Friday, January 20, 2012

Caring for older people



Reflexology - Caring for Older People


by Lynne Booth(more info)


listed in reflexology, originally published in issue 173 - August 2010

Introduction


Reflexology is increasingly being used in residential care facilities and among many fit older clients who want to maintain their health throughout retirement. There is no doubt that the reality of the silver tsunami of older people, i.e. the baby boomers following the Second World War, presents a considerable challenge that must be confronted not just by government, but by all of society. For the very first time in history, the demographic landscape has changed, and there are now more people in the UK who are aged over 65 than under 16. The International Longevity Centre in New York originally referred to the phenomenon of the ageing population as the "longevity revolution" - a momentous change akin to other milestones in human history which have shaped society, such as the industrial revolutionOlder resident receiving Hand Reflexology



Reflexology is a particularly suitable modality for older people as it helps circulation, normalizes bodily functions and can aid detoxification. No outer clothing, except footwear, need be removed, and the techniques can be easily applied in a sitting or reclining position and in many different locations: in bed, in wheelchairs or couches and simple self-help hand exercises can also be taught to be used anywhere.


With reflexology, the hands and feet are gently stimulated to trigger a self-healing response in specific parts of the body. It is important to register that the process of ageing does not always have to be a negative decline and that the ageing body still has an immense capacity for regeneration and healing given the right impetus. I have run a reflexology clinic for over 16 years at the St Monica Trust in Bristol, where innovative care is provide for all levels of health issues in older people, from sheltered housing to dementia facilities and 24 hour nursing care.


The aim of introducing reflexology to the Trust's programme of facilities, one of the largest in the UK, was to help chronically sick older people recover a certain degree of health through hand and foot reflexology and their own self-help applications on their hands. Many residents have multiple pathologies, take a number of medications and therefore welcome complementary therapies as a means of regaining some measure of health without potential side effects. It is also empowering to show a person simple self-help reflexology on their hands that they can apply at any time to help ease specific arthritic pain in their shoulder, for example, rub their left palm to ease indigestion or help to bring about deep relaxing sleep at night with a hand rocking technique I have devised.


The advent of improved public health, better medical care and beneficial changes in diet and nutrition has served to limit mortality in both early and later life. Clear evidence is emerging to indicate that the longer the life expectancy, the longer the health life expectancy, but paradoxically, it appears that the period of frailty towards the end of life is also increasing. A Reflexologist will aim to help support an older person to the maximum of their potential through what could be, at worst, an extended life of ill health. In the South west of England where I practise, the total number of people of 65 and over in the South West is projected to rise from 994,700 to over 1,427,600, an increase of 44% between 2008 to 2025. In some areas there is an expectation that the number of people with dementia will rise between 2008 -2025 by 50%. The rise in provision of complementary therapy within care facilities, as well as to the general public, indicates the increasing need to find ways of preserving quality of life for many who may now expect up to live through 35 years of retirement.

Benefits of Reflexology in the Care of Older People


Touch is a potent force in nearly all therapies, and for some isolated or lonely older people, the gentle relaxing sensation that reflexology achieves is the one time they can be treated holistically as the whole body is treated each time and all ailments, large or small, can be addressed. Emotional issues often surface due to the treatment itself, relaxing the person or because the client knows their confidentiality is respected.


Soon after qualifying, in the early 1990s, I worked as a Reflexologist in a long-term medical unit in a Bristol hospital for the older mentally disabled patients, many whom had a mental age of 1 and 5 years. It was often uncomfortable or inappropriate to work their feet, and many who could not verbally communicate, would become calmer when their hands were worked. Examples of a positive response to hand reflexology included a bed-ridden woman with a mental age of 3 years who began humming a tune and smiling when her hands were worked and another, who crouched all day with her arms and legs in a twisted pose, would only straighten and splay her limbs during a hand reflexology session and these effects of reflexology would last for several hours. On another occasion, the heart reflexes on a patient's hands were so sensitive that I alerted the medical staff who ran tests, and diagnosed an angina attack and the early stages of heart failure.


These experiences at the hospital were formative in my development of Vertical Reflex Therapy (VRT) for the hands. The term Vertical Reflexology is also used to describe the method where the dorsal reflexes on the hands and feet are briefly worked when the hands and feet are weight-bearing. This is obviously not so relaxing for the practitioner or client, but it is compensated by the fact that VRT is applied in this position for a maximum of five minutes only. Most of the VRT techniques can also be used on the passive hands which enhance a treatment but is not so powerful as in the weight-bearing mode. The weight-bearing hands can easily be worked by the therapist or client for a few minutes, and many older residents have commented that with VRT, they can feel warmth and/or their body adjusting as they are being treated.


Simple self-help techniques can be taught so that the client can work, for example, the bowel reflexes on the palm of the hand to ease constipation, or to rub some reflexes below the little finger to ease inflammation in the shoulder. Medication can sometimes be reduced by a GP following a course of reflexology that has helped the symptoms to ease naturally. I run Sleep Seminars at the St Monica Trust and teach residents a technique called Diaphragm Rocking on their hands to help them get to sleep or return to sleep. Two residents recently told me that this has helped to "buy them more time" in the day .i.e. they sleep better at night, are therefore not so tired in the day which has consequently transformed their afternoons from dozing into time for creative activity.


It is often interesting to see a frail new resident come into the St Monica Trust nursing home facility and begin to recover and improve in health and general mobility once they do not have to struggle to look after themselves. It is important to register that the process of ageing does not always have to be a negative decline, and that the body still has many resources to implement some regeneration, giving a multi-faceted approach to their nursing care.

References


Books

1. Booth, Lynne. Vertical Reflexology for Hands. Piatkus Books, London. ISBN: 0-7499-2319-9. 2003.

Reports


2. Putting Older People First in the South West: A regional housing market assessment, published November 2008.

3. St Monica St Monica Trust Annual Review. 2008-9.
www.stmonicatrust.org.uk

4. International Longevity Centre, USA www.ilcusa.org


About Lynne Booth


Lynne Booth BA (Hons) BRCP IIR ART Hons AoR Hons trained with the International Institute of Reflexology. She has a private practice and also runs a reflexology clinic at a 400-resident St Monica Trust in Bristol as well as a clinic for professional footballers. In 2011 Vertical Reflex Therapy won the Highly Commended Award for its Outstanding Contribution to Complementary Medicine from the Institute of Complementary and Natural Medicine (ICNM). The development of VRT and a small medical study were conducted at the Trust in the early to mid-1990s. Lynne frequently presents VRT at conferences internationally and she and VRT appointed tutors have taught VRT courses in the UK and internationally to approximately 6000 qualified Reflexologists. In 1998 Lynne was awarded an ART (Advanced Reflexology Techniques) fellowship for services to Reflexology and in 2008 The Association of Reflexologists (AoR) also gave her an honorary fellowship. She has written a best-selling book Vertical Reflexology and also Vertical Reflexology for Hands. A training DVD Vertical Reflexology for Hands and Feet was released in 2008. In 2011 The Institute of Complementary and Natural Medicine (ICNM) gave Lynne Booth a Highly Commended award to VRT's Outstanding Contribution to Natural Medicine. Her books are published in 6 languages including Japanese, where it is taught as a diploma course in Tokyo.



Problems Affecting Muscles and Joints




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Problems Affecting Muscles and Joints


by Mary Martin(more info)


listed in reflexology, originally published in issue 92 - September 2003




Rotator Cuff Syndrome – Charlotte


The rotator cuff is made up of a ring of muscles and ligaments that joins the head of the humerus to the shoulder joint. These stabilize the shoulder and allow a range of movements to the arm. This syndrome is caused through inflammation or damage to these muscles or ligaments. It can result in a frozen shoulder and long-term problems.


Charlotte was carrying a heavy bag on her left shoulder and weighty shopping draped over the same arm – a sure recipe for disaster! Initially her shoulder felt strained – quickly followed by excruciating pain. Her doctor diagnosed rotator cuff syndrome and prescribed painkillers.


Three days later I treated Charlotte who was still in terrible pain. She could only extend her left arm for nine inches sideways from her body.


Within a few hours of treatment, the pain had eased. Next day she had full movement of her arm, despite a dull ache in the upper arm when raised. Following treatment a week later she has had no further problems.


How Reflexology Works


Applying pressure to reflex points makes it possible to interact with the interconnected systems of the body at an energetic level and restore homeostatic function. Muscles relax, enabling blood flow to be re-established. Waste products that cause pain are eliminated, allowing oxygenated blood and nutrients to penetrate the tissues – relieving pain and stiffness. It optimizes the body's natural healing ability.


Early treatment provided a speedy recovery for Charlotte. Old, unresolved injuries may be alleviated but normally take longer, especially when aggravated by occupational stresses.


Gout


This is a metabolic disorder whereby excess uric acid in the blood gets deposited in joints. This build-up is either due to overproduction or to kidney problems and inadequate excretion. Some blood disorders and particular prescribed drugs are also triggers. There is a pre-disposition to gout in some families. Men are more prone to it than women.


Over-consumption of foods rich in chemicals called purines (that produce uric acid) may also trigger attacks. These include offal, game, fish roes, sardines, herring and lobster. Excessive amounts of alcohol decrease the kidneys' ability to excrete uric acid. In acute attacks the big toe is normally affected. There is excruciating pain – the toe joint becomes red, hot and swollen.


The skin may appear shiny, red or purple. There can be feverishness. Drugs are usually prescribed to counteract an attack and also to prevent further attacks.


Repeated attacks may cause pain, swelling and stiffness in the fingers, wrists, knees or feet. Left untreated, it can lead to permanent damage. Uric acid crystals may be deposited in the kidneys, causing kidney stones. Chalky deposits called tophi may appear under the skin around joints and in the cartilage of the ears.


Anna


Sixty-two year old Anna's right kidney was removed at aged 22 because of TB. Her bladder was also damaged during an operation. This resulted in a build-up of uric acid levels causing gout in her hands and feet with referred pain in her legs. This was despite taking the drug allopurinol for 'preventing' gout. She also took medication for hypertension and elevated cholesterol levels.


Due to chronic pain she slept badly and needed to pay seven or eight nightly visits to the bathroom. Being overweight and standing for long periods did not help her condition.


Within three treatments her pain lessened considerably, affording her a good night's sleep. By the fourth treatment her nightly visits to the bathroom had reduced to three. Her kidney and bladder function improved, resulting in reduced uric acid levels. Free from pain, Anna's sleep pattern improved – boosting her general health. She said that she felt better than she had felt for years. Monthly treatments maintain this level of improvement.


Michael


Michael, aged 47, suffered from gout in his hands, feet and knees for almost four years. This involved hereditary factors, as both parents had chronic gout. He took allopurinol.


Like his parents, Michael had high cholesterol levels. He had digestive problems, backache and slept badly. Due to an accident five years previously, he experienced frequent headaches – aggravated by working on a computer for long periods.


By his fourth weekly treatment he was free from pain in his hands and feet although his right knee – the worst affected – was still painful.


Within two months, all his pain had disappeared – unless he ate seafood. This was his favourite food and triggered attacks from time to time.


He now eats it occasionally without any ill effects. Blood tests show a substantial reduction in uric acid levels.


Furthermore, his backache improved within two treatments. He sleeps well and rarely gets a headache. Michael's digestive system is much improved and he is more energized. Blood tests show a substantial reduction in cholesterol levels. Regular treatment maintains this level of improvement.


Summary


A great advantage of reflexology is that it works indirectly on areas of pain. It does not normally conflict with orthodox treatment, but aims to bring functional improvement on all levels. Most people's health and well-being improves.


Life itself encourages an accumulation of muscular tension. Injuries such as Charlotte's appear to happen in an instant but are invariably due to years of misuse of the body. The straw that broke the camel's back!


In the long-term, preventive healthcare is preferable to suppression of symptoms through drugs. Many people recognize this but do nothing about it – yet creating a healthier lifestyle is such a liberating and empowering experience.
Mary Martin


A qualified teacher, Mary Martin established her School of Reflexology in 1987. She founded the Association of Reflexologists in 1984 and is an Honorary Life Member. Previously she practised as a Gerson therapist. Mary belongs to a network of therapists attached to the cancer centre at Mount Vernon Hospital. She has had a busy practice in Ruislip since 1983.


Coping With Stress



Coping With Stress


by Mary Martin(more info)


listed in reflexology, originally published in issue 157 - April 2009




Stress has been described as a 21st century plague. The correlation between stress and depressed immune function is well documented. About 70% of disorders are directly or indirectly related to stress. These include hypertension, heart disease, insomnia, onset of malignancy, depression and digestive disorders.


Doctors understand this but do not have the time to spend on getting to the underlying causes of stress. A GP's average consultation lasts 10 minutes or less. Treating symptoms with drugs offers short-term benefits.. Patients are concerned about side-effects and also dislike this impersonal approach, whereas Reflexology does not conflict with orthodox treatment. Many people are choosing Reflexology as a non-invasive way of coping with stress.

What Does Reflexology Offer?


Touch Technique


The sympathetic nervous system initiates the stress response. Reflexology activates the parasympathetic nervous system that is concerned with relaxation and recuperation. This helps patients move from being stuck in the sympathetic overactive state to one of deep relaxation. The effect is cumulative, and allows the body's systems to achieve normal balance . Studies show that if stress is managed properly, the immune system returns to normal. This lessens the likelihood of chronic health problems. It is also easier to face difficulties when mentally and physically relaxed.


Tension is held in the muscles which affects nerves and circulation. Existing conditions such as backache, neck pain, headaches, joint pain or sciatica are exacerbated by this. As muscular tension is released, pain is lessened. As nerve function improves and blood and lymph circulates freely, overall health and wellbeing improves. Touch is also a basic form of communication to convey empathy.

Empathy


Empathy and understanding are therapeutic in themselves. Reflexology is a patient-centred therapy, built on good practitioner/patient relationships. Relationships that are built on trust where patients are empowered and supported in making the necessary changes in their lives. It is very important to devote sufficient time to this. Reflexology practice acknowledges the interaction of the mind, body and spirit. Stress can be mental, physical or emotional and so this is significant.

Case Example


Louise suffered from chronic eczema covering her face and body. It had an adverse psychological effect on her. She then went off to university where she was virtually free of it. After returning home her eczema became chronic.


When I saw Louise she was very stressed and avoided eye-contact. Her self-esteem was low. Her face and back were covered in eczema. I warned her that Reflexology brings symptoms out and that her eczema might get worse initially. This was the case and then her eczema cleared.

It became apparent that her condition was exacerbated by the stress of an overbearing parent. Louise was relieved to discuss this delicate problem. She became relaxed and confident and decided to leave home for the sake of her health. Without reflexology, none of this would have happened.

Cancer Care


Coping with cancer is very stressful. Reflexology is particularly helpful in calming and supporting cancer patients. In many cases it relieves the side-effects of cancer treatments. It can also provide pain relief and functional improvement.

The Stress Response


Understanding how the body responds to stress makes us aware of how persistent exposure to stress causes disorders. Our primitive ancestors had to face life-threatening challenges such as attacks from wild animals. The body is programmed to respond to physical threats, instantly, via complex biological changes. This is called the 'fight or flight' response because there is only a split second to decide when to fight or flee.


The stressors we face today are usually of a psychological nature. They can relate to stress associated with relationships, employment, finance, housing or commuting etc. The body has not adapted to the rapid changes in modern society. It responds, as it has for centuries, by preparing for emergency physical action. Persistent stress takes its toll on health when the body is constantly placed in a high state of alert:
  • Muscles tense ready for action;

  • Heart-rate speeds up to circulate more blood to the muscles, brain and lungs;

  • Blood pressure rises;

  • Spleen pours more red blood cells into the bloodstream;

  • The airways dilate to increase oxygen intake from the lungs to the bloodstream;

  • Breathing becomes deeper and more rapid;

  • The hormone noradrenaline increases the rate at which blood clots in case of injury;

  • Stored glucose from the liver and fats stored in tissues are mobilized to supply extra fuel for the body;

  • The steroid hormone cortisol is released to reduce inflammation and to heal wounds. It suppresses allergic reactions;

  • Mental alertness and senses are sharpened. Pupils dilate to improve vision and hearing becomes more acute.

How Stress Contributes To Illness


Stress can be modified, but not eliminated; it needs to be managed. A moderate amount of stress is essential to help us attain our goals. It is the repeated or prolonged exposure to stress that invariably contributes to disorder. In prolonged, distressing situations we want to run away but cannot - we try to cope. This results in the release of an excessive amount of the steroid hormone, cortisol. Overproduction of cortisol suppresses the immune system.


In cases of non-threatening, lengthy challenges we may feel like fighting. If this is not possible, we experience feelings of frustration and anger. This results in the overproduction of the hormone, noradrenaline. It shows how feelings and emotions affect the activation of the stress response.


For example, Eleanor was undergoing a long and difficult divorce. She felt her security was threatened, both emotionally and financially. Her sleep was disturbed. Too much adrenaline had raised her heart-rate, making her agitated and fatigued. She experienced palpitations and had been diagnosed with high blood pressure and prescribed medication.


Her immune system was suppressed and she has had several colds and throat infections. She was angry and wanted to hit out at those responsible, but could not. It gnawed away at her as she tried to cope. Eleanor should have sought help sooner, but now Reflexology has reduced her stress levels.

Research


Research shows that stress has a negative effect on the immune system. There are cells that kill viral-infected cells and they are also anti-bacterial. These particular cells are also considered to prevent the formation of tumours and limit metastatic disease. Studies demonstrate that the function of these cells is reduced in animals and humans who are living in stressful conditions. When they escape from the stress their immune function improves.


Studies have shown that social support lessens susceptibility to infection. Patients with melanoma attended group therapy to reduce psychological distress. This produced improvement in the quantity and function of different types of killer cells. Research also showed that such intervention created a significant increase in patients' survival time


About Mary Martin


A qualified teacher, Mary Martin established her School of Reflexology in 1987. She founded the Association of Reflexologists in 1984 and is an Honorary Life Member. Previously she practised as a Gerson therapist. Mary belongs to a network of therapists attached to the cancer centre at Mount Vernon Hospital. She has had a busy practice in Ruislip since 1983.