Palliative Care

Whilst several different complementary therapies can provide some level of comfort, relaxation and stress relief to people who are terminally ill, reflexology is proving to be a particular favourite in the palliative care setting. 

This is largely because reflexology requires minimal disrobing, and can be performed on the client, regardless of whether they are sitting in a wheelchair in a communal area, or lying in a hospital bed. 

In ‘Enhancing quality of life for people in palliative care settings’, Hodkinson and Williams write: 

“Reflexology can be a valuable supportive treatment in the alleviation of many physical problems and side-effects of treatment, particularly in the relief of pain through the production of endorphins from its relaxation effects. (Grealish et al, 2000 & Stephenson and Weindrich, 2000)”. 

This research paper, with others like it, also suggests that reflexology can help to alleviate: 

• pain
• constipation
• diarrhoea
• poor appetite
• nausea
• breathing and communication difficulties
• fears of the future
• tiredness and problems with sleeping

As well as having physical benefits, reflexology is also believed to help clients on an emotional and spiritual level. The majority of people who have a terminal illness will, at some stage, experience one or more of the following: 

• feelings of fear
• denial 
• anxiety
• depression 
• guilt (for placing burden on others)
• job loss or financial worries 

Some will have to undergo surgery and treatments that may alter their appearance, such as a mastectomy or loss of hair. As a result of this, clients may feel disconnected or distanced from their physical selves, particularly if they are only “touched in a very mechanical way, either in the provision of basic care or during uncomfortable procedures” (1). Reflexology can greatly help some people to bridge this gap - particularly as the treatment involves positive and therapeutic touch only, showing the client that the body can still provide pleasure as well as pain. Simply having someone neutral to talk to can also be a means of emotional release for the client, and should not be underestimated as a treatment benefit. 

A good understanding of the client’s condition, symptoms, the treatments they will undergo (and any treatment side-effects) is vital. 

Good communication with other members of the client’s care team is very important, as their general health, mental state and treatments/ medication may change on a regular basis. 

Liaising with hospital staff and family will also ensure that appointment times do not clash with other treatments, etc. 

Even when the client is terminally ill, and the therapist is working closely with medical professionals, permission to treat should still be obtained officially and not ‘assumed’.

As always, client consent is also of paramount importance, and treatments should not be carried out if the client is not well enough to give consent. 

The duration and intensity of the treatment will obviously depend upon the individual, the stage of their illness, the treatments/ medication they are having, and how they feel on the day. Be aware that some illnesses/ medication can result in poor or sensitive skin, or interfere with the client’s perception of touch and pressure. 

References and suggested further reading:

1) Hodkinson, E., Williams, J.M. (2002): Enhancing quality of life for people in palliative care settings. Clinical Reflexology: A Guide for Health Professionals. (Edited by Mackereth and Tiran). Published by Churchill Livingston, 2002. ISBN: 0443071209. 

2) Hodgson, H. (2000): Does reflexology impact on cancer patients’ quality of life? Nursing Standard, 2000. Vol: 14. No. 31. P33-38. 

3) Grealish, L. et al (2000). A nursing intervention to modify the distressing symptoms of pain and nausea in patients hospitalised with cancer. Cancer Nursing™. Vol. 23. No. 3. P237-243. 

4) Stephenson, N.L.N. et al (2000). The effects of foot reflexology on anxiety and pain in patients with breast and lung cancer. Oncology Nursing Forum. Vol 27. No. 1. P67-72. 

5) The Prince of Wales’s Foundation for Integrated Health (2003). National Guidelines for the Use of Complementary Therapies in Supportive and Palliative Care. Published by Prince of Wales’s Foundation for Integrated Health. This publication can be downloaded free from the FIH website: www.fihealth.org.uk 

6) Nelson, D. (2002) From the Heart Through the Hands. Published by Findhorn Press. ISBN: 1899171932