1. Chapter 24: Alternative Health Modalities

2. 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.

3. 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.

4. 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

5. 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)

6. 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

7. 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.

8. 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

9. 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

10. Classifications of Complementary and Alternative Medicine (cont’d)
Guided imagery: Relieve Stress
ucts/Relieve-Stress-Health-Journeys/26

11. 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

12. 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)

13. 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

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

15. 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

16. 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.