6 Solace and Care Sources That Can Optimize End-of-life care
Today it requires more than medical care to help seniors who must also deal with physical disabilities and issues connected to cognitive decline. Complementary therapies, such as music and art, offer solace to those faced with a serious illness or age-related decline. When they are integrated with professional care services (such as geriatric care management) and specialized medical care (such as palliative care), patients or clients’ quality of life is optimized. Because all of these areas focus on quality of life, they are very applicable to end-of-life or hospice care, which a growing aging population is likely to utilize greatly. The primary goal of palliative care is to promote a patient’s quality of life by alleviating physiological, psychological, social and spiritual distress, and thereby improving comfort. The primary goal of hospice care, which involves a time span of 6 months or less, is to enable the patient to live as well as possible until death. There are several forms of solace or complementary therapies and care sources that can provide comfort and relief in palliative and hospice care. This blog focusses on six solace and care sources that can optimize end-of-life care.
Touch can be therapeutic. When used properly, it can transform the lives of patients, especially those experiencing terminal illnesses.
Patients in palliative and hospice care often experience physical and emotional problems. For example, as physical changes occur within their bodies, they are forced to adjust to an altered lifestyle and diminishing functions. As a result, patients can become angry, frustrated and even depressed as they undergo these changes. Massage therapy has been proven to help with these issues. It reduces anxiety, depression, agitation, pain and joint stiffness. Because massage therapy increases overall relaxation by activating the body’s vagus nerve, it also impacts patients’ overall quality of life.
A 2014 study that focused on integrating massage therapy into palliative care showed “significant changes in pain, anxiety, relaxation and inner peace of patients.”
Massage therapy is able to bring comfort to the entire being—physical, emotional, mental and spiritual.
To find a palliative or hospice massage therapist in Philadelphia click here.
Music is powerful; it has the ability to transcend words and connect people. When used as therapy, it promotes wellness, manages stress, alleviates pain, expresses memory, enhances memory, improves communication and promotes physical rehabilitation.
Music therapy also provides physical and emotional peace to end-of-life patients and their families. Like massage therapy, it has a positive effect on pain, physical comfort, fatigue and energy, anxiety and relaxation, time and duration of treatment, mood, spirituality and quality of life.
According to a 2005 study review on music therapy in palliative and hospice care, music therapists used methods such as song writing, improvisation, guided imagery and music, lyric analysis, singing, instrument playing and music therapy relaxation techniques to treat the many needs of patients and families receiving care. The needs often treated by music therapists in end-of-life care were comprehensive. Social needs included isolation, loneliness, boredom. The emotional needs involved areas such as depression, anxiety, anger, fear, frustration. The cognitive needs encompassed neurological impairments, disorientation, and confusion. The physical needs involved pain or shortness of breath. The spiritual involved the lack of spiritual connection and the need for spiritually-based rituals.
Like music, art therapy has shown to improve pain, fatigue, anxiety and depression in palliative and hospice care patients.
Art therapy can involve painting, assembling images into a collage or expressing through the visual arts. This creative mode of expression can improve the quality of life for dementia and terminally ill patients. For patients with Alzheimer’s and other dementias, art therapy serves as a type of facilitator by helping patients reconnect with long-term memories. For hospice patients, art therapy can help them find “meaning and closure through the concrete expression of personal accomplishments, important relationships, and cherished experiences” according to an article in MDEdge Psychiatry.
Through art therapy patients can create a legacy and feel a sense of accomplishment, especially if they wonder about the value of their contribution to life.
Art therapy can be a powerful tool for self-reflection and an expression of those thoughts and feelings as patients near their end-of-life journey.
In a study involving three elderly women from Wisconsin, art therapy created a sense of wholeness, connectedness and control. The patients were instructed to complete a collage with a loved one based on a story about their lives. The study emphasized the significance of individual responsibility, choices, actions, and self-examination. Each loved one also had to share a story about the patient. The collages were framed and presented to the patients and their loved one at the end of the session.
The project, according to the study, served to meet the goals and principles of hospice which underscore “connectedness, dignity, respect for the patients’ choices, and giving patients as much control over their lives as possible as they attend to psychological, physical, social, and spiritual concerns.”
Another type of therapy that meets the hospice goals and principles is dignity therapy. It’s quite similar to art therapy in its purpose. Dignity therapy creates meaning in the lives of patients who are dying. For dying patients, it is a way of communicating that their lives mattered. It is also another way patients can reflect on their lives and choose the legacy they want to leave behind.
Søren Kierkegaard, a Danish philosopher, said “Life can only be understood backwards; but it must be lived forwards.” When there is no more room to move forward, it is in looking backwards that patients find meaning and purpose.
Patients are interviewed by the dignity therapist about their passions, accomplishments and messages they want to leave behind. The information is recorded, transcribed and edited by the patients and therapist.
The finished document has great value for the families left behind. Some use it as a source of comfort for remembering their loved one. Some use sections of it at funerals.
In a dignity therapy study called Family Member Perspectives, 95% of family members said dignity therapy helped the patient; 78% reported that it heightened the patient’s sense of dignity; 72% reported that it heightened the patient’s sense of purpose; 65% reported that it helped the patient prepare for death; 65% reported that it was as important as any other aspect of the patient’s care; and 43% reported that dignity therapy reduced the patient’s suffering.
As for the family members, 78% reported that the document helped them during their time of grief; 77% reported that the document would continue to be a source of comfort for their families and themselves; and 95% reported they would recommend dignity therapy to other patients of family members confronting a terminal illness.
Dignity therapy is a therapeutic intervention that helps lessen the suffering for both patients and loved ones.
End-of-life doula is the new kid on the block. The International End of Life Doula Association (INELDA) is a nonprofit organization pioneered by Henry Fersko-Weiss, in 2003. The association conducted its first council meeting April 25, 2018 in Washington, D.C.
The National Hospice and Palliative Care Organization press release describes the end-of-life doulas (EOLDs) as “caregivers who offer non-medical, holistic support and comfort to dying people and their families. Services are varied to meet individual needs and requirements, and may include education and guidance, as well as emotional, spiritual or practical care.”
Doulas also assist people in finding meaning, creating a legacy project, and planning for how the last days will unfold.
If you’re interested in learning more about end-of-life doula, you may contact them here.
Professional Care Manager
Professional care managers are care experts. They manage your care and everything and everyone connected to it. Because each person is unique, their role and involvement will be based on the individual’s need(s). Lisa Rogers, a social worker and a professional care manager who specializes in geriatric and end-of-life care at Intervention Associates, can work with a team of professionals called the hospice team. In a podcast on end-of-life care, Rogers shares how everyone comes together to support the patient:
“The hospice team is made up of a physician who is the medical director. Underneath the doctor is a nurse. Under the nurse is a social worker, a chaplain, a volunteer coordinator, and some organizations have complementary therapies such as massage or music therapies that help.”
As a professional care manager, Rogers is the connector that links each of these professionals.
Other times Rogers works with elderly persons whose general diagnosis may simply be a failure to thrive as they age. Because the elderly are vulnerable, Rogers becomes their advocate, making sure that their needs are being met. Rogers’ job involves not just taking care of the patients but also taking care of their family, making sure that they’re okay with the care, and just being a professional support as they navigate the healthcare system during such a complex, difficult time in their lives.
Wherever you are on the journey, professional care managers such as Rogers can design the care you would like to have. You can have a voice in the type of care you would like to experience.
At Intervention Associates they can help you design your care interventions so that you experience quality of life to the end of your life journey.