one sees the person behind the illness
(Edvartsson et al 2003)
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Time-Touch- Therapy
One of the themes identified in a study on compassion in care
by Bramley & Malik 2 014 was” knowing me and giving me
your time, however fleeting the compassionate action". This is
the essence of complementary therapies
In connecting with the person coping with the loss of self in
Dementia, "Touch may well be the catalyst to making contact
with the inner me calming the agitation and disorientation of a
confused mind and bringing moments of comfort to failing
bodies” (Vanderbilt 2003)
Aim to have therapies flexible, focused on the client and
timely. Clients and treatments are evaluated at every session
and follow up planned accordingly within the multidisciplinary
care plan
outcome for clients.
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Complementary therapies in clinical care
Therapies refer to Holistic Massage, Aromatherapy and
Reflexology in Claremont.
These are the most common of complementary therapies
practiced by nurses in the clinical area; this is particularly true
in the area of dementia care (O’Regan et al 2010)
The benefits of a nurse having a qualification in
complementary therapies is their ability to move from one
paradigm of care to another, thus maximising healing choices
and enhancing feelings of wellbeing for the older person.
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Reasons for referral to C.N.S in
Complementary Therapies
Holistic health assessment
Pain management
Behaviour of concern with clients living with dementia
Anxiety and depression
Insomnia
Contracture management
Skincare
Meaningful activity/ emotional/friendship support
End of life care
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Outcome/Results
Has opened the discussion further on compassion in care
The integration of complementary therapies in care oft he
older person has raised awareness of the meaning of health,
and particularly in relation to understanding the determinants
of health.
Contribution to quality of life, palliation of symptoms and
promotion of comfort.
C.N.S participates in interdisciplinary and family meetings,
optimizing medication committee and I.F.H “ What matters to
me “ training.
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Benefits of massage, aromatherapy and
reflexology for older people
Main benefits of complementary therapies as supported by
mc Feeter et al 2016 and observed in our clinical experience
include……
Nurturing, promotes deep relaxation and feelings of comfort
Reduces need for pharmacological intervention
Positive effect on distressed behaviour, pain and sleep pattern
Improved sense of wellbeing, connection and support where
loneliness, recent bereavement and loss of purpose have
impacted on psychological wellbeing.
Touch remains important to health for the older person
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Plans for sustainability/future
C.N.S post shared across three units at present, visiting two
new sites in consultation /training role since 2015
Clients referred through from daycare to end of life care
continue through universal referral form
Teaching/training role in speciality continues to expand as
interest from healthcare staff has increased, thus promoting the
philosophy of holism and value of compassion in care further
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