Long-Term Care Survey Alert

Some providers are reaching outside the traditional Rx chest.

Using non-pharmacological remedies to treat common ailments can give your residents relief and improve the facility's quality of care and life.

For example, Alverno Health Care Facility offers "aromatherapy" to help residents with insomnia -- a "lavender scent" that staff pin to the resident's pajamas or pillow, reports Sheryl Schutte, RN, director of nursing for the Clinton, IA-based SNF and long-term care facility. Alverno plans to begin using several other scents in the near future, including one called "Awaken," a "blend of peppermint, lemon and lime" that serves as a stimulant, Schutte reports.

In addition to massage therapy, the facility also has a certified Reiki specialist on staff who provides Reiki sessions to promote well-being. Alverno massage therapist Sandy Orte says she incorporates Reiki, a very ancient Japanese treatment that works with energy fields, into every massage and then also provides Reiki sessions without massage.

Reiki is "very non-invasive," Orte says. "You don't have to touch the person to do Reiki."

Precaution: The facility obtains a physician order "for any type of massage," says Schutte. "Massage helps with pain management, muscle stiffness or some residents like it for relaxation and to promote a sense of well-being," she reports. "Reiki sessions are free but the residents pay for the massages."

Caring can be healing: Geriatrician Jeff Williamson believes that some alternative remedies may be helpful because they "involve human interaction. One study showed that patients undergoing surgery who were aware that people were praying for them had better outcomes," says Williamson, who is an investigator in a National Institutes of Health-funded study looking at the efficacy of the herbal remedy ginkgo biloba.

Shed Light on Depression

Baldomero Lopez State Veterans Nursing Home has experienced "good results in using halogen lights to improve residents' moods and address behavioral symptoms," reports Susan Poynter, activities director for the facility in Land o' Lakes, FL. The facility installed halogen lights in a section of the dining room but would eventually like to use the lighting throughout the facility, according to Poytner.

Studies indicate that the lighting helps promote normal circadian rhythms and sleep patterns and "helps with depression," says Poytner, who feels the lights have a positive effect on residents most of the time. "We are still evaluating this project but so far we like the results," she says. "It's such a drastic change from the normal lighting" that it captures "residents' attention at first and then they" report that they "enjoy" the lights, she adds.

Acupressure Wristbands to Combat Nausea?

If research pans out, postacute providers may one day put two wristbands on patients -- one for identification and the other to help prevent nausea caused by chemo or surgery. A number of National Cancer Institute-sponsored clinical trials have or are studying the effectiveness of the bands to prevent chemo-chemo-induced nausea and vomiting (www.clinicaltrials.gov).

An exploratory study by University of Rochester Medical Center researchers published in 2006 found that breast cancer patients who wore acupressure bands reported significantly less severe nausea following chemo compared to the group of patients who received standard care (44 percent versus 68 percent).

The bands are making their way into clinical practice. Mark Shulman, MD, program director of the anesthesiology and pain management at Caritas St. Elizabeth's, uses a "multi-modal approach" where he prescribes anti-emetic medication and acupressure wristbands to control post-operative N&V.

Shulman has prescribed acupressure bands that you can buy in drugstores. But those bands come with an adhesive fastener that can get too tight, he says. A new band, Pressure Right, has a gap that "doesn't get too tight around the person's wrist," Shulman explains. Patients don the bands in the admitting area before surgery so they can see if the bands fit correctly.

Therapeutics: 101 Inc. makes the five-inch Pressure Right Band. Joseph DiLustro, CEO and president of the firm in Tinton Falls, NJ, tells Eli that he developed the adhesive acupressure band primarily for surgery and chemotherapy patients. The wristband application could be "helpful" to postacute patients still suffering from nausea and vomiting caused by surgery despite the use of anti-emetic drugs, says DiLustro.