Manage Pain & Symptoms with Complimentary Therapies in Hospice

Introduction

There are many ways to help relieve distressing symptoms. Medications, properly chosen by your physician, are the mainstay of pain and symptom management. But, there are also ways to relieve distressing symptoms that go beyond taking medication.

Ask your care team what non-medical treatments might be helpful to you. Your hospice care team can coach you – as a patient or caregiver – in learning more about these techniques. They can also let you know what types of complementary therapies can be provided by specially trained hospice staff and volunteers.

Do not stop taking your medications. These treatments are meant to be used with – not instead of – medication. These treatments can help your medications work more effectively and may also relieve other symptoms such as anxiety. Before trying any new treatment, always check with your care team to be sure it is safe and recommended.

Using Heat and Cold

Applying heat or cold to painful areas works because the nerves at the surface of the skin send their signal to the brain more quickly than the nerves that send the painful signal. In effect, this “tricks” the brain because it can only process one signal at a time.
This technique works best on pain that aches, throbs and is muscular in nature. If you can point to the pain, and say “it hurts right here” then consider using hot or cold compresses.

Remember:

• Do not use heat or cold on an area with open or broken skin.
• Do not use hot or cold on areas with poor circulation or decreased sensation. For instance, if you have poor circulation to your feet, be careful not to soak them in very hot or cold water. Warm water is safest.

Where to Use Heat or Cold:

• At the site of the pain
• On the opposite side of the body as the pain (if the right shoulder aches, try applying to the left shoulder)
• Between the pain and the brain (if your foot is aching, apply to calf or thigh)

Heat

• Warmth increases blood flow and can help reduce joint stiffness.
• Protect skin by placing towel between heat and skin.
• Do not use on skin that has received radiation treatments.
• Apply for 20-30 minutes.
• Try alternating with cold application (20 minutes each) for skeletal muscle spasm.
• Avoid use with oil or menthol containing products which may irritate skin.

Equipment

• Microwavable hot packs (available at most drug and health stores)
• Warm moist towels (use hot tap water or heat moist towel briefly in microwave)
• Hot water bottles
• Electrical heating pads – moist heating pads best
• Warm baths/showers or whirlpool treatments

Cold/Ice

• Cold decreases blood flow to skin and reduces inflammation and decreases local sensation.
• Avoid cold if skin pales and then turns red after application; this indicates poor circulation to the area.
• Avoid using on abdomen and stomach area.
• Protect skin by wrapping cold source in towel.
• Apply for 20-30 minutes.

Equipment

• Gel packs – can be purchased at drug stores
• Cold or frozen damp towel
• Ice packs (sealed plastic bag with 1/3 alcohol and 2/3 water frozen until slushy
• Bag of frozen peas/corn (separate for flexibility)

Simple Gentle Massage

• A simple back rub can be comforting and relaxing. It assists with sleep and is a simple way to show care. Hand massage is very simple and can be very soothing.
• Don’t rub an area that is painful.
• Use lotion or oil if desired.
• Use long stroking motion, up and down back, and large circular motions at upper and lower back.
• Massaging hands and feet can be less intrusive to the person and is also comforting and very relaxing.
• Avoid deep massage of the lower legs.

Touch Therapy

The following therapies require special training and practice to administer. They are relaxing and may help to relieve such things as pain, anxiety, nausea and vomiting, shortness of breath and difficulty sleeping.

• Massage Therapy: The use of “hands on” techniques delivered by a Licensed Massage Therapist can promote relaxation, reduce anxiety/agitation, and create a sense of peacefulness.
• Therapeutic Touch: Don’t be confused by the name. In fact, therapeutic touch does not involve physically touching the body at all. It is a non-contact energy touch which promotes deep relaxation, reduces pain and is an excellent therapy for people who are feeling restless or agitated. Therapeutic touch can be easily taught to friends and family.
• Other Energy Techniques: Other techniques, including Healing Touch, Yoga and Reiki may be beneficial.

Meditation

Meditation and progressive relaxation or guided imagery techniques are also effective techniques for promoting peace, relaxation and relief of suffering. Meditation and progressive relaxation CDs or audio tapes can be purchased online or at your local bookstore.

Music Therapy

The use of music in providing comfort and relief is familiar to everyone. Lowering the lights and playing comforting music can ease a difficult day. Try playing old favorites. What is the response? For restlessness, research has shown that instrumentals can be very soothing.

Humor

Laughter has proven to be good medicine. Plato and Socrates used laughter as a remedy for colds and depression; Freud appreciated the benefits of laughter in releasing tension and reducing anxiety. Studies have documented that those exposed to humor showed an increase in activated T cells. Laughter also releases endorphins, the natural hormone that helps relieve pain. There are many books, videos, CDs and cartoons that can lift the spirits and ease suffering.

Aromatherapy

The use of essential oils to promote the health of the body, mind and spirit is an ancient practice. Essential oils affect chemicals in the brain in ways similar to the ways medications work. They can help to relax the body, relieve nausea, reduce unpleasant odors and promote restful sleep. Aromatherapy oils can be warmed for release in room air, used in lotions and bath water or used in a spritzer. Your hospice may have trained staff and volunteers who can bring this pleasant experience to your home.

Spiritual Care

Finding comfort in prayer, sacred readings or familiar rituals can be a healing and hopeful way to find peace and strength. Inspirational reading, poetry, and music may soothe and comfort. Consider requesting a visit from a hospice chaplain. Their non- judgmental, compassionate care can be reassuring and calming.

If you are interested in finding out more about any of these complimentary therapies, please ask your hospice team.

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