Map of life expectancy at birth from Global Education Project.

Wednesday, January 21, 2009

Natural Supports

I was interested to see that one of our commenters is an oncological massage therapist. It so happens I was recently involved in a project concerning that very subject. There is good evidence -- real scientifical type stuff -- that massage can be helpful in palliation of cancer. It can relieve pain and malaise, reducing the need for narcotics and other drugs, and relieve stress. Massage therapy is certainly something people should consider in various circumstances, so long as the claims for it aren't overblown.

Our project was a product to teach caregivers -- i.e. spouses, significant others, adult children, siblings, friends, etc. -- of people with cancer basic therapeutic massage techniques, using a manual and a video, based on a full-day instructional workshop given by professional massage therapists. I'm not trying to put our friend out of work -- there's obviously a role for professionals -- but there are also extra benefits to mobilizing natural supports in this way. For one thing, as became very clear in the workshop and follow-up, it can mean a lot to the loved ones to have something so tangible to offer. It can strengthen bonds and make the ordeal of cancer and cancer treatment easier to bear for both parties in profound ways that go well beyond the immediate physical benefits.

As we try to cope with the rising burdens of morbidity and disability that will inevitably come with an aging population, strengthening and enabling natural supports is one strategy that we ought to pursue more aggressively. People can stay at home longer or get out of institutions -- hospitals, intermediate care facilities, rehab hospitals, etc. -- sooner if we give caregivers some help. That includes skills, assistance, emotional support, maybe a little bit of money, and respite. Of course, sadly, not everybody has people in their lives who can do this, but there are strategies to fill even that need. There's a danger in the temptation to force this on people beyond the point where it's a positive choice, in order to save money, but on the other hand many people would prefer it.

Right now, Medicare, Medicaid and most private insurance don't offer much support for these strategies, or place arbitrary time limits and other restrictions that are counterproductive. Payers -- contrary to their own financial interests -- actually force people into institutions rather than strengthening and supplementing informal supports so that people can stay out of them. We need to rethink these policies, on both financial and humanitarian grounds.


MissFifi said...

Thank you thank you!! As a certified oncology massage therapist in NJ, who cannot find a job, it really is frustrating that insurance companies and big pharma, they go hand in hand, do NOT see us as an asset in treating the patient. It is all about comfort touch, relieving pain and nausea momentarily and helping patients to relax. We do not tout it as a cure or replacement, we just want to help ease the patients mind while getting 5hours of chemo. Thank you for addressing this matter.

Anonymous said...

When patients receiving palliative massage within days of dying can say " I feel like Paris Hilton", or another "I can't get any closer to heaven while on earth" they are certainly benefiting from massage. As a therapist I have been blessed beyond measure. It is an honor and a privilege to work with these patients at such a time in their lives.

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