CHAPAC Conference November 17, 2014

Transcription

1 CHAPAC Conference November 17, 2014 Total Pain Management of the Hospice Patient using Reiki Ann Marlatt, RN, Reiki Master Michelle Goldbach, MHA, BSN, RN, CHPN, Reiki Master

2 Learning Objectives Discuss the history Reiki and its origins State the integration of Reiki in Healthcare Compare and contrast the use of traditional pain protocols with the addition of Reiki in the relief of total pain at the end of life Describe the patient and family experience of those who received Reiki treatments

3 Learning Objectives Demonstration application of Apply Reiki Techniques for self care Discuss applications and ways in which to implement the use of Reiki in your agency Discuss lessons learned and considerations for further study

4 Reiki- Pronounced Ray-key Reiki Is a technique for stress reduction, relaxation and promotes healing Reiki IS life energy and is the non-physical energy that animates all living things Those attuned to Reiki energy becomes a healer whose energy channels are opened and cleared of obstructions allowing for an increase in life energy to flow resulting in the healing of self and others

5 Reiki- Pronounced Ray-key Reiki instantly connects the healer to the source of all energy. The source can be described in any way the healer choose to call it, including God, a higher power or the universe. When energy is high and flowing freely you are less likely to get sick. It is also the primary energy of our emotions, thoughts and spiritual life. Reiki energy goes where the person needs it.

6 History of Reiki and its Origins There are many stories and myths surrounding Reiki and perhaps we will never know the whole picture It is said that Reiki was thought to be planted in our genetic coding at birth but through the centuries it was lost The story of Reiki as researched by William Lee Rand- A knowledgeable authority on Reiki in the Western world

7 Religion or Not? There are many misconceptions about the origin of Reiki and Religions: Reiki came from Buddhist texts and has a religious basis Reiki healing energy is directed by human thought and will Reiki is not accepted by the medical community Japanese Reiki Masters who have knowledge of Buddhism have concluded that Reiki is religiously Neutral This life force energy is the source of life itself and far older in concept and fact than any religious philosophy

8 Reiki How does it work? When we speak of our health, energy (Ki) can be divided into two categories Genki-healthy Ki Byoki-unhealthy Ki Our minds have a direct connection to our Ki, causing it to change as the nature of our mind changes

9 Reiki How does it work? Specific kinds of thoughts and feeling form Ki that has an affinity with specific organs or parts of the body. Anger can create Byoki around the liver Fear creates Byoki around the kidneys Grief created Byoki around the lungs When Byoki forms in the energy field around a part of the body, it adversely affects the healthy functioning and also blocks the flow of Genki to that area thus creating dysfunction and eventually illness

10 Reiki How does it work? In addition to affecting our physical health, the quality of our Ki affects us in all areas of life including mind, emotions, spirituality and virtually every area of our experience Our diet, exercise and relationships also effect on our Ki

11 Reiki- How does it differ It is guided by a higher source and is not affected by the healers mind or subconscious mind. Energy flows into the persons energy field, affecting the Ki and it also flows around the organs and tissues. Provides a much higher level of nurturing to the body and also works on the mind, emotions and spirit. It promotes peace, acceptance and tranquility

12 Evidence Based Project CNESD (process of developing project) PICO Question Approvals: Quality vs Research Inclusions/exclusions Methodology Staff survey Pre-Staff In-service Data Collection Results Post Staff Survey

13 Literature Review & PICO At the end of life in the homecare setting, will the use of Reiki in addition to a traditional pain management protocol provide added relief of total pain vs. the use of a traditional pain management alone

14 Total Pain Management Physical Social Emotional Spiritual

15 Evidence Based Project CNESD (process of developing project) PICO Question Approvals: Quality vs Research Inclusions/exclusions Methodology Pre Staff survey Staff In-service Data Collection Results Post Staff Survey

16 Quality Improvement Project Approvals: Quality vs Research Inclusions/exclusions Methodology

17 Evidence Based Project CNESD (process of developing project) PICO Question Approvals: Quality vs Research Inclusions/exclusions Methodology Staff survey Staff In-service Data Collection Results

18 Pre Staff Survey- Demographics 30 Nursing 11 MSW 2 Chaplain 5 HA 2 Clinical Support 1 MD 1 PT 13.5% are Reiki Practitioners (most level 1) 86.5% are not Reiki Practitioners

19 Pre Staff Survey- How would you Define Reiki Healing Energy Healing Energy Relief of pain and suffering Touch/non-touch Therapy Emotional Healing Spiritual Healing Physical Healing Relaxation

20 Pre Staff Survey- How would you Define Reiki Uses power of angels and aliens I don t believe in this practice Similar to yoga, breathing, meditation Energy transmitted through mysterious channels, with patients reporting relief

21 Pre Staff Survey- How would you Define Reiki Massage with a purpose. I think it includes self-healing principles and relying on self instead of God Spiritual practice by Japanese Buddhist Reiki is a Japanese technique or spiritual practice through which energy chakras are accessed and energy is balanced through handson-healing or non-touch to promote physical, emotional, spiritual, and/or social healing in oneself and others.

22 Pre Staff Survey- What has been your experience with Reiki in Hospice Out 49 respondents: 32 had limited to no experience 6 have heard about the positive effects or benefits 5 have observed Reiki being done on their patient 2 have had Reiki performed on themselves 2 made a patient referral for Reiki 1 practices Reiki on her patients regularly 1prefers to practice Healing Touch

23 Pre Staff Survey- What was your experiences when your patient had Reiki Patient was relaxed and peaceful Moving Helped patient tremendously Reduced agitation Very soothing and calming Nothing Difficult due to my personal beliefs Interesting Nice adjunct to traditional medicine

24 Wonderful Pre Staff Survey: What is your belief in using Reiki in hospice care to assist in alleviating pain and symptom management? Decreases Pain Beneficial Helps to calm and relax Skeptical Reduces agitation I will support it if it is the patients wishes Do not believe it s a valid therapy-too much hocus pocus

25 Pre Staff Survey- I have performed or have seen Reiki performed on my patients 36 Yes 13 No Have you suggested the use of Reiki on any of your patients 15 Yes 33 No (1- didn t know we had it )

26 Pre Staff Survey- Would you suggest the use of Reiki in hospice for relief of pain and symptom management 37 Yes 3 No ( I don t believe in it) 5 Maybe- need more information 3 Unsure

27 Pre Staff Survey - Comments If a patient found comfort in the therapy I would not be opposed. Just because I don't believe it in doesn't mean the therapy should be discounted. There are many things I don't believe in that patients find comfort in and relief with. If a patient was interested in trying it I would encourage them to do so. I do not share my personal beliefs with patients, I would present them with the information they need to make their own decision

28 Pre Staff Survey - Comments If you can help a person center and evaluate their personal space within and around them to find some sort of peace and beauty, it can help tremendously in accepting and healing emotional aspects and in turn the physical portions also. It can support a person on a level different that we can reach with meds and physical support Only if the spiritual origin is explained to the pt. up front and it is consistent with their belief system

29 Evidence Based Project CNESD (process of developing project) PICO Question Approvals: Quality vs Research Inclusions/exclusions Methodology Pre-Staff Survey Staff In-service Data Collection Results Post Staff Survey

30 Results: Physical Pain Pre Reiki Session Post Reiki Session

31 Results: Social Pain Pre Reiki Session Post Reiki Session

32 Results: Emotional Pain Pre Reiki Session Post Reiki Session

33 Results: Spiritual Pain Pre Reiki Session Post Reiki Session

34 Results: Anxiety Pre Reiki Session Post Reiki Session

35 Statistical Significance t-test: Two-Sample Assuming Equal Variances variable n Mean Pre Mean Post P(T<=t) two-tail p<0.05 Pain Physical E-05 Social Emotional E-05 Spiritual Anxiety E-08 t-test: Paired Two Sample for Means Variable n Mean Pre Mean Post Pain Physical Social Emotional Spiritual Anxiety

36 Patient/Family Experiences- Before Treatment Hesitant and tense at first Will this go against my religion As a scientist I am not sure I believe in this stuff

37 Patient/Family Experiences- During and after Treatment Relaxation Saw Visions of Jesus Saw loved ones that have past Increased energy for several days Increased appetite for several days Increased acceptance of death Less fear of dying-surrendering Sad that only could receive 3 sessions Everyone should get this on Hospice

38 Patient/Family Journals Mom expressed her feelings of peace and tranquility. She said she felt so good during and after Reiki. She felt herself traveling thru like a space of light and warmth. She said I m starving and ate everything till she went to bed. The next day again she was hungry all day and eating a lot. She was happy, pain free and talked about her experience and how good she felt..no pain or unhappiness at all. She felt like she was walking on air Day 3 + she started to feel down again and pain started up in her belly.but she said, I did feel so good when the ladies were here. It s a wonderful thing (Reiki). It definitely made a difference to mom. I highly recommend Reiki to all critical patients to help them through the process of dying. It really works. My mom was proof. (Pt had 3 sessions.)

39 Patient/Family Journals Julie responded very well and feels very positive about Reiki. As her daughter, I observed that she looked very shining and serene as he lay on her arm chair while the four practitioners worked with her. There was a sense of strength in the calm air, a feeling of peace all over. (Pt had 3 sessions.)

40 Practitioner Journals Dtr said that this program should be available to anyone and everyone. Pain levels improved Pt says he is less tense and anxious with these treatments. Is sorry to see them end. (Pt had 3 sessions.) Wife told us this whole Reiki regime was doing wonders for patient. He was lighter in his essence, sleeping better, breathing better for a couple days afterward. Both Dtr and patient told us how pt slept better and was more comfortable physically and emotionally.

41 Practitioner Journals She had the best night s sleep that she had in months. Receptive to 2nd session. Fell asleep during healing. When we finished he was standing up straight, had a glow in his face and was brighter. Very happy and pleased with the session Son said patient has huge change, feeling more energetic, super please with her own condition. Son also said huge impact on whole household. Pt states she felt pretty good for days after our last session. (Pt. had 3 sessions.)

42 Practitioner Journals Dtr Pat and grandson Matt were present. Patient was so pleased to see us, told us after last Reiki she saw her (dec d) husband and grandmother. She was thrilled. Said she felt so much better, more at peace and she knows her husband is waiting for her Wife very interested and inquisitive about Reiki energy, how this works. He explained to us how exhausted he would be after any physical exertion. Afterward he was talkative, seemingly energized. I also did Reiki on wife; she said she instantly felt it, she had been worried/scared/uptight about her husband dying, and that this Reiki session lifted this weight from her. She felt it go.

43 Post Survey: Staff Experiences Discipline 4 Nurse 7MSW 2 Chaplain 2 Hospice Aid

44 Post Staff Survey: what was your thoughts or experiences on the effect of the Reiki treatment on your patient *Positive and worthwhile *Relaxation/Calmer It was good for the patient and their family Inspiring Patient did not like the second session

45 Post Staff Survey: what was your thoughts or experiences on the effect of the Reiki treatment on your patient Brought patient and family peace in the unknown world of dying. A comforted existed for them that they could experience and allow the highlight of the moment to take priority vs. the fear of the future Excellent-my patient stated that after the first session, she was able to sleep for several hours with good Quality of sleep which had been an issue for her

46 Post Staff Survey: What did your patient or family share about their experiences? Peace, comfort and love Positive, glad they did it More *relaxed, pain decreased First time they really relaxed in her whole life Patient thought it was silly but willing to try Patient shared that she did not receive any benefit from first visit and declined further sessions

47 Post Staff Survey: Would you recommend Reiki to other patients?- Yes- because the patients feel peace Absolutely. I think it can help patients and family members Yes- it has enhanced the quality of my patient s life Yes if they are interested Yes- I consider it a valuable alternative therapy Most definitely Yes I have seen positive results in patients who receive Reiki

48 Post Staff Survey: Has your beliefs on the use of Reiki in Hospice changed? I did not know what to expect, but I will refer them now It has changed for the better. I see it as a very useful tool in helping patients and families with stress and anxiety Yes- I never believed in it until my patient actually said that it worked on her and I see how much relaxed she had become Pleasantly surprised with recent outcomes No- remain very positive, I always supported it, always believed in it and alternative medicine Should continue to be available to our patients

49 Lessons Learned and Next Steps Education for practitioners collecting data Data Collection Control Group Several Patients Died before the 2nd or 3rd session MAR

50 Lessons Learned and Next Steps Pediatrics/Perinatal Add other modalities/integrate into Palliative Care Program SOP Training of Staff

51 Implementation: Reiki in your agency Vision- Backwards imaging Strategic Planning- SWOT analysis Stakeholders Action Persistence/Resistance Political- Cultural Factors Communication Plan- Elevator Speech

52 Implementation: Reiki in your agency Time consuming Dynamic process Often requires multiple meetings Requires dedicated team May need auditing process with re-auditing Remind staff of the project aims & importance Embed in routine training program, P&P, SOP, etc. Find a long-term champion or project owner Keep champions engaged = holding the gains

53 The effects of Change in Practice

54 References- Upon Request

55 Reiki Sessions Available This Week! Monday, November 17th Tuesday November 18th Tuesday, November 19th (room )

56 Contact Information Michelle Goldbach Ann Marlatt Karen Gardner Erika Leyva Everson Mary Joy Neuro Pam Sepesi Sally Schaffer Janet Falconer

57 Questions

58 Reiki Techniques for self care Do techniques