DR. NAWAL AL-HADAD, PHD, MSOT - EXECUTIVE DIRECTOR CLINICAL PROGRAM DEVELOPMENT & DEPUTY NATIONAL LEAD FOR IMPROVED HEALTH & WELLBEING FOR PEOPLE ...
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Dr. Nawal Al-Hadad, PhD, MSOT Executive Director Clinical Program Development & Deputy National Lead for Improved Health & Wellbeing for People with Special Needs - NHS2
Disclosures
I have no conflict of interest or
disclosure in relation to this
presentation
Holistic Rehabilitation:
Intentional Touch and it’s Effect on
Body, Mind, and Spirit
for Elderly Patients
“Disability asks us to consider what we value in life.”
Diagnosed with Glioblastomas Grade III in 1973. About 30 to 38% of
people with this type of tumor will survive for 5 years or more after
they are diagnosed. Had Open Craniotomy surgical procedure in 1973
and Radiation Therapy. Lived with a resulting right-side hemiplegia and
aphasia.
Aging with Disability: In 2013 became very ill as a result of an
Epileptic Seizure; had Gastrostomy Tube (G-tube) and
Tracheotomy.
The healing power of integrative therapy and benefits of
Massage Therapy and Aromatherapy in the Intensive Care
Unit (ICU).
4
Intensive Care Unit
Intensity of Intervention Critical Patients
Patients in the ICU experience many
Patients in ICU are exposed to many drug
symptoms such as dyspnea, pain, anxiety,
treatments in the technically equipped, loud
fear, depression, delirium, sleep problems,
intensive care environment, and morbidity
hallucinations, dehydration, and fatigue both
and mortality rates are high.
because of factors related to mechanical
ventilation and factors related to other
medical conditions.
5
AGENDA
01 02
Holistic Complementary
Rehabilitation Health Approaches
Intentional Touch &
Geriatric Massage 03 Research
Literature 04
6
Geriatric Population
The need for holistic care is of particular importance in the
geriatric population.
Holistic healthcare is crucial for older adults because of the
mental and physical changes that often accompany aging.
HEALTHCARE literature demonstrates an accelerated
tendency toward wellness and holistic care.
7
Holistic Medicine
Holistic Medicine is a form of
healing that considers the whole
person -- body, mind, spirit, and
emotions -- in the quest for optimal
health and wellness.
8
Principles of Holistic Medicine
Patient-Centered Innate Healing
The patient is a person, not a All people have innate healing
disease powers
Complementary
Team Approach Therapies
Healing takes a team approach Holistic practitioners may use a
involving the patient, doctor, and variety of treatment techniques,
other healthcare practitioners and from conventional medication to
addresses all aspects of a person's complementary therapies, to treat
life a patient.
9
How does Holistic Medicine work in Rehabilitation
Geriatric Population
Disability is a life changing experience. Aging with disability have a
wide range of physical and psychological implications.
Ageing with disability requires a holistic, individualized,
interdisciplinary perspective of rehabilitation care for elderly patients
and their caregivers.
In rehabilitation, current treatments/interventions often focus on
treating the condition, rather than the whole person.
10Holistic Rehabilitation: Focusing on the Whole Person
Rehab Therapists & Nurses
Rehabilitation therapists & nurses are uniquely positioned to
implement multidisciplinary, innovative holistic approaches to address
solutions for issues in patient care as well as serve as patient advocates
and interdisciplinary leaders in holistic rehabilitation.
What is Holistic Rehab?
Holistic rehabilitation treats the whole person, not just the disease. If
focuses on the whole person through holistic therapies that seek to
improve the physical and emotional well-being of an individual
empowering their recovery success.
11Holistic nursing: Focusing on the whole person
Holistic Approach to Elderly Patients care
Amid the move of health care toward a more holistic
approach to wellness, many disciplines including nursing
and allied health are embracing a holistic approach to
elderly patients care.
Holistic Nursing: A Specialty Practice
The American Nurses Association (ANA) officially recognized
holistic nursing as a specialty area of nursing practice in
2006. A holistic nurse recognizes and integrates the principles
and modalities of holistic healing into daily life and clinical
practice.
Dossey, B. M. (2013). Nursing: integral, integrative, and holistic—local to global. In: Dossey BM, Keegan L, 12
eds. Holistic Nursing: A Handbook for Practice. 6th ed. Sudbury, MA: Jones & Bartlett, 13, 3-57.Commission on Accreditation of Rehabilitation Facilities (CARF)
Holistic Assessment
In 2014, the Commission on Accreditation of Rehabilitation
Facilities (CARF) recommended the incorporation of holistic
assessment of wellness during stroke rehabilitation.
The 7 Dimensions of Wellness
The CARF recommendations are based on the Seven
Dimensions of Wellness, developed by Dr. Bill Hettler, co-
founder of the National Wellness Institute (NWI).
Nathenson, P. A., Nathenson, S. L., Divito, K. S. Implementing the New CARF Wellness
13
Standards. J Stroke and Cerebrovascular Disease. 2014; 23(5):1118–1130.The 7 Dimensions of Wellness
The Seven Dimensions of Wellness evaluates the
following domains:
§ Intellectual
§ Physical
§ Occupational
§ Social
§ Emotional
§ Spiritual
§ Environmental wellness
Peterson-Burch, F., Reuter-Rice, K., & Barr, T. L. (2017). Rethinking Recovery: Incorporating Holistic
14
Nursing Perspectives in Post-Stroke Care. Holistic Nursing Practice; 31(1): 3–6.Complementary Health Approaches (CHA)
Health care approaches that are not typically part of
conventional medical care or that may have origins
outside of usual Western practice.
Unlike “Alternative” approaches, CHA are used together
with conventional medicine
Integrative health care often brings conventional and complementary
approaches together in a coordinated way.
Researchers are currently exploring the potential benefits of
integrative health in a variety of situations, including pain
management, relief of symptoms in cancer patients and survivors,
and programs to promote healthy behaviors.
15of Complementary Health
Approaches
Mind and Body Practices Other Methods
Natural Products
This include a large and diverse group of
This group includes a variety of This include complementary approaches
procedures or techniques administered by
products, such as herbs (also known as that may not neatly fit into either of
a trained practitioner. It includes
botanicals), vitamins and minerals, these groups and include practices
interventions : yoga, chiropractic and
and probiotics. They are widely of traditional healers, Ayurvedic
osteopathic manipulation, meditation,
marketed, readily available to medicine, traditional Chinese medicine,
acupuncture, relaxation techniques,
consumers, and often sold as dietary homeopathy, naturopathy, and
movement therapies, reflexology, and
supplements. functional medicine.
massage therapy.
National Center for Complementary and Integrative Health-NCCIH. 16
https://nccih.nih.gov/health/integrative-health. Published 2016.Complementary Health Approaches (CHA)
A Body of knowledge Evidence-Based Research Standards of Practice
Extensive body of knowledge led by Over two decades of evidence-based research. The Defined standards of practice, Clinical
National Center for Complementary and amount of research varies widely depending on the Practice Guidelines, and required
Integrative Health (NCCIH) practice (many studies on acupuncture, yoga, spinal Continuing Education
manipulation, and massage)
17Body-Mind Practices
Geriatric Population
Body-Mind Practices are techniques that adopt a
holistic approach that require thoughtful
consideration of the whole person. It acknowledge
the role of body, mind, and spirit in the geriatrics
care and well-being.
Body-Mind Practices that seek to strengthen
body-mind-spirit interactions using various
modalities.
18Body, Mind, & Spirit
THE BODY
The body is our physical structure; the vessel holding our brains, body
parts, muscle and fat. It consists of roughly 50 trillion cells, which
collectively organize our tissues, nerves, bones, & organs
THE MIND
The mind governs our mental and emotional aspects. It houses our
consciousness – made up of our Superconscious, Subconscious and
Conscious psyches. Our mind allows us to be aware of the world, and
powers our ability to think and feel.
THE SPIRIT
Our Spirit is invisible to us, and to others. Its eternal nature doesn’t
need a physical body or need to conform to space and time. An
immortal being, our Spirit/Soul can connect us to something much
bigger than ourselves and our five senses.
19Integration of Body, Mind, & Spirit
While Body, Mind and Spirit may seem to be separate, they are each intimately connected
and reliant upon one another. When integrated, they complete our unique human essence.
The interconnectedness of our Body, Mind and Spirit means that what we experience in one
part, we experience in all three.
When we experience disease in our Body, our Mind and Spirit are also affected. When
negative thoughts or fears occur in our Mind, our Body and Spirit also feel stressed or ‘off-
balance’. When our connection to Spirit is frail, we may turn to our Mind and Body to find the
answers as to why. The truth is that each of our three aspects are always listening, and always
aware. Our Body, Mind and Spirit are always present in each and every single thing that we
think or do, consume or say.
20Why Body-Mind Practices for Geriatric Population?
Hospitalization in old age can be a difficult experience, which requires a
holistic approach with appropriate support from the health care team.
Moreover, an elderly person in rehabilitation often suffers from very
complex diagnoses and comorbidities.
Without a holistic approach, there’s always something missing. We’re also
more likely to focus on the symptoms, rather than the root cause. Because
our three parts are interconnected, every problem we address when
working with elderly patients must involve all three.
The overall goal of the mind-body-spirit practices is to impact resilience
and to improve the quality of life among older adults by helping them
understand the aging process and adapt to the changes associated with
aging. Rehabilitation aims to maximize functional independence and
autonomy for the elderly. To achieve this, it is important to consider their
personal preferences, values, and expectations for quality of life and
well-being.
21Intentional Touch
Definition Evidence-Based
Intentional Touch (InTouch) or Physical Touch Therapeutic Touch is a holistic scientifically
Therapy refers to a soft physical touch with based practice. Experimental research has
the aim to ease complaints and enhance well- been conducted at major hospital and long-
being. term care centers by researchers in nursing
and related fields.
22Most Common Therapeutic Touch for Geriatric Population
Massage Therapy
Massage
Reflexology
Reflexology
Aromatherapy
Aromatherapy
23Geriatric Massage Therapy
Definition Similarities
Geriatric massage is a form of massage In some ways, geriatric massage resembles a
designed to meet the specific needs of the lighter form of Swedish massage, but there
elderly population. are some important differences.
Differences Features
This type of massage employs It can include passive stretching
specialized techniques designed for and a light oil or lotion to permit
aging skin and muscles, more muscles to be worked on without
specifically, gentle and light application causing excessive friction to the
of massage techniques. skin.
2425
Flexibility in Positioning
Requires flexibility in positioning aging patients. Some patients may
not be able to get on or off a massage table easily, and options might
need to be explored.
Body placement
Characteristics
Body placement is important. For example, someone with of Geriatric
respiratory problems should not be placed in a prone position, and
the back should be worked with the person in a sitting position or
lying on his/her side.
Massage
Fluffing Techniques
Long, stripping strokes should be avoided, because skin thins with
age. A technique called fluffing, which combines rhythmic stroking
and gently lifting and squeezing the skin, may be more appropriate.Benefits of Geriatric Massage
Enhance Wellbeing Pain Management
01 Massage therapy enhances well-being and
02 The elderly are more prone to suffer from chronic
improve the health of elderly people. There is a pain interfering with their ability to function
relationship between massage therapy and normally. Massage therapy is useful in managing
health outcomes in the elderly. pain in older adults.
Reduce Depression and Anxiety Late-life Cognitive Disorders
03 Massage is shown to provide an immediate
source of relaxation and mental calm, which are
04 Age-related neurodegenerative diseases, such as
Alzheimer's disease (AD), which leads to cognitive
beneficial to depression, anxiety and stress- dysfunction, can dramatically challenge an older
related disorders, including insomnia in older adult's independence and lifestyle. Massage
adults. therapy is used in the management of cognitive and
behavioral symptoms of dementia.
26Effect of Hand and Foot Massage Therapy on Psychological Factors and EEG Activity
in Elderly People Requiring Long-Term Care: A Randomized Cross-Over Study (2019)
Study Design
This study was a randomized cross-over study. Participants
participants were randomly divided into two groups (A 12 elderly people who attended a day service center in
and B). Japan. Participants were 65 years and older (female, n =
9; male, n = 3; mean age: 81.9 years); had physical or
mental impairment and needed assistance with activities
of daily living.
Study Protocol
Group A received hand massage & group B received foot
massage, both for 15 min each. After 1 week, the body part for Results
massage was changed such that group A received foot massage Participants reported that they felt pleasant, relaxed, and
and group B received hand massage, both for 15 min each. refreshed to a high degree after both hand and foot
Emotions & mood states were assessed after each massage massage, but no significant difference was observed
(Post1 and Post2), and resting-state EEG activity was measured between the massage types.
before (Pre1 and Pre2) and after (Post1 and Post2) each There was significant increase in resting-state alpha activity
massage. in the left insular cortex after hand massage, and in the right
and left posterior cingulate cortex after foot massage
(related to positive emotions).
27
Nakano, H., Kodama, T., Ueda, T., Mori, I., Tani, T., & Murata. S. (2019). Effect of Hand and Foot Massage Therapy on Psychological Factors
and EEG Activity in Elderly People Requiring Long-Term Care: A Randomized Cross-Over Study. Brain Sciences, 9(3), 54-61.Massage, a complementary therapy effectively promoting the health
and well-being of older people in residential care settings: a review of
the literature (2016)
Advantages of massage for
Healthcare organizations
Fourteen (14) peer- older people in long-term
A critical research-based providing long-term care
reviewed studies published healthcare settings can
review on the efficacy and for older people should
date between 2002 – 2012 extend beyond the
health benefits of massage support the integration of
from USA, Hong Kong, promotion of relaxation
for older people in long- massage therapy as part of
Australia, Brazil, United and alleviation of pain, to
term care settings. the daily care due to its
Kingdom and Japan. include emotional status
sustained positive effects.
and psychosocial health.
Literature Review Study Peer-reviews Studies Results Implication for Practice
McFeeters, S., Pront, L., Cuthbertson, L., & King, L. (2016). Massage, a complementary therapy effectively 28
promoting the health and well-being of older people in residential care settings: a review of the literature.
International Journal of Older People Nursing. 11(4):266-283.Sleep Loss in Hospitalized Older Adults
In-Hospital Medical Response
Effects on Patient in Hospital
Ne gati ve He al th C on s e q u e n ce s
Compensatory Responses
Acute sleep loss in the § Hinder patients’
hospital for older adults These complications Another possible
participation in
often are associated with pathway by which
is associated with worse recovery activities
administration of sleep loss can impair
health outcomes, (e.g. physical therapy)
including: additional medications or recovery in
higher dosages of § Diminish patients’
§ Cardiometabolic hospitalized older
existing medications: desire and ability to
patients is due to:
effects such as high be an active
§ Antipsychotics § Fatigue
blood pressure and participant in their
hyperglycemia § Insulin § Excessive daytime care (i.e. understand
§ Increased risk of § Antihypertensives sleepiness medication changes,
delirium follow-up tests)
Despite the need for rest and recovery during acute illness, hospitalization is a period of acute sleep deprivation for older adults owing to
environmental, medical, and patient factors.
Stewart, N. H. & Arora, V. M. (2018). Sleep in Hospitalized Older Adults. Sleep Medicine Clinics. 13(1): 127–135. 29The Effect of Aromatherapy on Sleep Quality of Elderly People
Residing in a Nursing Home (2018)
Study design Participants Data collection tools
The study population consisted The “Pittsburgh Sleep
This quasi-experimental of 30 elderly Quality Index (PSQI)” was
research was conducted
individuals residing in a nursing used to measure the
with pretest and posttest
home. Age group of 60 to 83 quality of sleep. PSQI score
applied to same group.
years with a mean age of X = greater than 5 indicates poor
68.3 sleep quality.
Design Sample Data
Results Protocol
§ There was a statistically significant
difference between mean PSQI Intervention
scores before and after the
0.1 cc lavender oil drops
application of lavender oil
were dripped on
(significant improvement of sleep
quality). the pillows of the nursing
home residents every night
§ Aromatherapy by lavender oil has a
for a week.
positive effect on sleep quality of
nursing home residents.
30
Faydali, S. & Cetinkaya, F. (2018). The Effect of Aromatherapy on Sleep Quality of
Elderly People Residing in a Nursing Home. Holistic Nursing Practice, (1):8–16.Effects of Inhalation Aromatherapy on Symptoms of Sleep
Disturbance in the Elderly with Dementia(2017)
A total of 19 elderly individuals with dementia who were ≥65 years old
Participants and who were diagnosed with sleep disturbance from three nursing
facilities in Japan.
Normal sleep was observed for a 20-day control period, inhalation
aromatherapy was then applied for a 20-day intervention period, and the
Intervention control and intervention periods were compared. Three types of
essential oil blend were used for aromatherapy: lavender, sweet orange
oil, and Japanese cypress.
Sleep disturbance symptoms were measured as follows: 1) Difficulty
initiating sleep: sleep latency (SL); 2) Difficulty maintaining sleep: total
Measurement Tools sleep time (TST); 3) Duration of longest sustained sleep period (DLSSP),
and wake time after sleep onset (WTASO); 4) Daytime disorder: daytime
sleep was measured using the Neuropsychiatric Inventory (NPI)
The results suggest that administration of inhalation aromatherapy
Results improved sleep disturbance symptoms in the elderly with dementia.
Improvement seen in sleep time, DLSSP, and number of times of early
morning awakening.
31
Takeda, A., Watanuki, E. & Koyama, S. (2017). Effects of Inhalation Aromatherapy on Symptoms of Sleep
Disturbance in the Elderly with Dementia. Evidence-Based Complementary and Alternative Medicine, (4): 1-7.Effectiveness of Aromatherapy Massage and Inhalation on Symptoms of
Depression in Chinese Community-Dwelling Older Adults (2018)
Study Design Participants
Prospective, randomized, controlled, 8-week trial 60 participants were randomly assigned to the aromatherapy
with a 10-week follow-up. massage, aromatherapy inhalation, or
control group (each n = 20). Age > 60 with Geriatric
Depression Scale Short Form (GDS-SF) score >5.
Outcome Measures Measurement of 5-HT
The Chinese version of the Geriatric Fasting venous blood samples were collected from all
participants at baseline and after the 8-week
Depression Scale Short Form (GDS-SF) and
intervention to explore the effect of aromatherapy
the Patient Health Questionnaire-9 (PHQ-
massage or inhalation intervention on of 5-
9)
hydroxytryptamine (5-HT) concentration. Low
concentrations of 5-HT are significantly associated
with depression.
Protocol
Participate were assigned randomly to one of the Results
experimental groups or the control group.
The study showed that the symptoms of depression
Participants in the two experimental groups then
in older adults who received aromatherapy
received a 30-min aromatherapy
massage or inhalation were
massage or aromatherapy inhalation twice per
reduced more than those in control individuals.
week for 8 weeks (total of 16 interventions).
32
Xiong, M., Li, Y., Tang, P., Zhang, Y., Cao, M., Ni, J., & Xing, M. (2018). Effectiveness of Aromatherapy Massage and Inhalation on Symptoms of Depression in
Chinese Community-Dwelling Older Adults. The Journal of Alternative and Complementary Medicine, 24(7): 717–724.Effects of aromatherapy massage on agitation and related caregiver burden
in patients with moderate to severe dementia: A pilot study (2017)
Study sample Instruments Interventions Results
The study sample consisted of 56 The Neuropsychiatric Inventory The patients in the intervention group Both neuropsychiatric symptoms and
participants consisting of 28 elderly (NPI), the Zarit Burden Interview received hand massage aromatherapy agitation were significantly lower at 4
patients (mean age 78) with moderate to (ZBI), and the Massage and that used a mixture of lemongrass weeks of therapy for the intervention
severe dementia, and their primary Inhalation Monitoring Form. The essential oil (which has a calming and group. Caregiver burden according to
caregivers. Patients were from geriatrics ZBI measure stress in caregivers tranquilizing effect) and eucalyptus oil the ZBI was significantly lower in the
and neurology polyclinics of two of an elderly person (eucalyptus expands the airways, ensuring intervention group than in the control
hospitals in Turkey. Participants were a greater intake of the lemongrass aroma). group at 4weeks.
assigned to intervention and control Massage was done 3 days per week for 4
groups (each n = 14). weeks. 33
Kaymaz, T. T., & Ozdemir, L. (2017). Effects of aromatherapy on agitation and related caregiver burden in
patients with moderate to severe dementia: A pilot study. Geriatric Nursing, 38(3): 231-237Management of behavioral and psychological symptoms of
dementia by an aroma-massage with acupressure treatment protocol: A
randomized clinical trial (2017)
Design Participants
This randomized clinical trial utilized a three-arm
60 older adults from three long-term geriatric
parallel group design. Cognitive training was used
care facilities in China were randomly
as a conventional intervention to manage
assigned to the 3 groups (n = 20 each):
behavioral and psychological symptoms of
dementia, whereas exercise was considered Group 1: aroma-massage with acupressure +
“treatment as usual” in this study; both were used exercise,
as comparisons with the experimental protocol. Design Group 2: cognitive training + exercise
Group 3: aroma-massage with acupressure +
cognitive training
Sample Results
Intervention Results
§ 20 minutes of aromatherapy massage with
lavender essential oil combined with Protocol Combining aroma-massage with
acupressure was as effective as cognitive
acupressure on selected acu-points
training in reducing behavioral and
§ 20 min of cognitive training
psychological symptoms of dementia
§ 20 min of passive stretching exercises (BPSD).
Fung, J. K. & Tsang, H. W. (2017). Management of behavioral and psychological symptoms of dementia by an aroma- 34
massage with acupressure treatment protocol: A randomized clinical trial. Journal of Clinical Nursing, 27(9):1812–1825.Aromatherapy Hand Massage for Older Adults with
Chronic Pain Living in Long-Term Care (2014)
Study Design Participants
The study was a prospective, randomized three group
The sample size was 118 elderly with a mean age of 83 years old
control trial that compared the effect of aromatherapy and on daily pain medication; recruited from seven long-term care
hand massage, without aromatherapy, and nurse facilities in USA. Participants were randomly assigned into 3
presence on chronic pain. groups of 39 to 40 participants.
Intervention Measures
The intervention was hand massage with lavender The Geriatric Multidimensional Pain Illness Inventory (GMPI)
essential oil. The comparison intervention was hand measures three dimensions of chronic pain: (a) pain intensity and
massage without lavender aromatherapy. 6-week suffering, b) life interference, and (c) emotional distress in long-
protocol term care residents.
Results
Hand massage with or without aromatherapy significantly decreased chronic pain intensity compared
to nurse presence visits. Hand massage is a safe, simple, and effective intervention. Caregivers using it
could improve chronic pain management in this population.
35
Cino, K. (2014). Aromatherapy Hand Massage for Older Adults with Chronic Pain Living in Long-
Term Care. Journal of Holistic Nursing, 32(4): 304 – 313.Massage and Pain Management in the Elderly
Knee Osteoarthritis
Knee osteoarthritis is reputedly the most common joint disease
in the elderly and the largest cause of functional disability with
some 80% of people over 65 years of age showing radiological
symptoms of osteoarthritis.
Massage Therapy
Research literature on the effects of massage therapy on knee
osteoarthritis pain has consistently showed that massage is
effective in reducing pain and increasing range of motion,
specifically when moderate pressure massage was used on both the
quadriceps and hamstrings.
36Knee arthritis pain is reduced and range of motion is increased
following moderate pressure massage therapy (2015)
Massage Protocol
Participants Results
The massage group showed
The participants in the massage an immediate post-massage
group were massaged by a licensed increase in ROM and a
The sample size was 40
massage therapist once per week for decrease in ROM-associated
elderly females with Knee
a 4-week period. The 15-min pain. On the last versus the
Osteoarthritis and high level
massages (repeated twice during the first day of the study, the
of pain randomly assigned to
therapist sessions to total 30 min) massage group showed
the massage or waitlist
consisted of moderate pressure greater increases in ROM and
control groups (N = 23 in the
stroking (moving the skin) focused on decreases in ROM-related
massage group and N = 17 in
the quadriceps, the hamstrings and pain as well as less self-
the control group)
the tendons and ligaments reported pain and sleep
surrounding the patella. ROM and disturbances than the control
ROM-related pain were assessed group.
before and after the last sessions.
2015
37
Field, T., Gonzalez, G., Diego, M., & Funk, C.G. (2015). Knee pain is reduced and
range of motion is increased following massage therapy, Complementary Therapies
in Clinical Practice. 21(4), 233-237.Massage Therapy for Geriatric Population
Final Thoughts
Evidence-Based Practice Community Intervention
Within the integrative health care As an intervention approach, massage
research literature, scholars increasingly therapy has significant potential for older
report massage therapy to be one of the adults with depression and may have
most popular CHA and effective for the important implications for mental health
treatment and management of chronic promotion in the community.
health conditions in elderly people.
Integrative Approach Public Healthcare
CHA such as Massage Therapy can
There is new development within the
address therapeutic gaps in chronic
CHA literature with some scholars
disease management in hospital
drawing on health promotion theory
settings through provision of integrative
and practice to develop new
approach to complement and fill gaps in
frameworks to conceptualize the
the present treatment effectiveness for
potential role of CHA in public
elderly people experiencing complex,
healthcare Contexts.
chronic conditions.Towards Integrative Approach
for Geriatric Population
Maybe we should stop being skeptical and
We should start educating ourselves
try to find out ways of integrating CHA and
about the best practices in the
seek new information without any kind of
complementary systems of medicine
bias.
To achieve this integration, a new stream of healthcare To achieve that, we can offer continuing professional
practitioners will likely be needed, who can study the best of both devolvement in CHA for healthcare practitioners. In
worlds and can apply a combination of treatment principles for a addition, conventional medical schools can incorporate CHA
holistic and integrated care. curriculum together with their medicine academic to have
systems in place so that a combined medical curriculum can
be evolved.REFRENCES • Cino, K. (2014). Aromatherapy Hand Massage for Older Adults with Chronic Pain Living in Long-Term Care. Journal of Holistic Nursing, 32(4): 304 – 313. • Donatelli, N. S., Somes, J., & Miller, M. (2018). Essential Oils: Options for the Older Adult. Journal of Emergency Nursing, 44(5): 520-522. • Erdo˘gan, Z. & Atik, D. (2017). Complementary Health Approaches Used in the Intensive Care Unit. Holistic Nursing Practice, 31(5), 325-342. • Faydali, S. & Cetinkaya, F. (2018). The Effect of Aromatherapy on Sleep Quality of Elderly People Residing in a Nursing Home. Holistic Nursing Practice, (1):8–16. • Fung, J. K. & Tsang, H. W. (2017). Management of behavioral and psychological symptoms of dementia by an aroma- massage with acupressure treatment protocol: A randomized clinical trial. Journal of Clinical Nursing, 27(9):1812–1825. • Kaymaz, T. T., & Ozdemir, L. (2017). Effects of aromatherapy on agitation and related caregiver burden in patients with moderate to severe dementia: A pilot study. Geriatric Nursing, 38(3): 231-237. • Nakano, H., Kodama, T., Ueda, T., Mori, I., Tani, T., & Murata. S. (2019). Effect of Hand and Foot Massage Therapy on Psychological Factors and EEG Activity in Elderly People Requiring Long-Term Care: A Randomized Cross-Over Study. Brain Sciences, 9(3), 54-61.
REFRENCES • National Center for Complementary and Integrative Health-NCCIH. https://nccih.nih.gov/health/integrative- health. Published 2016. • Peterson-Burch, F., Reuter-Rice, K., & Barr, T. L. (2017). Rethinking Recovery: Incorporating Holistic Nursing Perspectives in Post-Stroke Care. Holistic Nursing Practice, 31(1): 3–6. • Rodrigues, M. G. & S´echaud, L. (2019). Caring Models in Geriatric Rehabilitation: An Integrative Review. Holistic Nursing Practice, 3(4):237–253. • Singer, J. & Adams, J. (2014). Integrating complementary and alternative medicine into mainstream healthcare services: The perspectives of health service managers. BMC Complementary and Alternative Medicine, 14, 167- 177. • Shin, J. Y., Pohlig, R. T., & Habermann, B. (2017). Beliefs About Use of Complementary Health Approaches for Parkinson’s Disease. Holistic Nursing Practice, 31(5): 290–294. • Takeda, A., Watanuki, E. & Koyama, S. (2017). Effects of Inhalation Aromatherapy on Symptoms of Sleep Disturbance in the Elderly with Dementia. Evidence-Based Complementary and Alternative Medicine, (4): 1-7. • Xiong, M., Li, Y., Tang, P., Zhang, Y., Cao, M., Ni, J., & Xing, M. (2018). Effectiveness of Aromatherapy Massage and Inhalation on Symptoms of Depression in Chinese Community-Dwelling Older Adults. The Journal of Alternative and Complementary Medicine, 24(7): 717–724.
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