Kozak L, Kayes L, Walkinshaw K, McCarty R, Congdon S,
Buri M, Standish LJ.
Use of complementary and alternative therapies in hospice
care: results from a 2005 survey in Washington State.
Bastyr University, 14500 Juanita Dr NE, Academics
& Research, Kenmore, WA 98028. leilak@bastyr.edu
PURPOSE: The purpose of this study was to assess
the use of complementary and alternative (CAM) therapies in hospice
care in the state of Washington.
METHODS: A list of hospices offering inpatient
and outpatient care in Washington State was obtained through the Washington
Hospice and Palliative Care Organization and the Washington State Department
of Health. Only organizations identified as hospice providers were included
in the survey. We excluded organizations that offered home health care
but were not primarily hospice providers. The survey consisted of 11
questions inquiring about type of CAM services available, "popularity"
of services offered, the hospice's daily census, marketing strategies
used to offer these services, how the comfort care program was administered
and how and if the providers were paid for these services. One of the
investigators contacted all hospices by phone and obtained answers from
either the hospice's director, a nurse with administrative duties or
a volunteer coordinator.
RESULTS: The survey's response rate was 100%.
Results indicated that 86% of Washington State hospices offer at least
one type of CAM therapy to their patients. For those hospices, massage
was the most frequently offered therapy (87%), followed by music therapy
(74%), energy healing (65%), Aromatherapy (45%), Guided imagery (45%),
Compassionate Touch (42%), Acupuncture (32%), Pet therapy (32%), Meditation
(29%), Art therapy (22%), Reflexology (19%), and Hypnotherapy (16%).
A category of "Other therapies" (with a frequency use of 25%)
included therapies such as life review, soothing video, gardening, chi
gong, and volunteer companionship. The majority of hospices (93%) relied
either on volunteers or a combination of volunteers, grants and donations
to offer such services. Only two out of the 36 hospices interviewed
relied either on out of pocket payments or a combination of out of pocket
and hospice funding (7%). Most hospices (74%) offered between three
to seven different therapies. Four hospices (12.9%) offered one or two
therapies while another four (12.9%) offered between eight to twelve
therapies.
CONCLUSIONS: CAM therapies appear to be widely
used in comfort care in Washington State hospices. At least 17 different
CAM therapies were offered through hospice care. Massage, music therapy
and energy healing were the most offered therapies. These CAM therapies
are usually offered either through volunteers or a combination of volunteers,
grants and donations. Most hospices (86.9%) offer a variety of CAM therapies,
ranging from three to twelve different CAM modalities per hospice.
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