National Advisory Council on Aging - Expressions - Alternative Medicine and Seniors: an Emphasis on Collaboration

Not a week goes by without alternative medicine being mentioned. Seniors are no exception to this; they too are becoming more and more interested in alternative medicine. In fact, for many people, alternative medicines are not necessarily that 'alternative'. For a great number of Native seniors and seniors from Asia and the Middle East, traditional medicine is not the kind of medicine used by North Americans.

The majority of medicines which are now referred to as 'alternative' have their source in time immemorial. Herodieus, one of Hippocrates' teachers, used massage in the 5th Century B.C. to extend the life of his older patients. He had so much success that Plato reproached him of unduly prolonging the life expectancy of the elderly. Despite this reproach, Plato faithfully adopted the practice of being massaged regularly until he died at age one hundred and four.¹

For the past two centuries, scientific medicine from the Western world overshadowed the ancestral knowledge of the healing power of touch, plants and other means. The success of major discoveries such as inoculation, pasteurization, antibiotics and the production of powerful medications by chemical synthesis, as well as the growing influence of medical doctors explain why the situation has arisen. Since then, the two types of medicine have coexisted and struggled with each other, sometimes for the better of the sick, and sometimes at their detriment.

Scientific medicine is familiar to us in Canada. What about alternative medicines? What are their techniques? Are they useful for seniors? While a small percentage of seniors currently use them, tomorrow's seniors, people aged 50 to 64, are already using them fairly frequently.

Since its creation, the National Advisory Council on Aging (NACA) has encouraged seniors to get as much information as possible about the health care services and drug treatments they are prescribed in order to make informed decisions. This advice remains, whether it concerns traditional or alternative treatment.

Since age stereotypes can cause professionals to make mistakes in their clinical judgements, NACA has always invited health care professionals to be sensitive to the specific needs of seniors. Similarly, the need for a better awareness of seniors is applicable to alternative practitioners.

Medicines for the Body and Soul

Perhaps you have tried chiropractic, homeopathy, acupuncture or massage. Other practices such as Ayurvedic medicine, shamanism, therapeutic touch and Reiki may seem more exotic. And you may not have even heard of the founders of certain methods or schools aimed at promoting well-being, such as the Feldenkreis Method, Trager and Barbara Brennan's Healing Science. This is not surprising: a glossary found on the Internet listed no less than 128 'alternative' practices.

A few of these practices, such as massage and chiropractic, focus primarily on the body. Others take a more holistic approach. They are based on the principle that physical problems are often caused by lifestyles, behaviours and value systems that are inappropriate for the individual. According to Marie- Isabelle Dumazeaud, a medical doctor and acupuncturist, the difficult role of the therapist is to help the patient understand the meaning of the illness and that it did not just happen by chance. She figures that illness is the result of a conflict between the various levels of one's being. To heal yourself, you have to know what is good for you.²

The degree of interest in different practices also varies considerably. Some therapies are more widespread among given ethnic groups, such as shamanism among North American Aboriginal peoples, acupuncture and Qi-Jong among the Chinese, and Ayurvedic medicine among East Indians and Pakistanis. However, the popularity of the various techniques is increasingly extending beyond the boundaries of these communities.

There are several explanations for the popularity of alternative therapies. According to the Report of the Task Force on So-Called Alternative Therapies, published by the Corporation professionnelle des médecins du Québec in 1989, "Modern scientific medicine's commonplace use of therapeutic interventions and extensive use of technology and pharmacotherapy produce spectacular results, but sometimes involve undesirable side effects. In addition, changes in the patient/physician relationship, particularly a too frequent lack of dialogue, listening and empathy, result in many unmet expectations."

Indeed, the medical and hospital sectors are often criticized for the dehumanizing aspect of their exclusive focus on physiology and biology. They treat a heart, a stomach or a leg, not the whole person. Ideologically, the holistic approach of alternative medicines seeks precisely to take into consideration people's values, attitudes, behaviour, emotions and even spirituality and to use them as levers to promote healing.

For some people, using alternative therapies is the result of a conscious health choice. They have adopted a lifestyle that is close to nature and, politically, they have chosen to rely on the formal health care system as little as possible.

For still others, it is a matter of having no other choice. Suffering from lung and brain cancer, Franklin Dantremont had exhausted the resources of scientific medicine. He recounted his experience at the Medical Wellness Centre, a clinic in Chester, Nova Scotia. The first thing the therapist told him was that he could not cure his cancer, but that he would help him boost his immune system. "He supported me, first of all, in my spiritual beliefs and I feel without that I would have no peace and quiet in my body to do the rest of the stuff" (physical improvement).³

As well, immigration has brought about an increased interest in practices from other countries and societies. Immigrants bring with them their values, their perceptions of health and illness, new knowledge and needs. Expressed or not, these needs eventually influence how the official health care services respond. This exposure to other ethnic groups opens up new horizons for health care professionals, who sometimes decide to become better informed about these practices. Some of these health care professionals have learned to master these techniques and decided to incorporate them into their therapeutic approach.

Finally, cost is sometimes an important factor. For example, in Cuba, Fidel Castro has ordered the ministries of public health and agriculture to institute the practice of alternative medicines and to grow medicinal plants. Since they can no longer import pharmaceuticals because of the collapse of the country's economy, Cuban physicians, dentists and veterinarians must now learn to use plants to treat people. The government has even set up a program to collect remedies used by elderly people in rural areas.⁴ Obviously, Canada has not reached this point. But on an individual level, it may prove to be less expensive to use certain plants than a pharmaceutical drug.

However, a substantial proportion of the public and medical community find it difficult to have confidence in something that is not scientifically proven or in practitioners whose training is not recognized by official institutions. Furthermore, alternative practices are rarely regulated and no government or professional body is responsible for ensuring the quality of this care. As well, this field, like others, has its share of charlatans and quacks who take advantage of people at a time when they are most vulnerable.

It is a sign of the times that increasing efforts are being made to evaluate alternative therapies in relation to Western scientific medicine. On October 21, 1996, the Vancouver Hospital and Health Science Centre in British Columbia opened the Tzu Chi Institute for Complementary and Alternative Medicine, a project aimed at integrating Western medicine with traditional Asian therapies. According to the hospital's president, Murray Martin, the project is innovative in two respects: it provides traditional practitioners with a work space at a major Western hospital and, through rigorous scientific research, it will make it possible to verify or disprove the value of these practices.⁵ Moreover, the staff members have agreed that the Institute's ultimate goal would be to set standards for alternative therapies.

Health Canada, for its part, has funded two projects of interest as part of the Seniors Independence Research Program. The first, set up by Muriel Montbriand, Saskatoon District Health and Applied Research/Psychiatry, is entitled Senior and Professional Perceptions and Communication About Use of Medications: Prescription Medications and Alternative Therapies. The second project, headed by Erin Tjam, is a survey on the distribution of Chinese medicines by Canadian retailers. Ms. Tjam is studying the use of Chinese and Western medicines by elderly Canadians of Chinese origin from Ontario's Waterloo area. Using the information collected, the two researchers plan to develop educational programs on the subject. The findings of the studies are expected to be available in 1998-1999.

The common element shared by all alternative therapies is that health is the condition of perfect balance in the body, the state in which the least effort is expended. According to Dr. Andrew Weil, author of Spontaneous Healing, when the body is no longer in balance, it seeks to regain that balance.⁶ Here is a brief summary of some approaches which help maintain or restore the body's balance.

Massage does not offer a treatment for specific illnesses. However, it helps to relax the mind and the body and to soothe the worries and muscle tensions of daily life. Physically, this therapy seeks to improve circulation, muscle tone and the nervous system and also to help the body rid itself of wastes.⁷ There are several massage techniques - Swedish, shiatsu, California - and they are adapted to the clients' age and physical condition. However, massage is not recommended for people who have fever, varicose veins or phlebitis.

Therapeutic touch, popularized by Dolores Krieger, a professor of nursing, is a massage of the human energy field, called the 'aura'. This practice is based on the idea that there is a universal energy that sustains all life. When a person is healthy, the energy flow is smooth and balanced. When a person is ill, physically or emotionally injured, the flow is blocked. By moving his or her hands in the patient's energy field, the therapist can sense that blockage and restore vitality where there is depletion.⁸ This technique is used, for example, to reduce swelling from sprains, to calm car accident victims and to reduce stress, be it in newborns or the dying. In the United States, more than 200 hospitals have nurses trained in this technique and Canada is following close behind, with Nova Scotia leading the way.

Chiropractic is a method of treating pain through manipulations of the joints, to improve circulation and repair mechanical defects of the spine. Movement of any part of the skeleton can put pressure on the nerves and increase or decrease their transmission capability, thereby creating a dysfunction which can cause illness.⁹ It was based on this observation and reportedly after restoring the hearing of his caretaker, who had been deaf for 17 years, that Daniel D. Palmer established the first school of chiropractic in New England. This technique practised with the hands uses neither drugs nor surgery.

More than 90% of a chiropractor's patients suffer from musculoskeletal problems such as back pain and neck pain.¹⁰ According to the 1994 National Population Health Survey, chiropractic services are the most common non-conventional form of health care. Some 15% of respondents reported using a form of alternative medicine in the previous year, and 11% of these had consulted a chiropractor.¹¹

In 1810, the German physician Samuel Hahnemann proposed a method which emphasized each individual's unique character and claimed that his or her constitution determines the diseases to which he or she is more susceptible and the symptoms likely to appear.¹² He had rediscovered a principle expressed by Hippocrates in the fifth century which states that 'like cures like'. He concluded from this that symptoms are the body's means of defence and that substances capable of reproducing the symptoms of a given disease could be used to heal that disease.

Homeopathy is used to treat such conditions as allergies, hay fever, respiratory infections, migraines, and certain types of rheumatism and disorders of the digestive system. Homeopathic medications are composed of highly diluted toxic natural substances that are found in plants, animals and minerals. Homeopaths believe that the more the substance is diluted, the more powerful it is. According to Rhonda Beauregard, a Montreal homeopath, it is important to ask seniors who come for a consultation whether they are taking any medications in order to avoid prescribing homeopathic products which might cause negative interactions. The question is also useful for determining the level of dilution of the product should a remedy prove to be necessary.

According to Chinese medicine, the interaction of six external factors (wind, cold, heat, moisture, dryness and internal heat) with the seven emotions (happiness, anger, worry, pensiveness, grief, fear and surprise) can cause disease. This theory, coupled with the theory of 'latent phenomena' such as the predominance of yin or yang, is used to analyze the patient's constitution and his or her illness and to diagnose the exact nature of his or her physical and psychological loss of balance.¹³

Acupuncture, the most well-known of Chinese medicines, is some 5,000 years old. Depending on the quality of the pulses (there are three), the acupuncturist determines whether yin (female energy) or yang (male energy) is displaced. If the pulses are too strong, hard or full, there is too much Chi, the vital energy flow, in one organ or another. The therapist will then use needles to direct Chi to where it belongs. Chi travels along 12 meridians connected to the lungs, heart, colon, liver, spleen and other organs. When the needles are placed in the meridians, they help rebalance the energy in the body and the meridians.¹⁴ This technique is used, among other things, to treat arthritis, infections, allergies, insomnia, physical and mental stress and dependency on drugs.

There are other Chinese medicines. Qi-Jong, for example, is a system of exercises designed to stimulate and balance Chi along the acupressure meridians. It is used to reduce stress and improve blood circulation and immune functions. Tai-chi and aikido, well-known martial arts, are used to promote good physical condition and relaxation, as well as to foster spiritual and mental development.

The Chinese also rely on a vast plant, animal and mineral based pharmacology prescribed in the form of teas and infusions. The medications are prescribed in the form of poultices, powders, oils and alcohols.

Traditional Native medicine also operates in a holistic way. Today, many Native people are aware that their definition of health matches that of the World Health Organization. They agree that individual health depends not only on a person's individual resources, but can best be assured through maintenance of healthy social, economic and cultural systems. Two levels of intervention seem to be necessary when an individual becomes sick: intervention with the person and intervention with the person's entourage and environment. According to Bertha Blondin, a healer of the Dene Nation, the individual has to take responsibility for his or her own healing. Too often, she says, people give others the responsibility and in a disconnected way to take care of their mind, their body, their emotions and their spirituality. "As a healer I was taught that you never separate the four. You always take the four parts and connect them all together."¹⁵ However, this is not enough. For Sylvie Basile and Chief Jean-Charles Piétacho, both from Mingan First Nation Community, "the process of healing must be based on our traditional spiritual values of respect, pride, dignity, sharing, hospitality and mutual aid..."¹⁶ NACA member Peter Fraser adds that healing cannot be taught to someone who has never been sick.

Since the Elders (also known as the Old Ones, the Wise Ones, Grandmothers and Grandfathers) are living embodiments of Aboriginal traditions and cultures, they have an important and very visible role in the healing process. "Through the Creator's gifts and their years of walking the earth, they have acquired knowledge and experience to live well and thrive in the physical world."¹⁷ Elders are the keepers of spiritual knowledge. They know the healing benefits provided by the human touch, plants (for example, the muskeg), animals (for example, the beaver), minerals (for example, the soapstone), symbols of their culture (for example, the medicine wheel), Healing Circles, Spirits, sweat lodge ceremonies and the interpretation of dreams. One of the means the Elders use is the 'Kumik', also known as the Elders' Lodge. They operate in a fashion similar to that of self-help groups.¹⁸

The Royal Commission on Aboriginal Peoples recognizes the importance of the role of traditional healing among Native communities. In its final report released to the public in November 1996, the Commission recommended that "Governments, health authorities and traditional practitioners co-operate to protect and extend the practices of traditional health and healing and explore their application to contemporary Aboriginal health and healing problems."¹⁹

Certain ancient methods have been adapted in the West, such as those used by Reiki, Pathwork and the Barbara Brennan School of Healing. These methods use the hands' innate ability to heal.

Barbara Brennan, physicist, healer and teacher, believes that "illness is the result of imbalance. Imbalance is a result of forgetting who you are. Forgetting who you are creates thoughts and actions that lead to an unhealthy lifestyle and eventually to illness."²⁰ She also believes that in order to get a good knowledge of oneself, it is necessary to look inside the layers of the aura.

It is in these layers (which are larger than the body but are also part of it) that the repressed emotions and negative attitudes which are responsible for energy blockages are found. Since energy is no longer flowing in a balanced manner from these layers to the physical body, the organs and other structures, such as the circulatory system, are affected.

To 'repair' the aura, 'chelation' is used; this is a technique whereby the energy of the healer's hands interacts with the energy of the client and helps to unblock the blockages in order to restore the balance of the individual's metabolism. (Chelation should not be confused with another technique by the same name which consists in giving a series of intravenous injections of EDTA, an amino acid, to treat patients suffering from arteriosclerosis.) The role of therapists is to identify energy blockages and help their clients recognize their harmful value systems, to become aware of them and to experience the emotions which they have repressed or even forgotten. Ms. Brennan believes that once released, these emotions give way to the energy of healing which love of oneself, love of others and spiritual love bring. According to her, this interaction is also beneficial to the person providing the chelation.

Although this approach is not aimed specifically at healing physical illnesses, it frequently happens as a sort of fringe benefit that the illness subsides or disappears. Clients of all ages suffering from various problems (cancer, ovarian cysts, scoliosis, infections, diabetes and alcoholism) claim that they have been transformed.

There are examples of effective collaboration between conventional and alternative medicine. This is the case of Margaret Nazer, of the Boston Veterans Administration Hospital, who treats stroke and head injury victims. She combines her knowledge of Western medicine and her training in acupuncture and is able to identify from CT scans those patients who will respond well to acupuncture, that is, those whose symptoms will be alleviated.²¹

Many people from all backgrounds and traditions dream of the day when these various medicines will be integrated into a single, unified form of medicine, offering people the knowledge they need to preserve their health, to recover when they are ill or to improve their quality of life if they suffer from a terminal illness.

IN MEMORIAM

The National Advisory Council on Aging regrets to report that Mary Davis, a founding member of NACA, passed away in Edmonton, Alberta, on December 30, 1996. She was committed to gerontology and to a better recognition of all seniors.

In 1994, 12% of Canadians consulted both a doctor and an alternative medicine practitioner. Only 2% of adults relied exclusively on some form of alternative medicine. The use of alternative medicine tends to be more common among women (16%) than among men (13%).
Millar, W. and M.P. Beaudet. Data taken from the 1994 National Population Health Survey. Canadian Social Trends, Spring 1996, p. 27.

A number of studies have shown that it is the most educated and highest income-earners who make greater use of alternative medicines.
Kelner, M., B. Wellman and B. Wigdor. The Use of Medical and Alternative Care by Older Adults. Research conducted at the Institute for Human Development, Life Course and Aging, University of Toronto.

A study conducted on the use of medicine, both conventional and alternative, among certain Torontonians over the age of 55 shows that only 42 of the 240 respondents had consulted an alternative medicine practitioner. The author noted that patients using this approach are more likely to take an active part in their health care.
Kelner, M., op. cit.

A gerontology research team in Vancouver studied self-health techniques among 940 adults over the age of 50. The most common techniques were exercise (70%), dietary changes (50%), stress reduction (50%), weight control (50%), prayer and meditation (45%) and smoking cessation (25%). Self-help groups (10%) and alternative medicines including plant-based remedies, acupuncture and massage (15%) were the least used.
Mitchell, B. Preliminary Results from the First Wave. North Shore Self Care Study Newsletter, August 1996, p. 3, published by the Gerontology Research Centre of Simon Fraser University, British Columbia.

Americans spend $13.7 billion every year on therapies of all kinds.
Langone, J. The Frontiers of Medicine. TIME, Special Issue, October 1996.

According to an American survey, 91.5% of respondents indicated that their symptoms had disappeared or improved after acupuncture treatment; 84% reported that they were seeing their doctor less; 79% said that they were using fewer prescription drugs and 70% reported that they were able to avoid surgery which had been recommended to them.
Cassidy, M.C., Ph.D. Patients' Own Words. Survey conducted by the Traditional Acupuncture Institute among 575 people, 1991. Article on the Internet.

Poundmaker's Lodge: A Healing Place. Director: Obomsawin, A. Video produced by the National Film Board, 1987. (29 minutes)

Healing Spirit. A journey within, to a place where spirit and matter touch. Director: Schuurman, H. Video produced by the National Film Board, 1993. (57 minutes)

The Spirit Within. Directors: Campbell, W. and G. Cardinal. Video produced by the National Film Board, 1990. (51 minutes)

Janiger, O. and P. Goldberg. A Different Kind of Healing. New York: A Jeremy P. Tarcher/Putnam Book, 1993.

Therapeutic Touch: A Video Home Study Course for Family Caregivers. A video by Janet Quinn, available for $29.95 from the National League for Nursing, 350 Hudson St., New York, NY 10014. Orders can be placed by calling 1-800-669-9656, extension 138, free of charge.

Wieland, D. et al. Cultural Diversity and Geriatric Care: Challenges to the Health Professions. New York: The Haworth Press, 1994.

Notes

¹,²Dumazeaud, M.-I. et al. Pour soigner autrement. L'infirmière et les médecines différentes. Paris: Éditions Lamarre, 1990. p. 104, 259.

³ The Nature of Things - Teaching new doctors new tricks, television program hosted by David Suzuki, broadcast on CBC, November 7, 1996.

⁴ Walker, G. Saved By Disaster, Cuba Goes Holistic. Natural Health, July-August 1996. p. 90.

¹⁶,17 Royal Commission on Aboriginal Peoples. People to People, Nation to Nation. Ottawa: Supply and Services Canada, 1996. p. 103, 60.

¹⁸ For more information on the Kumik, contact Louise McGregor at Indian and Northern Affairs Canada, 10 Wellington St., Room 102, Hull, QC K1A 0H4, tel.: (819) 953-2913; fax: (819) 994- 7171.

20 Brennan, B.A. Hands of Light. New York: Bantam New Age Books, 1989. p. 131.

Expression is published four times a year by the National Advisory Council on Aging, Ottawa, ON
Canada K1A 1B4,
tel.: (613) 957-1968
fax: (613) 957-9938.

E-mail: info@naca-ccnta.ca
Internet: http://www.phac-aspc.gc.ca/seniors-aines/index.html

The opinions expressed do not necessarily imply endorsement by NACA.
ISSN: 0822-8213.