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Alternative Medicine and Seniors:
an Emphasis on Collaboration
TABLE OF CONTENTS
Member's Editorial
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.
Peter Fraser,
NACA Member
Northwest Territories
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.
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Tips List
- Get information from family and friends. As well, there are numerous
publications on the subject of alternative medicines; your municipal
library probably has some. Health food stores are also familiar with
the resources in your community.
- Ask questions. If your alternative medicine practitioner recommends
an unusual procedure, think it over. Why is it recommended? Are there
any contraindications or side effects? What results can you hope for?
- Ask yourself whether you have confidence in the practitioner. Confidence
is important. Do you feel that this person is listening to your needs?
Does he or she understand your priorities? Is he or she able to allay
your concerns?
- Alternative therapies often require significant participation on the
part of the patient. Ask yourself whether you are prepared to commit
yourself to this process, which may require some major lifestyle changes.
- Beware of people who promise you a cure-all. There are fads in this
field as in others. Inquire about the type of training and experience
your practitioner has.
- As with any other service, re-evaluate your commitment to the selected
therapy if you do not obtain benefits from it.
Fact File
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.
For Further Information...
Siegel, B. Love, Medicine and Miracles. New York: Springer, 1986.
Weil, A. Health and Healing. Boston: Houghton Mifflin Company,
1983.
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.
Payer, L. Medicine and Culture. New York: Penguin, 1988.
Wieland, D. et al. Cultural Diversity and Geriatric Care: Challenges
to the Health Professions. New York: The Haworth Press, 1994.
1,2
Dumazeaud, 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.
5 Crary, D. Venture into ancient
healing gives some doctors a headache. The Ottawa Citizen,
Monday, October 21, 1996. p. A4.
6 Lemley, B. My Dinner with
Andy. New Age Journal, November-December 1995. p. 64.
7 Guide familial des
médecines alternatives. Sélection du Reader's Digest (Canada)
Limitée (ed). 1st Canadian edition, 1993. p. 224.
8 Arnold, J. The Healing Power
of Touch. New Woman, July 1996. p. 82.
9,10 Guide
familial des médecines alternatives, op. cit., p. 90.
11 Millar, W. and M.P. Beaudet. Health data from the 1994 National Population Health Survey. Canadian
Social Trends, Spring 1996. p. 30.
12 Guide familial
des médecines alternatives, op. cit., p. 186.
13 Chinese Medicine.
Article on the Internet.
14 Braun, P. Acupuncture. Article in Dr.
Bower's Complementary Medicine Home Page, on the Internet.
15 Cronin-Schafflit, V. Interview with Bertha Blondin May 1, 1995. Master's
degree thesis, not published.
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.
19 Canada. Guide
to the Principal Findings and Recommendations of the Final Report of the
Royal Commission on Aboriginal Peoples. Document enclosed in the
press kit distributed for the official release of the Final Report. Recommendation
3.3.21, p. 64.
20 Brennan, B.A. Hands of Light.
New York: Bantam New Age Books, 1989. p. 131.
21 The Nature of
Things, op. cit.
Expression on pensions available on audio cassette
NACA is pleased to inform its readers that Expression , Volume 10,
No. 3, entitled Canada's Retirement Income System: Myths and Realities
is now available on audio cassette. The cassettes, taped by the CNIB,
can be borrowed by calling the Council at (613) 952-7605 or by faxing
a request at (613) 957-7627. |
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.
The bulletin is also available on the Internet:
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.
VOLUME 11
NUMBER 2
WINTER 1996-97
PHOTO: Canapress Photo Services.
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