From animals to acupuncture, hospices are supplementing traditional “heads, meds, and beds” care with complementary therapies.
Programs such as pet/animal therapy, acupuncture, massage, aromatherapy, meditation, art, music, and other complementary therapies are drawing increased patient and family attention, leading more hospices to offer these types of services.
In one study, 29% of hospices (169 out of 591) reported employing an art, massage, or music therapist. Of those hospices, 74% employed a massage therapist, 53% a music therapist, and 22% an art therapist, and 42% included these therapists in interdisciplinary staff meetings.
“Many hospices offer these therapies to help manage physical symptoms, such as pain or nausea,” As Angela Rhoads, vice president of hospice operations at Interim HealthCare Inc. told Hospice News. “There are additional benefits that have been studied, such as complementary therapies’ impact on decreasing anxiety and depression. Sometimes these therapies are used with dementia patients to provide connection with family.”
In a 2017 study of 1,321 hospice patients in the United Kingdom, patients reported significant improvement in symptoms such as pain, shortness of breath, anxiety and nausea after receiving complementary therapies. Patients did not report improvement in relation to their constipation, fatigue, insomnia or appetites.
Rosemont, Ill.-based hospice provider Seasons Healthcare Management offers a range of complementary modalities, including art therapy and music therapy as well as massage, acupuncture, pet therapy and reiki at some locations.
Seasons is currently the largest employer of music therapists in the health care space both nationally and internationally, Yelena Zatulovsky, vice president of patient experience for Seasons, told Hospice News.
Seasons employs a music therapist at each one of hospice’s locations and art therapists at select locations depending on the needs of the patient population. The therapists are board-certified paid employees who are a part of the core interdisciplinary care team.
“A lot of [the therapists’] role is variable, based on the needs of the patient and family, so it could be used for nonpharmacologic symptom support, or it could be very much focused on the counseling element or in some cases funeral or memorial planning. It’s very individualized based on each family’s needs,” Zatulovsky said. “Our art therapists do a tremendous amount of work in terms of education. So you think of art in terms of a discipline and a medium for education about end-of-life care, symptom management, as well as non-verbal communication for somebody to have an emotional expression.”
In addition to benefiting patients, offering a portfolio of these services helps some hospices build market share by distinguishing them from their competitors. Diversification is a key goal, ensuring that patients and families have a range of options that they can receive in accordance with their goals and preferences.
“It’s providing the experience of life for hospice patients and families that provides the competitive advantage,” Rhoads said. “One of the key investments is training for staff and the implementation of the program offering. While offering services may be a differentiator in the marketplace, the competitive advantage comes through the consistent execution of matching the patient and therapy and providing the service in such a way that provides an enriched patient and family experience.”
Interim applies the same process used for hiring any licensed staff to validate licensure/credentialing and continued monitoring for renewals of those licenses, according to Rhoads. Background checks are also an important consideration, even when the therapist is a volunteer.
The programs themselves tend to have low overhead, as many of the providers are volunteers or contract employees (though that is not always the case). Potential costs associated with these programs include advertising, investment in supplies and specific therapist time, as well as training for clinicians and staff, according to David Klaeser, owner of Interim HealthCare and Hospice of Sacramento, Calif.
The cost of time and effort should also be weighed, as well as data collection to evaluate patient, family, and caregiver needs and level of satisfaction, Klaeser told Hospice News. For example, consider returns on promotional program efforts or collect feedback with patient and family evaluation forms or surveys.
“We believe that people deserve to be living while they are dying and opposed to preparing for death. The gift of serving a hospice patient through end-of-life care and the family through a bereavement process is that — unlike in other many health care areas, we actually get to do something relatively unique — we are being welcomed into the last chapter of somebody’s story,” Zatulovsky said. “A lot of what we do involves the collection of stories. We get to hear a lot of these stories of patients and families that they share with us and carry them forward. The right thing to do is to provide a modality to help them express whatever they need or wish to, whether it is verbal or nonverbal or both.”
Written by Holly Vossel