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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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Final thought

“Giving touch has the power to illuminate the

experience of the healthcare professional

caring for the older person suffering from pain

in all modalities giving them the ability to be a

valuable person and professional”

(Edwardsson Et al 2003)

Thankyou

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