Massage for Those in Later Life Stages

Comment

Comment by Lisa Curran Parenteau on October 6, 2009 at 1:23pm

John,

I am oging to send your comments to a colleague at the Hospice of the FL Suncoast-who may be able to shed some light-I will get back to you here-also please consider posting on the Compassionate Touch facebook page-perhaps others may have some ideas as well.

Comment by John C. Tresise on October 6, 2009 at 1:03pm

Has anyone recently experienced a change in how they are being asked to work with hospice patients. Let me explain:

I worked as an independent contractor for a small, privately owned hospice for about eight years. About three months ago, I was told that I could no longer work as an independent contractor, that I would have to become an employee of the hospice. It was explained that the Medicare Conditions of Participation NOW required that ALL therapists be employees. I searched the COP's extensively and found that Massage Therapists were NOT specifically named (as were Speach Therapists, Physical Therapists, etc who were specificaly named) as needing to be employees. The COP's have provisions for a hospice using an independent contractor, but those conditions do require extra monitoring of those contractors activities. I asked the hospice where in the COP's MT's were required to become employees and was told, "well, they're not in the COP's but in the "Interpretations." When given the option of becomming an employee I asked for a few days to think it over and offered to continue to work with my patients on a "volunteer basis." I also added that if I chose not to become an employee, I would continue to work with these folks on a volunteer basis until they all made their transitions. I was told that the COP's did not allow for massage therapists to work as volunteers.

In as much as the hospice work comprised 80 to 85% of the work I was doing, becoming an employee would have seriously jeopardized my status as a "business owner" and therefore all the business write-offs come tax time. This and a number of other changes in the way we were going to be allowed to work with patients prompted me to severe my relationship with this organization.

I was charging, basically a dollar minute for the time my hands were actually on a patient or caregiver. I charged mileage, but not for any of the time going to or from a client's home, for the time I did paperwork or for any time in conversation/counselling apart from when I actually had my hands on a client. Actually, I did keep track of that time and donated it to the hospice as "volunteer hours" to help them meet their Medicare volunteer component. I explain all of this only to say that the overall economic impact to the hospice by making this change would not have been significant because, as an employee, I would have been paid for all of this additional time even though the overall hourly rate would have been less.

Hospice work has been extremely satisfying and I have been told on many occassions by family and other hospice staff that the work I did really made a difference. I would like to continue to do hospice work, but am discouraged in doing so because I'm afraid that this has become the rule and other hospices I may approach will require me to become an employee?

So, I'm curious if anyone else has been confronted with the same interpretation of the Medicare Conditions of Participation and if so, what relationship they have taken to the change?

Comment by Lisa Curran Parenteau on October 6, 2009 at 11:44am

Interesting post differentiating reversible and chronic dementia
Dementia - More Than Just Memory Loss

Comment by Lisa Curran Parenteau on September 30, 2009 at 11:27pm

Great new post from Irene Smith of Everflowing
Professional Integrity; An Ongoing Process

Comment by Le Murray on September 30, 2009 at 6:48pm

I am looking for an AIS seminar or further info...is there anything AIS that is specifically tied in with geriatric work or have you just adapted it?

Comment by Lisa Curran Parenteau on September 2, 2009 at 9:31am

Great post on CareBuzz
"But just because it occurs doesn’t mean it’s okay. Take a stand against it with these tips for abolishing ageism:"
6 Tips for Abolishing Ageism

Comment by Ann Catlin on August 31, 2009 at 1:09pm

Hi all,
Thanks, Lisa, for setting up this group-- it serves us all to connect with like-minded people. While at an airport recently someone left behind their Sept. issue of Oprah and I opened it to an article called Do You Have Compassion Fatigue? Burnout/fatigue is an issue not only for family caregivers, but professionals, too. This forum for connecting with others is one small way to take care of ourselves. Thanks!

Comment by Lisa Curran Parenteau on August 29, 2009 at 7:12am

Great article
Eldercare and Caregiver Burnout - Your "Caring" May Be Contributing...

Comment by Lisa Curran Parenteau on August 28, 2009 at 10:36pm

Jagruti,

I 'd love to hear more about your experiences! How did you get engaged with your patients? What does your pricing structure look like? What are some tips you would share with other therapists who are interested in doing this work?

Lisa

Comment by Rudy Munoz on August 28, 2009 at 10:31pm

Noreen, AIS is Active Isolated Stretchging. Check out stretchingusa.com or Aaron Mattes in google. Incredible tool for getting people that are having leg, shoulder, and neck pains. You simply apply a light dose of AIS and they think you're more powerful than a doctor. Of course you must have some sense of the way older muscles can be rather brittle or stringy dry. Again due to the lack of hydration, which you must convince them that hydrating is better in most cases to help moisten the organs and soft tissues. AIS allows you to work fully clothed lying down, side lying, sitting, or prone positions. Most elderly don't move about like they used to even as recently as five years ago. Injuries, medications, emotional trauma, loss of balance, these all contribute to the reasons why their muscles tend to be somewhat tightened and tense most of their wakened time. They are afraid to fall! Imagine having that fear everytime you ambulate. That's scary! Anyway Adjusting AIS for the geriatric community is the way to go, along with your other touch modalities.I recommend a basic seminar in AIS with a certified AIS trainer or with Aaron himself.

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