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Published on March 28, 2008

Author: csourby

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PALLIATIVE CARE:  3/28/2008 1 PALLIATIVE CARE SOUNDS AND SENSES IN THE GARDEN Charles Sourby, MS Ed. Bonsai Gardens, Seed Starting, Aroma Therapy, Plants of the Bible, Garden Prayers, Useful Terminology, Useful Plants Learn how therapeutic recreation & Horticultural therapy addresses a patient’s negative feelings; threats to self esteem, and help restore a sense of control, contributing to an improved health related quality of life. Reflection:  3/28/2008 2 Reflection To affect the quality of the day is the highest of arts. Henry David Thoreau Key Words:  3/28/2008 3 Key Words American Horticultural Therapy Association Cancer Care Commitment Disengagement Horticultural Therapy Life Continues Non-abandonment Patient Garden Palliative Care Psycho-Social Impact of Dying R.O.P.E.s Social Comparison Theory Terminal Illness The Horticultural Therapist:  3/28/2008 4 The Horticultural Therapist Horticultural therapists, traditionally concerned with the quality and potential of human life, face a difficult challenge in providing Horticultural Therapy in settings that serve people with life threatening illnesses such as advanced or end-stage cancer. Connoly--1993 Horticultural Therapy :  3/28/2008 5 Horticultural Therapy As defined by the American Horticultural Therapy Association (AHTA), horticultural therapy is a discipline that uses plants, gardening activities, and the natural world as vehicles of professionally conducted programs in therapy and rehabilitation. Horticultural therapy can be applied in every type of medical and social service setting ranging from hospitals, to corrections, to youths at risk, to vocational programs. AHTA Horticultural Therapy:  3/28/2008 6 Horticultural Therapy Horticultural therapy can address the dying patient’s negative feelings; threats to self esteem and help restore a sense of control, contributing to an improved quality of life. Horticultural Therapy goals focus on alleviating stress and anxiety, decreasing social isolation, rebuilding self-esteem, increasing independence, and maximizing functioning. The role of HT is to support the palliative goal in the treatment of advanced cancer patients. AHTA, 2004 Cancer:  3/28/2008 7 Cancer Despite all of the technological advances in medicine, some cancers simply cannot be cured. Cancer affects people from all cultures, socio-economic classes, ages, and backgrounds. More than 1.2 million Americans are diagnosed with cancer each year and no less than 500,000 die from the disease annually. CNN--1995 Slide8:  3/28/2008 8 Treatment often involves surgery, radiation, and chemotherapy. The disease and subsequent treatments can be painful and uncomfortable. For the patient who does not respond to treatment, or, who is medically determined to be at the end stage of the disease process, being admitted to a hospital or hospice is a common occurrence. Treatment for the patient at the terminal or end stage of cancer increasingly involves an approach called palliative care. Cancer Care Palliative Care:  3/28/2008 9 Palliative Care The palliative approach to treatment includes control of pain and other symptoms while simultaneously addressing the individual patient’s psychological, social, and spiritual concerns, in an effort to provide the best possible quality of life for the dying patient as well as his or her family. Stoll--1988 Palliative Care:  3/28/2008 10 Palliative Care Slide11:  3/28/2008 11 “Palliative care is the active total care of patients whose disease is not responsive to curative treatment. Control of pain, of other symptoms, and of psychological, social, and spiritual problems is paramount. The goal of palliative care is achievement of the best possible quality of life for patients and their families. Many aspects of palliative care are also applicable earlier in the course of the illness, in conjunction with anti-cancer treatment.” Conference On Care Near The End Of Life, Harvard Medical School. Division of Continuing Education, Boston 1995 Palliative Care Palliative Care:  3/28/2008 12 Palliative Care The Psychosocial Impact of Dying:  3/28/2008 13 The Psychosocial Impact of Dying Is monumental, involving the search for meaning, confronting fears, dealing with the loss of control, and issues of loss. The dying patient often experiences anger, guilt, disorganization, isolation, and depression. Kubler-Ross--1969 The Psychosocial Impact of Dying:  3/28/2008 14 The Psychosocial Impact of Dying Terminal Illness :  3/28/2008 15 Terminal Illness Terminal illness, such as advanced cancer, is defined as an illness that cannot be cured by present day medical technology and that generally leads to death within a specified period of time. Turk & Feldman 1992 Slide16:  3/28/2008 16 In Palliative Care, the sense of non-abandonment is paramount. Aaronson & Beckman--1987 Non—Abandonment Social Comparison Theory:  3/28/2008 17 Social Comparison Theory Those receiving palliative care need to socialize. Support is derived from seeing others in similar situations. Research demonstrates an elevated sense of hope and a better outlook following social interactions with peers. Brietbart & Holland—1993 Description of Patient:  3/28/2008 18 Description of Patient Description of Patient:  3/28/2008 19 Description of Patient The patient, often in pain, is to endure life’s final stages. (In some cases the diagnoses is less than ninety days old.) The patient receives palliative medical treatment and has psychosocial needs addressed through contact support, compassion, and comfort provided by a number of disciplines to help complete life with dignity and grace. Rando—1984 Calvary Hospital:  3/28/2008 20 Calvary Hospital Case Study: Barbara (see hand-out) Diagnosis: Terminal cancer of larynx and breast 1 year Background Complication of chemotherapy induces cardiac arrest. History of alcohol abuse Smoked two packs of cigarettes a day Retired teacher Barbara:  3/28/2008 21 Barbara Reason for referral Activities Results Program Planning: Learning the R.O.P.E.S. :  3/28/2008 22 Program Planning: Learning the R.O.P.E.S. Review-What garden activity preceded this one? Overview—What is the process? Presentation—Today’s garden activities Experiential—Immerse patient in the activity Summary—Review what happened Program Concepts & Design:  3/28/2008 23 Program Concepts & Design Patient Garden—the plants belong to the patients Living Legacy of Plants—I plant you a dish garden Life Continues—Through plants, life carries on Sounds, Senses and Healing—Music, Scents, Touch, Color and Prayer Garden projects:  3/28/2008 24 Garden projects Plants of the Bible Hold, touch, reflect Aroma Therapy Aware of the breadth of life Bonsai & Dish Gardens Disengagement gifts Planting Seeds Renewal The Spiritual Nature of Plants:  3/28/2008 25 The Spiritual Nature of Plants Plants have a spiritual value that is therapeutic in palliative care. Plants help patients cope, enjoy a sense of healing and regain perspective. The fragrance of Biblical flowers and herbs revitalize people at the end of life. Interacting with a flower or herb from the Bible lifts spirits and a sense that life continues. Sourby--1998 Group Therapeutic Horticulture:  3/28/2008 26 Group Therapeutic Horticulture January Winter twig study Seed catalogs Division propagation: Pot up various ferns February Start Caladium bulbs, plan garden Pressed flowers for Valentine Cards Sweet Potato House Plants Group Therapeutic Horticulture:  3/28/2008 27 Group Therapeutic Horticulture March Vegetable seed study/ poster Plant annuals Plants of the Bible Fantasy Garden Collage Group Therapeutic Horticulture:  3/28/2008 28 Group Therapeutic Horticulture April Signs of Spring Seedling maintenance Plant early peas Flower arrangements for Easter and Passover Group Therapeutic Horticulture:  3/28/2008 29 Group Therapeutic Horticulture May Window box planting (3 sessions) Mothers’ Day Flowers everywhere. Group Therapeutic Horticulture:  3/28/2008 30 Group Therapeutic Horticulture June Nature Drawing Press flowers, drying flowers Pinch mums Make Herb Vinegar Group Therapeutic Horticulture:  3/28/2008 31 Group Therapeutic Horticulture July Window box maintenance Press dry flowers Leaf and twig study Sensory experience: herbs and flowers Order bulbs for forcing Group Therapeutic Horticulture:  3/28/2008 32 Group Therapeutic Horticulture August Divide house plants Taste this year’s tomato crop Garden party with iced teas Press flowers Make natural dyes Group Therapeutic Horticulture:  3/28/2008 33 Group Therapeutic Horticulture September Press leaves Plant mums in containers Start topiary with Ivy Sensory Sachets Harvest Party Group Therapeutic Horticulture:  3/28/2008 34 Group Therapeutic Horticulture Group Therapeutic Horticulture:  3/28/2008 35 Group Therapeutic Horticulture October Dried flower arrangements Cuttings from scented geraniums Amaryllis Bulbs Paper-whites Make scarecrows Group Therapeutic Horticulture:  3/28/2008 36 Group Therapeutic Horticulture November Sun catchers Pinecone bird feeders Bulbs Natural holiday decorations Group Therapeutic Horticulture:  3/28/2008 37 Group Therapeutic Horticulture December Natural ornaments Pressed flower holiday cards Dried leaf wreaths Winter solstice program Summary:  3/28/2008 38 Summary Horticultural Therapy is an effective intervention in Palliative Care involving the search for meaning, confronting fears, dealing with the loss of control, and issues of loss. Horticultural Therapy can address the dying patient’s negative feelings; threats to self esteem and help restore a sense of control, contributing to an improved quality of life. Approach to treatment includes control of pain and other symptoms while simultaneously addressing the patient’s psychological, social, and spiritual concerns, in an effort to provide the best possible quality of life. Therapeutic horticulture reduces boredom, fosters a sense of accomplishment and enhances psycho-social supports within the patient’s community. Reflection:  3/28/2008 39 Reflection We are invited to discover the inner garden of our soul. Connecting the soil seed and gardens leads us to the presence of God and the mysterious rhythm of healing and growth. Spiritual Nature of Plants:  3/28/2008 40 Spiritual Nature of Plants Explore the healing of the soul that gardening and gardens offer. NYBG:  3/28/2008 41 NYBG Bibliography:  3/28/2008 42 Bibliography Aaronsen, N.K. & Beckman, J.H. (1987) The quality of life of Cancer Patients, New York, Raven Press. pp.75-86 Avedon, E. (1966) Recreation research, The American Association for Health, Physical Education, & Recreation. Bost L.S. & Brown E.M. (1982) Recreation therapy: A humanistic adjunct to oncology treatment. Oncology Nursing Forum , (Vol. 9[4] pp.43-49. Slide43:  3/28/2008 43 Breitbart, W. & Holland, J.C. (1993) Psychiatric aspects of symptom management in cancer patients, Washington DC, The American Psychiatric Press. pp. 155-165. Burlingame, J. & Blaschko, T.M. (1994) Assessment Tools For Recreation Therapy: Redbook #1. Revensdale, Washington. Idyll Arbor, Inc. pp.117-125 Slide44:  3/28/2008 44 Cimino, J.E. (1997) Commentary: Non-abandonment, physicians and nurses as allies, New York, The American Journal of Hospice & Palliative Care (Vol14 [3]) pp. 106-107. Cimino, J.E. (1995) Definition of palliative medicine, Third Year Class Orientation Lecture Notes, New York Medical College Slide45:  3/28/2008 45 Connoly, P. (1993) Balancing changing health care needs with the shortage of quality health care professionals: Implications for therapeutic recreation, Journal of Loss, Grief & Care, New York , Haworth Press. pp.15-21. Davison, D.C. & Neale, J.M. (1996). Abnormal Psychology. New York: John Wiley & Sons, Inc . Kane, Brunton & Fournier (1999) Cancer, Press. Kavanaugh, R. E. (1972) Facing death, Baltimore, Maryland,, Friedman Fairfax, pp.14-68 Slide46:  3/28/2008 46 Kavanaugh, R. E. (1972) Facing death, Baltimore, Maryland, Penguin Press. pp.105-124. Kubler-Ross, E. (1969) On death & dying, New York, Macmillan Publishing, pp. 38-110. Korchin, S.J. (1976) Modern Clinical Psychology (1976). New York. Basic Books. Slide47:  3/28/2008 47 Kunstler R. & Sokoloff, S. (1993) Clinical effectiveness in intensive therapeutic recreation: A multiple case study of private practice intervention. Journal of Loss, Grief & Care, New York. 23-28. Lahey, M.P. (1993) Acute care vs. chronic care models of services to the elderly: Implications for therapeutic recreation, Journal of Loss, Grief & Care, New York. 55-62. Slide48:  3/28/2008 48 Rando, T. A. (1984) Grief, Death, & Dying: Clinical interventions for caregivers, Champaign, Illinois, The Research Press. pp. 227-250. Simpson, S. (1996) Journal of Therapeutic Horticulture, Gathersburg , MD. Slide49:  3/28/2008 49 Sourby, Charles A. (2002), from: Flowers of the Bible and How to Grow Them, New York, Citadel Press. Sourby, Charles A. (2003) from: Herbs of the Bible and How to Grow Them, New York, Citadel Press. Sourby, Charles A. (1998), Barbara-Palliative Care, Journal of Therapeutic Horticulture. Slide50:  3/28/2008 50 Swenson, Allan A. (1995) Plants of the Bible and How to Grow Them, Citadel Press. Spacapan, S. & Oscamp, S. (1988) The social psychology of Health, Beverly Hills, California pp. 285-193 Steuer, F.B. (1994) The Psychological Development of Children. Pacific Grove, California. Brooks/Cole Publishing. Slide51:  3/28/2008 51 Stjernsward, J. & Colleu. S.M.(1996) The W.H.O. cancer pain and palliative care program: past, Present, and Furture, New York, Journal of Pain and Symptom Management (Vol 12[2]), pp.65-66. Strensrud, C. (1993) Quality of living until death: A fusion of death awareness into therapeutic recreation-leisure education, The Journal of Loss, Grief, & Care, New York, The Haworth Press. pp. 33-37. Slide52:  3/28/2008 52 Stoll, B. A. (1988) Coping with cancer stress, The Netherlands, Nijhoff Publishers, pp. 45, 86, 116, & 119. Taylor, E.J. (1992). The search for meaning among persons living with recurrent cancer. University of Pennsylvania. PH.D. thesis, pp. 35. Slide53:  3/28/2008 53 Turk , D.C. & Feldman C.S. (1992) Noninvasive approaches to pain control in terminal illness: The contribution of psychological variables, The Hospice Journal, (Vols. 8[1, 2]). Willetts, H.C. & Sperling, A. (1983) The role of therapeutic recreationist in assisting the oncology patient to cope, New York, Futura Publications, pp38-54.

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