Complementary therapies offer new options

Different techniques benefit patient needs

Complementary. Integrative. Alternative. These three words often have been used interchangeably to describe non-traditional therapies to relieve pain or stress and reduce anxiety and heart rates. Before including these therapies in your home health services, be sure to know how to describe them, suggests Kathleen M. Wesa, MD, an internist and specialist in integrative medicine at Memorial Sloan-Kettering Cancer Center in New York.

"An alternative therapy is an unproven treatment that is used in the place of proven, traditional medical treatment," explains Wesa. The therapies that home health agencies are most likely to implement can be called integrative or complementary, she says. "This means that they are used in addition to medications and traditional care to enhance care," she explains.

The most effective therapies for home health, according to Wesa, include:

  • Self-hypnosis

"This therapy is helpful in reducing anxiety or panic attacks," says Wesa. While it is a safe therapy, it must be taught by a staff member who is trained and certified to teach hypnosis, she points out. "This ensures that the therapy is effective for the patient," she adds.

  • Acupuncture

Although acupuncture is typically performed in a clinic setting, it is very effective in reducing pain, says Wesa. "Patients with chronic pain who undergo acupuncture can reduce the dose of pain medication over time," she says. Be sure that the acupuncturist is licensed, well trained, and experienced, she adds.

  • Physical fitness

Yoga and tai chi can be taught by homecare nurses to help bed-bound and homebound patients improve strength and balance along with their emotional outlook, says Wesa. "Focusing on the exercise can help patients reduce pain, anxiety, and nausea," she says. Be sure that the exercise is appropriate for the patient's age and condition, she adds.

  • Massage

"Gentle massage is appropriate for all patients, even frail patients, when done correctly," says Wesa. While most nurses or home health aides may not feel comfortable giving full body massages, they can easily be trained for foot and hand massages, she says. Not only does massage reduce pain and depression at the time of the massage, but the effects of a 20-minute massage can last at least 48 hours, she points out.

  • Meditation

Not all home health patients are comfortable with meditation, but there are a number of techniques that can be used to relax patients, reduce stress, and decrease heart rate and blood pressure, says Wesa. Meditation with a centering prayer and guided imagery can greatly improve a patient's emotional well-being, she says. "If the patient is not visual the patient can focus on breath awareness instead of visual images," she points out.

  • Music Therapy

Although some home health agencies do use certified music therapists in their program, nurses and home health aides can use music to calm an anxious patient or prompt conversations. "If music was a part of the patient's life prior to illness, it can be a very moving therapy," says Wesa.

Be aware of state licensing requirements for different complementary therapists, suggests Wesa. "Licensing and credentialing requirements differ from state to state," she warns. If you choose to partner with a community-based therapist for acupuncture, massage, or music therapy, be sure that, in addition to the proper training, they have experience with ill, homebound, frail, or elderly patients, she suggests.