What Play Therapy Can Reveal About Children’s Grief

Death is never easy to understand or process at any age. This fact is especially true for children. Nevertheless, sometimes a child’s mind operates on a different level. Deep insight can be revealed about children’s grief when play therapy is introduced into the equation.

What is Play Therapy and Why Does it Work?

Dating back to the time of Plato, play therapy has been used as a communication tool in order for people to work through emotions and traumatic experiences. But not all play can be viewed as play therapy. According to the Association for Play Therapy, a counselor or therapist needs to guide children to help them address and resolve their issues and problems for play to be therapeutic.

Play therapy works because it is founded on the principle that children learn the most when they communicate with others. Guided by trained therapists in a safe environment, play therapy allows children to express deep thoughts and feelings in a manner that feels comfortable.

Play therapy helps children:

Learn to experience and express emotion
Develop empathy and respect for thoughts and feelings of others
Learn new social skills
Grow more responsible for behaviors
Develop respect and acceptance of self and others

Perfect Example of Play Therapy Revelation

What could compulsive brushing of teeth reveal about a child? Could there be a connection to death and grief? For an 8-year-old boy, there was a strong connection that became evident when play therapy was introduced.

“Tyler” brushed his teeth compulsively, which baffled his school teachers and the counselors he saw at the Good Shepherd Hospice Bethany Center. There was nothing wrong with him physically, but Tyler did so much damage to his teeth and gums that his dentist made him a special gentle toothbrush to decrease the destruction.

Although Tyler participated in counseling sessions and attended Camp Brave Heart, it took some time for him to come out of his shell. “We knew that the tooth brushing was somehow related to his father’s death, but we didn’t know how,” said Allyson Moskowitz, Director of Social Services, Bereavement and Volunteers at Chapters Health System.

Tyler discovered special support at the Bethany Center’s individual and group counseling. Especially groundbreaking was the opportunity for Tyler to express himself through play therapy. One day during play therapy, Tyler felt safe enough to tell everyone the last thing his father said when he left for his night job and kissed him goodbye: “Be a good boy, brush your teeth and I’ll see you in the morning.”

Tyler did not brush his teeth that night and his father didn’t come home. “Children are so literal. When something bad happens, they search and search for meaning,” commented Moskowitz.

According to Dr. Jean Piaget, Swiss clinical psychologist pioneer, during the first 10 years of life, children are not capable of understanding complex issues, feelings and motives because they lack the ability to think abstractly. Therefore, in his mind, Tyler made the connection between his father not coming home and not brushing his teeth. And so the young boy brushed his teeth compulsively to prevent anyone else he loved from dying and never coming home again.

“For children, their work is play,” added Moskowitz. “It’s how children express themselves and learn. When kids are grieving, many questions surface. Play therapy gives them lots of ways to work through their grief.”

Play Therapy Activities

Just like children come in all shapes and sizes, the same can be said about play therapy activities. Here are some sample activities:

Arts and Crafts

Memory Lantern: Made from Mason jars, these lanterns are decorated with memories and pictures.

Safe Place Pillow Case: A plain white pillow case is decorated with pictures and words for children to use when they sleep.

Shattered Pot: As the starting point, a whole clay pot is shattered carefully. Each piece is labeled with an emotion, decorated and glued back together.

Games

M&M Feelings Game: Different colored M&M candies are used to express feelings during the course of the game.

Word Game: Tiled letters are used to spell out feelings.

Feelings Jenga: The game is played normally, but when a piece is pulled out from the tower, it has an emotion listed on it. The child pulling out the block shares a story about a time when he or she experienced that emotion.

At Chapters Health System, every day is devoted to educating our patients and keeping them in the place they call home. We are dedicated to ensuring that patients, young and old alike, and their families are able to make educated decisions about important healthcare matters. For more information, please call our helpful Chapters Health team at 1.866.204.8611 or send an email to info@chaptershealth.org.

Note: The name of the child in this post was changed to protect the family’s privacy.

About Phoebe Ochman

Phoebe Ochman, Director of Corporate Communications for Chapters Health System, manages all content and communications for the not-for-profit organization.

10 Book Titles to Talk About Death with Children

There are many books that explain death and dying in terms that are age appropriate for kids. The following books are just a few that can be useful resources when discussing death and dying with children, primarily for those under the age of 10:

The Invisible String (child 3+)
The Fall of Freddie the Leaf: A Story of Life for All Ages (child 4+)
Always and Forever (child 4+)
A Terrible Thing Happened (child 4+)
Ghost Wings (child 5+)
Lifetimes: The Beautiful Way to Explain Death to Children (child 5+)
The Saddest Time (children 6-9)
Badger’s Parting Gifts (children 4-8)
A Taste of Blackberries (children 8-12)
Bridge to Terabithia (children 8-12)

Discussing Hospice with a Loved One

A time historically reserved for barbecues, pool parties and longed-for vacations, summer is now officially in full swing. Unfortunately, the fun is oftentimes on hold for families who have a loved one facing a life-limiting illness. Yet, festivities don’t need to be paused. Why not? If the affected loved one was open to hospice, the family can still make the most of life. But where does one even begin discussing hospice with a loved one?

How to Start Discussing Hospice

Most of us know someone—neighbor, co-worker, friend or in-law—who relied on hospice to help care for a loved one. With the presence of hospice staff to better meet the needs of the patient, the benefits are priceless. But the crucial conversation that needs to take place long before hospice arrives is why many patients who could have comfort and help simply do not. It’s a talk that many are not ready emotionally to have with a dying parent, spouse, sibling or other family member.

Discussing Hospice Tips

Start the conversation early. Open and honest communication is the best way to start. As the proverb goes, “forewarned is forearmed,” and the sooner you know all vital information, such as life expectancy and available options, the better.

Many times when loved ones hear the devastating news about their disease and life expectancy, they are unable to fully grasp and understand the information. This fact was validated in a study published in the British Journal of Cancer. Then a group at Johns Hopkins University School of Medicine showed that there are patients who might firmly believe their disease is curable even though their physician said otherwise. There are many instances when a doctor says one thing but the patient hears another. You need to be aware and know the full story.

Nevertheless, once you have a full understanding and knowledge base, you can introduce the topic of hospice and gauge your loved one’s thoughts on the subject. Maybe they are not medically or emotionally ready for hospice now, but at least you would understand and recognize what their thoughts and feelings on the subject are when the time comes.

Choose the right location for the discussion. Pick a location that is comfortable. It can be at home sitting in comfy chairs, a spacious sofa or at the kitchen table. Or maybe your family member enjoys the outdoors, and you can opt for a park setting. The choice should also be quiet and free from disturbances. Minimize distractions by turning off cell phones, and avoiding the television and radio.

Be educated about the benefits of hospice. Many people have misinformation when it comes to hospice. (Learn the truth about hospice here.) Loved ones might fear that their quality of life will be lessened if hospice is called in, and that simply is not true. Hospice can help patients make the most of life.

Share with loved ones that hospice staff will make visits to their home. Additionally, with an interdisciplinary team, everyone works together to coordinate care for their specific disease. The hospice team helps patients ease and manage pain and symptoms. Patients should expect an increase in comfort and thus an improved quality of life.

If you need help, just make a call. Sometimes people are scared to have the conversation and don’t want the situation to get beyond their control. Having someone else talk about hospice with a loved one might be a better solution. At Chapters Health System and its affiliates—Good Shepherd Hospice, HPH Hospice and LifePath Hospice—we have people experienced in discussing hospice with loved ones and their families.

They know:

What to say when the individual is fearful
How to answer any and all questions
How to explain what patients can expect at the various stages of the end-of-life journey

Granted the hospice conversation is not an easy one to have. But once the bridge is crossed, the discussion takes place and hospice is agreed upon, your loved one will experience the benefits of hospice and all it can offer. You will be glad you had the conversation.

About Phoebe Ochman

Phoebe Ochman, Director of Corporate Communications for Chapters Health System, manages all content and communications for the not-for-profit organization.

Two Helpful Quizzes

We created two quizzes that can give you a baseline as to what you know about hospice. Discover your Hospice IQ by clicking on that image below:

Or find out whether, hospice care might be right for you or a loved one by clicking the Hospice Self-Evaluation Tool image below:

Dispelling 10 Top Hospice Myths

It has been more than a year since the Discovery Channel’s Mythbusters last aired, leaving a void in people’s need to know what is true or false. So today, we take up the reins and set the record straight with regard to hospice myths.

Top 10 Hospice Myths Debunked

Myth #1: Hospice is a place.

Hospice is not a place but a philosophy of care. Wherever a patient calls home is where hospice care is provided: residence, assisted living facility, nursing home, inpatient facility (hospice house) or hospital.

Myth #2: Hospice patients cannot live longer than six months.

Once an individual becomes a patient at Good Shepherd Hospice, HPH Hospice or LifePath Hospice, he or she continues to receive services for as long as they are required and appropriate. Hospice services are NOT discontinued unless they are no longer necessary or appropriate, or the patient chooses to stop them. If a patient makes this decision, a revocation form is signed.

Myth #3: Hospice care is only for people with cancer or those who are bedridden or very ill.

Although many patients do have cancer, Good Shepherd Hospice, HPH Hospice and LifePath Hospice serve terminally ill patients of all ages, with all types of progressive and chronic diseases. Many of our patients are able to enjoy life as much as they did before their diagnoses. This fact is especially true if care is accessed early in their illness. Our patients are seen by trained healthcare professionals who can address their medical conditions and support family members. Additionally, hospice care can include complementary therapy such as pet visits.

Myth #4: Hospice care is expensive.

Hospice care is actually less expensive than care provided in a traditional medical setting. Additionally, Medicare, Medicaid and most other insurances cover the cost of hospice care. As a community-based, not-for-profit organization, Chapters Health System and its affiliates never turn away an individual who might need hospice care due to an inability to pay.

Myth #5: Hospice is for patients who do not need a high level of care.

End-of-life care is extremely complex. The interdisciplinary team at each affiliate—Good Shepherd Hospice, HPH Hospice and LifePath Hospice—is composed of specially trained physicians, pharmacists, nurses and therapists who can provide comprehensive medical care. Their efforts are complemented by a team of other trained professionals and volunteers who offer a full range of support services, which help the entire family.

Myth #6: Hospice patients require a “Do Not Resuscitate” status prior to admission.

At Good Shepherd Hospice, HPH Hospice and LifePath Hospice, we acknowledge and respect the end-of-life choices that our patients and families make. Therefore, we do NOT require “Do Not Resuscitate” status for admission.

Myth #7: Hospice requires family members to provide care to patients.

In many instances, Chapters Health staff trains family members to assist in the care of their loved ones. Family members can call our nursing help hotline—HospiceHelp24®—24/7/365 for assistance. In cases where the patient lives alone or family members are unable to assist with care, the Good Shepherd Hospice, HPH Hospice or LifePath Hospice team can help. And lastly, care is possible at any one of our hospice houses if appropriate.

Myth #8: Hospice means “nothing more can be done.”

When a cure is no longer an option, there is still a great deal that can be done to control symptoms, and provide care, comfort and support. The hospice interdisciplinary team includes nurses, physicians, hospice aides, social workers, chaplains, bereavement counselors and trained volunteers. Team members visit patients and families wherever they call home and are available 24/7 for support and care.

Myth #9: Hospice is just for the patient.

Hospice focuses on providing comfort, dignity and emotional support to the patient and their loved ones. Quality of life for all concerned is our highest priority. We are with you and beside you every step of the way.

Myth #10: Once you go to hospice, you can’t change your mind or seek a cure.

Hospice patients always have the right to return to medical care that focuses on curing their disease at any time and for any reason. If a condition improves or the disease goes into remission, a patient can be discharged from hospice and go back to aggressive, curative measures. This is all based on patient choice. If a discharged patient wants to return to hospice care at a later date, Medicare, Medicaid and most private insurance companies will allow readmission.

The shared hospice myths examples are just a few of the many misconceptions regarding hospice care. Our interdisciplinary team is well-versed in openly discussing end-of-life wishes and can assist in developing plans to meet patients’ needs and desires.

About Phoebe Ochman

Phoebe Ochman, Director of Corporate Communications for Chapters Health System, manages all content and communications for the not-for-profit organization.

Busting Five Top Myths

Myths and urban legends seem to arise when enough people share the misinformation that it is viewed as gospel. Check out these myths, and discover the truth.

Myth #1: Chewing gum will stay in your stomach for 7 years.

How many times growing up did you ever swallow gum? You probably thought to yourself, “Now I’ve gone and done it, and the gum will be in my stomach for the next 7 years!” Well, you worried needlessly. Like anything else you eat, your stomach is capable of moving gum along your digestive tract so it eventually leaves the body like food. There are rare cases when gum can block the digestive tract. This occurs when other items, like coins, are swallowed along with the gum.

Myth #2: Vikings hats had horns.

Close your eyes and imagine a Viking. If you added horns to the helmet on top of his head, you couldn’t be further from the truth. Archaeologists have discovered only simple iron or leather helmets, and some with wings, dating back to Viking times. So how did this myth come about? In the 1800s, Swedish artist Gustav Malmström depicted Vikings wearing horned helmets in his work. Later in the 19^th century, Carl Emil Doepler designed costumes for Richard Wagner’s opera Der Ring des Nibelungen, whereby the raiders were portrayed wearing headgear with horns on top.

Myth #3: Bananas grow on trees.

Even though the song “Yellow Bird” has the lyrical line, “Yellow bird, up high in the banana tree,” bananas do not grow on trees. The stem does not possess any wood-type tissue. In fact, bananas more accurately grow as a perennial herb plant, and the resulting fruit is really a berry.

Myth #4: Bats are blind.

We have all heard the saying “blind as a bat,” but there is actually no truth backing the statement. Truth be told, bats don’t see in color but have excellent night vision. In fact, according to Rob Mies, executive director and co-founder of the Organization for Bat Conservation, large bats can see three times more accurately than humans. Additionally, bats have a heightened sense of hearing with a natural ability to echolocate, or use sound waves to determine where objects are located.

Myth #5: Napoleon was short.

We have often heard people described as having a Napoleon complex and believed that it was due to the fact that the military general overcompensated with his ambitious drive because of his short height. Actually in truth, Napoleon was the height of an average Frenchman at the time, clocking in at 5 feet 6 inches to 5 feet 7 inches, depending on the source. How did this myth come about? At the beginning of his career in the military, Napoleon was given the nickname of Le Petit Corporal (The Little Corporal), which was used by his fellow soldiers to make fun of his low rank.

Complementary Therapy: Expanding the Possibilities (Part II)

Earlier this week on the blog (see Complementary Therapy: Comfort Available in Unexpected Ways), we introduced the concept of complementary therapy to help hospice patients with their symptom management. We shared the available options that require licensure of practitioners. Today, we expand complementary therapy possibilities to include practices that can be initially taught and then performed at home: tai chi and yoga. From soothing and gentle exercise movements to relaxing poses, these types of complementary therapy allow hospice patients and families to get comfort outside the box of the traditional methods.

Expanding Complementary Therapy

If initially taught by an instructor, gentle exercise in the form of tai chi or yoga can assist in relieving stress and anxiety for hospice patients and caregivers, too.

It is important to note that patients and family members should talk with their physician before beginning any exercise program.

Tai Chi

Although created in China as a form of self-defense, tai chi has evolved into something entirely different. It is an exercise that involves deep breathing and slow, deliberate and gentle movements. Many people have even gone so far as to describe tai chi as meditation in motion.

What is so appealing about tai chi? It is a low-impact form of exercise with minimal stress on muscles and joints, and so tai chi is generally appropriate for people of all ages with varying fitness levels. And as an added bonus, people who practice tai chi don’t need any special equipment, which makes it an inexpensive exercise option.

How Does Someone Get Started?

Although there are quite a number of books and videos available, it is advisable to learn the correct technique from an instructor. In a class, you will be taught various positions and how to properly breathe. The next step would be to find a health or fitness class that offers tai chi classes. You might even discover a senior center that holds classes. And once you have had a class or two under your belt, you can transition to practicing tai chi in the comfort of your own home.

What are the Benefits of Tai Chi, and Specifically for Hospice Patients?

There are quite a number of benefits that tai chi provides for beginners to elite athletes. In fact, even Super Bowl MVP Tom Brady recognizes the benefits that this centuries-old gentle movement can have. But what makes tai chi helpful for hospice patients? A number of studies have shown that tai chi practice improves the quality of life for patients.

Dr. Fuzhong Li and his associates researched how tai chi helped patients diagnosed with Parkinson’s disease, and their findings were published in the New England Journal of Medicine. They concluded that tai chi improved stability and balance and thus demonstrated that Parkinson’s disease patients had a decrease in the occurrence of falls with this complementary therapy.

Backed with funds from the National Center for Complementary and Integrative Health, Dr. Peter Wayne’s group looked into whether tai chi affected brain function and reasoning in older individuals. The group discovered that tai chi indeed improved the ability to reason especially for patients who showed signs of mild dementia. And for cancer patients, studies indicate that tai chi helps lift mood and decrease fatigue.

Yoga

Like tai chi, yoga is an exercise that combines movement and breathing but with more stretching and physical poses. Dating back 2,000 years ago, Patanjali, an Indian sage, developed yoga with an estimated 196 philosophical statements that can be placed into eight categories: restraints (yamas), observances (niyamas), postures (asana), breathing (pranayama), withdrawal of senses (pratyahara), concentration (diharana), meditation (dhyani) and absorption (samadhi).

In the 21^st century, most people practice yoga based on asana postures. As one moves from one yoga pose to another, the individual also concentrates on breathing─stilling the mind from outside distractions allowing the yoga practitioner to be in the moment. In traditional yoga practice, the session starts and ends with a chant of “Om.”

Yoga differs from other forms of exercise due to the fact that the physical is just a small aspect of the practice. It also taps into the mind and spirit. Recently in Frontiers in Immunology, a study showed that there is a pattern in test participants whereby specific changes occurred. These changes benefited the participant’s mental and physical health. The researchers specifically looked at the effect of yoga and meditation and actually concluded that the practice affects DNA to the point that it reverses stress. According to psychologist Ivana Buric, who led the research, many people know the benefit of yoga but may not realize that it can take place on a molecular level to the point of changing genetic code.

How Does Someone Get Started?

There are many different types of yoga, and the choices can be overwhelming. There’s hatha, vinyasa flow, anusara, ashtanga, bikram (hot yoga), iyengar and the list goes on. To learn more about each one, click here. But for those just starting out, hatha or vinyasa are both excellent paths to take. Like tai chi, one can learn the various poses from books and videos, but it is best to take a class. A great resource to finding a yoga studio in your area with qualified instructors is Yogafinder.

What are the Benefits of Yoga for Hospice Patients?

It is widely known that yoga practice can lower stress, so it is easy to understand how this complementary therapy can help both patients and caregivers. As stated earlier, yoga can enhance well-being: physically, mentally and emotionally.

A study at the University of Rochester took on the task of discovering whether or not yoga helped cancer patients. Their findings were presented at the American Society of Clinical Oncology. They demonstrated that cancer patients who participated in yoga classes twice a week experienced an improvement in sleep, less fatigue and thus better quality of life. A subsequent study by Dr. Karen Mustian and her group took a more in-depth look at the effect of yoga on fatigue in cancer patients. They were able to confirm that yoga reduces cancer-related fatigue physically and mentally.

Stay tuned in the coming weeks to learn even more about other types of complementary therapy and how they provide comfort to hospice patients and their families.

About Phoebe Ochman

Phoebe Ochman, Director of Corporate Communications for Chapters Health System, manages all content and communications for the not-for-profit organization.

Did You Know?

Here are some fun facts about yoga:

Started in 2015 and backed by the United Nations, International Yoga Day takes place on June 21.
Lenova has a tablet named Yoga.
The world’s oldest yoga instructor is Tao Porchon-Lynch, age 98, who teaches classes at the Fred Astaire Dance Studio in Hartsdale, New York.
According to the Guinness Book of World Records, the largest yoga class was held in 2015 and led by India Prime Minister Narendra Modi. Total number in the class: 35,985.
The first U.S. yoga studio, The Yoga Center, opened in 1919 on 53^rd Street in New York City.
Started in 2002 by Suzi Teitelman in New York, “doga” is yoga for dogs. The theory behind this practice is that the bond between owner and dog is strengthened. With doga, pet owners use their dogs as yoga props. And the latest yoga craze involves goats.
With yoga practice and associated deep breathing, people discover that they possess a dominant nostril but it can change every 20 minutes.

Complementary Therapy: Comfort Available in Unexpected Ways (Part I)

Trouble getting a solid 40 winks? Battling nausea when the sight of your favorite foods comes into view? Overwhelming anxious feelings at the drop of a dime? Experiencing unrelenting pain 24 hours a day/7 days a week? Most hospice patients, at one time or another, will face these battles during the course of their illness. Sometimes symptom management isn’t easy, and traditional methods just don’t quite make the grade. But comfort is available in unexpected ways─complementary therapy.

What is Complementary Therapy?

Complementary therapy is defined as any non-pharmaceutical, symptom management tool that relieves common discomforts and improves quality of life. And it’s not just for hospice patients, as caregivers can also reap the benefits. Often times, complementary therapy is used in conjunction with medical care. It is important to note it does NOT replace conventional methods.

Practitioners who offer complementary therapy follow the belief that it is important to treat the whole person and not just a symptom. These options are used as a “complement” to traditional medical practice. Many people assume that the term “alternative therapy” can be used interchangeably with complementary medicine, but alternative therapy is used instead of conventional medical care. Complementary therapy helps patients feel and cope better with their disease while receiving traditional medical care.

What are Some Types of Complementary Therapy?

There are a number of therapies considered to be complementary. They can be divided into categories, and we will begin with the therapies that should be provided by a certified practitioner.

Practitioner Required

Acupuncture: With this complementary therapy, tiny sterile needles are inserted into the skin at precise points by a licensed practitioner. According to a study in the Journal of the American Medical Association, acupuncture improved outcomes in patients with chronic pain. Additionally, a number of researchers looked into the benefits of acupuncture to ease the symptoms that many breast cancer patients face. One group at Memorial Sloane Kettering Cancer Center used electro-acupuncture to reduce hot flashes in breast cancer patients, which resulted in improved sleep. The results of this study were recently published in the journal Menopause.

How does one find a certified acupuncturist? Today, many physicians take approved acupuncture training provided by the American Board of Medical Acupuncture. Click here to search the list. There are also certified acupuncturists who are not medical doctors. These individuals undertake thousands of hours of master’s degree program training that is accredited by the Accreditation Commission for Acupuncture and Oriental Medicine. Practitioners must pass a board exam in order to become a certified acupuncturist. Click here to search the list.

Hypnosis: When many hear the term hypnosis, they often visualize TV shows or movies depicting people losing their freedom to choose. In reality, when people are hypnotized, they achieve a deep state of concentration, aware of their surroundings but yet open to the power of suggestion put forth by the certified therapist.

During the last decade, more and more studies took on the task of determining how hypnosis can significantly reduce pain, especially for those suffering chronically. In 2013, Dr. Mark Jensen, editor-in-chief of the Journal of Pain, shared his findings during a presentation at the American Society of Clinical Hypnosis Annual Scientific Meeting. This complementary therapy was shown through imaging studies to decrease pain intensity by targeting brain areas where the experience of pain occurs. Additionally, hypnosis can impact the areas of the brain that process the emotional side of pain. If interested in finding a certified hypnotherapist, click here.

Massage: It is easy to understand how massaging the skin, muscles and tendons can produce a therapeutic response. In fact, the National Hospice and Palliative Care Organization whole-heartedly supports massage as a complementary therapy for hospice patients. According to Ann Catlin, OTR, LMT, founder of the Center for Compassionate Touch, massage therapy offers a great deal to hospice patients. At an American Massage Therapy Association national convention, Catlin shared the following, “Hospice is about providing comfort and dignity at the end of life. You are there to help people live until they die. Quality of life is the goal.” Massage therapy helps realize that goal.

Reputable therapists should be certified by the National Certification Board of Therapeutic Massage and Bodywork. To find a certified massage therapist, click here.

Music Therapy: The benefits of music can come in a variety of forms, from listening to a sonata or playing an instrument to singing songs or writing lyrics. A pioneer on the subject of death and dying, Elisabeth Kübler-Ross firmly believed in the power of music to help patients at the end of life. She especially recognized the value of music therapy for patients who might have withdrawn from family and friends.

While numerous studies over the years demonstrated how music therapy can help hospice patients with anxiety, pain and other symptoms, Lisa M. Gallagher and associates at the Cleveland Clinic recently researched how this complementary therapy positively impacted caregivers. Published in the June 2017 issue of Supportive Care in Cancer, their findings concluded that family members had an immediate positive effect from music therapy.

Reiki: Japanese in origin, this complementary therapy is performed by skilled practitioners who place hands on or above a person providing a gentle touch for energy flow. With Reiki, it is believed that humans have a life-force energy not seen by the naked eye. If you are battling a chronic disease or facing end-of-life issues, the life-force energy would be low under this theory. Therefore, if a practitioner provides Reiki therapy, the natural conclusion would be that your quality of life will improve.

Although created in 1865 in Japan by Dr. Mikao Usui, the first practicing Reiki clinic did not open until 1922. More than a decade passed before the practice of Reiki was introduced into Western cultures by a former patient of Dr. Usui’s—a Japanese-American woman named Hawayo Takata.

Starting in 2012, a hospice associated with the University of Pennsylvania, Penn Wissahickon Hospice explored Reiki as a complementary option for hospice patients. Studies have also been conducted by the National Center for Complementary and Integrative Health, part of the National Institutes of Health, with regard to the benefit that Reiki provides patients with diagnoses such as prostate cancer and advanced AIDS.

Today, Reiki is gaining more popularity as a complementary therapy option for hospice patients. To find a registered Reiki practitioner, click here.

Stay tuned for Part II in Thursday’s blog when we explore complementary therapy options that do not necessarily need a certified or licensed practitioner in order to reap the benefits.

About Phoebe Ochman

Phoebe Ochman, Director of Corporate Communications for Chapters Health System, manages all content and communications for the not-for-profit organization.

How does acupuncture relieve pain and lessen other symptoms? It is believed that needle insertion stimulates the natural release of painkillers by the nervous symptom, which then head to the troublesome area(s) of the body.

Other acupuncture studies show that this complementary therapy may:

Help relieve fatigue
Decrease nausea
Reduce vomiting

Caring for Caregivers: Lessons for the Sandwich Generation (Part II)

In yesterday’s blog post titled “Caught in the Middle: Sandwich Generation Explained,” we started at the ground floor and sketched out exactly what the title states. Today we tackle the issue of caring for caregivers because as responsibilities for the sandwich generation increase, stress invariably stakes a claim and camps out in their lives.

Who Cares for Sandwich Generation Caregivers?

Unfortunately, the answer to the question of who cares for sandwich generation caregivers is no one. The majority of caregivers work full time and try to balance career obligations with the care they must provide to their children, parents and even grandparents.

What happens one day when disaster strikes? Here’s a possible scenario to contemplate to truly grasp what life can be like for a sandwich generation caregiver.

The said caregiver is about to give a presentation to the C-suite, and he or she gets two calls in the span of hours. A parent is rushed to the hospital and school calls to say that Diana is running a 101^ofever and complaining of a sore throat. How does the sandwich generation caregiver juggle these familial obligations? On the outside looking in, one might think a hospitalization might provide a respite from career responsibilities but alas the stress of having a parent in the hospital offsets any ease.

There are many problems that caregivers face, not just sandwich generation members. According to the American Psychological Association, the most common problems plaguing caregivers fall into two main categories: health and mental health.

For health, caregivers’ concerns are:

Sleep problems
Fatigue
Risk for illness, injury and even death

On the mental health side, caregivers often experience:

Anxiety
Depression
Stress
Range of battling emotions, such as guilt, sadness, worry and dread

What Can Help Caregivers?

In helping caregivers, it is all about communication and listening to his or her needs and wants. Some caregivers might desire intermittent times of solitude and space. Or perhaps adult time would help ease stress. And don’t discount something as simple as appreciation from both generations—from rebellious teenager to curmudgeon father and everything in between.

The following are some possible solutions that can ease the stress on caregivers:

Weekly family meetings
Clarification of house rules
Preparing a financial plan
Professional counseling

However, one of the most important tips for caregivers would be to take care of themselves. If the caregiver is not well, physically or emotionally, how can he or she care for either end of the generational spectrum they help?

Being sandwich generation caregivers is not all doom and gloom. There are a number of benefits to taking care of children, parents and grandparents. Individuals in the middle of the sandwich have a great sense of belonging and family well-being. And when caregiving is shared, the burden is eased for each family member.

At Chapters Health System, every day is devoted to educating our patients and keeping them in the place they call home. We are dedicated to ensuring that patients, young and old alike, and their families are able to make educated decisions about important healthcare matters. For more information, please call our helpful Chapters Health team at 1.866.204.8611 or send an email to info@chaptershealth.org.

About Phoebe Ochman

Phoebe Ochman, Director of Corporate Communications for Chapters Health System, manages all content and communications for the not-for-profit organization.

Here are three easy steps for caregivers to follow that can prove beneficial:

Eat a well-balanced diet: Following the food pyramid is easy. Make half your grains whole, vary your vegetables, focus on fruits, consume calcium-rich foods, go lean with protein and know your limits on fat, sugar and salt. And don’t forget to keep well hydrated. Learn more from the United State Department of Agriculture (USDA) and its updated food pyramid, MyPyramid.
Exercise regularly: As the American Heart Association recommends for overall health, try to performing 30 minutes of brisk cardiovascular activity, five times a week. In addition, numerous studies prove that regular exercise reduces anxiety, depression and tension.
Find a stress buster: If you like to write, journaling allows you to express feelings. Hobbies like drawing, sewing, painting, knitting and reading are also great ways to relieve stress. And don’t discount heading out to the courts for a round of tennis or to the greens for a round of golf if that’s your cup of tea.

Additionally, it is important for sandwich generation caregivers to know their limits, set boundaries, ask for help, not allow guilt to rule and always have contingency plans.

Caught in the Middle: Sandwich Generation Explained (Part I)

Panini bread, romaine lettuce, plum tomato, Swiss cheese, smoked turkey, dab of mayo and Dijon mustard … some delish fixin’s for an awesome sandwich. Depending on your likes, there are many other types of sandwiches people across the globe create daily. But then aside from foodies’ needs and desires, there’s another type of sandwich being concocted. It is a sandwich made when an adult or couple cares for both older parents and children—better known as the Sandwich Generation.

What is the Sandwich Generation?

Dating back to 1981, the term ”sandwich generation” was coined by two women, Dorothy Miller and Elaine Brody, and was primarily introduced to social workers and gerontologists. At that time, the middle generation in the sandwich was Baby Boomers. In today’s world, the adult or couple has shifted to Generation Xers. Of course as time marches, the sandwich generation will be largely composed of Millennials.

In the 1980s, the term was specifically used to describe women in their 30s to 40s who were “sandwiched” between aging parents and young children acting as everyone’s caregiver. Fast forward to the 21^st century, where the term is defined more accurately as a couple between the ages of 40 and 65 who are responsible for older children and elderly parents.

What are the Statistics for the Sandwich Generation?

In 2013, the Pew Research Center looked into the numbers, and according to their findings, about one in eight Americans between the ages of 40 and 60 is rearing a child and caring for a parent. In fact, about 8.5 million are caring for an elderly parent from a long distance. Additionally, when evaluating U.S. Census Bureau data, these statistics will increase. The government agency postulates that by 2030, there will be more than 70 million Americans over the age of 65.

The National Alliance for Caregiving conducted its own study titled “Caregiving in the U.S. 2015.” The study discovered that approximately 43.5 million Americans provided unpaid care for an adult or child in the prior 12 months. Actual caregivers who responded to the survey came in at 18.2 percent.

Are There Different Types of Sandwiches?

Believe it or not, there are different types of sandwiches that make up this unique generation: traditional, club and open. Sandwich generation authority Carol Abaya defined each of the sandwich types as follows:

Traditional: adults sandwiched between aging parents who need care and/or help and their own children

Club: adults in their 50s or 60s sandwiched between aging parents, adult children and grandchildren, or adults in their 30s and 40s with young children, and both aging parents and grandparents

Open: anyone else involved in elder care

What are some of the Challenges Faced by the Sandwich Generation?

The sandwich generation faces numerous challenges, and many are dependent upon age and generational needs. For instance, an infant has different needs and issues based on trust and mistrust; a toddler’s fall under autonomy and shame; a preschooler with initiative and guilt; an adolescent with identity and role confusion; a young adult with intimacy and isolation; a middle-aged adult with stagnation; and an elderly person with despair.

As our children get older, they move away and transition from being dependent to independent. For an aging parent, the reverse is true. As our parents get older and undergo normal decline, they require more assistance and thus transform from independence to dependence.

As caring demands an increase time and financial resources, the physical and emotional health of the sandwich generation naturally tends to decline. So who cares for the sandwich generation? Stay tuned for Part II in our series on the Sandwich Generation tomorrow on the blog.

At Chapters Health System, every day is devoted to educating our patients and keeping them in the place they call home. We are dedicated to ensuring that patients, young and old alike, and their families are able to make educated decisions about important healthcare matters. For more information, please call our helpful Chapters Health team at 1.866.204.8611 or send an email to info@chaptershealth.org.

About Phoebe Ochman

Phoebe Ochman, Director of Corporate Communications for Chapters Health System, manages all content and communications for the not-for-profit organization.

Interesting factoid: In July 2006, the term was officially added to the Merriam-Webster dictionary.

A Modern-day Primer for Skin Cancer Awareness: Do You Know Your ABCDEs?

Does the following ring true about your past habits? Have you ever lathered up with baby oil in preparation for a glorious day spent on Clearwater Beach getting a tan? Or did you buy a five-session package of tanning salon sessions due to your desire to not look pale as a ghost for an upcoming vacation? If these scenarios sound familiar, hopefully by now, you have corrected your habits of old and opted for applying lotion with a high SPF when outdoors, and said no to speedy tanning on ultraviolet (UV) radiation beds. But is that enough to protect you against skin cancer?

Raising Skin Cancer Awareness

According to the American Cancer Society, if you added breast, prostate, lung and colon cancer incidence together, the number would be lower than new cases of skin cancer. Even more troublesome is the fact that current estimates say that one in five Americans will develop skin cancer over the course of their life.

On average, Floridians can expect 246 sunny days every year, and if you add in partly cloudy days, it’s not a far stretch to understand that our skin can be exposed to harm more than expected. In addition to putting sunscreen on exposed skin when outside and avoiding tanning salons, there are some other things that people can do to protect their skin from skin cancer. If caught early, most skin cancer can be completely cured.

No matter if it is winter, spring, summer or fall, it is important to examine your skin every month in the search for anything on your skin that looks suspicious. But would you know the difference between normal, benign or harmful? By following some simple ABCDEs, you can be on the right side of the bell curve.

At Chapters Health System, every day is devoted to educating our patients and keeping them in the place they call home. We are dedicated to ensuring that patients, young and old alike, and their families are able to make educated decisions about important healthcare matters. For more information, please call our helpful Chapters Health team at 1.866.204.8611 or send an email to info@chaptershealth.org.

About Phoebe Ochman

Phoebe Ochman, Director of Corporate Communications for Chapters Health System, manages all content and communications for the not-for-profit organization.

Knowing Your ABCDs

When it comes to early skin cancer detection, specifically melanoma which can be deadly, knowing your ABCDs can be a lifesaver.

But where does one begin? When checking your skin, a good starting point is to be on the lookout for any new growths or moles. Then from there you can become a skin melanoma detective by observing the following ABCD clues.

A–asymmetrical. If you have a mole already, imagine drawing a line through it to divide in half. A warning sign of melanoma is that the two halves would not be equal.

B-border. If the border or edge of a mole or lesion is uneven, scalloped or there’s a notch, there can be cause for concern.

C–color. The majority of benign skin spots are one color and usually that means brown. A red flag is a lesion with a number of different colors or shades, usually a variety of brown shades. And believe it or not, melanoma can even be patriotic in appearance—red, white and blue.

D–diameter. The diameter of a mole is very telling: The larger the diameter of a mole the more suspicious the lesion. Statistically, melanomas are about the size of a pencil eraser.

E–evolving. A prior growth that’s changed significantly or a spot that itches, bleeds or doesn’t heal could be an alarm.

If you discover one or more ABCDs during your skin check make an appointment with your physician for a comprehensive skin cancer screening. The good news is that when caught early, the cure rate for skin cancer, even melanoma, is high.

Honoring Our Veterans

Richard and Sherry Whitford by the “Table for One” they arrange every Veterans Day at the Sturgill Hospice House.

Honoring Our Veterans

My husband, Richard and I, are passionate about HPH Hospice and have been involved in nearly all aspects of its volunteer program. However, we’re both drawn to the agency’s We Honor Veterans program, which began in 2011 and is now hundreds of volunteers strong. You see, Richard is a Vietnam era veteran and I am a huge military supporter. Being involved with veterans and their loved ones through hospice provides a powerful way to say thank you to the brave men and women who have sacrificed much so that we can be free.

Since April 2013, Richard and I have had the privilege of being involved in literally hundreds of hospice pinnings. This involves providing the veteran with a customized certificate, a We Honor Veterans pin and a star. The back of the star reads: “I am part of our American flag that has flown over a home in Florida. I can no longer fly. The sun and winds have caused me to become tattered and torn. Please carry me as a reminder that you are not forgotten.”

Each pinning is simple, beautiful and unique. Because we are also 11th Hour volunteers, Richard and I are on call to be at bedside of actively dying HPH Hospice patients. We never miss the opportunity to say thank you to our veterans.

Touched by the Ceremonies to Honor Veterans

Families are so touched and grateful for the pinning ceremonies. A few times, we’ve made visits to honor a patient but not everyone in the family has been able to be present. So, imagine how wonderful we feel when family members ask if we can return and repeat the ceremony when everyone can be there. Of course, we say yes! During the pinnings, patients will often share short stories about what happened during their years of military service – stories that their loved ones may have never heard before.

Perhaps one of our most touching moments occurred when Richard and I did a pinning for a patient who was not responsive. The family was there, but because the patient was near death, we were talking primarily to the family. The patient was wearing a U.S. Marines cap, and Richard leaned over to place the veteran’s pin on it, stating aloud how grateful he was for the gentleman’s many years of military service.

As he saluted the patient, Richard said: “From one veteran to another, I salute you, sir.” The patient then saluted Richard in return! Everyone started to cry, but they were tears of joy.

Moments like these are priceless. When we’ve been asked by family members to attend or participate in their loved one’s funeral on behalf of HPH Hospice, we are deeply touched. And, it’s a huge honor for the family to ask us to write and deliver the eulogy.

On Veterans Day and on other significant military occasions throughout the year, Richard and I arrange a “table for one” in the dining room at the Sturgill Hospice House in Brooksville to honor and remember our POW/MIA.

We give thanks for our veterans and their families, and are grateful for all the wonderful men and women, veterans and non-veterans, for whom we’ve met during our volunteer service.

Let them never be forgotten.