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Lewes, Delaware
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July 3, 1998     Cape Gazette
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July 3, 1998

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CAPE GAZETTE, Friday, July 3 - July 9, 1998 - 37 HEALTH & FITNESS Massage can be just the fight touch for seniors By Rosanne Pack Travelers dashing through airports, tensed-up gamblers in casinos and spent- out shoppers at the mall can pause for the pick-me-up of a chair massage; it only seems appropriate that senior citizens and other residents of nursing and rehabilitation facilities should have the same option. That service is now available to residents of Harbor Health Care and Rehabilitation Center in Lewes. Nancy Ashby, certified massage therapist, recently visited the cen- ter to familiarize staff members with the benefits of massage for seniors, and for staff as well. During a staff inservice day, she demonstrated and explained how a few minutes in a massage chair can have posi- tive effects on the mind and many parts of the body, not just the areas of massage. "Massage is the best for mental well-be- ing, but it also works on many aspects of physical well-being," Ashby said. "It can be very helpful for those whose movement is restricted because of a stroke or other condition, and it's just generally beneficial for those who are not too active any more." Ashby, who is trained in Compassionate Touch, said most people know that massage feels good on the skin and below the sur- face in the muscles; however, the positive effects go much further than that. She said that circulation, which is key to all of the organs of the body, is stimulated and im- proved by massage. She said kneading and stretching tight muscles initially increases circulation, which improves natural joint lubrication and can lead to better mobility of joints. Im- proved circulation also improves the tone :and overall elasticity of skin and can help give relief from dry, itchy skin. It also can help reduce swelling caused by water reten- tion by gently moving fluids into the circu- lation system, where they can be naturally Rosanne Pack photos Nancy Ashby, certified massage therapist, gives Harbor Health Care and Re- habilitation Center resident Fay McNichol a minimassage, as McNichol tells Ashby how her arms and shoulders feel. eliminated. Ashby pointed out that an additional bonus that many would not expect of in- creased circulation is that the resulting im- proved flow of oxygen and nutrients to cells actually helps heal wounds from in- jury or surgery. "Massage generally helps muscle tone and helps get rid of some aches and pains of being in bed or a chair much of the time, but the mental boost can't be overlooked," Ashby said. "It definitely cheers people, and some people just need the touch. We sometimes forget how good it is to be touched by someone." The massage therapist is certified by the National Board of Therapeutic Massage and she said that she continues to learn by researching methods and techniques on her own. She said some physicians are becom- ing more aware of the complementary ef- fect of massage along with other traditional medical practice. "Some doctors will now refer patients for massage," Ashby said. "It is an ancient form of treatment that is coming back into being recognized for the physical as well as the mental benefits. "Of course, a board certified massage therapist has to know the right protocol for certain medical conditions. There is the right kind of stroking for certain things, and there are some conditions where massage is contraindicated." Ashby can provide a chair massage that lasts 10 to 20 minutes or a full massage. She has a special massage chair that travels with her. Her services are available to resi- dents or to staff members. Sandy Dole, program director for the center, said that the staff and some residents are becoming aware of the therapeutic pos- sibilities of massage. "It definitely reduces stress and also can have other health benefits," Dole said. "It's good to be able to offer the service to our workers as well as our residents." Ashby recently gave a demonstration massage to Harbor Health resident Fay Mc- Nichol. The 79-year-old suffered a mild stroke two years ago and she experiences some loss of movement on one side of her body. As Ashby massaged her arms and shoul- ders, she said that she could detect areas of muscle tension that could lead to other problems, including poor circulation and general stiffness and loss of motion. McNi- chol commented that she frequently experi- ences a sensation of being chilled, which she associates with poor circulation and loss of motion associated with the stroke. She said the massage left her arms and shoulders feeling relaxed and warmer. Ashby said, "It takes time to overcome the effects of a stroke or even just being sedentary for some time. You won't neces- sarily see much response to massage right away. "A 15-minute massage three times a week is close to ideal, but you don't often have the opportunity to do that. Even once a week or twice a month is beneficial." In the case of Harbor Health residents, the massage therapist said she would have to have the referral of the resident's physi- cian before she could administer a massage. She said conditions that are commonly re- lieved by massage include headaches, low back pain, mental stress and muscle ten- sion. She said the massage therapist might also detect conditions that can be helpful to a physician. "Sometimes, you will come across 'trig- ger points' that cause pain in other areas of the body. That can signal that there's some- thing that the physician needs to explore," she said. In most cases, therapeutic massage is not covered by medical insurance. However, Ashby has lbund that many family mem- bers and friends will give gift certificates to nursing home residents if they realize the service is available. Rates vary according to the type and length of massage. Continued on page 39 Mental health care: cost doesn't have to I)e barrier This is the second of a two-part series by national board-certified therapist Carolyn J. Gover, who discusses why people seek mental health counseling - off the record. Part Ih Cost Insurance companies are gener- ally staffed by people who know little, if anything, about mental health care. Consequently, mental health care is either not provided or is provided at a rate so steep that 80 percent of the population can't aftbrd it. This is doubly unfortunate be- cause mental or emotional prob- lems, left untreated, often lead to both physical and mental later. At the least, mental disorders under- mine the immune system; at worst they fester unnoticed until they manifest as far more serious psy- chological conditions. Many people are aware that they should seek help but have no health-care coverage, or have health-care coverage that does not pay for mental health treatment. Or, they have mental health cover- age that demands such a large de- ductible and copay, they might as well have no coverage at all. Bypassing your HMO, howev- er, may not be as costly or diffi- cult as you imagine. For example, many mental health professionals charge on a sliding-scale basis, ac- cording to income. If you earn $40,000 or more, you pay the full fee. If you earn less, you pay less. If yo u are jobless or earn less than $12,000 you may pay only $20. Another example is if you have coverage that requires a $1,000 deductible and a copay fee for mental health care, you may choose to suffer in.silence rather than risk missing a mortgage or car payment - even though the cost of ignoring treatment could be an untim:iy death. Even if you fit this category, there is an alter- native. Let's say you are expected to pay the $1,000 deductible plus a $30 copayment for 10 sessions, for a total of $1,300. If, instead, you bypass your insurer and pay $50 per session, according to a sliding fee scale based on your in- come, with no deductible, the cost would total $500 for the same 10 sessions, a saving of $800. Suppose a person with a history of psychological problems or ad- diction pays an insurance compa- ny extra for mental health cover- age. Let's say this person pays $100 a month extra, for $1,200 per year. Suppose this person needs six counseling sessions a year, plus four medication checks. If he or she pays $50 on a Sliding fee scale for psychological coun- seling, and $15 each for quarterly medication checks, the total cost would be $360. This would be a saving of $840. Therapists who use a sliding scale may save, too - in time and turmoil. A tremendous amount of paperwork, phone calls and argu- ments can be eliminated by the therapist working directly with clients. Insurance companies to- day often make it extremely diffi- cult for their approved providers to get paid; they rarely get paid in a timely fashion. Another alternative is .to pay with MasterCard TM or VISA. TM You can probably get your thera- pist to bill your card at a time of the month most convenient to you. Among mental health-care pro- fessionals, there is currently a great lament about confidentiality and cost when dealing with insur- ancecompanies. And it some- times seems that there is no alter- native to insurance companie s in today's political climate. But there is a silver lining to that dark cloud: costs can be re- duced and confidentiality main- tained by bypassing the insurance companies. HEALTH TOPICS Carolyn Gover Carolyn J. Cover is in private practice with Gover Counseling Services in Rehoboth Beach. For more information, call 226-0744 or 888-285-4645.