The delicate dance that is pain management requires a harmonious balance between physical, emotional and spiritual relief. It’s an orchestration that Hospice of Michigan has mastered in providing comfort care to patients at the end of life.

Combining medical interventions with complementary therapies like pet, music and massage, HOM is seeking a more holistic approach to pain management to help patients control symptoms of their disease, deal with stress and relieve anxiety and depression. These alternative therapies — or complementary therapies — can help alleviate pain of the psyche, and are just as important as the medical treatments targeting physical distress. This multifaceted approach to comfort care can help patients maximize their quality of life.

There is much research supporting how music therapy can help reduce pain and anxiety. Because music can trigger cherished memories or even unresolved issues, a music therapist can help patients process these feelings. It’s especially effective in reaching those with dementia who are no longer communicative.

Pet therapy can be equally therapeutic for patients who find comfort in cuddling with a canine or a cat. Specially trained Hospice of Michigan volunteers regularly visit patients with their pets, an array that even includes a number of bunnies and an occasional bird.

Massage is another complementary therapy that offers tremendous benefit for patients. It’s a relatively new tool in the hospice and palliative care pain management arsenal which HOM is introducing into its care model. Complementary therapies are provided at no cost to HOM patients and are funded through donations to the nonprofit agency’s foundation.

“Massage can help reduce edema, lower blood pressure, enhance circulation, improve bowel and heart function and much more. It can even help stimulate a patient’s appetite,” said Michelle Chaves-Torres, BC, LMT, a massage therapist for HOM’s affiliate Arbor Hospice.

Chaves-Torres performs therapy on her fully clothed patients in their own beds, chairs, wherever they are most comfortable. For ALS patients like Mike Pankow, who she has been visiting regularly since February, massage has helped Pankow maximize his muscle function.

Chaves-Torres’ original therapy goals for the 56-year-old were to control pain and maintain his muscle strength and flexibility so he could remain as mobile as possible. As Pankow’s condition has progressed, massage sessions focus on maintaining optimal circulation in his arms and legs.

Like other hospice patients, Pankow also benefits from massage on a psychosocial level. “Mike’s outlook is pretty positive,” Chaves-Torres said. “But like many people I see, he experiences muscle tension from unexpressed feelings.”

As with music and pet therapy, massage therapy releases serotonin and endorphins that boost happiness. The elevated mood this flood of “feel good” hormones creates not only counters physical pain, but helps enhance emotional and spiritual well-being.

“All therapy, including massage, supports life review, which is an important part of the end-of-life journey that helps patients acknowledge and deal with psychosocial pain,” Alison Wagner, director of volunteer services and complementary therapies, said.

“As specific muscles are relaxed during massage, memories can be released that patients often share – including some they may have never expressed before,” Chaves-Torres said. “This helps them validate where they currently are.”

Chaves-Torres passes these conversations along to her social work team members for follow up on issues that are troubling patients.

Caregivers also benefit from patient massages — seeing their loved ones comforted and relaxed, relieves their stress and helps them relax as well. To alleviate the common fear that touching will exacerbate their loved one’s condition, Chaves-Torres demonstrates techniques caregivers can use between her visits.

“As a patient or a caregiver, ALS is very isolating. Many people don’t know how to react and are often hesitant to hug or touch my husband,” Kim Pankow said. “Massage therapy for Mike reduces his anxiety, improves blood flow, and also has the benefit of the human touch. He looks forward to seeing Michelle because it helps him relax, and we both enjoy her company.”

Chaves-Torres’s visits also provide respite.

“Most times, I will take a break during his massage to pay bills, make phone calls, or just relax and read a book,” Kim said.

For more information about HOM’s complementary therapies, or to make a donation, visit www.hom.org or call 800-669-9335.For more about volunteer opportunities, call 888-247-5701.