Preparation for Practice Placements: BSc in Complementary Therapies

Palliative Care

Improving supportive and palliative care for adults with cancer Cancer service guidance, CSGSP - Issued: March 2004 The NICE clinical guidance on supportive and palliative care (CSG) advises those who develop and deliver cancer services for adults with cancer about what is needed to make sure that patients, and their families and carers, are well informed, cared for and supported.

Information should be available free of charge Improving supportive and palliative care for adults with cancer Cancer service guidance, CSGSP - Issued: March 2004 Key recommendations: People affected by cancer should be involved in developing cancer services There should be good communication, and people affected by cancer should be involved in decision making Information should be available free of charge People affected by cancer should be offered a range of physical, emotional, spiritual and social support

Improving supportive and palliative care for adults with cancer – cont. There should be services to help people living with the after-effects of cancer manage these for themselves People with advanced cancer should have access to a range of services to improve their quality of life There should be support for people dying from cancer The needs of family and other carers of people with cancer should be met There should be a trained workforce to provide services In February 2009 NICE published guidance on advanced breast cancer that complements the cancer service guidance.(NICE 2011)

Palliative and Hospice Care Compassionate care for people facing serious life-threatening illness Team-orientated approach to expert medical care, pain management, emotional and spiritual support specifically tailored to a patient’s needs and wishes Support is also provided for the patient’s family

CHRONIC CONDITIONS Tense muscles Stress/Anxiety SYMPTOM CYCLE Difficult emotions Depression Fatigue Pain Shortness of breath

Considerations for treating patients with cancer Treat as a person NOT an illness Adapting pressure/no pressure Bony metastases Awareness of lymphoedema/ascites Tumour sites, stomas, surgical sites, wounds Catheters & picc lines, syringe drivers Low platelet count

“Touching hands are not like pharmaceuticals or scalpels. They are like flashlights in a darkened room. The medicine they administer is self-awareness and for many of our painful conditions, this is the aid most urgently needed” (Juhan 2003)

Considerations cont. Chemotherapy (CT) Radiotherapy (RT) Neutropenia (insufficient neutrophils from bone marrow – side effect of CT) Impaired immune systems Skin sensitivities, fragility Infection control Deep vein thrombosis (DVT) Cord compression

How can aromatherapy help? Improve well-being and quality of life Encourage relaxation Provide emotional support Reduce psychological distress Improve sleep patterns Ease side effects of CT and RT & symptoms such as: Stress/tension, pain, breathlessness, nausea, fatigue, constipation and diarrhoea HANDS UNDER

Complementary Therapies and Children with special needs

Special Needs Environment Autism Epilepsy Digestion Impaired mobility Impaired verbal communication Inflamed joints Oedema Damaged skin Medication Selecting oils /Dilution

Epilepsy and Aromatherapy Affects a large proportion of this client group Some oils may trigger seizures Calming oils help to reduce onset of anxiety-induced seizures Unlikely to affect treatment if usual considerations are taken into account

Mental Health

Mental Health What is Mental Health? Treat as a person NOT an illness Be aware that client may be on (numerous) medications May be very talkative May be reluctant to divulge information Possibly reluctant to have full body massage Possibly restless

Mental Health cont Host organisation will have systems in place to assure therapist safety. Therapist needs to observe these Work to support client’s needs: Relaxation Muscle tension Self esteem

Some useful resources Juhan D (2003)Job’s Body. A Handbook for Bodywork. Station Hill Press. Macdonald G (2007) Medicine Hands: Massage Therapy for People with Cancer. 2nd Edition. Findhorn. Findhorn Press Metzger D (1997) Tree Essays & Pieces 3rd Edition. Berkley. North Atlantic Books. National Council Palliative Care. www.ncpc.co.uk Rothschild B & Rand M (2006)Help for the Helper: Self-care Strategies for Managing Burnout and Stress. England. Norton

References Juhan D (2003)Job’s Body. A Handbook for Bodywork. Station Hill Press. NICE. http://www.nice.org.uk/csgsp (Accessed 03/03/14)