Chapter 24: Alternative Health Modalities

Learning Objectives Explain each classification of CAM. Discuss nursing interventions associated with the most popular herbal products. Compare the benefits and drawbacks of the diets identified under natural products.

Learning Objectives (cont’d) Distinguish the differences between veritable and putative energy fields. Discuss why older adults may use CAM. Contrast Ayurveda and traditional Chinese medicine (TCM) systems. Discuss the benefits and supports for mind– body interventions.

What is Complementary and Alternative Medicine? NCCAM defines CAM as a group of diverse medical and health care systems, practices, and products that are not presently considered part of conventional medicine .(Table 24-1, P. 832) Many of these modalities are considered mainstream in other countries

Classifications of Complementary and Alternative Medicine 1. Natural Products includes botanicals, animal-derived extracts, vitamins, minerals, fatty acids, proteins, prebiotics and probiotics, whole diets, and functional foods Vegetarian, macrobiotic, Atkins, Pritikin, Ornish, and Zone are examples of whole diets included in the biologically based category (p. 833)

Classifications of CAM (cont’d) 10 Most Used Natural Products (T. 24-4, P. 836; case study 24-1) Echinacea Ginseng Ginko biloba Garlic supplements Glucosamine St. John’s Wort Peppermint Fish oils/omega fatty acids Ginger supplements Soy supplements

Classifications of CAM (cont’d) Black Cohosh – good for menopause relief Saw Palmetto – good for benign prostate hypertrophy Echinacea – Increase immune 4 G: Do not use with Warfarin Garlic – natural antibiotics, decrease cholesterol & BP Ginger – helps N/V, joint pain Gingko biloba – improve memory function Ginseng – increase stamina Aloe – soothing sunburn St. John’s wort – increase immune, do not use with antidepressant meds. Kava – Do not use with antianxiety meds.

Classifications of CAM(cont’d) 2. Manipulative and body-based practices Chiropractice: helping place the body in proper alignment. Research supports use of chiropractic for migraines and cervicogenic headaches Massage therapy low-risk intervention, but contraindicated under circumstances such as deep vein thrombosis, burns, skin infections, eczema, open wounds, bone fractures, and advanced osteoporosis

Classifications of Complementary and Alternative Medicine (cont’d) 3. Mind-body interventions Prayer Deep breathing Meditation Yoga Biofeedback Tai chi Guided imagery Pet therapy Music therapy

Classifications of Complementary and Alternative Medicine (cont’d) Guided imagery: Relieve Stress http://www.healthjourneys.com/Store/Prod ucts/Relieve-Stress-Health-Journeys/26

Classifications of CAM (cont’d) 4. Whole medical systems Homeopathy: when someone is out of balance, health problems will develop Naturopathic medicine: healing power of nature Ayurveda: emphasizes prevention and encourages maintaining health, rooted in the ancient Hindu Traditional Chinese medicine (TCM): Yin & Yang Acupuncture, Exercise (Tai Chi) Herbal medicine Dietary therapy Massage Lifestyle modification

Classifications of CAM (cont’d) 5. Energy Medicine Veritable energy fields: Can be measured Mechanical vibration Electromagnetic forces Music, light, magnets Putative energy fields : Cannot be measured Reiki: healing through manipulation of qi qi gong: manipulating qi (energy) through meditation/movement healing (or therapeutic) touch prayer for the health of others (intercessory prayer)

Classifications of Complementary and Alternative Medicine (cont’d) Therapeutic (healing) touch Reiki: no evidence that therapeutic touch promotes the healing of wounds Sound energy therapy Theory that specific frequencies facilitate the body’s healing Music therapy Light therapy for seasonal affective disorder

Reasons for Complementary and Alternative Medicine Use Pain relief Quality of life Health and fitness Belief systems Difficulty accessing traditional medical care or medications

Nursing Interventions During assessments, nurses should ask patients about their use of CAM in a nonjudgmental way Includes herbal medicines, “natural products,” vitamin and mineral supplements: these can interfere with medications and produce side effects

Summary Nurses have responsibility to knowledgeable about modalities clients may be using 80% of world’s population estimated to use some form of CAM Effectiveness of CAM in older populations has not been well researched.