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Archive for December, 2009

Setting the atmosphere with music is standard practice among massage therapists. As a client, I have usually found this practice soothing, although occasionally it has proven highly irritating.

Taste in music can be as varied as taste in food. What relaxes one person might start someone else’s TMJ grinding. A Chopin piano nocturne, John Coltrane album, or Tibetan bowls send me right into a trance. Elevator music, electronic “new age” tunes, and Vivaldi overlaid with rainforest sounds will definitely produce extra wear and tear on my bicuspids.

I’ve had clients bring in their own music: some like Sade, others relax to Led Zeppelin. Still others prefer silence. In any case, I try to let the wishes of the client determine what we are listening to.

And then there’s eldercare and hospice: two settings chock full of sounds, most of which are not conducive to relaxation. In these settings, I have spent years face-to-face with the tyranny of the TV.

As someone who values music, and silence, TV holds an ambivalent place in my life. Personally, I watch a little TV most days, and I will confess I am addicted to General Hospital. As a massage therapist it is easy to see TV as the enemy of relaxation, but that kind of value judgment can get in the way of patient-centered care.

For many people, having the TV on all the time is automatic. It provides background noise, a soundtrack underpinning everyday life. It can be company, a connection to the outside world, a guard against loneliness.

When I enter a patient’s home or hospice room where there is a TV on, and he is capable of choosing, I always ask whether he wants me to leave the TV on or turn it off. Although I have some pretty strong opinions about what constitutes an optimally relaxing sound atmosphere, the patient’s own opinions count more.

Leaving the TV on at the patient’s request sometimes creates unforeseen issues. One day, at my hospice job, a patient was watching “Home Improvement” and wanted to keep it on. I was supervising a trainee, who was performing the massage. It was the beginning of the episode and ¬†we were unfamiliar with the show, so we listened to it as she worked.

As the plot developed, it turned out to be centered around how the characters were dealing with the recent death of a colleague. For a sitcom, there were a lot of heavy emotions floating around, all relating to mortality and fear of death. My trainee and I listened to the show and looked at each other with a growing sense of horror at its content, and concern that it might upset our patient. We watched for signs of disturbance but saw none. He was drifting in and out of sleep like anyone else getting a massage while listening to Chopin.

Regardless of the media in the room, the massage itself is a powerful tool for relaxation. TV isn’t what I would choose for background noise, but if it’s what the patient wants, who am I to overrule his wishes?

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When I started my hospice job in January of this year, I had some concerns about the framework of the program I was hired to develop. Using a model from a successful palliative massage program (where I volunteered when I first started my specialty geriatric practice), I was expected to recruit and train volunteers who were licensed massage therapists. These volunteers would then hopefully make themselves available once per week for a least a year, and maybe even longer. Where, I wondered, would they come from?

My own experience in this field had shown me that making a living as a massage therapist, especially one who works with special populations, was extremely challenging. Building a referral network and reaching enough clients who had resources sufficient to pay out-of-pocket had taken me eight years. I had committed myself to creating jobs in this field for my friends and colleagues by growing my practice and inviting like-minded practitioners to work with me. Yes, I volunteered for a year when I first started, but I had begun to assume that the massage therapy field was full of people who needed jobs more than they needed volunteer opportunities.

I wanted healthcare institutions to hire massage therapists so that massage would be integrated into the medical field, and I was frustrated when I saw these institutions posting notices for massage therapy volunteers instead of creating paid positions. We massage therapists have such a hard time supporting ourselves as it is, I thought, why are we the only healthcare professionals who are consistently asked to donate our services?

And so when I accepted a (paid) position as a complementary therapy program coordinator, I found myself on the other side of the fence. I had to accept the fact that the healthcare industry moves much more slowly than I would like, but I would try to work to change it from within. After all, the job I was hired for was a step in the right direction.

I did not know what to expect when I started looking for volunteers. For the first six months I had only one volunteer, who had been with our hospice since before I came, and who had been waiting patiently for the opportunity to provide massages for our patients. She has been a trusted colleague and a supportive friend throughout the process, and has even begun helping me train new volunteers.

Over the summer we began publicizing our program in earnest, and we now have ten potential volunteers in various stages of training, out of a group of more than thirty massage therapists who have inquired about volunteering with us. I had no idea that so many massage therapists would be willing, and eager, to give of their time and talents.

They are tenacious in the face of all the required medical exams, immunizations, and other procedural hoops they must jump through. They are committed in their desire to use their considerable talents to relieve the suffering of those who are dying. They are inspiring to work with and they give me so much, with their willingness to learn, and serve.

In return, I try to give each volunteer as rich and as powerful a learning experience as I am able. I work to create a feeling of community in a field that can be profoundly isolating. And I thank them for their service whenever I can.

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