Tag Archives: Creative Interventions

Your Body as Healer…

An article titled “Miracle Survivors,” in Forbes (March 2, 2009), portrays stories of people who have spontaneous remissions from several different types of cancers. Explanations by the medical community range from “…a complete mystery,” “divine intervention,” or “the immune system.”  With regard to the latter explanation, our bodies have all the necessary elements to heal itself. 

Everyone knows who Deepak Chopra  is…here is his explanation and understanding of spontaneous remission taken from intentblog

“Essentially remission is based on our understanding of the science of self-repair. Our bodies have learned to heal themselves over millions of years of mhand_bodymindsoulemotionevolutionary time. Our bodies are the best pharmacies in nature. They make antibodies, sleeping pills, tranquilizers, immunomodulators, and anti-cancer drugs in the precise dose at the precise time and for the right taget organ; and all the instructions come in the packaging! The “packaging” is your own inner self - the ultimate and supreme genius which mirrors the wisdom of the universe.  Cognition or thinking, moods, feelings and emotions, behavior, social interactions, personal relationships, environment, diet, and the inner world of consciousness including attention and intentionality all influence the biology of healing.”

Now, back to the Forbes article…

It states that “spontaneous remissions are among the rarest and most mysterious events in medicine, with only several hundred cases that can be considered well documented.”  In 1993, two authors for the Institute of Noetic Sciences, created a database of  medically reported cases of spontaneous remission in the world from more than 3,500 references.  This data shows the ability of our bodies to heal itself is not such a rare event. 

Btw, the authors defined spontaneous remission as “the disappearance, complete or incomplete, of a disease or cancer without medical treatment or treatment that is considered inadequate to produce the resulting  disappearance of disease symptoms or tumor.” 

Activate the body’s self-healing properties with Creative Interventions in Patient Care:

  • Art-making
  • Writing
  • Music
  • Dance
  • Humor
  • Laughing Clubs
  • Art Exhibits with artwork created by patients, families, professional staff
  • Indoor and outdoor gardens
  • Art at the bedside
  • Limitless possibilities

 MHand_cycleswritingpaintpalette1flower-butterfly

Lingering effects after the I.C.U

Have you had a family member or friend stay in the I.C.U (intensive care unit) for treatment of an illness?  Those of us who work in theICU critical care units (past tense in my case) are happy to see patients tranferred to step-down units because we feel we applied our best efforts in getting these patients on the road to recovery…and we did.  We stablized their bodies and healed them physically, but researchers are finding out that spending days, weeks or months on life support in the units can bring unexpected, long-lasting undesireable effects.

According to a New York Times article (Jan. 11, 2009), some patients  experience lingering effects from staying in the ICU for months to years after they are discharged from the hospital, such as:

  • Lingering generalized weakness
  • 25% of patients on mechanical ventiliation for a minimum of 5 days got so weak, they were unable to lift their arms
  • Poor concentration
  • Significant weight loss
  • Some patients experienced symptoms of PTSD (post traumatic nightmarestress disorder) such as hallucinations, nightmares during sedation, mood disorders, anxiety, shortness of temper and frightening memories - click here for symptoms of PTSD in a previous post.

Dr. Dale Needham at John Hopkins has begun a 5 year study of patients discharged from the hospital and is finding many patients have difficulty in regaining their strength.  Families are finding their loved one(s) are not the same person anymore.  The difficultly lies in determining which disabilities come from the illnes as opposed to the I.C.U stay, when many patients are on a mechanical ventilator, and receives high doses of sedatives, narcotics and anesthetics.  Particularly surprising is how quickly patients loose their strength.

Patients in intensive care not only experience physical stress due to SleepDeprivedbodily trauma, but also psychosocial stressors with pain, inability to communicate, sleep deprivation, feelings of isolation or lonliness, and fear or anxiety being the most common.  A review of the literature has shown each of these stressors are associated with decreased immune functioning. (2)

In  Laitinen’s study, patients emphasized the importance and need of closeness with a healthcare professional whom they could trust to reduce feelings of anxiety, isolation and increased sense of security. (3)

 

And how are medical professionals addressing these issues? 

By…

  • reducing sedation levels of pain medications, narcotics and anesthetics.
  • getting patients mobilized and walking along with all the ICU paraphernalia like intravenous lines, ventilators, and monitoring equipment.
  • mobilizing patients as soon as possible – patients seem to recover faster and spend less time in the intensive care and the hospital.  

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Implement Creative Interventions for patients in the intensive care units

I encourage the use of Creative Interventions as non-invasive modalities to counter the psychosocial stressors and loss of strength patients experience during their intensive care stay.  Families and CB030187friends can help by bringing the supplies listed below, and more importantly, become active participants in their family member’s care.

Naturally, not all patients in the intensive care units will be capable of actively participating in creative interventions due to their conditions.   However, applying a headset to unconscious patients and playing soft soothing music is much better than hearing noxious noises and sounds of ICUs. 

Here are a few Creative Interventions to start with:

  1. Headset,  ipod or CD player.  Encourage families and friends to compose the patient’s favorite playlist (soft and classical music music-notes1are best), and play during visiting hours.  Nursing staff can apply this intervention during non-visiting hours.  I wrote several posts on the benefits of listening to music in reducing anxiety, pain, and as a form of relaxation.  The posts are titled, Rx: Listen to Music, Listening to Music: Another Creative Intervention.
  2. Listening to music with headsets also reduces noise inherent in intensive care units.
  3. Art-making activities: encourage families and friends to bring in simple art-making materials, such as watercolor markers and sketch pad or other creative materials. 
  4. Engaging patients in creative activities provides a sense of enjoyment, pleasure and diversion in a bewildering and frightening environment.                                                                                                                                                                                                                                     
  5. Give a lump of clay to patients with strokes (or any patient) to create small sculptures.  By manipulating the clay with their hands, the physical motions will help with maintaining muscle strength, dexerity, and divert their attention from their current situation.                                                                                                                                                                                                                                                                                     dog mask

 

Note: email me if you want the bibliography.

Rx:Listen to Music

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Rx: Listen to Music

Is listening to music good for us?  Does music help in healing medical ailments?  Is there science supporting the benefical effects of the arts?  These are just a few questions raised  and being studied by scientists across the globe. 

In a recent New York Times article (March 29, 2009),  Michael Roizen, MD – chief wellness medical officer of the Wellness Institute at the Clevland Clinic – states listening to classical music on a consistent basis suggests “decreases in all-cause mortality, reflecting slower aging of arteries as well as cancer-related and environmental factors.  Attending sports events like soccer or football offers none of these benefits.” (1)   He states he’s not sure if the decrease in all-cause mortality is due to stress relief or other properties. 

Dr. Michael Roizen is also studying the effects of singing to help patients with strokes to relearn language.  Remember the singing1999 movie “Flawless?”  The main character (Robert Deniro) suffers a debilitating stroke and is prescribed to take therapeutic singing lessons for his paralyzed larynx.  His music teacher is his gay next-door neighbor.  The outcome from taking singing lessons is positive, for relearning and regaining speech AND learning tolerance of different lifestyles.

Another researcher in neurocognition of music and language at U of Sussex in England, Stefan Koelsch, is studying the same subject, i.e., music-notes2active music participation by patients suffering from depression.  According to the Mr. Koelsch, “physiologically, it’s perfectly plausible that music would affect not only psychiatric conditions but also endocrine, autonomic and autoimmune disorders.”

The main purposes of the article was to shed light on the collaborative efforts of the music and medical fields to quantify the effects of music on patients diagnosed with certain disease conditions, and highlight several companies creating and marketing propietary music  for ‘medicinal purposes’.   Here are a few interesting points made in the article: unlike prescription medication with known side and adverse effects, listening to music has no side effects; prescribe music as a prescription, just like prescribing a drug or therapeutic modality. And finally, listening to music does affect mood and well-being.

Hippocrates2The therapeutic effects of music  is not new news…the method of delivering music, marketing and money needed for these new elaborate systems are.  WHO is paying for the high-cost of audio systems fit for concert halls in hospitals?  Instead, pay musicians to play in clinical settings.  Music is their passion and their presence will help humanize an environment that can be frightening and dehumanizing.

Florence Nightingale, the founder of modern nursing recognized the beneficial power of music on the sick. (2)  Hippocrates, the father of modern medicine, believed that the human body acts as a whole, so that when an organ is ill, the whole body is being afflicted, ie., humans are psychosomatic entities. (3)

Numerous investigations on the effectiveness of music on adult patients in critical care settings in the 1990′s showed reduced anxiety states (4-6),  physiological relaxation as evidenced by reduced vital signs (blood pressure, heart rate and respirations), improved mood in critically ill patients on mechanical ventilation (7-8), and published accounts indicate critically ill patients enjoy and find music helpful in dealing with the environment and in coping with the critical illness itself .(6,9-10)

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For healthcare professionals working inpatient and outpatient venues, and families with a loved one going through medical treatment, try music as a creative intervention by gathering the following:

  1.  Headset
  2. iPod or CD player
  3. Playlist of the patients’ favorite music – soft, classical or sounds of nature
  4. Play the music on a consistent basis

Here’s my Rx for you…

‘Time to Say Goodbye’

by

Andrea Bocelli & Sarah Brightman

 

Note: email me if you want the bibliography marti@martihand.com

 

Concierge services in hospitals…

Back in February 2009, I wrote a post titled ‘Creative Interventions as Patienttinybrain Amenities in Hospitals’ based on an article in BusinessWeek (Feb. 16, 2009).  To summarize, the article cited a RAND marketing study indicating concierge/hospitality services as more desireable than high-quality patient care.  If this is any indication how consumers think and choose their healthcare institutions based only on plush accomodations versus low mortality (death) rates to recover from mild to life-threatening conditions, we are becoming a nation of non-thinkers.  Concierge services does NOT equal high-quality patient care!

As an advocate for integrating creativity and the creative process in healthcare, I believe creating environments conducive to the healing process is a step in the right direction.  But concierge services?  How do these services help patients and monet_givernyfamilies heal?  Are there any long-term benefits of  hotel-like services for patients?  Or have hospitals strayed from their original missions and visions?  I believe the latter may be true, i.e., hospitals have lost their original vision of healing the sick in an attempt to gain market share, but at least we’ll be able to attend a cooking class at Henry Ford West Bloomfield Hospital.

                                          (Garden at Giverny, 1900 Claude Monet)

And this trend of hospitals offering concierge services termed ‘amentities’ is growing.  In July 2008, USA News had an article titled, “Who Says a Hospital Stay Can’t Be Fun?”  It shed light on the growing movement of hospitals to function more like hotels by offering amenities, such as gourmet dining, fine art, field trips, cooking and gardening classes, afternoon tea service, Wi-Fi connection, and much, much more!

Here’s a few examples of amentities offerings at some hospitals across the US: Century City Doctors Hospital in Los Angelos’ markets it’s menu created by Wolfgang Puck…installed flat-screen TVs in all rooms…M.D. Anderson Cancer Center offers patients field trips to local museums…cooking classes at Henry Ford West Bloomfield Hospital.  I wonder if patients attending a cooking class or taking a field trip actually need to be in the hospital.  WHO is paying for all this luxury?

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Let’s offer Creative Interventions as Patient Amenities.  At least, there is scientific data to support the benefits of engaging in the creative process and the arts.  Read ’The Science Supporting Creativity in Healthcare’ under TOPICS on the left side.

 

Creative Interventions = Patient Amenities

Creative Interventions = Smart Marketing Strategy

Creative Interventions = Cost-Effective Treatment Modalities

catherinelindaMHand_nurses fingerprint_blue sm

 Activate the body’s self-healing properties by exploring the  relationship between art making and self-care with

Creative Interventions in Healthcare:

  • Art-making
  • Writing
  • Music
  • Dance
  • Humor
  • Laughter clubs
  • Art exhibits with artwork created by patients, families, professional staff
  • Indoor and outdoor healing gardens
  • Art at the bedside
  • Creative interventions for healthcare professionals
  • Integrative medicine modalities

Blair Sadler, former President & CEO of Rady Children’s Hospital & Health Center (San Diego) and strong supporter of the arts in healthcare said the following…

“The arts optimize patient care and can create a strategic business advantage by differentiating themselves from competitors, and effectively garner support for starting and maintaining art programs.”

waterfall

Nature…the ultimate healer.

Drawing as a diagnostic tool in lupus patients

Here’s another interesting article on the use of drawing as a diagnostic tool in Med-U-Gdanskassessing people diagnosed with lupus, aka, systemic lupus erythematosus (SLE).   A qualitative study was conducted at the Medical University of Gdansk, Poland with 2 main goals.  First, to examine the ways illness is perceived and experienced by patients with lupus and second, to assess the use of drawing as as a diagnostic tool. 

But first, let’s look at some facts about lupus…

What is lupus or systemic lupus erythematosus (SLE)?

According to the Lupus Foundation in Washington, D.C.,  “lupus is a chronic inflammatory disease that can affect various parts of the body, especially the skin, joints, blood, kidneys”, heart, blood vessels, lungs and brain. 

Lupus, like rheumatoid arthritis, is an autoimmunie disorder where the immune system cannot tell the difference butterfly_lupusbetween foreign substances and its own cells and tissues.  The immune system is designed to attack foreign substances in the body, but in lupus, something goes wrong with the immune system and begins to make antibodies that attack healthy cells and tissues causing inflammation, pain and damage to the body. 

  • The primary feature of lupus is inflammation and is characterized by pain, heat, redness, swelling and loss of function, either on the inside or on the outside of the body (or both).
  • For most people, lupus is a mild disease ususally affecting a few organs.  But, for others, it may cause serious and even life-threatening problems.
  • Lupus affects more than 1.5 million Americans, and at least five million persons worldwide. 
  • There is no known cause, but is believed to be triggered by a number of factors, such as environment and genetics.  Environmental factors triggering the disease are infections, antibiotics (sulfa and penicillin groups), UV light, certain drugs, hormones and extreme stress.
  • Scientists believe there may be a genetic predisposition to the disease, as lupus is known to occur within families. But, there is no known gene or genes which are thought to cause the illness.
  • More than 16,000 Americans develop lupus each year.
  • Lupus is more prevalent in women of African-American, Hispanic, Asian and Native American culturesmulticultural
  • Symptoms may be sporadic. The times when a person is having symptoms are called flares, which can range from mild to severe. New symptoms may appear at any time.
  • Common symptoms include: pain or swelling in joints,  muscle pain, fever sad-sunwith no known cause, red rashes on the face, chest pain when taking deep breaths, hair loss, pale or purple fingers or toes, sensitivity to the sun, swelling in legs or around the eyes, ulcers in the mouth, swollen glands, and feeling fatigued.

(Sources: Lupus Foundation, NAIMS/NIH)

 And now, back to the study on the use of drawing as a perceptual and diagnostic tool in assessing persons with lupus.  To summarize, the key points are below:

  1. Patients’ perceptions of their disease influences emotions, behavior, health care needs and expectations, and these perceptions results in differences in attitude, coping and functioning among patients with similiar clincial symptoms.  Which means patients’ personal views and attitudes of their disease differ despite similar clinical symptoms and diagnosis, and are important in promoting self-care and self-responsibility.
  2. Perceptions of illness can be a better indicator of future physical damage to the body and health condition than clincial signs and symptoms.
  3. Currently, the primary draw_crayonassessment tool in measuring illness perception is verbal communication.  By drawing their disease,  it had patients think about their disease in a different way, and produced “incredibly tangible” insight of the impact of lupus to the patients themselves and healthcare professionals.
  4. The study concludes there are a variety of symptoms and different clincial pictures based on the drawings, rather than ‘general’ symptoms experienced by patients with the same diagnosis.
  5. Drawing as a diagnostic tool can help healthcare professionals avoid forming and categorizing patient symptoms with the same diagnosis.

Asking patients to draw their disease provides a wealth of information  they may not be able to express in words.  The old phrase ‘a picture is worth a thousand words’ definitely applies here.  This is helpful in developing more individualized treatment plans that take patients’ perceptions and attitudes of their disease into account.  By actively engaging patients’ to take interest in their own treatment plans, the tenets of self-care and self-responsibility are more readily accepted by patients, thus leading to better patient outcomes. 

Drawing provides valuable sensory and cognitive information to health professionals in understanding and treating patients with different disease conditions, not just lupus.

Note: email me if you want the bibliography

Below is a favorite Rumi quote…

rumi

Have you figured out what your particular work is?

Use of Drawing in Disability Research

I just read an interesting article on the use of drawings as a way to understand the personal experience of persons with spinal cord injuries.  The drawings were part of a larger study focused on the community integration and participation of adults with spinal cord injury. 

But, first some facts and figures on spinal cord injuries (SCI) from the National Spinal Cord Injury Statistical Center:

  • A spinal cord injury usually begins with a sudden, traumatic blow to the spine that fractures or dislocates vertebrae. The damage begins at the spinalcord1moment of injury when displaced bone fragments, disc material, or ligaments bruise or tear into spinal cord tissue. Most injuries to the spinal cord don’t completely sever it. Instead, an injury is more likely to cause fractures and compression of the vertebrae, which then crush and destroy the axons, extensions of nerve cells that carry signals up and down the spinal cord between the brain and the rest of the body. An injury to the spinal cord can damage a few, many, or almost all of these axons. Some injuries will allow almost complete recovery. Others will result in complete paralysis.
  • There is an estimated 10,000 – 12,000 spinal cord injuries every year in the US.  
  • A quarter of a million Americans are currently living with spinal cord injuries.
  • Costs: The average yearly health care and living expenses and the estimated lifetime costs that are directly attributable to SCI vary greatly according to severity of injury.

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  • Since 2005, the most common cause of all spinal cord injuries are due to car accidents followed by falls (27%) followed by violent encounters sci(gunshot wounds). The rest are due to sporting accidents, and work-related accidents.  Interestingly, the proportion of injuries due to sports decreased over time while the proportion of injuries due to falls has increased. Acts of violence caused 13.3% of spinal cord injuries prior to 1980, and peaked between 1990 and 1999 at 24.8% before declining to only 15.3% since 2005.
  • The average age at injury is 39.5 years.
  • Since 2000, over 75% (77.8%) spinal cord injuries reported to the national database have occurred among males.

(Source: Facts and Figures at a Glance, updated February 2009. National Spinal Cord Injury Statistical Center)

  Now, back to the article…

The research project titled, ‘Images of self and spinal cord injury: exploring drawing as a visual method in disability research,’ (VCross K, Kabel A, Lysack C. Visual Studies, Vol.21, No.2, Oct 2006, p183-193)used drawings by persons with SCI which provided unique insights into the personal meanings of spinal cord injury and how this injury is understood and represented to others.  The purpose of the study was to use paticipants’ own drawings as a useful adjunct to the traditional narrative approach.   The 2 specific questions to elicit drawings were “Draw your self.” and ”Draw how you see spinal cord injury in your mind.”

Drawings of ‘Self’

The drawings fell into 3 categories: 1) drawings that included a wheelchair; 2) drawings that didn’t include a wheelchair, 3) drawings where ‘the self’ was depicted as a head or a head and torso only, with no reference to paralyzed limbs.  Below are the social researchers’ analyses of the drawings:

  • depth and intensity of mhand_bodymindsoulemotionparticipants’ feelings went unrecognized until the drawing task.  I am not surprised by this at all…engaging in the creative process allows the spirit/soul to assume control and communicates with the body, mind and emotions via complex biochemical pathways.  See my diagram to the right ->
  • Participants didn’t deny that their body had deficits, they did not consider those deficits important or relevant to ‘who they really were.’
  • Physical disabilites invites misperceptions by non-disabled persons as ‘not normal,’ based on their appearance rather than on ‘who they really are.’ 
  • Participants with SCI recognized that ultimately they need to adjust their own impressions and perceptions of disabled persons.

Drawings of “Spinal Cord Injury”

One of the goals of the study was to understand how individuals disabled by SCI understood the injury.  The majority of drawings fell into 3 groups: 1) anatomical drawings, 2) metaphorical drawings, and 3) abstract drawings. Here are the findings:

  • SCI represented a literal ‘break’ of the bones and  nerves
  • Feelings of powerlessness to change or reshape  social interactions and negative social attitudes about disability.
  • Abled-body persons more accepting if persons with SCI downplayed their disabilities.  There is pressure to conform to non-disabled societal expectations and views of ‘normal’

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Of interest…

The U-M Model Spinal Cord Injury Care System, part of the University of Michigan Health System, is one of the 14 institutions to be classified as a Model Spinal Cord Injury Center by the National Institute on Disability and Rehabilitation Research (NIDRR).  Interestingly, University of Michigan Health System has a comprehensive arts-in-healthcare program titled “Gifts of Art.”  On their website is this description:

“During times of stress and illness, the arts have the power to nurture and engage. Gifts of Art programs utilize the arts to assist and enhance the healing process, reduce stress, support human dignity and renew the spirit.”

If one of the purposes of healthcare is promoting health, wellness and recovery – why aren’t there more health systems, including public health systems, more open-minded and holistic like University of Michigan Health System?  Healing and caring for people is more than attending to the physical body…it’s addressing the whole person – body, mind, spirit, emotions.

Guest Writer – Sara Baker

I invited a guest to write this week’s post – Sara Baker. 

Sara is a novelist, short story writer and dramatist. Her works have been published in a number of publications. Her screenplay, ‘Looking for Sylvia’, was a sara-bakerwinner in the Atlanta Film and Video Contest; her screenplay, ‘One of Us’, was a semifinalist in the Cinestory 1997 Screenwriting Contest. She has written three books – 2 novels (Shadow Dance and Horography), and a collection of short fiction titled ‘No Part of the Body is Not Sacred.’  Sara holds a Masters degree from Boston College. She has taught English at the University of Georgia, Georgia Institute of Technology, and Piedmont College. In addition, she has been a Georgia Artist in the schools and conducted workshops throughout the state. Sara created the Woven Dialog Workshops, writing workshops that aid in facilitating the healing process at Loran Smith Center for Cancer Support in Athnes, Georgia.

Read more about Sara at her website Sara Baker titled “Woven Dialog Workshops,” and blog ‘Word Medicine.’

 

And now, here’s Sara…

 

asklepieion_sara-baker1 

Returning to the Roots of Western Medicine

The arts in healthcare are often regarded as a nice but certainly not essential component of patient care, just as the arts in the broader American culture are often considered a valuable but inessential asset. Certainly, they are not considered essential to our well-being. We are a pragmatic nation, proud of our technological prowess. We are more comfortable with the Newtonian idea of the body as a machine to be fixed than as the physical expression of a soul.

Yet the very roots of Western medicine are sunk deeply in a tradition which proceeded from a very different premise. In ancient Greece, the hippocratesill would go to healing temples, or temenos, which means a piece of land cut off or set apart and dedicated for sacred purposes. The temples dedicated to healing were call asclepieia, after the god of healing, Asclepius. The sick would come and bathe in healing waters and prepare themselves for a sacred dream, which they would then report to a priest, who would prescribe a cure. The earliest of these temples date from 420 BC, and both Hippocrates and Galen trained in asclepieia, and Hippocrates traced his ancestry to Asclepius.

What the ancient Greeks understood and what Hippocrates espoused, was that a person carried within themselves the resources to help direct their healing. They understood that the unconscious often held the key to healing and allowed a time and place for that knowledge to arise.

It has been said that if you listen well to a patient, he will give you the key to what is wrong with him. Yet in our modern medical environments, there is little time for truly listening. And the language of medicine is one that often reduces the ill person to a body or a pathology, rather than addresses the emotional and spiritual experience of the person undergoing the experience of illness. (see Arthur Frank, At the Will of the Body). Chaplains and social workers, those assigned to “deal with” these issues, are often overburdened. butterfly1Patients themselves often feel as if they are somehow wrong to have feelings of despair, disempowerment, grief, and stress and lack the language to acknowledge or access feelings which may actually, by their lack of expression, be blocking their healing process.

By providing arts experiences in hospital settings, however, we are providing our own temenos. Here, in the safe space set apart from other concerns, patients are invited to have a healing, although waking, dream. They are able to find the symbolic language to express the crisis they are experiencing, and also, through the process of art, to seek new, imaginative ways to go forward. Thomas Moore, author of Dark Nights of the Soul, talks about the “unfolding self,” the part of us that is always evolving and going through deep transformations. “The unfolding self hungers for symbols and language to understand and mark the transitions it is going through.” (pg. 35) Through the process of creating art, the patient-artist both creates the distance necessary to reflect on his/her experience and honors the transformative process that is always part of the experience of illness.

In many respects, then, incorporating art into the healthcare setting is writingnot something new, but something very old. It is an acknowledgement that healing is not only about curing physical ills, but also about giving patients the tools to cope with the spiritual and emotional dimensions of illness. The science supporting the physical and emotional benefits of arts intervention is growing exponentially (see Marti’s excellent “The Science Supporting Creativity in Healthcare). Medicine has always been a blending of art-intuition, perception, creativity-and science-knowledge, skill, experience. While the current structure of our medical system so often mitigates against providing healing environments that address the whole person, my experience has been that all those involved in healthcare want such environments. By incorporating the arts as healing modalities, hospitals are returning to the roots of Western medicine. ~sara baker.

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Don’t forget to visit Sara at her website Sara Baker titled “Woven Dialog Workshops,” and blog ‘Word Medicine.’

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Listening to Music: another Creative Intervention for patients

I think music in itself is healing. It’s an explosive expression of humanity. It’s something we are all touched by. No matter what culture we’re from, everyone loves music.” ~billy joel

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Like art, many believe music to be a universal language…that there is no need for words.  To the listener, the effects of music is both simultaneously individual and universal, i.e., communing with oneself and the larger commUNITY.

Music can induce both physiological and psychological responses in you.  The use of music to promote health and well-being is referred to by many as music therapy.  However, I prefer the term ‘Creative Intervention or Music Intervention,’ over music therapy.  Why?  Because, the word ‘therapy’ is most often associated with the behavioral music-notes6health field where healthcare professionals have expertise in the art of helping a patient psychologically.   A study of an arts support program concluded the word ‘therapy’ may be threatening to patients because most do not view themselves as needing ‘therapy.’ (1)   But, I’m not going to quibble about choosing a couple words; the most important thing is implementing music as a creative modality in healthcare so patients, families, healthcare professionals, management team and local communities all benefit.

Benefits of Listening to Music

Several studies conducted by nursing academicans present the use of music as an effective, noninvasive intervention in creating a healing environment to promote health and well-being.  Below are the main points on the physiological and psychological responses in listening to music (2-4):

  • Themes identified in art literature are similar with the values in nursing theory, i.e., beauty, personal sensitivity, celebration of life, compassion, consciousness, patience, dignity, spiritual healing, and expression of human experience
  • The arts (music) have a liberalizing effect…stimulating artistic creativity and creativity of the body in wellness and healingmusic-notes41
  • Music relieves anxiety, pain, increases feelings of relaxation, heightens the immune system, decreases blood pressure, pulse and breathing
  • Music affects emotions via the limbic system where memories are evoked in response to sensory stimuli
  • Reduces stress levels and feelings of isolation
  • Music may stimulate the release of endorphins – the body’s natural opiates and associated with pain relief and pleasurable emotions
  • Improves motivation and elevates mood.
  • Fosters comfort in uncomfortable situations
  • Listening to music increased salivary immunoglobulin A, serum melatonin levels, and decreased muscle rigidty.
  • Allows patients a sense of control in an environment that often controls them

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Another qualitative study confirms the benefits of music with patients with advanced or end stage cancer at a cancer center in Australia.  Patients’ and family comments included “aliveness,” “expanded consciousness in a context where life’s vulnerability is constatnly apparent.” (5)

Music offers the nursing profession the chance to explore new strategies to enhance their care, and can be part of nursing’s healing modalities in meeting patient outcomes. Nursing interventions have always been to support, facilitate, and validate; the use of music and other creative activities in healthcare settings is no different.

To heal means not only to become well, but whole…bringing the person back in harmony with oneself, including physically, cognitively, spiritually and emotionally.

Author, Daniel Pink, concludes in his book A Whole New Mind: why right-brainers will rule the future that “the detached scientific method is no longer sufficient in medical treatment and care…approach to patient care is changing from detached concern to empathy…nursing is an empathic profession and will be one of the key professions in an age where many technical services are being outsourced, e.g. x-rays outsourced to Bangalore radiologists, etc.  Empathy – touch, presence, and comfort cannot be outsourced; it requires emotional intelligence and compassion.”

Note: if you want the bibliography – email me.

 

Creative Interventions as Patient Amenities in Hospitals

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What do consumers look for in hospitals?  A recent article in BusinessWeek (Feb. 16, 2009) touched on this topic by citing a RAND marketing survey that plush accomodations may be more of a draw than high-quality care.  2 RAND economists studied hospital choices of 8,721 Medicare patients diagnosed with pneumonia.  The study showed a high amenities score of a hospital was more popular with patients than a low pneumonia mortality (death) rate, pneumonia-mortalitywhich I find very interesting.  If I were diagnosed with pneumonia, should I go to Hospital A with a low death rate, and therefore, a much greater chance of recovery and survival or  Hospital B that functioned more like a hotel with gourmet meals, flat-screen TVs and plush accomodations  - hmmmm, let me think about this!

Apparently, Medicare patients diagnosed with pneumonia preferred the fluff amenities of plush accomodations, flat screen TVs, cable.  Instead of offering hotel-like services, let’s focus on the business of healing by offering cost-effective Creative Interventions as patient amentities over cushy accomodations.  Here’s a few questions to ponder on:ultimate_creativity_for_site

  • Which is more cost-effective – creative interventions for patients or expensive accomodations in a financially overburdened healthcare system? 
  • Which service will be more benefical to patients and families long-term – creative interventions or a designer comforter? 
  • Which service addresses and complies with the standards set by  Joint Commission (JACHO) and the Commission on Cancer – creative interventions or plush accomodations?

My idea of patient amenities are not flat-screen TVs, gourmet meals, concierge services and the like.  I understand the desire for fluff services – when I’m well so I can enjoy and appreciate them.  If I’m sick, well, I just want to get better so I can return to my life.  I believe comfortable and soothing environments are conducive to healing…gardens, nature, soft lights, along with offering Creative Interventions (creative amentities) to patients.

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   Creative Interventions = Patient  Amenities

 mhand_infinity_sm                                                        (“infinity” Marti Hand, 2008 )

Below is the abstract for the RAND study…

“Hospitals As Hotels: The Role of Patient Amenities in Hospital Demand” 

Amenities such as good food, attentive staff, and pleasant surroundings may play an important role in hospital demand. We use a marketing survey to measure amenities at hospitals in greater Los Angeles and analyze the choice behavior of Medicare pneumonia patients in this market. We find that the mean valuation of amenities is positive and substantial. From the patient perspective, hospital quality therefore embodies amenities as well as clinical quality. We also find that a one-standard-deviation increase in amenities raises a hospital’s demand by 38.4% on average, whereas demand is substantially less responsive to clinical quality as measured by pneumonia mortality. These findings imply that hospitals may have an incentive to compete in amenities, with potentially important implications for welfare.  (Dana Goldman and John A. Romley. 2008. “Hospitals As Hotels: The Role of Patient Amenities in Hospital Demand” National Bureau of Economic Research Working Paper)

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Something to ponder on…”More damage has been done to others by persons leading lives of quiet desperation…” Neale Donald Walsch, 1998 in Conversations with God: an uncommon dialogue.

Are you living your life in quiet desperation?

Drumming to WELLNESS

I was browsing through some old pictures a few days ago,  and came upon photosdrumming1 of a drumming circle I had at my home a few years ago, and decided to use drumming as the topic for this post.

In the picture to the right, is my friend Judy Chiger, teaching and leading us (all women) in musical expression with drums.  Judy is a physician, holistic practitioner, and promotes drumming as a mechanism for stress reduction, health promotion, spiritual connection, healing,  and fun – something we all need more of.  The drums she uses are Health Rhythms.

Drumming Circles

Drum or drumming circles are not new…they’re probably one of the oldest forms of community and team building known.  Drumming is becoming a cultural phenomenom, and the media is beginning to report on the proliferation of group drumming and its application for health and wellness.  

Drumming circles essentailly provides a portal into musical and creative expression, making it an easy and accessible experience for anyone at any age or ability.  Most people participating in drumming circles are most often not professional musicians.

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(drumming circle and blowing bubbles at night, 2006)

Drumming circles are happening in many, many places. People attend these events not to become better percussionists, but to reduce stress, build commUNITY, and have fun. It is an expressive and musical activity that engages the mind, body, spirit, and emotions.  Arthur Hull, father of the modern day drum circle, developed his unique approach to facilitating drum circles in the 1980s through an observation of the nmusic-notes1eed that extended beyond percussion skill development. According to Arthur, “when we drum together, it changes our relationships and helps us cope with whatever challenges life hands us.”

Other healing and transforming effects can occur when people join together in drumming. Those who’ve been depressed can recover their overall will to live through this kind of celebration.

Benefits of Drumming

Music can also allay stress. In one recent study, neurologist Barry Bittman of the Mind-Body Wellness Center in Meadville, Pennsylvania, drumsgathered a group of 10 people and had them beat hand drums for an hour while a music “facilitator” conducted. Afterward, Bittman took blood samples. The drummers, he found, had heightened levels of immune cells called natural killer cells that seek out and destroy both cancer cells and cells infected by viruses. A control group that read in silence experienced no such upsurge.

Bittman believes that group drumming, through its camaraderie, support, exercise, and music making, signals the brain to lower the production of cortisol, a stress hormone secreted by the adrenal glands. Less cortisol has been associated with a heightened immune response and may help the body fight off infection. “I’m not saying I have a cure for cancer,” Bittman cautions. “But what I am saying is that we have a very important step in understanding a delightful, enjoyable, and fun way for people to reverse the stress response in a manner that leads us to positive biological changes.”  (Discover Magazine. By Josie Glausiusz,  August 2001)

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(drum circle held in hospital education center, UK)

African and Asian cultures have been practicing community percussion for thousands of years. Now Americans are fast joining “drum circles,” informally or through organized centers, to reduce stress, connect with others or just jam. A recent study in the journal, Alternative Therapies, even found an increase in disease-fighting cells among participants in drum circles. (Time.com.  Drumming Circles By Harriet Barovick.  Monday, May 7, 2001)drum-healthrhythms

Drumming in Healthcare

Drumming can be incoporated into all types of healthcare settings for music making, such as inpatient hospitals, outpatient facilities, VA hospital systems, cancer centers, children’s hospitals, support groups, women’s centers and medical practices.  Patients, families and healthcare staff can drum their way to:

  • personal health
  • social well-being
  • combat social isolation and lonliness
  • reduce stress, anxiety, depression
  • boost their immune system
  • enhance overall well-being

Other areas worth exploring are corporations for teambuilding and local recreational centers for commUNITY building.

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And now, I leave you with this thought…

Medical treatment is fully effective only when the whole person is being treated – body, mind, spirit, emotion.