“The loss of normalcy; the fear of economic toll; the loss of connection. This is hitting us and we’re grieving. Collectively. We are not used to this kind of collective grief in the air.“
Month: March 2020
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Massage Therapy in Hospice
“Embracing the truth that all things inevitably must end encourages us not to wait in order to begin living each moment in a manner that is deeply engaged.” ~ Frank Ostaseski
Touch is the first sense to develop in our bodies and may be the last sense to fade.
Touch is our instinctive form of communication. When we are born we discover the people and objects around us through touching and develop our physical relationship with our bodies through tactile exploration.
Touch is as natural a need as food and water. In the 13th century a study was performed by the German Emperor Frederick. The Emperor was curious to know what language children would speak if they were raised without hearing any words at all. The nurses were instructed to feed a group of infants, but not touch or talk to them. The infants never learned a language. They all died before they could speak. Frederick unwittingly made an important discovery: Tactile stimulation can be a matter of life and death.
https://www.digma.com/digma-images/video-scripts/fredericks_experiment.pdf
Why Touch?
As confirmed by Tiffany Fields, Director of the Touch Research institute at the Miami School of Medicine, a simple touch of a hand on the shoulder or an arm around the waist can:
- Lower blood pressure
- Stabilize heart rate
- Stimulate the release of endorphins, the body’s natural pain suppressors
How does the simple act of touch have such a profound effect on another living being? There are as many as 5 million touch receptors in the human skin. These receptors send messages along the spinal cord to the brain. Providing care through massage and intentional touch literally transmits messages to the receivers brain.
https://www.researchgate.net/scientific-contributions/39335193_Tiffany_Field
How is Massage in Hospice Different from Typical Massage?
Massage Therapy in Hospice requires a physicians order. Massage is nurturing, deliberate and provides the comfort and tranquility a dying person deserves.
As the physical and mental functions of the hospice patient slow down so should the approach of care. Typical massage such as deep tissue or hot stone massage is not appropriate at end of life when the patient is in a fragile state.
The massage may take place wherever the patient is most comfortable. This could be a chair, a bed or a sofa. Transferring or adjusting location may be unsafe and possibly exacerbate pain and/or confusion.
Presence and intention are most significant when working with the dying. Massage is delivered slowly, gently and deliberately. Techniques may include, stroking, soft compressions, rhythmic movements, very gentle kneading and holding. Sometimes a gentle lift and reset of the extremities may produce relief.
Each visit is tailored to meet the ever-changing needs of the patient. Often, the massage is focused to one or two areas of the body such as the head or the feet. The length of each session varies according to individual needs and response.
These focused sessions often produce comfort, relaxation, improved sleep, ease of tense muscles and feelings of being cared for and loved.
Dying persons are vulnerable. This depth of vulnerability requires the practitioner to create a safe environment or container in which the dying person feels that his or her vulnerability is witnessed, validated and honored. ~ Irene Smith, Everflowing
Benefits for the Dying
- Non-pharmacological treatment for pain
- Deep relaxation
- Releases endorphins
- Physical, mental and emotional comfort
- Improves sleep and eases tense muscles
Aside from the physical response, touch provides the hospice patient with an opportunity for quiet reflection as they focus on the touch experience. These moments of quiet reflection may allow one to recall life’s experiences with a deeper insight into the feelings connected to these memories.
Focused or intentional touch can convey a message of being cared for, being safe, worthwhile and being connected to a greater whole.
Feelings of safety and belonging help the patient develop a more positive relationship with their physical body and in turn with their dying process. This helps ease feelings of anger, depression and fear.
Touch provides the patient with one-on-one social contact and thereby assists in easing feelings of isolation and loneliness. These stressors often contribute to physical and emotional pain.
Easing the stressors that contribute to the experience of pain in conjunction with the stimulation of endorphins makes touch a wonderful partner in controlling pain.
As the hospice patient loses the ability to utilize typical forms of communication, a new means of communication may be established through touch by family, friends and caregivers.
By supporting feelings of emotional safety and easing a portion of the physical and emotional pain experienced by the hospice patient massage/touch may also help ease a bit of the stress that the family and health care team often experience in providing care to the dying.
As the “death positive” movement continues to grow, the inclusion of massage therapy and other complementary therapies are becoming part of the norm in hospice care, rather than the exception.
“One great lesson is dying people are still living. Dying is these final moments of a life, and therefore a very potent, essential, really concentrated part of life. But it’s a part of life. That’s the first lesson… ‘Oh, right. Dying’s part of the deal, and I’m still living when I’m dying.’” ~ BJ Miller
BJ Miller is a hospice and palliative care specialist at UCSF Health. He shares his own story and valuable insight to the dying process in the links below.
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Children’s Bedtime Meditation
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Music Session!
Join Natasha for a fun music session!
“Hello Song”- Appropriate greetings, speech
“Egg Shaker Song Choice”- Spelling, color identification
“3 Little Pigs”- Counting, socialization, following directions, breathing
“BINGO”- Spelling, counting, following directions, recognition
“If I Can Say it, I Can Play it”- Gross motor, rhythm, counting, syllables, speech
“Purple Scarf”- Emotional regulation, cool-down, visual tracking
“Goodbye Song”- Appropriate goodbye, recall of activities, speech.
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Homemade Egg Shaker
Join me to learn how to make shakers at home using things you may already have in your pantry! They can be used to play music along with me!
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Body Scan Meditation
A simple meditation to ground your mind and bring your focus and energy to the present by checking in with your body and releasing physical tension you may be holding on to.
Music by Natasha Grossfeld, MT-BC.
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Simple Relaxation Tips
Sometimes it’s challenging to find balance once we feel overwhelmed or anxious. Interrupting the cycle of worrisome thoughts can be helpful in taking the edge off and resetting to a space of equanimity. Next time anxiety begins hijacking your mind and body, give one of these anxiety reducing methods a try
Breathe Yourself Calm
Breath is one of our best defenses against stress, fear, and frustration. When we find ourselves in a heightened state of anxiety the first step is to calm the sympathetic nervous system. This is the part of our nervous system that activates the fight or flight response. A simple way to restore equanimity is with long, deep breaths. So, let’s give it a try.
- Start by taking a full breath, counting five on the inhale 1..2..3..4..5
- Pause at the top of the inhale as long as is comfortable to do so, perhaps 3-5 seconds
- Now, on the exhale, count down 5..4..3..2..1. With the exhale, purposefully allow the tension to take leave of your body and mind
- You may choose to pause at the bottom of the exhale if it feels right for you
- With just this first intentional breath, you have begun to calm the nervous system
- Continue this breathing pattern 3-5 cycles or, until you feel soothed
Quick Calming Methods
- Grab two ice cubes. Hold them in each of your hands for a few moments.This “cools” the brain and brings down anxiety
- Close your eyes and slowly count to 10. If necessary, repeat and count to 20 or an even higher number. Keep counting until you feel your anxiety subsiding. Counting can relax you because it gives you something to focus on besides your anxiety
- Simply push against the wall with flat palms and feet planted on the floor for 5 to 10 seconds. Placing the weight of our body against a solid, immobile surface and feeling the pull of gravity is stabilizing, even on a subconscious level
Move You Body to Ease Your Mind
Go for a walk, jog, do jumping jacks, skip down the sidewalk, bike or walk up and down the steps. Exercise brings down anxiety FAST! It doesn’t have to be intense, find the type movement that feels right for you.
Stretch
We tend to contract during stressful times. Everything contracts. Our mind, as our thinking loops in a tight circle, our bodies stiffen, it even shows on our faces with furrowed brows, a tightened jaw and pinched mouth. Our muscles shorten and become less flexible causing discomfort. Stretching releases physical tension, changes focus to body and breath providing overall expansion and relief! Yay!
Having trouble getting started? This is a simple and effective stretch – lay down on the floor, legs extended, arms up over head – imagine your hands and your feet are reaching toward opposite ends of the room. Don’t force anything, stretching shouldn’t hurt. It should have you feeling like a bowl of pudding! Don’t forget to BREEEEATHE
Imagery
It’s helpful to shift our minds by using our imagination or connecting with memories of safety and happiness. The brain doesn’t know the difference between reality and imagination. Cool, huh?
By getting in touch with a happy memory or visualizing a positive experience your body will begin to release neurotransmitters that counteract the stress hormones. Buh, bye cortisol!
This imagery can be a special moment with a loved one, a relaxing day on the beach, an exhilarating hike or the loving embrace of someone special…. let your memories and/or imagination roam to happy places. Imagine the feelings, sounds and scents that might be part of the memory/visualization.
You can easily drift toward this delightful place in your mind when you feel anxious in the future.
What’s Your Mantra?
Find your personal mantra, repeat everyday and many times throughout the day. Repeat to yourself or out loud. You may already have a mantra. That’s great!! Use it! If not, here are some examples:
A Chant: “Om”….Ommmmmmm ~ the “m” vibration is so nice for the brain
Self-loving: “I am enough” or “I am kind, I am loving”
A Favorite Quote: “One day at a time” or “What we think, we become”
Positivity: “I breathe in peace, I breathe out peace”, “I Choose Love” or “I am grateful”
A Mantra holds a different meaning for each of us. It may reflect something you are experiencing right now, who you are at a soul level or how you express yourself to the world. Mostly, it should feel beautifully aligned with your heart, head and spirit as the words move comfortably across your tongue
Self-Compassion
“This is a moment of suffering. Suffering is part of life. May I be kind to myself in this moment. May I give myself the compassion I need” ~~ Kristen Neff
What words do you need to hear to comfort yourself during troubling times? It’s okay to feel cranky, angry, sad, scared. Give yourself permission to sit in your feelings without judgment. By tending to difficult emotions mindfully and with self-compassion you learn how to work with them rather than stuffing them away. 💛 Take a moment to place your hand over your heart, or maybe on your tummy, talk to yourself in a warm and compassionate voice. What would you say to a loved one? Now, say those words to yourself. Reassure yourself. Soothe yourself. Be kind to yourself 💛
Laughter – Humor
What’s Forrest Gump’s password?
1forrest1
😂 I heard all of you reading that just the way Jenny said it in the movie!
Try to laugh at least once a day. If you’re having trouble finding things that make you laugh, don’t worry, I have a boatload of corny jokes!
Watch funny animal videos, comedy shows and maybe standup comedians- there are a bunch available on Netflix. Chat/text with your humorous friends regularly!
- https://www.youtube.com/channel/UCLnBA8Eva1h5JNW2JSkLduA
- https://www.instagram.com/happiness4all/?hl=en
“If you wish to provide peace, provide peace for another“~~ Dalai Lama
With deep gratitude and awe for each of you who selflessly provide an incredible sense of peace to others, may it return to you tenfold as peace in your heart, peace of mind and peace in your soul.
❤️ Maureen
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What is Music Therapy?
Music therapy is defined by the American Music Therapy Association (AMTA) as:
… The clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program.
AMTA, https://www.musictherapy.org/
In simpler terms, music therapy is the use of music and music-based interventions to meet clinical goals by a board certified music therapist.
The field of Music Therapy has been around since World Wars I and II, when amateur and professional musicians began visiting Veterans hospitals and providing live music. Patient response was so notable that doctors and nurses began requesting musician visits. Due to the sensitive nature of medical work, it was clear that training was necessary for musicians and college programs began to open in the 1940’s.
Music therapists today must obtain a minimum of a Bachelor’s Degree in Music Therapy where they study clinical music, musicianship, and science/psychology. While training, music therapists engage in various practicum training to gain experience in implementing music interventions with a variety of populations. When all coursework is complete, music therapists then fulfill 1,200 hours of clinical work through an internship. When done, the student can then sit for the CBMT (Certification Board for Music Therapists) exam to finally obtain their MT-BC (Music Therapist- Board Certified) credentials.
Practicing MT-BC’s can be found almost everywhere. You can find music therapists at schools working with various childhood development goals, psychiatric hospitals, nursing homes, rehabilitation facilities, medical facilities, and just about any location where there are clinical and therapeutic needs.
Probably the most public case of music therapy in action is in that of congresswoman Gabby Giffords who survived a gunshot wound to the head in 2011 that changed her life completely:
Congresswoman Giffords’ life will never be the same, but it is clear that music therapy had a strong impact on her ability to regain speech since her injury.
Music therapists all over the world are working hard to help people meet their clinical goals, whether they be large undertakings such as regaining of speech, or smaller-scale needs, such as decreased isolation for those who are hospitalized. The field has much supportive research demonstrating the profound impact music has on human processing in all domains, and the breadth of knowledge continues to grow. It is clear that music is a powerful non-pharmacological tool when utilized by a credentialed professional that can greatly improve the lives of patients and clients throughout the world.
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Superman (It’s Not Easy)
Join me for an analysis of the song “Superman (It’s Not Easy)” by Five for Fighting in regards to caregivers and the importance of acknowledging your emotions, even when you’re “the strong one.”
Lyrics:
I can’t stand to fly
I’m not that naive
I’m just out to find
The better part of me
I’m more than a bird, I’m more than a plane
I’m more than some pretty face beside a train
And it’s not easy to be me
I wish that I could cry
Fall upon my knees
Find a way to lie
About a home I’ll never see
It may sound absurd, but don’t be naive
Even heroes have the right to bleed
I may be disturbed, but won’t you concede
Even heroes have the right to dream
And it’s not easy to be me
Up, up and away, away from me
Well, it’s all right, you can all sleep sound tonight
I’m not crazy or anything
I can’t stand to fly
I’m not that naive
Men weren’t meant to ride
With clouds between their knees
I’m only a man in a silly red sheet
Digging for kryptonite on this one way street
Only a man in a funny red sheet
Looking for special things inside of me
I’m only a man
In a funny red sheet
I’m only a man
Looking for a dream
I’m only a man
In a funny red sheet
And it’s not easy
It’s not easy to be me