Home is Where the Healing is

The healing environment and quality of health care varies from institution to institution and home to home. An impersonal, rushed assembly line approach to hospitalization may leave people's emotional and spiritual needs unmet. A person is expected to take on the role of the 'patient', one who suffers in silence. The needs of the individual are generally placed second to those of the hospital. Routines are adjusted to the convenience of the hospital. People are awakened to receive drugs or give blood when staff is available. Meals are served by hospital schedule.

The stress of working in a climate of constant life and death struggles leaves staff emotionally numbed and spiritually drained. Developing emotional armor is a job requirement. Colleagues warn, "Don't get attached to your patients." This might translate to "Don't care about these people." A client who upsets protocol may face hostility from the entire staff. A moment of anger or frustration with one staff member may get one branded as uncooperative. Judgments about lifestyle may cause withholding of care.

Mistakes are made routinely. According to a recent Journal of the American Medical Association, 'two percent of hospitalized patients have recognizable complications from medication errors.' This is the equivalent of 60,000 patients/year injured.

The Impact of Hospital Care on the Spirit

The Shamanic view of health recognizes other hospital risks. The souls of people who die in hospitals are often neglected. People die in pain, fear, loneliness and terror. They are confused and often unaware that they have dropped their bodies and are no longer subject to earthly maladies. Lacking in spiritual guidance many don't know what to do. They're lost. Others are so focused on the pain or fear surrounding their deaths they are unaware of anything else.

These entities may attach to other people's bodies for a variety of reasons draining the person's energy and manifesting symptoms in the body. Confusing thoughts or cravings may haunt the unaware host. Hospitals are seldom cleansed of these influences.

The closeness of people who are scared, in pain, and in a state of shock or despair create a psychically abuse environment. The constant bombardment by these vibrations create emotional distress and the resulting physical stress. Stress is a major contributing factor in many of the conditions that result in hospital visits and prolonged stays. A detached, invasive approach to patient care does little to relieve this anxiety. Drugs are often required to override this intrusive environment inducing artificial sleep, hindering the healing process.

The Advantages of Home Health Care

Home health care provides many solutions. Shorter hospital stays followed by home health care allows more personal attention. Hospital stays may be avoided. Visiting health care professionals can provide high quality health care at a fraction of the cost of comparable hospital care.

Comprehensive home care may include nurturing body, mind, emotion and spirit. (In a larger view your family is part of your immune system in that they contribute to and affect your emotional and spiritual health.) These have a recognized influence on your physical health. Your healing depends on the healing of your relationship with your environment. This may include finding a safer environment as in the case of the person who develops health problems in order to be in an enviroment that feels safer, like a hospital. You may prefer to change your relationship with your present environment, like with personal therapy, family counseling or spiritual guidance.

Just as the personalities, intents and desires of the unique family members affect the healing quality of the household, these same traits in individual health care workers influence the quality of specific home health care environments. The healing climate results in a specific home from the relationship between the client, the health care team members, the family and the friends.

Nurse Burt Ray says two kinds of nurses are: The caring, compassionate nurse and the techno-nurse. The caring nurse develops relationships with the people he works with. He may find more satifaction in home care settings. A home care setting promotes greater trust and communication between client and health care team. The treatment regimen may be constantly adjusted with the understanding and the cooperation of the client. The degree to which a person is involved in his own health care treatment may indicate the degree he feels able to heal. Being involved provides some feeling of control at time when everything may seem out of control.

The following is a description of a specific home care setting. The core of the team includes myself, three registered nurses, a live-in caregiver and a physician who rarely sees him, but is available on an as needed basis. John has been diagnosed with Lou Gehrig's Disease and is totally paralyzed. He communicates by moving a needle on a biofeedback device.

The household has been setup for John's comfort and the efficiency of the health care team. Body work and psychotherapy have been available to John and to his family, as well as to the health care team. It's recognized that the health of the nurses, live-in caregiver and family all contribute to John's health. The over-all treatment approach is eclectic. Western medicine and standard nursing practices are complemented by herbal treatments, macrobiotic diet, mind-body therapy, Shamanic healing and energetic healing.

The treatment has evolved according to John's needs and choices. The close personal relationships that have developed between John and his caregivers allows him constant participation in his treatment and care. His nurse Burt once started to give him an enema without thinking to ask his permission. Letter-by-letter John laboriously communicated this message. "How dare you presume it's okay to be sticking things up my butt!" Burt always involves John in every aspect of his health care decisions now. The caregivers understand that they work for him and his best interest. His needs aren't secondary to the needs of running a hospital. His wishes aren't second to those of a faceless physician. There is a one-to-one caregiver relationship in the home that's not possible in a hospital where each staff member must care for many individuals. John is at the top in the hierarchy of in his health care pyramid.

John has control over choice of caregivers. A core team has evolved in response to his specific needs. The team members feel empowered to learn new treatments and to make adjustments independently. A climate that affirms and encourages the knowledge and skill of individual team members makes each feel valued for his or her unique contribution. They are inspired to constant education. Their views and understanding of healing continually expands. "We're not trying to just prevent illness, but optimize wellness." Says primary nurse Victoria Hall.

The nurses have higher self-esteem and team-esteem. They see the results of their work instead of being insulated by the compartmental nature of specialized teams working on specific problems and sending the person off to another specialist, often never knowing what happened to them. In John's care each team member has the ability to see the overall picture of his health and contribute in ways that might never be considered in a more compartmentalized setting. The caregivers feel valued and affirmed in their skills and knowledge.

The nurses are allowed autonomy. They have earned the respect and confidence of the physician through their performance. John's relative health indicates he is receiving top quality care.

John has been home for the last 15 months attached to a ventilator without the need for an emergency room visit or hospital stay. Friends visit without restrictions. A few still visit regularly. Most of the time his only companions are the ever vigilant nurses.

Top priority is to keep John out of the hospital. He has left specific orders that he not be hospitalized or resuscitated. He and his health care team agree that he would probably not survive long in that climate.

Some people find the hospital environment safer and more healing than their homes. Not all home environments are healthy, safe or healing. The chronic stress that results in many diseases may start at home. Anger, fear and resentment hang in the air of many homes.

The overall health and self-esteem of the health care team are factors in John's immune system. The general state of mind and health of those who hold his life in their hands are important in John's feelings of safety and well being as well as his emotional health. All influence the body's ability to heal and grow. John's health care team is literally part of his immune function and the overall physical, mental and spiritual health of his caregivers influences the quality of his care.

Being at home nurtures John's spirit. He's surrounded by the things he loves. He feels as safe and in control as possible. As John's conditions change so do his needs. His care evolves with his needs. Burt says of the quality of healing in this environment, "The physical healing is better because the spiritual and psychological healing are better."

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Written by Carl Brahe, MA and Victoria Hall, RN

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